We rarely have much to celebrate in the health sector, and broadly this is still the case. The fundamental reform that the sector requires to meet the health needs of the Nigerian people is yet to happen. It requires political courage, not something this government has demonstrated much of. However for the first time in a while, we do have a few successes to celebrate, giving rise to a discussion on whom we should declare our “Person of the Year”.
First, after 10 years of discussion and deliberation, both federal houses of assembly in Nigeria finally passed the National Health Bill and the President signed it into law. We therefore congratulate not only our politicians, but all the Non Governmental Organisations that have for years advocated for a new bill to define the regulation and allocation of resources and responsibilities in the health sector. While the implementation of the new Act will be the responsibility of a new Government, and will be the next challenge; at least now we have a framework. Many heroes and heroines fought for these and we are grateful.
Although we have made little progress in our public health indicators, there have been concerted efforts in this regard. One of the most important indicators of the performance of a country’s health sector is the maternal mortality ratio. Our maternal mortality ratio has barely moved from the from 545 maternal deaths per 100,000 live births in the 2008 Demographic and Health Survey (DHS) to the 576 maternal deaths per 100,000 live births reported in the 2013 Demographic and Health Survey. I guess that we can celebrate that despite the security situation in large parts of the country, this indicator is no worse than it was five years ago. While it is difficult to directly attribute cause and effect, these are likely to be partly as a result of the growing middle class in Nigeria, and partly as a result of several vertical programmes such as the SURE-P Maternal & Child Health programme, NPHCDA’s Midwives Service Scheme and others. We have reported the fewest numbers of polio cases ever, and with the continued support of many partners including the Rotary Club, the Bill & Melinda Gates Foundation and other partners we may be on the verge of what could be the biggest victory of modern times in Nigeria. Better late than never, Nigeria is about to introduce the conjugate pneumococcal vaccine into the childhood vaccination schedule in Nigeria. Pneumonia is one of the largest causes of childhood mortality worldwide. Many heroes and heroines fought for these changes and we are grateful.
This year has also seen, for the first time we have seen a renewed interest in health by the private sector. We have always wondered why the famed Nigerian entrepreneurial spirit has not found it possible to create value in a sector that contributes up to 15% to 20% of the GDP in other countries. While the mass exodus of Nigerians to India for healthcare continues to happen, we are beginning to see some huge private sector investments in the health space and hope that these will come to fruition in the next few years. In addition to hospital projects, Nigeria’s private sector leaders, including Aliko Dangote, Jim Ovia and Aigboje Aig-Imoukhuede, have come together to form a Private Sector Health Alliance that seeks to use market forces to introduce new and better products and services to the health services in Nigeria. We salute the innovators in the Nigerian health space for their contributions and we are grateful.
The response that has brought the most accolades to the health sector in Nigeria in 2014, and deservedly are our “Person of the Year”, are all the TEAMS involved in Nigeria’s response to the Ebola outbreak.
From the Federal Government of Nigeria response team led by the Former Minister of Health Professor Chukwu and the Lagos State Ministry of Health team led by Dr Jide Idris, including the teams in the Ebola Emergency Response Centre that evolved out of the Polio Response Centre led by Dr Faisal Shuaib; the team from the Nigerian Centre for Disease Control, led by Dr Abdulsalami Nasidi. We salute the various clinical service teams that provided care to the early patients initially by the late Dr Adadevoh at First Consultants Medical Centre and the WHO doctors including Dr Maurizio Barbeschi and colleagues who provided care at the treatment centre in Lagos before most Nigerian colleagues were trained and able to contribute. We also congratulate the Port Health teams under the leadership of Dr Sani Gwarzo, Director of Port Health at the Federal Ministry of Health who in a matter of weeks recruited hundreds of new staff and trained them to implement new entry health processes at our airports. Without being given the responsibility, Dr Lawal Bakare and his colleagues at @Ebolaalert rapidly mobilized colleagues and friends to become the most important source of information during the Ebola response in Nigeria. Reading through this, there is an obviously noticeable trend, it was all about teams. There was no one single hero. Change in the health sector is rarely achieved by single heroes. It is always about the team. For the first time in many years, we got accolades from across the world, features on television, asking the question: how did you do it? Indeed, it took many teams working together to achieve these and we are grateful. Perhaps there is a lesson for our nation as we move into 2015, an important year for our country. Tackling the challenges that we face, in the health sector and wider, will require us all to work together, as a team.
Nigeria has subsequently shown leadership by being the first African country to send a substantial contingent of health professionals to the most affected countries made up of about a hundred doctors and nurses as part of an AU team. (South Africa has had a mobile laboratory team in Sierra Leone for since September). We must now focus on building our institutional capacity to respond to future outbreaks.
With a new government in the next year, irrespective of who wins the elections, will present a real opportunity to bring fundamental change to the sector. This will not be easy. Even in the most developed countries, reforming that health sector has never been easy and requires political courage. The continued strikes in the sector have led to most public sector hospitals barely functioning this year. We are in the middle of another one as we write this, and there is no end in sight. This cannot continue. It is time for a re-boot. There will be some short term pain, but it is just no longer possible to run our public hospitals the way they have been done over the years. In the next year we will offer some options for change, but for now let us celebrate a few heroes in health that have done us proud in 2015.