Tinubu
Nigerians spend between $1.2 and $1.6 billion annually on medical tourism – FG
. Parking of presidential jet during Buhari’s London medical trip in 2017 cost £360,000 or 0.07 per cent of Nigeria’s health sector budget for same year
. 5,600 Nigerian medical doctors have migrated to the UK in the last 8 years – NMA
. With 218m population, Nigeria needs at least 363,000 additional doctors to meet WHO’s doctor/patient/ recommended ratio of 1 doctor to 600 patients – NMA
By Hassan John
Flowing from the February 25 2023 presidential election the Independent National Electoral Commission (INEC) has duly announced a president-elect. He is the ruling All Progressives Congress, APC, candidate, Senator Bola Ahmed Tinubu.
Beyond the fact that some aggrieved political parties including the Labour Party (LP) and the Peoples Democratic Party (PDP) have indicated their intention to challenge the process in court, many Nigerians are looking ahead at the development imperatives facing the in-coming administration.
At the core of these development concerns are the brain drain syndrome and rampant medical tourism bleeding the Nigerian economy, among others. It is, therefore, pertinent to begin to interrogate these vital issues and ask vital questions, especially, in the health sector. It is indisputable that Nigeria’s health indices are not good enough.
According to the World Health Organisation (WHO), Nigeria’s health indices are among the worst in the world.
Nigeria, the global world health body said, has 10 per cent of the global disease burden. It has the highest rate of malaria infections and the third highest HIV burden on earth. The country has very high infant and maternal mortality which is said to be fourth worldwide at 512/100,000 live births.
Nigeria also has high child mortality – eighth in the world at 132/1,000 live births. Women continue to die from preventable causes including obstetric hemorrhage, eclampsia and many other avoidable causes.
Also, the rate at which Nigerians go outside the country for medical tourism is alarming and worrisome. On the flip side, the rate at which the nation’s medical experts leave the country for greener pastures in other countries is a source of deep concern.
Worst still, is the rate at which Nigeria’s leaders including the president, ministers and top government officials fly out for medical treatment abroad at the expense of tax payers money.
This gives heartache and gloomy picture as to whether there is hope for the nation’s health care delivery system to take care of the health challenges of its large population.
The way and manner the frequent trips abroad by Nigeria’s political leaders is overlooked even at the expense of the country’s meagre resources, to many critical stakeholders in the health sector, is the reason for the poor health infrastructure in Nigeria.
Some stakeholders in the health sector are of the opinion that the lack of confidence in the health systems by our leaders and the fact that they can afford the frequent trips abroad with tax payers’ money remain a motivation for the continuation of the ugly trend.
It is shocking to know that as at the last count in October 2022, since 2015 President Muhammadu Buhari had spent at least 237 days away on medical trips abroad. This therefore propels the crucial question: can the president-elect, Senator Tinubu stop medical tourism and brain drain in Nigeria?
Can Tinubu Halt Medical Tourism, Brain Drain?
It is pertinent to mention here that the President-elect is also very guilty of going abroad for medical checks and treatments. Though it is his fundamental right to decide where to seek medical checks, there is the fear that he may go the way of President Muhammadu Buhari, who is a regular patient abroad.
The fear is heightened by the fact that there is an allegation that the president-elect is currently nursing an undisclosed medical ailment which needs regular attention.
It would be recalled that the Federal Government last year revealed that Nigerians spend between $1.2 and $1.6 billion on medical tourism yearly. It however did not disclose how much of that amount is borne by taxpayers on behalf of political leaders.
For instance, the cost of parking Nigeria’s President, Muhammadu Buhari’s plane during his London trip in 2017 is estimated at £360,000 – equivalent to 0.07 per cent of Nigeria’s budget allocation for health in that same year.
Peeping into other countries in Africa, it is annoying to know that it is estimated that in Uganda, the funds spent to treat top government officials abroad every year could build 10 hospitals. This is huge.
