MDG target:15% fund injection into nation’s health sector imminent

…Experts say inadequate financing may worsen healthcare

While healthcare needs seem to be on the increase, government expenditure on health in developing countries appears to decline. This has resulted in a situation whereby as the teeming population gets older, as more people suffer chronic diseases like hypertension, diabetes, and as new and more expensive treatments appear, health costs seem to soar.

Even as the target set for countries attaining the Millennium Development Goals (MDGs) vis-a-vis improving healthcare, environmental sustainability, reducing infant and maternal mortality barely four years away, recent reports by the World Health Organisation (WHO) leaves nothing to cheer as most member countries of African Union (AU) are not yet on track to achieve the health-related MDGs.

A scorecard released by the WHO entitled: “The Abuja Declaration: Ten Years On,” revealed that only Rwanda and South Africa have achieved the Abuja Declaration target adopted by the African Union (AU) in April 2001 to increase government’s health funding to at least 15 percent.

The global health body also identified Nigeria among 46 African countries to have failed in meeting the Abuja Declaration- made in April 2001 by heads of state of AU countries that met and pledged to set a target of allocating, at least, 15 percent of their annual budgets to improve the health sector, while at the same time, urging donor countries to increase their funding levels - and one of the 38 countries that are off-track in meeting the health-related goals of the United Nations (UN) set Millennium Development Goals (MDGs) by 2015.

In view of this arduous reality, health experts have called for increased budgetary allocation to the health sector if it is to operate at optimal capacity, deliver healthcare to millions of Nigerians and meet the MDG target.

In an interview with BusinessDay, Edamisan Temiye, chairman, Nigerian Medical Association (NMA), Lagos State Branch, disclosed that Nigeria hasn’t met AU’s commitment in Abuja in 2001 to spend 15 percent of its national budget to health as only N34 billion representing about seven percent was proposed in the sector for 2011 budget.

Temiye revealed that it is believed that 70 percent of the nation’s health budget is spent in urban areas where about 30 percent of the population resides. He noted that to actualise the MDG target and solve most of health care problems, Nigeria is expected to spend 15 percent of its total budget on health.

In his words: “ Nigeria ’s allocation to the health sector in the 2009 budget was N39.6 billion (out of N796 billion earmarked for capital expenditure the same year). If you cast your mind back, N114billion has been spent by Bill Gates in eradicating Polio in Nigeria . Gates has spent N1.2 trillion on polio eradication globally. This amount is one-third of Nigeria ’s 2010 budget of N4.079 trillion.”

Lending his view, Emeka Okeke, MD Havanna Hospitals, described as worrisome the inability of the Federal Government to meet up the 15 percent health funding of the health sector as about 50 percent of Nigerians have chances of dying from minor illnesses due to environmental factors.

For Saheed Babajide, secretary general, Association of Resident Doctors, Lagos State University Teaching Hospital (LASUTH), the health sector takes less than four percent of the national’s budget which is inadequate in delivering the minimum health delivery.

Babajide disclosed that if the sector can get 25 percent of budget allocations, it will go a long way in improving healthcare delivery in all tiers of government - local, state and federal- in the sense that one would no longer travel outside the country for medical attention.

“In this case, all levels of healthcare- from the primary, secondary and tertiary levels- will be improved. Don’t forget that adequate equipment and the enabling environment for better health care delivery will be provided with these funds which will in turn reduce mortality rate in the country. Don’t forget that this will also improve health research which is currently being underfunded by government and has left some of these research centres at the mercies of foreign agencies and grants,” Babajide said.

Available records on the progress made since 2001 in the AU countries on government spending on health show that Nigeria is one of the 17 African countries that spent less than $33 per capita as health share of total government spending. Sadly, Nigeria shares this unenviable league with countries like Burundi , Chad , Liberia , Mali , Uganda and Zambia to name but a few.

It is unfortunate that in spite of the nation’s health challenges, financing of the sector remains a bottleneck in the national budget. The consequences of this are glaring; the country still grapples with high incidence of malaria, tuberculosis and other water borne diseases. Diseases that have been eradicated elsewhere, including polio, still ravage the Nigerian populace.

Part of the nation’s health problem is mismanagement of resources which is possibly why some refurbished hospitals in the country referred to as “centres of excellence” are yet to deliver excellent medical services while some of these hospitals have refurbished equipment which do not meet the required standard. Little wonder there is surge of Nigerians seeking medical attention in India and other countries.

As good health is essential to human welfare and to sustain economic and social development, domestic health financing systems must be robust enough to attain and sustain increased coverage. No doubt, direct payments required when people obtain care (e.g. user charges) prevent many people from seeking care in the first place, and may result in financial catastrophe, even impoverishment, for many.

verage requires raising the bulk of funds through forms of prepayment (e.g. taxes and/or insurance), and then pool these funds to spread the financial risk of illness across the population. The current National Health Insurance Scheme (NHIS) coverage should extend beyond blue chip companies and the formal sector to the informal sector in order to ensure that a vast majority of the population have access to healthcare at a minimal cost.