Tinubu, Atiku, Kwankwaso and Obi
•Experts challenge candidates on political economy of health, how to improve ailing sector
Health is wealth. A healthy nation is a wealthy nation. Several studies have shown that there cannot be any meaningful development without a robust health plan.
At the heart of World Health Organisation’s (WHO) ideal health plan is ensuring Universal Health Insurance (UHC) through pre-paid health insurance model.
Ahead of February 25 presidential and National Assembly elections, the four leading presidential candidates -Peter Obi of the Labour Party, Rabiu Kwankwaso of New Nigeria Peoples Party (NNPP), Atiku Abubakar of the Peoples Democratic Party (PDP) and Bola Tinubu of the All Progressives Congress (APC)- through their manifestos, have made promises to Nigerians on why they should be elected.
Obi, Kwankwaso, Atiku and Tinubu have listed their priorities for fixing Nigeria’s ailing health sector. They have promised to tackle lots of issues, including Nigeria’s degenerating national security, energy, education, economy, women empowerment and most importantly to reform the country’s failing health sector.
The country’s health sector has suffered a myriad of challenges over the years. From brain drain to inequities in health services, coupled with the devastating impact of the COVID-19 pandemic and lack of a functional primary healthcare system, the sector is one of those that require urgent attention.
The Federal Government has failed for the umpteenth time to meet the Abuja Declaration by African leaders in 2001 and the WHO to allocate, at least, 15 per cent of yearly national budgets to health. In April 2001, the African Union (AU) countries met in Abuja and set a target of, at least, 15 per cent of their yearly budget to improve the health sector.
Obi’s health policy
On his part, the candidate of LP, Peter Obi, in his manifesto, plans to address medical tourism by supporting national teaching hospitals to specialise in niche areas of medicine, thus enjoying expeditious faculty and facilities enhancement and the attendant comparative advantage.
In his manifesto titled: “Our Pact with Nigerians,” Obi said his administration would implement the National Health Act of 2014, and enforce the provision of its Section 46.
He said there would be a “comprehensive mapping of Nigeria’s healthcare system occupational categories, to generate relevant data on human capacity and resources for healthcare training, with a view to reversing brain drain and stopping medical tourism while tapping into our huge diaspora capacity in healthcare.”
Obi also plans to expand the National Health Insurance Agency (NHIA), formerly NHIS, uptake, with a robust healthcare insurance scheme at the basic healthcare level to provide cover for the 133 million poorest Nigerians including pregnant women, children, elderly people and persons living with disabilities.
He also promised to honour Nigeria’s commitment pursuant to the 2001 African union Abuja Declaration on Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), Tuberculosis and other related infectious diseases, which set a target of allocating 15 per cent of annual budgets to the improvement of health sector in African countries.
He said his administration would generate innovative healthcare financing by encouraging public-private healthcare sector initiatives and implementing special taxes and duty waivers.
The manifesto reads in part: “This will include special incentives to encourage the domestic production of pharmaceuticals, drugs, vaccines and medical consumables.”
Tinubu’s health policy
The former Governor of Lagos State and presidential candidate of the ruling APC, Bola Tinubu, has also promised to mitigate brain drain and retain health workers by improving their welfare.
According to Tinubu’s manifesto which is titled: “The Renewed Hope”, part of the policies to be implemented in making this a reality “include performance-based salary increases, health insurance to cover family members, favourable mortgage or home-ownership plans for health workers, and tertiary education scholarships for their children.”
On UHC, the APC candidate plans to reform the healthcare system by making UHC a primary objective and central theme of his healthcare reforms.
“By making universal coverage our primary objective, we shall create new jobs and bring greater economic and social development to the Nigerian people,” he said.
As part of efforts to achieve this, Tinubu plans to scale up the National Health Insurance Authority Act, “with the objective of implementing a mandatory health insurance scheme to cover at least 40 per cent of the population within two years.”
He also promised to augment the financial mechanism such as the Basic Health Care Provision Fund and Vulnerable Group Fund to cover vulnerable populations.
He said funds recovered from petrol subsidy would be saved and used to enhance health coverage for Nigerians.
He said: “In addition to other sources, funds saved by the removal of the fuel subsidy shall be earmarked for use in helping to provide health coverage for pregnant women and children under-five.”
