The 2019 political discourse should be issue- based and bringing health into it is very fundamental because a healthy nation…
Victor Oliver Abel
In accordance with the International Covenant on Economic, Social and Cultural Rights, health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity. Also, everyone has the right to a standard of living adequate for the health of himself and of his family, including food, clothing, housing and medical care and necessary social services. Section 14(2)(b) of the 1999 Constitution (as amended) states that the security and welfare of the people shall be the primary purpose of government.
From the foregoing, it is undoubtedly clear that government owes her citizens the obligation to provide and make available a good health care delivery system that will ensure that everyone enjoys the highest attainable standard of health conducive to living a life in dignity. There could be no better welfare for the people when good health care system is not provided. Therefore, access to other fundamental human rights is completely dependent on the right to life which is made possible by access to good health care system.
According to the World Health Statistics 2018, Nigeria currently has the following health indicators: Life expectancy at birth for Male is 54.7, and 55.7 for female, maternal mortality ratio per 100,000 lives birth is 814, proportion of births attended by skilled health personnel is 43%, under five mortality rate per 1000 live births is 104.3, Malaria incidence per 1000 population at risk is 350, density of physicians per 1000 population is 0.4, density of nursing and midwifery personnel per 1000 population is 1.5, density of dentistry personnel per 1000 population is 0.0, tuberculosis incidence per 100,000 population is 219, prevalence of stunting in children under 5 age is 43.4% etc. With such very poor health indicators, it means that most Nigerians are very far from enjoying the right to health and it calls for a very serious attention as we move towards 2019 election. It is the responsibility of each political party seeking to get power come 2019 to state in clear terms the “WHAT” and “HOW’ strategy to be used in handling the present poor health indicators. The trend of giving mere promises by political parties without stating how those promises will be accomplished should change. The 2019 political discourse should be issue- based and bringing health into it is very fundamental because a healthy nation, they say, is a wealthy nation.
Taking an insight from the present administration manifesto on health, they promised to: (1) Prioritize the reduction of the infant mortality rate by 2019 to 3%; reduce maternal mortality by more than 70%; reduce HIV/AIDS infection rate by 50% and other infectious diseases by 75%; improve life expectancy by additional 10 years on average through the national healthy living program. (2) Increase the number of physicians from 19 per 1000 population to 50 per 1000; increase national health expenditure per person per annum to about NGN50,000 (from less than NGN10,000 currently) (3) Increase the quality of all federal government’s owned hospitals to world class standard within five years (4) Invest in cutting edge technology such as telemedicine in all major health centres in the country through active investment and partnership programmes with the private sector (5) Provide free antenatal care for pregnant women, free health care for babies and children up to school-going age and for the aged and free treatment for those afflicted with infectious diseases such as tuberculosis and HIV/AIDS (4) Boost the local manufacture of pharmaceuticals and make non-adulterated drugs readily available.
Looking at the above promises and what the administration planned to do in the health sector, the “HOW” to bring those wonderful promises were entirely omitted. The same applies to all the other political parties. They state the “WHAT TO DO” without the “HOW TO DO”. The question begging for answer from the above manifesto is: How many years does it take to train a medical doctor if they are to increase the number of physicians from 19 per 1000 population to 50 per 1000? What is the present health budget if they are to increase national health expenditure per person per annum to about NGN50,000 (from less than NGN10,000 currently)? Failure to state how this will be done has often been the challenge of all the political parties in Nigeria.
Therefore, as we prepare for 2019, the right engagement should begin by citizens demanding to know what and how each of the political parties will bring about serious change in the health sector – changes that will improve the present poor health indicators. We should not be carried away by vote buying. We should not forget that the vote we sell will deny us access to good health care system which is our fundamental human right. An ideal political party should carry out research and come up with strong strategies to handle these poor health indicators, come up with effective health financing strategy on how to finance health beyond the annual government budget. Good health insurance package that will provide affordable and accessible universal health coverage for Nigerians should be the norm. Campaigns and other political discourse should be issue-based and not just mere attack and exchange of hurtful words.
According to a World Bank Report of 2014, some African countries that are less endowed in resources dedicated larger percentages to healthcare: Algeria (10.67%), Botswana (8.82%),The Gambia (10.62%), Ghana (7.08%), Guinea Bissau (9.51%), Madagascar (15.61%), Malawi (10.77%), Sierra Leone, (7.86%), South Africa (14.06%), Tunisia (13.57%). Political parties desirous of taking over government come 2019 should study them and find out how they were able to dedicate such percentages to health.
The average budget for health in the last 9 years has never crossed 5%. Based on Abuja Declaration, the Federal Government is to dedicate 15% of the federal budget to health but this has not been achieved since 2010. Based on the 15% projected allocation, from 2010 to 2018, only N2.429 trillion has been budgeted for health as against N7.553 trillion, leading to a funding gap of N5.124 trillion. Unfortunately, the amounts budgeted are never fully released and cash backed. Come 2019, political parties should tell Nigerians how they intend to change this poor provision and implementation of the health sector budget.
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Must we continue going round the circle without any plan to improve health indicators in Nigeria? For how long will a woman die while trying to bring into existence another life? Is it an offence to be born in Nigeria because many children die at the point of birth? When the rich and those in power fly abroad for medical treatment, what becomes the fate of the ordinary Nigerians who cannot afford medical treatment abroad? Health is a fundamental human right and it is the core responsibility of government to respect, protect and fulfill the right. Political parties, therefore, need to tell Nigerians how they plan to fulfill the health right.