The bold healthcare reforms implemented in the first year of President Bola Tinubu’s administration have sent a clear signal to investors, attracting over $4.8 billion in potential investment and demonstrating the administration’s commitment to revitalising the sector with a well-defined roadmap.
But Nigerians still long a real impact in taming surging costs of medicines and treatment, reducing hospital waiting times and shortage of health workers and widening health coverage to vulnerable Nigerians who are increasingly dragged into poverty by worsening economic woes.
When Muhammad Ali Pate, coordinating Minister of Health and Social Welfare kicked off leadership, he unveiled a series of reforms delineated under four pillars: transforming the governance of healthcare; improving population health outcomes; unlocking the healthcare value chain; and health security.
His scorecard indicates efforts are ongoing to realise the goals in each of these areas. However, most of them may take years to materialise.
To unlock the healthcare value chain, the government launched an initiative aimed at boosting the domestic production of drugs, medical devices, and consumables. As part of this effort, the minister has held two consultative forums with key stakeholders over the past five months.
BusinessDay understands that key stakeholders are currently being engaged to achieve holistic solutions including the draft of an executive order.
Once signed by the President, Pate said the policy will enable Nigerian manufacturers to produce essential items such as syringes, needles, generic pharmaceuticals, test kits, and long-lasting insecticide-treated nets for malaria.
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His leadership is particularly keen on shifting the production of bed nets, currently manufactured abroad, to local production, fostering self-sufficiency and economic growth, according to Pate.
He revealed in his scorecard that one of the world’s largest treated bed net manufacturers is looking to establish a manufacturing plant in Nigeria to produce for Africa.
Pate also disclosed that his team has also secured a commitment to establish a US$240 million generic manufacturing plant in Nigeria from a Brazilian firm.
In addition, three entities are also set to produce test kits, with one already operational in Lagos and two more on the way.
“This marks a significant shift from the past 25 years, where such kits were imported. The policy changes initiated by the President are now fostering domestic production and more are on the horizon,” Pate stated.
“The executive order, prepared in collaboration with the Attorney General, will pave the way for local manufacturing, job creation, and economic value retention within Nigeria. This initiative will shape the pharmaceutical market to support local industries.”
Cyril Usifoh, president of the Pharmaceutical Society of Nigeria of Nigeria said the government has expressed the will to work with the private sector players to address their challenges and critical efforts are being made to overhaul the gaps in the local manufacturing.
The professor of Pharmaceutical Chemistry said most stakeholders expect actions to back the talks already made and are anticipating certain outcomes in the following months.
“We are duly awaiting the outcomes of deliberations and we are working hand in hand with government to ensure that no one is left out,” Usifoh said.
Primary Healthcare
Another significant reform is the revitalization of primary healthcare centres. Pate aims to double the number of fully functional Primary Healthcare Centres from 8,809 to 17,618 by 2027.
To achieve this, about N260 billion has been disbursed to states from the Basic Health Care Provision Fund (BHCPF).
States are expected to deploy this fund to refurbish these health centres and equip them to deliver essential services such as immunization, reproductive, maternal, newborn, and child health services, treatment of non-communicable diseases, and to facilitate referrals to secondary facilities.
Unlike in the past, the government is not just throwing money at the problem. Pate said his team has provided guidelines to assist the states in the implementation of the projects, ensuring that the resources are used prudently for their intended purposes
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The minister also noted that his team reviewed audits on the previous utilisation of such financial resources and identified major gaps in several states.
“These issues were addressed through the National Economic Council and the Governors’ Forum. The transparency of disbursing the funds was enhanced by conducting it publicly and establishing a hotline for Nigerians to report any misuse of resources.
“Oversight bodies such as the ICPC and EFCC are also encouraged to monitor to ensure that the implementation at the state level aligns with the intended objectives, particularly in terms of infrastructure and equipment and that the resources not misused.”
Despite some suggesting that Pate’s leadership is improving coordination between government bodies, development partners, and the private sector, the Association of Nigeria Private Medical Practitioners (ANPMP) is calling for greater involvement of private hospitals in primary care delivery.
Kay Adesola, ANPMP president said concentrating the entire healthcare on the development of teaching hospitals could constitute a conundrum when about 70 per cent of healthcare delivery is by private hospitals.
He also urged that the drive to make primary health centres the fulcrum of healthcare should also give priority to providing skilled healthcare workers to man those centres, especially doctors.
“You cannot drive healthcare just by building structures all over the place without the manpower. A healthcare centre with a doctor is far better and more useful, productive and beneficial to the citizens than when you just deploy a community health person. The private healthcare sector should be consciously involved all the time,” Adesola said.
Pate-led Federal Ministry of Health oversees 30 teaching hospitals, 22 federal medical centres, 21 speciality hospitals, five core agencies, 16 regulatory bodies, 10 departments, and three special units.
In September, the ministry announced a plan to retrain 120,000 frontline health workers as part of a three-year agenda to develop human resources for health and community health delivery.
Pate’s scorecard indicates the trainers have been trained in almost all states and the training is expected to commence across all states within the next two weeks.
Over the next three years, the minister expects at least 120,000 frontline health workers serving rural populations will be equipped with the necessary skills, supported by the infrastructure and equipment we will provide.
“At least 1,400 Primary Health Care Centers are now equipped to provide skilled birth attendance, funded through the NPHCDA and the NHIA, covering the 8,300 facilities. More than 2,400 health workers, including nurses, doctors, and midwives, have been recruited to provide services to Nigerians, many of whom are women in rural areas delivering essential services,” Pate said.
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In the area of vaccination, the minister stated that over five million Nigerian children have been vaccinated against diphtheria using the pentavalent vaccine. More than 10 million Nigerian children received tetanus and diphtheria vaccines, while it is working hard to stop the circulating variant polioviruses showing up in Kano, Katsina Sokoto, Zamfara, and Kebbi States.
In addition, measles vaccines have been delivered to more than 5 million children to protect them against measles, and 4.95 million girls 9-14 years in 15 states have received HPV vaccines to protect them against cervical cancer, representing 80 per cent target, among the highest in the world.
About 6 million more are planned to receive the vaccines in the next phase for 21 states starting May 27, 2024.
Regarding hospital equipment and infrastructure, Pate revealed that the federal hospitals have executed 201 specific infrastructure projects in the last year.
Additionally, 179 specific pieces of important medical equipment were procured by the federal government and distributed across the six geopolitical zones.
“In 33 of the federal tertiary hospitals, approximately 4.5 million Nigerians accessed outpatient health services, and 1.6 million had inpatient admissions, showing that Nigerians are using the services provided by the Federal Government in those facilities, supported by an amazing army of health professionals,” Pate said.
To address the issue of medical tourism, Pate plans to upgrade infrastructure, equipment, and training for health workers. The ministry will construct six new cancer healthcare centres within the next three years, and the government has sealed a deal with NSIA for state-of-the-art radiotherapy equipment.
Pate has also kicked off the process to digitize Nigeria’s healthcare system and improve data collection. The government has constituted a 20-person implementation committee for Nigeria’s digital in-health initiative.
Despite the ambitious nature of these reforms and the challenges faced, Pate’s leadership and the government’s commitment to healthcare are evident. The reforms attract significant investments and partnerships, which could lead to tangible improvements in healthcare delivery and outcomes for Nigerians.
“We have signed a $232 million grant with GFATM, $200 million with a philanthropic foundation and expecting an additional $60 million in grants, $150 million announced by the Gavi Alliance, in addition to US$1 billion facility governed by MOU signed with Afreximbank to unlock the healthcare value chains,” Pate revealed.
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