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COVID-19 and Nigerian health sector


Despite several reports and commentaries drawing the attention of our duty bearers to the decay in the health sector before the current virus pandemic, no attention was paid, after all. And now the consequences of executive negligence are here with all of us. 
Some of the pre-COVID-19 editorials and headlines include: ‘‘Equip Nigerian hospitals like UK’s, ‘‘That Buhari may finish ‘healthy’,” ‘‘Nigeria’s healthcare system under threat,’’ NMA’s five-year plan for health sector’’ ‘‘FG and another health sector plan,’’ ‘‘Healthcare, boy Ali and our conscience!,’’ ‘‘NMA and unbridled doctors’’ exodus,’’ ‘‘Africa’s public service and health sector brain drain,’’ ‘‘As Nigerian doctors seek jobs abroad,’’ ‘‘Buhari’s curious lamentation about medical tourism,’’ and ‘‘Foreign medical treatment for public officials’’ among others. 
It is a shame because our leaders failed to read the writing on the wall because they could easily fly to other countries for their healthcare. This is unwarranted self-centredness and Covid-19 challenge has become the ‘‘arbiter.’’ The borderless Covid-19 pandemic, which is an equal-opportunity killer, has brought to the fore the effect of the age-long neglect of the health sector in Nigeria. It is hoped that the authorities are now alert to the poor state of the health sector. 

As a matter of fact, the Covid-19 pandemic is an experience that is and will be the best teacher for our leaders and high net-worth individuals, because no sick political office holder/public officer can be flown abroad for health care for obvious reasons – the lockdown in a global context. 
With the lockdown, sick Nigerian elite and public officers are trapped in their power and wealth to the extent that they have stooped so low. The big men and women never knew that one day Nigerians could never travel abroad for one week and the world would be shut down by one virus. These were partly responsible for the nation’s under-preparedness to fight the strange leveller, Covid-19. 
Currently, all international airports are closed; and the health systems of the developed countries that have been their safe havens are overwhelmed by the healthcare needs of their citizens and migrants occasioned by Covid-19 because some of them are now the worst-hit countries.
As such, our leaders at all levels are compulsorily ‘‘patronising’’ Nigerian health facilities either for a test or on admission in strange isolation centres.  Obviously, the rejected stone by the builder is now the headstone. The same public officers who neglected our hospitals are taking over the limited available healthcare resources. 
It has been so embarrassing that some states have so neglected their health facilities to the extent that the samples of some of our political leaders are being taken to other states for tests, or some senior public servants are being taken to other states for care. This is the dividend of their indifference to the public sector over the years.
So, Covid-19 is now making them enjoy the benefits of their ‘‘good governance.’’ What is more? Some of them are being flown from the capital of the federation to Lagos (we left 44 years ago) to receive treatment. What a reproach! 
As such, something positive is coming out of the Covid-19 pandemic: it is a wake-up call for the government at all levels and the private sector to improve our healthcare systems. 
Today, the Federal Government has released about N15 billion as grants and some state governments have released hundreds of millions. In the same vein, wealthy Nigerians and the organised private sector including banks have donated billions of naira to help fund medical centres and provide essential materials. 
These interventions show the organised private sector can work with the government to draw up a health sector development plan to revamp the sector and stem medical tourism. Therefore, the key lesson from Covid-19 management is that as a country, Nigeria can brace up and invest to ‘equip Nigerian hospitals like UK’s’’ as we once suggested.
So, this is a time for our negligent political leaders to gather needed data to reposition the health sector. Again, the government should set up a team of experts to assess the health needs of each state and their preparedness to respond to emergencies such as the current pandemic.
Essentially, medicare should be seen as an investment just like real estate. With commitment and determination, the Nigerian health sector can be repositioned too through a private sector intervention. A private sector-led world-class specialist hospitals, driven by local investors, especially members of Nigerian Medical Association (NMA), Nigerian health professionals and experts in the diaspora, health professional organisations, development agencies and health-related not-for-profit organisations in partnership can improve Nigeria’s health sector. This collaboration is important because facilities alone do not run hospitals; the human capacity is an important resource. 

This new paradigm should be intentional to invest in research and vaccine production instead of being import-dependent. Meanwhile, the authorities should use this time to plan robust investment in science education, which is the building block, in this regard. 

Besides, this is a time the private sector-led group can partner with the government and take over the gigantic hospital buildings that have been wasting away and turn them into quality health care facilities. This strategic partnership is needed at this time and beyond as it can lead to more people having access to quality health care at an affordable cost in the country.


On preventive health, government at all levels should raise the bar. They should ensure access to basic necessities such as running water and other basic amenities and consumables to reduce the vulnerability of the low socio-economic group to diseases. The ongoing fumigation and disinfection of public places to reduce the spread of coronavirus should be part of an elaborate and comprehensive national preventive health strategy of the country. 

Where is the National Orientation Agency (NOA), which should embark on a massive and continuous campaign on preventive healthcare delivery at this time?

All told this is the time for the authorities in Abuja to realise the danger of a unitary system of government this newspaper has repeatedly decried. It is time to migrate from unhelpful rhetoric of restructuring to action. Let all governors and local (government) leaders, find the political need to invest in healthcare facilities in their states and local councils. This devolution of powers will minimise the reproach of an independent country is dependent on the health services of other countries. And so this COVID-19 wake-up call should not make us a prisoner of hope. The sobering lesson should produce some cosmos (order) after the current confusion that has diminished us as Africa’s main giant. 


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