Nigeria is facing a healthcare crisis even though many government officials in charge of the sector may not admit it.
From 1st January to 23rd December 2018, a total of 3441 suspected cases of lassa fever were reported.
Of these, 611 were confirmed positive, 19 probables, 2811 negative (not a case), according to Nigeria Centre for Disease Control.
Nigeria recorded 1,110 deaths in 2018 from cholera outbreaks in 29 states across the country between January and November 2018.
This was many times higher than 84 recorded within the same period of 2017, the Nigerian Centre for Disease Control (NCDC) said.
The country has only seven radiotherapy machines for cancer patients, but only two are working. Yet cancer is responsible for the deaths of 72,000 Nigerians yearly, according to Wellbeing Foundation Africa (WBFA)’s 2019 research.
Less than 10 percent wealthy Nigerians spend $1 billion annually treating themselves abroad when they are ill. Politicians who dip their hands in public tills are also part of this game. So, the game is on for the rich but off for the poor.
Nigeria has allocated only 2.9 percent of its total budget on health in the last three years, as against South Africa’s 13 to 15 percent over the same period, according to BusinessDay calculations.
The hospitals have become glorified morgues while many private health centres in cannot conduct tests.
The year before last, 2017, had also been marred by outbreaks of diseases such Lassa fever, which occurred in 718 cases wherein 68 persons died. Between January and July 2018, there have been 115 deaths in confirmed cases and 10 in probable cases. Cerebrospinal meningitis was suspected in 14,518 cases across 181 local government councils, with 1,166 people reported death. Other outbreaks last year included monkey pox and cholera.
Records show that 42 days after the Ebola epidemic ravaged parts of Nigeria in 2014, the country recorded 19 cases, which led to 10 deaths.
“The World Health Organisation has a standard benchmark that should be followed by developing countries with high rates of diseases. Compare that ratio with what we have in Nigeria and you will see why we still struggle with health issues,” Okey Akpa, chairman of Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (MAN), told BusinessDay on the phone.
“This is a global benchmark, which is a product of research,” Akpa added.
Experts are asking for innovative preventive measures, investment and public-private partnership to save the citizens from dying every day in the hospitals.
They say unless surveillance is strengthened and infrastructure provided, the country will continue to lag peers in the area of disease prevention.
“Strengthening Nigeria’s epidemic preparedness and response will require bold innovative approaches and complementary public private partnerships,” Muntaqa Umar-Sadiq, chief executive officer, Private Sector Health Alliance of Nigeria (PHN) recently.
Muntaqa said Nigeria’s epidemic preparedness and response capacity highlight six priority gaps required to enhance detection, prevention and management of an outbreak.
“Priority gaps include infrastructure, logistics, commodities, technology, human resource and communication.
“With more outbreaks on the horizon, Nigeria can’t afford to repeat this cycle of uncertain priorities, wasted time and investments. We need strong and clear leadership; effective deployment of new innovations,” he stressed.
He pointed out that the state of health in Nigeria is characterised by poor health outcomes and suboptimal health care systems vulnerable to the threat of future epidemics and outbreaks, which threaten global health security.
“There is a compelling opportunity to engage the private sector and other non-state actors to complement government in advancing its health security agenda,” said Muntaqa.
Public health experts say the next government must invest heavily in tackling disease outbreaks, stressing that Nigeria must do more to improve health infrastructure, logistics, commodities, technology, human resource and communication.
However, there are important lessons to learn around partnership, leadership, communication and innovation.
Chikwe Ihekweazu, chief executive officer, NCDC, recently reiterated the need to develop the Nigerian healthcare system to effectively prevent, protect, and respond to disease emergencies, saying it is as important as, or more important than, an emergency response.
“It costs less to invest in advance and to be ready,” Ihekweazu said.
“Infectious diseases do not respect borders or class. There is an urgent need for investment in preparedness and the time to prepare is now,” he added.
Oladoyin Odubanjo, chair, Association of Public Health Physicians of Nigeria (APHPN), Lagos chapter, added that Nigeria needs to be more proactive in preventing diseases, stressing that the country must begin to apply the lessons learnt.
Odubanjo said key success factors of the past should be applied in order to prepare the country against other outbreaks.
“Effective surveillance is clearly important. Containment and general precaution measures will minimise risk of transmission of the viral disease coming into the county,” said Odubanjo.
President Muhammadu Buhari, on coming to power, had barred civil servants from seeking medical treatment abroad, promising to visit local hospitals himself. Incidentally, he became the first to visit a London hospital when he fell sick.
In March last year, Bill Gates, co- chair of Bill and Melinda Gates Foundation, had pointed out that Nigeria was one of the most dangerous places in the world to give birth and 4th country with the worst maternal mortality rate ahead of Sierra Leone, Central African Republic and Chad.
According to World Bank estimates, Nigeria’s Maternal Mortality Rate (MMR) is still as high as 821 per 100,000 live births. Of the 303,000 women that died globally due to complications of pregnancy and child births in 2015, 58,000 women were Nigerians.
At the 18th General Membership Meeting on Reproductive Health Supplies Coalition (RHSC) in Brussels, experts reeled out numbers that should bother anyone who becomes President in May. In sub-Saharan Africa, for example, Africa’s most populous country has a modelled estimate Maternal Mortality Ratio of 821 per 100,000 live births. The closest was Kenya with 540 per 100,000 live births and 8,000 maternal deaths in 2015. Kenya was followed by Tanzania and Uganda. Nigeria has a life time risk of maternal death of 4.62 percent, fertility rate of 5.71, and annual births of almost 7 percent. These are worrying statistics.
“A child whose mother dies in childbirth is three to 10 times more likely to die before his or her second birthday,” Fiona Theunissen, programme manager in-charge of Maternal Health, Concept Foundation, Reproductive Health Supplies Coalition (RHSC) in Brussels, said at the event.
Health sector watchers believe that deaths are happening in hospitals and clinics every day but nobody cares because they occur mainly dominantly among the poor, adding that unless certain measures are put in place to revivify the healthcare system, many more epidemics will occur in 2019.
ODINAKA ANUDU& ANTHONIA OBOKOH
