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COVID-19: Urgent Need for African Governments to Upgrade Health Systems

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map of africa

By Kester Kenn Klomegah

Amid multifold theories and disinformation spreading around the COVID-19 in Africa, it is important for African governments to consider strengthening the existing health systems and infrastructures, and allocate substantial funds for health research and production of basic equipment, for attaining sustainable development goals set in the African Agenda 2063, according to experts.

Over the years, most African countries with the exception of South Africa, Botswana and a few others have not improved much on their healthcare system since independence, partly as a result of pure negligence on the part of senior officials who prefer to be treated abroad. The leaders of Cameroon, Nigeria and Zimbabwe are notorious for spending long periods of time abroad in hospitals, according to Dr Chipo Dendere, Zimbabwean Professor of African Politics at Wellesley College in Massachusetts.

As Dendere further noted in a discussion with IDN, “African leaders have to start thinking seriously about issues of healthcare or people will die. They have to realize that going abroad is no longer an option. In all, it is significant for the leaders to focus on financing sustainable public health system, make investment in the health sector using public and natural resources. Public/private partnerships have never hurt, but have to be seriously considered”.

Particularly because Africa’s population is growing, and presents future health challenges, she added. Dendere, however, stressed that various debt relief efforts by international organizations should not be an end itself, and instead African leaders must necessarily look for long-term solutions for existing pitfalls in the sector.

In the month of April, the International Monetary Fund (IMF) and the World Bank (WB) have offered debt relief to African countries. The IMF is set to provide $11 billion to 32 countries in sub-Saharan Africa that have requested assistance in fighting the coronavirus pandemic and its impact on the region’s economies.

These steps by the IMF and its partners – the World Bank, World Health Organization, the African Development Bank and the African Union – will support domestic measures including transfers to vulnerable households, monetary and fiscal policy responses, Abebe Aemro Selassie, the director of the IMF’s African Department, said in a statement.

In a similar argument, Charles Prempeh, a lecturer in Africana Studies at the African University College of Communications (AUCC), Accra and doctoral candidate at the University of Cambridge, explained in an email to IDN that there are a lot of deficiencies – ranging from poor health policies through inadequate funding of health infrastructure to training and research – that have characterized the health sector in Africa.

In his view, amid the fast spreading coronavirus in some regions, it is simply “providential” that the African continent has not recorded high numbers, compared to the western countries. But it is also true that even with the relatively smaller number of cases that most countries in Africa have recorded, they have come under disproportionate strain.

Prempreh argued that over the years, many African leaders travelled abroad (including South Africa) in search of medical care. While many African countries have research institutions, designed for studying so-called orthodox and indigenous medicines, the existence of these institutions has not yielded the expected results of enhancing the quality of healthcare on the continent, he said, adding: “In many cases, these health research institutions have been starved of funding.”

Consequently, many countries in Africa are looking up to the west to find an antidote to COVID-19 that has held the world hostage. This has implied that few Africans have invested in exploring the extent to which indigenous medicine could potentially provide an answer to the current health crisis. It is, therefore, not surprising that the COVID-19 pandemic provides lenses to peep into the deep cracks in the entire health system in Africa. It also provides important lessons for African leaders to learn now to invest in the health sector, Prempreh concluded.

Beyond all the arguments raised above, Dr Antipas Massawe, a former lecturer from the Department of Chemical and Mining Engineering, University of Dar es Salaam in Tanzania, East Africa, strongly insisted that “the scale of the challenges facing the health sector is tremendous, it requires extensive investment of resources and state to direct focus on the development agenda”.

Acknowledging that Africa is a huge continent of vast inequality where almost two-thirds still live in abject poverty and years of neglect has left the health system in tatters, Massawe added: “As compared with most of the other advanced countries that have global competitive healthcare systems, African countries spend peanuts within the budget on bolstering health infrastructure in Africa.”

The African governments should create the environment conducive for the evolution of competitive healthcare systems through prioritization. Governments have to work toward the empowerment of wealth creation endeavours, adopt system approach that would enable to understand the interdependence of African problems and outline how to tackle questions of the largely weak health as fast as possible, he suggested.

The Economic Commission for Africa (ECA), in a new report on the coronavirus pandemic, underscored that the economic implications of this disease are detrimental not only to public health systems but also the economy and sociocultural lives of the entire population of Africa.

The ECA makes explicitly clear that as the pandemic continues to impact the continent’s struggling economies whose growth are expected to slow down from 3.2 percent to 1.8 percent, within this short period it is likely to push close to 27 million people into extreme poverty.