He also promised to partner state and local governments to facilitate the upgrading, equipping and staffing of a general hospital in every local government area, a tertiary facility in each state and a world-class specialist hospital in each geo-political zone.
Atiku’s health policy
Atiku plans to improve access to basic healthcare services through innovations – such as the mobile healthcare delivery scheme.
He said the policy thrust of his administration will be all-embracing and targeted towards a preventive care strategy by creating a clean environment, modernising living conditions, carrying out enlightenment campaigns on healthy living, and supporting with curative care through the provision of state-of-the-art healthcare facilities in hospitals and in rural clinics.
As stated in his manifesto, which has been tagged: “My Covenant with Nigerians”, Atiku plans to ensure universal access to basic maternal and child health, reproductive health, immunisation and mental health while also accelerating Nigeria’s transition towards achieving universal access to affordable and quality healthcare services for all by 2030.
According to the manifesto, the former vice president intends to attract Nigerian doctors in the diaspora to reverse brain drain.
Kwankwaso’s health policy
In his manifesto titled: “My Pledge to You,” the candidate of the NNPP, Rabiu Kwankwaso, said he plans to improve and modernise healthcare services in the country.
Kwankwaso, a former governor of Kano State, said his administration would be committed to ensuring the country’s healthcare system is positively overhauled to ensure humane, effective, efficient, and qualitative service.
“Saving lives and building a healthy citizenry shall be the priority of all our healthcare institutions because health is wealth,” he said
For the past three decades or so, Nigeria’s public service has virtually collapsed. We pledge to reform the service so as to revitalise and reinvigorate it to be able to operate with competence and professionalism.
Illicit drugs are the fuel that fans the embers of insecurity. Fake and counterfeit drugs do not only provide serious public health challenges but also undermine the economy and security. He said: “We will work decisively and systematically to end the menace of substance abuse, the proliferation of fake and counterfeit drugs as well as end the smuggling and circulation of illicit drugs in our country. We shall establish reformatories/sanatoria in each geopolitical zone to mitigate against the effects of drug abuse/addiction.”
Political economy of health
Stakeholders at the 2022 Future of Health Conference titled, ‘The Political Economy of Health: Investing in the Future of Nigeria’, organised by the Nigeria Health Watch, said the 2023 general elections provides opportunity to push healthcare up the political agenda and ensure that it takes its rightful place.
They cited a McKinsey Report, which showed that the economic benefits from various health improvement strategies are substantial enough to add $12 trillion or eight per cent to global Gross Domestic Product (GDP) by 2040. That translates into 0.4 per cent faster growth every year.
Ultimately, they said, focusing on known health improvements could deliver an incremental economic benefit of $2 to $4 for each $1 invested.
Former Director General, Nigerian Institute for Medical Research (NIMR), Yaba, Lagos and past President, Nigerian Medical Association (NMA), Prof. Innocent Ujah, called for an overhaul of the nation’s health sector.
Ujah, who is also Vice Chancellor, Federal University Of Health Sciences, Otukpo, Benue State, stressed the need for improved budgetary allocation and effective implementation of the NHIA.
A consultant obstetrician and gynecologist and medical director, Optimal Specialist Hospital, Surulere Lagos, Dr. Ugochukwu Chukwunenye, told The Guardian: “The problems of the health sector cannot be solved by in a hurry. There is a need for the next president to put square pegs in square holes, ensure the appointees achieve appropriately set targets, and are backed up with appropriate funds, which must be judiciously utilised. The only evidence that the political will is there, is when the top echelon of the government and those at the commanding heights of business, religion, and tradition renounce medical tourism and receive all their health needs within the country.”
A Pharmaceutical Chemist and Project Lead of Bloom Public Health, Prof. Chimezie Anyakora, said the next president should create African driven solutions to solve African public health issues, especially in the pharmaceutical sector. “There is need to look inwards. The presidential candidates have good manifestoes, but they must find innovative ways of funding the programmes,” he said.
“They should be mindful of meeting and exceeding the 15 per cent recommendation for yearly health budget by African Heads of State (Abuja Declaration) and the World Health Organisation (WHO),” he said.
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