Experts decry proposed N820bn for health in 2022 appropriation bill

Stakeholders in the health sector have decried the proposed N820 billion budgetary allocation for health, which represents five per cent of the N16.39 trillion 2022 appropriation Bill presented recently to the National Assembly by President Muhammadu Buhari.

A virologist, vaccinologist and Chief Executive of Innovative Biotech Limited, United States and Nassarawa State, Dr. Simon Agwale, told The Guardian: “Unfortunately, the entire national budget is just a drop in the ocean and I don’t think anything would change even if it is properly implemented. The entire national budget is just about $40 billion and what can you do with that in a country with over 200 million people?”

Agwale, who was a researcher at Nigerian Institute of Pharmaceutical Research Development (NIPRD) Abuja, said the budget of the United States National Institutes of Health (NIH) for 2020 is over $40billion (one institution); so five per cent of $40 billion is about $200 million.

He said the entire health budget of Nigeria is not enough to run two teaching hospitals properly in the country. “So, honestly, I don’t know how we can solve our current health sector challenges with N820 billion. I, therefore, don’t expect anything to change if nothing is done to improve revenues and focus on knowledge-based economy. Moderna, a small Biotech company last year is now valued at least $129 billion (a one product company) today, which is more than all the banks in Nigeria put together, so, we need a national dialogue to reposition the country into a more progressive path,” Agwale said.

Medical Director, Merit Healthcare and Fellow, Pharmaceutical Society of Nigeria (PSN), Dr. Lolu Ojo, told The Guardian: “The 2022 budgetary allocation for health is the usual misadventure in everything Nigeria. We deploy resources to solve problems that we created and for which no benefit is expected.

“How much has the insurgency in the North East cost this nation? What if this money has been used to develop our healthcare infrastructures and advancements? So many questions but no sensible answers.”

Ojo, who is a PSN presidential candidate, said the health sector is in need of a total overhaul. “We should do a thorough analysis, set a sincere target and be honest and pragmatic in our projections,” he said. The consultant pharmacist said 15 per cent budgetary allocation for health is possible in Nigeria.

“It is possible with sincere and solution focused leadership,” Ojo said. On what is obtainable in other climes, Ojo said: “It is obvious and that is why our leaders go to Europe, America, Asia and Middle East for their medical needs. The systems there are working,” he said.

On whether 15 per cent budgetary allocation for health recommended by African Union (AU) and World Health Organisation (WHO) will solve Nigeria’s health woes and reverse poor outcomes, Ojo said: “Certainly no. It is not about the quantum or size of the allocation but more of resources management. What has happened to the allocation of yester years?

“The 15 per cent is just a guide to emphasise that adequate resources are required to build an efficient, effective and sustainable healthcare delivery system. What give us what we want is the sincerity of purpose and execution capability of our leaders.”

A consultant ophthalmologist at the College of Medicine University of Lagos (CMUL)/Lagos University Teaching Hospital (LUTH) and Chairman, Lagos State Traditional Medicine Board (LSTMB), Prof. Adebukunola Adefule-Ositelu, told The Guardian: “A healthy nation is a progressive nation. We have those who know what is right. To whom might is given mightier is expected. We place them before The Almighty God to allow themselves be directed to serve their subjects judiciously and fairly well. History is recorded on earth as well as with The Creator. We deserve better than the present and pray for better days soonest.”

Chairman, Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN) and Chairman, Fidson Healthcare PLC, Dr. Fidelis Ayebae, told The Guardian: “It is a very grey and controversial area. Let government tell you why it is difficult to appropriately provide substantial money for anything. Then you will realise what challenging times we are in.”

President, PSN, and founder/former Chief Executive Officer (CEO) of Neimeth Pharmaceutical, Mazi Sam Ohuabunwa, told journalists: “To be sincere with you, it is inadequate but of course, the inadequacy is also as a size of the budget. They could be a five percent of a budget that can be adequate. There is nothing about 15 per cent as a magic word. What is inadequate?

“Again, in line with competing needs. I do not want to be selfish and say give health care about 15 per cent and then I cannot even get to the hospital cause there is no road then, even if I get to the hospital, I cannot get home because of kidnappers because there is no work. So, security has to get some as well as education and other sectors. I believe that what we need to do is first, is to cut cost. First, I check the priority. I want to do one hundred things; must I do all of them? Which ones are more important? And which are the ones I will today that can help the others. You know some have multiplier effect. For example, in this country, if you reduce poverty, we would have dealt with corruption. If we reduce injustice, we would have dealt with insecurity to a large extent.”

So, certain things have more multiplier effect. I think government should re prioritise first.” Ohuabunwa, who is Convener of the New Nigeria Group (NNG) and former Chairman of the Nigerian Economic Summit Group (NESG), added: “Secondly, and I feel very serious about this, is that we need to cut our cost. We are not getting value for money. Every contract government awards is loaded. It is loaded because of two things, corruption, because the people that are executing the contract are giving in something for other people who are going to be stakeholders in the contract. Number two, lack of fidelity. Because you tell somebody supply this, I will pay you in a month, they do not pay you in three years. So, the man now learns his lesson as he is already building the cost of money for three years because he knows he will not be paid. So, they build that all into their cost. I know this for sure. So, I just hope that we will become more efficient. Let us change our procurement mechanism and assure our contractors that we shall pay them.”

Mallam Musbahu Magayaki of the Department of Health Education, Aminu Saleh College of Education, Azare, in a letter to The Guardian noted: “I write with dismay about the proposed N820 billion health sector budgetary allocation for the year 2022, despite the fact that the area is supposed to account for the lion’s share of the budget due to the number of Nigerians suffering from the global epidemic. They frequently struggle to afford their medical bills, and there are few well-equipped local and state government hospitals.

“Tragically, the health sector has only received five per cent of the budget, which is less than the 15 per cent declaration by African Union leaders. However, I wrote an article where I called on the President’s attention about his trip to London to seek medical attention published in the Daily Trust of Sunday, June 27, 2021, where I admonished him to, instead of these frivolous trips abroad, rehabilitate our dilapidated hospitals. But it seems like he has not heard of my suggestion.

“There are countless Primary Health Care Centres and General Hospitals run by the state governments where lower-class Nigerians attend to seek medical attention, but the hospitals are antiquated and have inadequate medical supplies.

“Shouldn’t the Federal Government collaborate with the state government by equipping them with medical equipment so that impoverished Nigerians have appropriate access to effective medical care? Because some Nigerians, if not all, cannot afford the Federal Government’s hospital expenses.

“Take, for example, malaria and cholera: two diseases that are spreading like wildfire. Almost the majority of Nigerians attend these primary health care centres and general hospitals since they are far less expensive to manage. The Federal Government should prioritise them in this regard.

“Despite the contributions of international health donors to the sector, we have failed to reduce, if not eliminate, cholera, malaria, and other deadly diseases. This year, Nigerians have not received or procured sufficient number of mosquito nets, while the malady claims the lives of too many Nigerians.

“In a nutshell, I would like to implore the Federal Government to urgently heed my observations and suggestions to achieve an optimal health system in our dear country.”