Martins Ifijeh
Despite the recurrent bouts of disease outbreaks in Nigeria and the looming threat from Coronavirus, the Nigerian government has deemed it fit to budget a paltry eight naira (2.1 cents) for prevention, diagnosis and management of communicable diseases of each citizen in 2020.
Data exclusively obtained by THISDAY shows that only a meager N1, 673, 486, 127 was allocated to the Nigeria Centre for Disease Control (NCDC), the country’s national public health institute, responsible for epidemic preparedness, detection and response to infectious disease outbreaks and public health emergencies for over 200 million Nigerians.
This implies that the allocated amount (if entirely released) will be spent on preventing and managing Lassa fever, Ebola, Coronavirus (Covid-19) Yellow fever, cholera, meningitis, measles; building, equipping and maintaining of specialised laboratories; administration and human resource for 213 staff; surveillance and epidemiology; emergency disease response; and a host of other mandates of NCDC.
On the surface value, when divided against the 200 million populations, it means the Nigerian government will spend eight naira per person yearly, which amounts to 66 kobo per month, an unrealistic amount it magically hopes will prevent Nigerians from contracting or dying from the myriads of epidemics currently being battled or lurking around the corner.
Meanwhile, NCDC’s counterpart in the United States, the Centre for Disease Control (CDC) will spend $6.594 billion on epidemic preparedness this year, which is about N2.34 trillion, an amount that exceeds Nigeria’s entire Federal Ministry of Health allocation for five years.
This means, if the CDC budget is spread across the population, the centre will spend at least 20 dollars (N7, 200) on epidemic preparedness for every American resident, while Nigeria, a country which prides itself as the giant of Africa and the economic hub of the black continent, will spend eight naira on same disease prevention and management in a full year per citizen.
This perhaps explains why the country has continued to battle with disease outbreaks, including Lassa fever, which has, since January 2020, killed 47 Nigerians with hundreds of persons infected across 19 states of the federation.
Covid-19, which started from Wuhan city in China has killed at least 1100 persons, infected over 4400 persons and has spread to 27 other countries, with Nigeria listed by the World Health Organisation (WHO) as a high risk country for the spread. It is unclear if the Nigerian government considers international public health threats when budgeting for epidemic preparedness.
When THISDAY reached the Chief Executive Officer, NCDC, Dr. Chikwe Ihekweazu to get his thought on this, he said the centre has continued to work optimally to ensure effective prevention, detection and management of disease outbreaks across the country, but the public health institute will achieve its mandate more if given a special status because of its importance to the nation.
Ihekweazu said: “Our primary challenge is that NCDC is still funded the same way all other agencies are funded. What we should advocate for is a special status enabling first line funding to ensure stability of funding with appropriate controls similar as for police.”
He described the method as 3s; substantial, stable and sustainable funding.
Records have shown that many developed countries give their disease control agencies the special status they deserve, especially because of their roles to health, security and economy. NCDC is responsible for Nigeria’s national health security.
Like NCDC, like the Health Ministry
The Nigerian government’s poor financial allocation for the health of its citizens is not limited to budget for epidemic preparedness. The entire health sector is also battling with poor government funding, a decision that has played out in the health indices of the country.
The health sector generally has had one of the lowest budget allocations in the country, even far lower than sectors relatively not as crucial as the health sector.
This is despite the pledge made by the country in April 2001 during the ‘Abuja Declaration’ where it, along with other heads of state under the African Union platform, declared to increase health budget allocation to 15 per cent of the entire national budget every year.
Unlike the big brother clout which Nigeria used in bringing these countries together to make the now famous ‘Abuja Declaration’, where the agreement was made, the country quickly made a volte face and has since then refused to honour an agreement it played host to 19 years ago, resulting in the poor health indices, high mortality rate and reduced life expectancy rate currently experienced in the country.
Since the Declaration, the highest health allocation for Nigeria was in 2012 where 5.95 per cent was allotted to the sector. In 2014, it allocated N216.40 billion to healthcare, representing 4.4 per cent. In 2015, it was N237 billion, which represents 5.5 per cent of the entire budget, same with 2016 (4.23 per cent), 2017 (4.16 per cent), 2018 at 340.5 billion (3.9 per cent), and 2019 at N315.6 billion (4.1 per cent).
Like a habit which has now been considered normal, the Nigerian government, again in 2020, followed the same trend with only 4.14 per cent of the entire budget allocated to the health sector, amounting to N427 billion; an allocation less than 25 per cent of what CDC alone will spend on epidemic preparedness.
But the World Health Organisation (WHO) says for Nigeria to be seen to have prioritised healthcare, it must at least spend a minimum of N6, 908 per Nigerian in a year, which when multiplied by 200 million people will amount to N1.38 trillion, which is around 12 per cent of Nigeria’s entire budget for 2020.
The WHO, in its wisdom, also recommended a minimum of 13 per cent of annual budget for health.
Between African Union’s 15 per cent and WHO’s 13 per cent, the Nigerian government has tilted towards none.
Thankfully, some countries have started raising their health budgetary allocations towards fully keying into the WHO recommendation of 13 per cent or the Abuja Declaration of 15 per cent.
For instance, Rwanda reportedly devoted 18 per cent of its total 2016 budget to healthcare. Botswana budgeted 17.8 per cent to health; Malawi, 17.1 per cent, Zambia, 16.4 per cent and Burkina Faso, 15.8 per cent. But Nigeria still lags behind in this regard, which has had direct consequences on the funding capacity of the Health Ministry and its affiliated agencies and parastatals, thereby making the fight against poor healthcare very unrealistic.
This puts Nigeria as one of the nations of the world with the least healthcare spending per head when compared with other countries, especially in Africa.