The emerging public consensus is that President-elect, Senator Tinubu must then know the blunt truth that there is nothing honourable about a leader who seeks medical help abroad, but abandons his people to bear the brunt of a decaying health sector. This, Nigerians will not accept regardless of any excuses he may proffer.
Nigerians are tired of leaders who are using their meagre resources to care and nurse undisclosed ailments. This is the bitter truth.
On the issue of the brain drain of medical doctors and other health workers in the country, the President, Nigeria Medical Association (NMA), Dr. Uche Rowland, recently disclosed that 5,600 of medical doctors have migrated to the United Kingdom (UK) in the last eight years.
He revealed that according to the WHO, a country requires a mix of 23 doctors, nurses, and midwives per 10,000 population to deliver essential health services. He however, regretted that only one doctor is available to treat 30,000 patients in some Southern states, while in the North, it is one doctor to 45,000 patients.
“In some rural areas, patients have to travel more than 30 kilometres from their abodes to get medical attention where available thus making access to healthcare a rarity,” he said.
The NMA President noted that with the only 24,000 doctors available in Nigeria, the current doctor-patient ratio is 1:9,083, a stark contrast with WHO’s recommendation of One doctor to 600 patients.
With 218 million people to cater for, Nigeria requires at least 363,000 additional doctors to meet this target.
With this dangerous reality before us, the President-elect, must assemble experts across party lines and find an urgent and pragmatic way to tackle the situation.
Tinubu’s Antecedent
At a recent interview with journalists in Abuja, the former Commissioner for Health in Lagos State, Dr. Jide Idris, disclosed that the President-elect has the capacity and is prepared to turn the health sector around considering what he did when he was the governor of Lagos State.
“One of the basic problems in the health system is leadership and governance. It is a major problem. But people don’t understand what leadership and governance is. We cannot move forward without a proactive leader.
“A leader that has vision who knows what he wants to do. He has the ability to tell the people working around him to do the same thing. That was what Bola Ahmed Tinubu did in Lagos.
“Apart from that, because of that foresight, he set up a governance structure. It is key. These are processes that will help you address the problems in the system.
“To provide solution, you have to have policies, plans; you have to have legislations, decision making processes and many things. These are things that are on ground that we need to build upon them and he (Tinubu) created that culture of continuity,” Dr. Idris said.
The Way Forward
The President-elect must provide focused leadership and clear vision for the healthcare sector. This is the first way out in improving health indices and reducing inequalities.
The incoming president must also take a holistic approach in addressing the challenges confronting the sector through a health sector reform bill that takes cognizance of all existing health institutions and agencies with the aim of making them more efficient in line with current realities.
On the other hand, the way and manner the state and local government levels only depend on the federal government for provision of health services, must be discouraged.
The President-elect must ensure that collaboration along all tiers of government is strengthened. It is necessary to advise the President-elect, immediately he assumes office, to declare a National Emergency on the brain drain syndrome/human resources challenge popularly known as JAPA.
In order to address a lot of the institutional challenges, the President-elect must, as a matter of urgency, revisit and implement the Health Act of 2014.
While advising the new government to jack up public healthcare funding with increased budgetary allocation to a minimum of 15% in order to make significant progress with universal healthcare coverage, there is also the need for the strengthening of Emergency Medical Services across all levels.
In order to retain the legion of health workers who leave the country in droves, there is the need to improve the working environment, welfare concerns, the general remuneration and improve the Healthcare Infrastructure across all tiers of government through innovative ways of financing.
The president-elect must also explore ways to ensure that there is peace and harmony in the health sector. This, will no doubt, prevent rivalry and agitation which will eventually lead to the shut-down of the health sector.
One must admit that the expectations are huge on the president-elect as far as the health sector is concerned.
Nigerians are, therefore, keenly watching the approach he will adopt in fixing the many challenges in the health sector, prominent among which are brain drain and medical tourism. He must not fail Nigerians.
