Drugs are increasingly getting out of reach. The authorities should please help out
Perhaps no critical sector has been impacted by the astronomical hike in the prices of goods and services in the country like the health sector. From common illnesses like malaria fever and headache to chronic ones like high blood pressure, diabetes, kidney, and liver diseases, most of the medications are being priced beyond the reach of the average Nigerian. For some of the drugs, which are being imported, prices have skyrocketed by as many as 200 per cent. The Coordinating Minister of Health and Social Welfare, Mohammed Pate, has his job cut out for him as he seeks a solution to the challenge.
We endorse the reduction of duties on drugs and other ideas being suggested in some professional quarters to address the situation. But we are also aware that it is always a challenge paying for drugs out- of – pocket, even when prices are low or stable. Therefore, the only sustainable solution lies in implementing the mandatory Universal Health Coverage (UCH), including the social component for the aged, retirees and the unemployed. Out- of- pocket spending on health is less than ideal, especially in these tough times when many families are more concerned about where the next meal would come from.
Although many countries, including Rwanda and Ghana, have recorded successes in UHC, it took Nigeria 18 years after first establishing the National Health Insurance Scheme (NHIS) to own a document that now mandates every citizen to be enrolled into an insurance programme for their future health needs. Last year, former President Buhari described the scheme as a path towards providing universal health for at least 83 million poor Nigerians who cannot afford to pay premium. But stakeholders in the health sector still express concerns that there are huge gaps to cover if Nigeria is to attain UHC. “We need to have a metric in terms of how much we are spending, who is getting it, and if there is deviation from what one is supposed to be achieving what happens? Accountability is very important,” said health expert, Gafar Alawode, who recently highlighted the low insurance coverage penetration in the country.
As we noted when the NHIS was signed into law, the bulk of the work lies in its implementation. The repealed NHIS could not grow the scheme beyond five per cent of the population due to lack of political will. As a result, the country was losing hundreds of thousands of its citizens yearly due to inability to pay out- of – pocket expenses for their healthcare. The defining trouble with NHIS at the time was the system-wide inequalities in its implementation, including the lack of cohesion between the federal scheme and the ones promoted by some of the 36 states, private sector, and healthcare providers.
The NHIA, in collaboration with state governments, private sector, healthcare providers, among others must collaborate to ensure that every Nigerian – from the formal to informal sector, to the unemployed, and other bodies – is enrolled into health insurance schemes. With UCH as the goal, all tiers of government, healthcare providers and the various schemes must work together in the interest of Nigerians.
The benefits of a health insurance scheme that works in a country like ours are many. One, the idea of cashless treatment for those insured makes it imperative for them to get immediate treatment during sudden ill-health while the premium paid on health insurance is usually tax deductible. But only a small proportion of Nigerians have prepaid health care. The effectiveness of a UCH would be strengthened with the inclusion of 36 states into the scheme and getting them to setup and manage their own insurance schemes in line with the provisions of the law.