The report launched virtually in mid-April titled, “COVID-19: Protecting African Lives and Economies” says Africa’s fragile health systems could see additional costs being imposed on them because of the growing crisis that has to-date, resulted in thousands infected Africans.

Dr Vera Songwe, UN Under-Secretary-General and Executive Secretary of ECA said: “To protect and build towards the Continent’s shared prosperity, $100 billion is needed to urgently and immediately provide fiscal space to all countries to help address the immediate safety net needs of the populations.”

Africa, notes Songwe, is particularly susceptible because 56 percent of its urban population is concentrated in slums or “informal” dwellings and only 34 percent of African households have access to basic handwashing facilities. Among others, she proposes that intellectual property on medical supplies, novel testing kits, and vaccines be shared to help Africa’s private sector play its role in the response, and most importantly policies must be firm and clear on good governance to safeguard health systems, ensure proper use of emergency funds.

In a widely circulated letter, various co-signatories in April, including 100 leading academics and writers, have called on African leaders to govern with compassion and see the current global health crisis as a chance for a radical change of direction. “Like a tectonic storm, the COVID-19 pandemic threatens to shatter the foundations of states and institutions whose profound failings have been ignored for too long. It is impossible to list these, suffice it to mention chronic under-investment in public health” in Africa notes the letter.

As a continent that is familiar with pandemic outbreaks, Africa has a head start in the management of large-scale health crises. But the belief is that “emergency” cannot and should not constitute a mode of governance. Beyond the state of emergency, however, African leaders can and should propose to their societies a new political idea of Africa, says the letter.

In consequence, it continues, the coronavirus pandemic reveals the deficit of a collective continental response, both in the health and other sectors. More than ever, we call upon leaders to ponder the necessity to adopt a concerted approach to governance sectors related to public health, fundamental research in all disciplines and to public policy.

In the same vein, health has to be conceived as essential public good, the status of health workers needs to be enhanced, hospital infrastructure needs to be upgraded to a level that allows everybody, including leaders themselves, to receive adequate treatment in Africa. Furthermore, failure to implement these reforms would be cataclysmic. For it is in the most trying moments that new/innovative orientations must be explored and lasting solutions adopted.

Today, Africa comprises 54 sovereign countries, most of which have borders that were drawn during the era of European colonialism. In the 21st century, however, the number of armed conflicts in Africa has steadily declined.

The improved stability and economic reforms have led to a great increase in foreign investment in many African nations, mainly from China, which has spurred quick economic growth in many countries, seemingly ending decades of stagnation and decline. Africa is now at risk of being in debt once again, particularly in sub-Saharan African countries.

Although it has abundant natural resources, Africa remains the world’s poorest and least-developed continent, the result of a variety of causes that may include corrupt governments and policies fraught with dubious methods. Africa is the world’s second largest and second-most populous continent after Asia. With an estimated 1.3 billion people as of 2019, it accounts for about 16% of the world’s population.

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NHIA Says 22 million Nigerians Now Have Health Insurance Coverage

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National Health Insurance Authority NHIA Health Insurance Coverage

By Adedapo Adesanya

The National Health Insurance Authority (NHIA) says the number of Nigerians enrolled in health insurance has risen to more than 22 million.

The Director-General of NHIA, Mr Kelechi Ohiri, said this resulted from the implementation of the mandatory health insurance, which has gained momentum nationwide.

He said this on Wednesday at the Annual General Meeting of the Nigerian Association of Insurance and Pension Editors (NAIPE) in Lagos.

Mr Ohiri said enrolment had increased to 22.03 million, representing a 35 per cent year-on-year growth, attributing this to stronger collaboration with state social health insurance agencies, ministries, departments and agencies, organised labour, employers, the private sector, and the gradual implementation of the mandatory health insurance provisions of the NHIA Act.

He said that the country had moved beyond policy formulation to delivering measurable improvements in healthcare access, service quality and consumer protection in line with the federal government’s health sector reform agenda.

According to him, Nigeria already has the necessary policies and legislation to achieve Universal Health Coverage, positing that the key challenge was effective implementation.

“The decisive variable is now implementation- consistent, rigorous and accountable execution that converts political commitment into healthcare access for real Nigerians,” he said.

Mr Ohiri said that the transition from the former National Health Insurance Scheme to the NHIA had strengthened regulation, consumer protection, accountability and strategic purchasing, while providing the legal and operational framework for achieving Universal Health Coverage.

