December 3, 2023

Lara Adejoro

Nigeria bears the highest burdens of tuberculosis and paediatric HIV, while accounting for 50 per cent of neglected tropical diseases in Africa, the World Health Organisation has said.

The WHO said although the prevalence of malaria has declined from 42 per cent to 23 per cent, Nigeria contributes 27 per cent of global cases and 24 per cent of global deaths.

The WHO Country Representative, Dr. Walter Mulombo disclosed this on Thursday at the 6th Annual Conference of the Association of Nigerian Health Journalists with the theme, ‘Health security, Universal Health Coverage, and National Health Insurance Act: How can Nigeria get it right – The role of the media in perspective.’

Dr. Mulombo, who was represented by the Field Presence Cluster Lead, WHO, Ahmed Khedr, said non-communicable diseases account for 29 per cent of all deaths in Nigeria with premature mortality from the four main NCDs-hypertension, diabetes, cancers, and malnutrition, accounting for 22 per cent of all deaths.

He said “As you are aware, the UHC means ensuring that all people have access to quality promotive, preventive, curative, and rehabilitative health services they need at an affordable cost without the risk of financial hardship linked to paying for care. Indeed, no one should get sick, be denied healthcare, or die just because they are poor, or because the services they need are too far away from where they live.

“The WHO was founded 74 years ago on the conviction that health is a human right to be enjoyed by all people, not a privilege for the few. Although much has changed in 74 years, that conviction has not. If the term ‘universal health coverage’ had existed in 1948, it would have been in the constitution of the WHO. But even today, more than half the world’s population lacks access to essential health services, and almost 100 million people are pushed into extreme poverty every year because of the costs of paying for care out of their own pockets.

“Here in Nigeria, healthcare is financed predominantly by households, who pay for healthcare out of their pockets. With healthcare out-of-pocket expenditure at 70.5 per cent of the Current Health Expenditure in 2019, General Government Health Expenditure as a percentage of the GDP was 0.6 per cent, while Government Expenditure per Capita was $14.6 compared with the WHO’s $86 benchmark for universal health coverage.

“Currently, the country bears the highest burdens of tuberculosis and paediatric HIV, while accounting for 50 per cent of neglected tropical diseases in Africa. Although the prevalence of malaria is declining (from 42 per cent to 23 per cent), the country contributes 27 per cent of global cases and 24 per cent of global deaths. The NCDs account for 29 per cent of all deaths in Nigeria with premature mortality from the four main NCDs (Hypertension, Diabetes, Cancers, and Malnutrition) accounting for 22 per cent of all deaths.

“While the poorest households feel the heaviest impact of these inefficiencies and poor health outcomes as they have limited access to essential health services, the negative externalities pose huge losses to the Nigerian economy.

“There is no single pathway to the UHC. All countries must find their own way, in the context of their own social, political, and economic circumstances. But the foundation everywhere must be a political commitment to building a strong health system, based on primary care, with an emphasis on disease prevention and health promotion. Such health systems do not only provide the best health outcomes; they are also the best defence against outbreaks and other health emergencies. In this sense, the UHC and health security are truly two sides of the same coin.

“For that reason, Nigeria’s Presidential Summit on universal health coverage in 2014 was a vital step. Its Declaration that was signed by Mr. President and all State Governors affirms that the UHC is key to ensuring equitable access to high-quality, affordable health care for all Nigerians. The declaration contains a 23-point statement which recommends a greater commitment of all tiers of government to improving UHC and the institution of mandatory health insurance.”

The country representative also noted that the National Health Act enacted in 2014 laid a firm foundation for making the UHC a reality, by guaranteeing a basic package of health services for all Nigerians while making available predictable financing through the Basic Healthcare Provision Fund.

“Just in May 2022, the President signed into law, the National Health Insurance Authority Bill, making health insurance mandatory for all legal residents in Nigeria, designating States the implementers of health insurance, and creating the Vulnerable Group Fund meant to cater to over 83 million poor and vulnerable citizens. What is most critical at this time is to ensure diligent implementation of these laws towards accelerating access to their well-intended dividends to the people.

“Let me at this point most sincerely appreciate the government of Nigeria for consistently releasing its commitment of at least one per cent of their consolidated revenue fund towards the Basic Healthcare Provision Fund. It is expected that the BHCPF if well implemented, would provide a great opportunity to turn political commitment into tangible gains, while rallying development partners and the private sector around revitalising primary health care as the foundation of the UHC.

He added that the WHO, from Alma-Ata, had continued to provide technical support to member-states, including Nigeria, towards achieving the health system of their dreams embedded in primary healthcare.

In his opening remarks, the President of the ANHEJ, Hassan Zaggi, urged the government to prioritise health in its blueprint ahead of the 2023 elections.

“I call on our senators, House of Representatives members, House of Assembly members, (and) councillors to adopt villages, communities, and individuals in their constituencies by paying their health insurance premium annually.

“Since democracy has come to stay in Nigeria, sustainability and continuity of this model should not be a challenge for our current leaders’ successors,” he said.

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