Nigeria’s health sector heavily dependent on international donor funds may witness a reversal of current gains if the country does to tackle this problem as donors withdraw such funds.
From the fight against HIV to poliomyelitis, Nigerian government contributes just a little of 20 percent of such disease responses.
With Nigeria currently rated as Africa’s biggest economy, the country is no longer qualified to received many of the international donor grants meant for poor world countries still struggling to archive minimum standards of health and education.
The Director-General of the National Agency for the Control of AIDS (NACA) Professor John Idoko told LEADERSHIP on Tuesday that Nigerian government funding for HIV activities is worrisome.
He said “We signed an agreement with our biggest donor in 2011 that by 15, Nigeria should be able to fund HIV related activities to 50 per cent.”
According to Idoko, up till now, government funding for HIV is still below 25 per cent.
“Clearly we are not doing well, we are the second most burdened country after South Africa. South Africa has about six million people with HIV and it contributes 90 per cent of funding for its HIV response. Currently, they have over three million people on drugs,” he said at a press conference to commence this year’s world AIDS day in Abuja.
Also, the the National Coordinator of the National Blood Transfusion Service (NBTS) Dr Oluwatoyin Smith is calling on the government to dedicate funds for the service as its biggest donor, the United States Centre for Disease Control is withdrawing funding from the service.
Dr Smith said that with the increasing terrorist attacks and other large scale human emergencies requiring immediate health attention, the agency is been stretched beyond limit.
“Funds needs to dedicated to the course. We have thrived on $5 million in the past and going forward, we need to be able to be able to produce safe blood units for victims of accidents, sickle cell patients, women with postpartum hemorrhage and children,” she said.
She added that the NBTS needs $5 million on the minimum to be able to carry out its mandate.
Last week, during the commemoration World Diabetes Day in Abuja, pharmaceutical gaint, GlaxoSmithKline announced a 10-year steady reduction in price of pneumococcal vaccines to enable Nigeria continue to purchase vaccines at prices meant for low-income countries still dependent on support from the Global Alliance for Vaccine Initiative (GAVI).
GAVI support pools donor funds from around the world to pay for vaccines used in low-income countries, but Nigeria’s rebasing its economy has made the country no longer eligible for that support by 2021.
According to Dr Olakunle Oladehin, cluster medical leader for GSK’s sub-Saharan Africa division, the plan is to ensure that Nigeria after graduating from GAVI eligibility continues to enjoy the same GAVI from GSK to sustain vaccination.”
The tendency is that if Nigeria graduates from GAVI and we revert to regular price, it may be an inhibition for government to continue to procure vaccines.”
Geneva based GAVI has been paying for 60 per cent of Nigeria’s vaccine need for the past 10 years. Nigeria pays the balance of 40 per cent.
Now because Nigeria has rebased its economy, it can no more qualify for (immunisation funding for countries with lower daily dollar spending).
GAVI has said that they will withdraw the money gradually, by reducing Nigeria’s payment by 20 per cent every year, so that by 2020 the country would have exhausted the 20 per cent and from 2021, it will be paying 100 per cent of the cost of vaccines
According to Idoko, in the years past, the U.S. government used to support Nigeria almost 80 per cent but now it is reducing its expansion to 32 of the 774 local governments of the country.
“Given the situation we are, domestic funding is key, we cannot leave treatment in the hands of donors because donor money is gradually declining.
“There are many innovative ways that are on the table and that National and State Health Insurance is a very good way to go on.
“We are one of the countries with this large large number of persons to treat but we cannot produce any of the drugs that we require with WHO prequalification. We do not produce test kits or condoms and those are the key things any nation fighting HIV should be able to produce.”
With about three million Nigerians requiring treatment and given the new guideline by the World Health Organisation of test and treat, it means that Nigeria has a lot of work to do.
He said the biggest challenge facing HIV activities in Nigeria is how to fund its response as donors withdraw support.
“A response that is dedicated 80 per cent to donors is not healthy at all particularly as it stands now, everyone who has HIV needs to treated.
“But we want the funding to go beyond the government. Resource mobilisatiom must come from every level from the federal, state and local government and to the private sector.
“We have been to states like Delta and Benue who have put state health insurance agency and which I think is really going to work because we cannot continue looking at the government.
“Instead of looking to the government, everybody is putting money as a premium and even funders are interested in putting money as a premium. When you do that, there’s a lot more money for health and ensures that those put money also put their eyes there.
“There are still other ways like taxes. Abroad, they are doing airline tax, GSM tax, in Taiwan, there national health insurance incorporates all these and ensures that have more money,” Idoko said.
Also, the secretary of Network of People Living with HIV/AIDS in Nigeria (NEPWHAN), Abdul Kadir Ibrahim charged Nigerians and people living with HIV to own up to responsibility by stop demanding for stipends before visiting clinics.
“We also need to contribute to the HIV response as well. Government and partners pay for the drugs and the laboratory baseline investigations.
“Why should a mentor mother still be asking for stipend for the service she gave gave to her colleagues who are also HIV positive like her? As individuals, we also need to be paying back to the community. It is high time we came and volunteered at some of our facilities,” he said.
Meanwhile, the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr Ado Muhammed, is optimistic that even with dwindling donor funds, the agency can survive with funds as provided by the National Health Act.
He said: “The National Health Act provides for the Basic Health Care Provision Fund to provide access to basic health care services for Nigerians, the first such fund in the history of the country. This will be disbursed as grants to states.
“The Basic Health Care Provision fund shall be financed from the federal government annual grant of not less than one per cent of its Consolidated Revenue Fund, and grants by international donor partners.
Muhammed added that passage of the Bill is a significant milestone towards achieving Universal Health Coverage (UHC) for all Nigerians.
Source: Leadership Newspaper
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