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To President Buhari: ‘There is still time to become Nigeria’s universal health coverage hero’

Ifeanyi M. Nsofor
By Ifeanyi M. Nsofor

Dr Ifeanyi M. Nsofor is a Senior New Voices Fellow at the Aspen Institute and a Senior Atlantic Fellow for Health Equity at George Washington University. He is CEO of EpiAFRIC and Director Policy and Advocacy at Nigeria Health Watch. You can follow him on Twitter @ekemma.

Posted on Thursday, 8 April 2021 12:17, updated on Friday, 9 April 2021 14:08

Virus Outbreak Nigeria Vaccines
Nigeria’s President Muhammadu Buhari, receives one of the country's first coronavirus vaccinations (Sunday Aghaeze/Nigeria State House via AP)

President Muhammadu Buhari has embarked on another medical tourism trip to the UK for two weeks. By the time he comes back to the country next week, he will have spent more than 200 days going on medical tourism since he was sworn-in as Nigeria’s President in May 2015. In comparison, millions of Nigerians do not have access to healthcare and have no form of health insurance cover. 

Should President Buhari be traveling to the United Kingdom for healthcare? What does that say about his belief in Nigeria’s health system? What has he done to improve Nigeria’s health system after more than five years of leading the country? Is the State House Clinic in Abuja incapable of conducting a medical check up on the President? Why should President Buhari embark on another medical tourism when resident doctors were about to stage a nationwide strike? The questions are legion.

To be clear, I understand that sometimes the healthcare one needs may not be available in one’s country. My family traveled to India for an open-heart surgery for our newborn baby in 2009. Our daughter, Yagazie was born with four different congenital health defects. The most life-threatening of the defects was transposition of the great arteries.

It was a very challenging time for our young family — both emotionally and financially — and as a result, we were literally pushed into poverty. In contrast, President Buhari goes on medical tourism at the expense of taxpayers.

Medical tourism is not a bad venture. However, it should not be done at the expense of taxpayers. It especially should not be done when so many of those taxpayers lack sufficient health coverage themselves.

Unplanned health expenditure pushes Nigerians into poverty. At an average of N30,000 ($73) premium per person, the amount spent on partial fuel subsidy would provide health insurance for about 3.4 million poorest Nigerians.

President Buhari still has time to become Nigeria’s universal health coverage hero before he hands over power to his successor in 2023. He can direct a complete removal of fuel subsidy and channeling the funds through the National Health Insurance Scheme to provide health insurance cover to the poorest Nigerians.

Indeed, Robert Yates, Senior Research Fellow at Chatham House, made this recommendation at the Nigeria Health Watch 2015 future of health conference (months after Buhari was sworn-in in 2015). Sadly, with the current partial fuel subsidy, Nigeria still spends about N103bn ($270m) monthly on fuel subsidy. (This amounts to more than 50% of the 2021 budget of Seychelles). Fuel subsidy is unsustainable and open to corruption.

Brain drain by health workers

Unplanned health expenditure push Nigerians into poverty. At an average of N30,000 ($73) premium per person, the amount spent on partial fuel subsidy would provide health insurance for about 3.4 million poorest Nigerians.

President Buhari must push for upward review of salaries and allowances of health workers. This is important to reduce the brain drain by health workers. As politicians embark on medical tourism, Nigerian health workers are migrating in droves to other countries for better salaries and conditions of service.

In 2017, Nigeria Health Watch and NOI Polls conducted a survey on emigration of Nigerian medical doctors. More than 700 doctors in and outside of Nigeria were interviewed. The result showed that 88% of respondents were seeking work opportunities abroad.

Low work satisfaction (92%), and poor salaries and emoluments (91%) were mentioned as challenges doctors face that make them consider moving abroad. Other reasons for emigration by Nigerian doctors were better facilities and work environment; higher remuneration; career progression and professional advancement as well as better quality of life.

President Buhari should consult with state governors and provide fair and regular salaries and allowances for all cadres of health workers. He must end the absurdity of paying Nigerian doctors monthly hazard allowance of N5000 ($11).

He should designate six teaching hospitals (one per Nigeria’s geo-political zones) as centres of excellence to provide specialist care for cancer. Based on 2020 estimates by the Global Cancer Observatory, there were 124,815 cancer cases and 78,899 cancer deaths in Nigeria.

This means that 63% of Nigerians who had different forms of cancer in 2020 died. These deaths are too high and unacceptable. Having one teaching hospital in each zone providing specialist cancer care, brings services closer to Nigerians. People would not have to travel thousands of miles for treatment and care.

Set the tone for civil servants

Lastly, President Buhari must ban public officials (including himself) from using public funds for medical tourism. Henceforth, if he wants to travel to the United Kingdom or any other country for medical checkups, he should pay from his personal funds.

Even better, imagine how inspiring it would be if President Buhari’s next checkup was at the State House Clinic in Abuja or National Hospital Abuja. It would set the tone for civil servants and politicians that medical tourism is no longer allowed on state funds. It would honor doctors and other health workers who strive to save lives in Nigeria despite very challenging work environments.

The last Nigerian President who did a medical checkup locally was Olusegun Obasanjo at the National Hospital Abuja. Nigerian Presidents going for prevention, treatment and care at the country’s hospitals must become the norm.

I wish President Buhari good health and a long life. However, he must ensure that no Nigerian is denied healthcare for whatever reason. Doing so should begin by paying fair wages to health workers and improving their conditions of services. Period!

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