This piece was first publised on the BMJ blog
by ike anya and chikwe ihekweazu
A quiet milestone passed in May this year, when Nigerians marked nine years of unbroken civilian government, the longest period in the 48 years since independence. A year earlier, the peaceful handover of power from one civilian president to another was another significant milestone. This period has coincided with an era of unprecedented high oil prices, Nigeria’s major source of income.
The past nine years of relative peace and democratic governance have seen changes in the economy with steady growth, large reduction in external debt, and structural reforms of the financial and telecommunications sectors.
Apart from increased access to mobile phones, these changes have had little impact on the lives of ordinary Nigerians.
From a health perspective, there are still many challenges. The health systems are weak, immunisation coverage is poor, and prospects of achieving the Millennium Development Goals (MDGS) are remote.
With a population of an estimated 140 million, improving health in Nigeria is a key step towards achieving global health goals like eradicating polio, achieving the Millennium Developmental Goals (MDGs), preparing for pandemic flu and achieving universal access to antiretrovirals for HIV/AIDS.
Perhaps because of our large population, Nigerians can be found all over the world. Meeting Nigerians working in public health at international conferences and meetings 
was the stimulus for founding the Nigerian Public Health Network a few years ago. The network now consists of over a hundred members working all over the world, including in Nigeria; and in our electronic conversations, it emerged that there were a large number of initiatives aiming to improve health in Nigeria, a broad range of expertise and skills, and a keen interest in engaging in the onerous task of improving health in Nigeria.
The large number of Nigerian health professionals working abroad and the reasons for this are well known. Our study of three graduating classes from a Nigerian medical school indicated that nearly half were living abroad ten years after graduation, with the majority based in the UK, the US and Ireland. While a handful of colleagues keep seeking opportunities to work in Nigeria, many have become disillusioned with Nigeria, frustrated by bureaucracy of engagement.
On our frequent visits back to Nigeria, we also sought to engage with policy makers who often spoke of their hopes of engaging the vast health diaspora. Their attempts to do this yielded little fruit as colleagues often returned to Nigeria in small teams for medical missions all over the country with little cohesion in planning or implementation.
A number of UK institutions and donor organizations are also active in Nigeria. Money, energy and air miles are spent in efforts to support Nigeria in providing health for her people.
With all these in mind, we felt that it would be important to bring together these groups to understand policy initiatives and the priorities of the Nigerian government and where each group can help. We felt it was time to start working together, as Nigerian health professionals in the UK and elsewhere and with our friends and partners. It was time to pull together from the same end of the rope.
Why has health slipped down the order of priorities in Nigeria?
Is this a sustainable state of affairs for the country with the largest population on the African continent, the 8th largest crude oil producer in the world?
Most importantly; what can we do about it?
To answer these important questions we have called a conference
which will hold at UCL, London on 22 November.
This is being convened by the Nigerian Public Health Network, in association with the Medical Association of Nigerian Specialists and General Practitioners, the Tropical Health and Education Trust, University College London and AfricaRecruit.
Together
, perhaps we can spark the drive to awaken the sleeping giant. Perhaps Nigeria can avoid being the last country to eradicate polio. Perhaps we can improve on our health sector ranking as the 187th out of 191 by WHO. Perhaps we can ask why our politicians have to be flown abroad for the slightest ailments and why our healthcare workers continue to leave. Perhaps this conference can help put these difficult questions on the table, and suggest a credible, pragmatic way forward. Perhaps we can achieve a re-energised Nigerian health workforce in the diaspora together with our friends and partners ready to re-engage with Nigeria.
PERHAPS…you should be there…details @ www.nigeriahealth2008.org
This piece was first publised on the BMJ blog
Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead
I think we are still getting it wrong. Improvement in health is measured by life expectancy, infant and child mortality and maternal mortality. From international best practices and evidences on ground, all these can only be achieved by eliminating health inequity and inequality in Nigeria. Primary Healthcare is the only way out because it takes services to the door steps of the citizens with an informed need. Constructing hospitals here and there is good but how many of them are primary healthcare?. How many have integrated health care services?. Health is a political issue and lies much on the ideology of the government in power. How is our policy on Health systems reform performed?. Why is Polio still endemic in Nigeria and killing and paralysing children, limiting them from unleashing their full potentials in life.
Lets look at the opportunities in the Primary Health Care and invest more on the revitalisation of the systems.
Health care workers should be motivated even not by salary increase then by continuos training and capacity building.
Dr. Ezikeanyi: MD, MPA, MPH
Hebrew University, Jerusalem, Israel