By GREGORY T. OKERE
Inequality in the healthcare system of Nigeria can be defined as discrimination or imbalance in the medical care of individual citizens of Nigeria. It can also be defined as the unfair sharing of the medical provisions made available for Nigerian citizens through the constitution, the Federal Ministry of Health and other departments and agencies, the effect of which drags the majority of the citizenry to financial hardship, underdevelopment and mass poverty. Universal Health Coverage (UHC) is ensuring that people have access to the health care they need without suffering financial hardship. It also helps drive better health and development outcomes.
Quality and affordable health care is the foundation for individuals to enjoy productive and fulfilled lives, and for countries to have strong and unwavering economies. In recent years, the UHC movement has gained global momentum, with the World Health Assembly and the United Nations General Assembly calling on countries, including Nigeria, to urgently and significantly scale up efforts to accelerate the transition towards universal access to affordable and quality healthcare services.
Universal Health Coverage is the key to achieving the World Bank Group’s (WBG) twin goals of ending extreme poverty and increasing equity and shared prosperity. It is also an essential part of the Sustainable Development Goals (SDGs). One of the cardinal interests of Sustainable Development Goal includes a target to achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, affordable and essential medicines and vaccines for all. Thus, the goal to end poverty in all its forms everywhere is in peril without UHC, as hundreds of millions of people are impoverished by healthcare costs every year.
Health is a human right; the government of Nigeria owes it a duty to provide healthcare for its citizens. Kate Gilmore, the United Nations Deputy High Commissioner for Human Rights, in an interview with United Nation’s News, on October 24, 2017 said “We see health not only as the absence of disease and not only a question of access to services, but in fact the right to be human in a manner that you have your physical and mental integrity upheld.”
In recognition of the mandatory equal health provisions accruing to every human being and citizens of the various countries of the world, Article I of the Universal Declaration of Human Rights (UNDHR) provides thus: “All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”
Also, Article 25 (1) of UNDHR provides as follows: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
Also, section 16 (2) (d) of the Constitution of the Federal Republic of Nigeria 1999 (as amended) provides: that “suitable and adequate shelter, suitable and adequate food, reasonable national minimum living wage, old age care and pensions, and unemployment, sick benefits and welfare of the disabled are provided for all citizens. However, the above provision of the UNDHR as well as the constitution has not been observed and practised by the government at all levels and tiers in Nigeria, maybe because the provision is non- justiciable or, perhaps Nigerian citizens, particularly the masses at the grassroots who form the greater number of the Nigerian population, are not aware that such rights exist in the Nigerian constitution.
Thus, it is hereby recommended that (a) the incumbent legislature, both at the Federal and State Levels should amend Chapter Two of the Constitution of the Federal Republic of Nigeria to become justiciable before the end of its tenure, (b) the Human Rights Ministries, Departments and Agencies (MDAs), as well as Civil Society Organisations (CSOs) and health workers should intensify efforts towards educating the greater number of the Nigerian population about their rights to healthcare and the importance of Universal Health Coverage.
In conclusion, all levels of government should intensify efforts towards achieving international best practices in the area of healthcare through Universal Health Coverage for all and sundry.
Okere writes from Centre for Social Justice, Abuja.