Tinubu’s plan for long-term diseases to face test of scale -

Part of the plan of Bola Tinubu, Nigeria’s president-elect, to reduce the burden of long-term diseases is facilitating systems that enable early detection of cases and leverage universal health coverage in broadening access to treatment.

He has identified preventive care as a tool and plans to get state and local governments to key into measures encourage such as vaccinations, eye tests, and cancer screening, blood pressure monitoring and diabetes testing.

“Such preventative care services will be grassroot based, gender sensitive, and affordable,” his health plan states, noting that President’s Muhammadu Buhari’s restructuring of the national health insurance scheme will serve as a great footing to begin its execution.

But if the plan must move from paper concept to practical solutions, it must be ready to pass the test of scale, stakeholders says.

For cancer treatment in particular, health advocates are looking to see a more inclusive package that eases the burden of patients.

The impact of the current package under the NHIS is feather weight for roughly 90 percent of the population, who are uninsured and face the dire effects of a health system where about 77 percent of health expenditure is out-of-pocket.

The NHIS in 2019 for instance began to cover some cancer medications which are used for treatment. They have been included on the essential medicine list.

However, the provision does not cover most of the expensive drugs required for treatment which often runs into millions.

A large pool of cancer patients increasingly young are also not under the vulnerable group which now as a special fund. The NHIS does not cover surgery and radiotherapy among others.

Runcie Chidebe, executive director, Project Pink Blue, a non-profit cancer advocacy group, in an interview, told BusinessDay he expects the government will widen the vulnerable group to include both people who are indigent financially, and others battling terminal diseases or disease who their treatments are really expensive.

“The healthcare system in Nigeria is largely in the hands of donor agencies and not the government. The responsibility on the government to implement the National Health Act of that stipulates 15 percent of the national budget should go to healthcare should be held to seriously for a change,” he said.

According to Femi Olugbile, 70 percent of things that typically take people to hospital are already covered under the national insurance act. It could offset the majority of the health costs and would provide a significant relief on the already high out-of-pocket expenditure of Nigerians.

“It now depends on whether the government has the will to implement these plans. That’s the big elephant in the room. If they have the muscle to enforce then that will be a major game-changer. Government still has to show willingness and deliberate intent and muscle to execute,” he said.
Stakeholders have also called for actions towards the initiative to establish a National Catastrophic Fund to specifically address terminal ailments such as cancer, advanced heart disease, among others.

Mohammed Sambo, director-general of the scheme had in 2021 said that the contributions to the health insurance pool was insufficient to cater for some packages and programmes of the scheme.

Sufficient funds could help the authority cover the treatment and management of cancers and other terminal diseases fully, he said.
Under Tinubu’s plan, the goal is to increase health spending braising the allocation of healthcare in the national budget. His government plans to scale-up the National Health Insurance Authority Act to cover at least 40 percent of the population within two years.
“We will also expand public-sector driven mandatory health insurance coverage while augmenting the financial mechanism such as the Basic Health Care Provision Fund and Vulnerable Group Fund to cover vulnerable in order to provide universal basic healthcare to all,” Tinubu wrote.
In addition to other sources, funds saved by the removal of the fuel subsidy would be earmarked to provide health coverage.