He added that improving the experience of enrollees remained central to the Authority’s reform agenda.

According to him, NHIA has strengthened its complaints management system, introduced faster resolution timelines, and intensified compliance monitoring of Health Maintenance Organisations (HMOs) and healthcare providers.

He further added that NHIA had sanctioned facilities that failed to meet the required standards, adding that his organisation had resolved 3,878 complaints, representing an 87 per cent resolution rate, while 95 per cent of the cases were concluded within prescribed timelines.

Mr Ohiri noted that more than N14.2 million had been refunded to enrollees, while non-compliant healthcare facilities had been sanctioned.

He said NHIA had also introduced service standards, including a one-hour treatment commencement target for enrollees requiring urgent care, to improve access to timely and quality healthcare services.

The NHIA boss further disclosed that capitation payments to healthcare providers had been increased by 93 per cent.

He said fee-for-service reimbursements rose by 378 per cent to enable providers to invest more in personnel, equipment and infrastructure.

According to him, 7,592 healthcare facilities have been assessed under the SafeCare quality framework as part of efforts to institutionalise continuous quality improvement across the country.

Mr Ohiri also highlighted interventions targeted at vulnerable groups, including support for more than 48,500 pregnant women, expanded maternal and newborn healthcare services, the Vulnerable Group Fund, and improved access to healthcare for pensioners and retirees.

He said Universal Health Coverage could only be achieved if every Nigerian, regardless of income or location, had access to quality healthcare services.

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SUNU Health Backs NHIA’s One-Hour Authorisation Policy

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One-Hour Authorisation Policy

By Modupe Gbadeyanka

The new one-hour authorisation response time ultimatum policy introduced by the National Health Insurance Authority (NHIA) has received the full backing of SUNU Health Nigeria Limited.

This policy was introduced by the agency to ensure enrollees get prompt approval codes to access care.

Healthcare service providers have been urged to report any Health Maintenance Organisation (HMO) that violates this initiative through an email, with the HMO in copy and a timestamp attached as evidence of the request. They may proceed to offer services to enrollees thereafter.

Speaking at the company’s second-quarter Providers’ Forum for the Lagos-Ogun region in Lagos recently, the chief executive of SUNU Health, Dr Moyosore Olomola, expressed optimism that this policy would improve healthcare delivery in the country, especially for enrollees, who crave quality service.

At the event themed Improving Quality and Access to Care Through Stronger Provider Network, and held at the Nigerian Institute of Medical Research (NIMR) in Yaba, Lagos, Mr Olomola reaffirmed the HMO’s commitment to operating within legal and operational frameworks to guarantee adequate care for enrollees.

“Access to care and quality of care remain key priorities in our healthcare systems. We know quite well that deliberate collaboration, strategic partnerships, and a shared commitment to excellence are required to achieve these priorities.

“A strong provider network is doubtless the backbone of any effective healthcare system. It ensures that our mutual enrollees receive the right care, at the right time, in the right place, and at the right price,” Mr Olomola, represented at the programme by the organisation’s Chief Operating Officer (COO), Dr Faith Nwachi, stated.

He further assured that SUNU Health would strictly adhere to the one-hour authorisation limit, stressing that this aligns seamlessly with one of the organisation’s core values—promptness and its corporate slogan, Humanity is the centre of our initiatives.

In a bid to further improve access and quality of care, SUNU Health also demonstrated its new operational software and Mobile app, aptly named SUNU Legacy.

Also speaking at the event, the NHIA Lagos State Coordinator (Ikeja), Dr Bethuel-Kasimu Abraham, noted that the forum’s expected outcome is to significantly reduce delays in accessing medical care.

Other key expectations include ensuring continuity of care, improving patient outcomes, and strengthening accountability among HMOs.

Addressing specific pain points faced by enrollees, the NHIA Ogun State Coordinator, Mr Dare Adefeso, acknowledged that the agency had received complaints regarding out-of-stock drugs and the discrimination of enrollees by certain providers.

He affirmed that the NHIA is actively addressing these issues, stressing that moving forward, every facility must ensure enrollees are properly catered to regardless of their status, provided they have an active health insurance plan.

Corroborating the long-standing legacy of SUNU Health, the Ogun State Director of the National Orientation Agency (NOA), Mrs Aishat Tiamiyu, shared that her agency is responsible for public information dissemination and has been enrolled with SUNU Health for over 25 years.

Commending the HMO’s stellar service over two decades, she called for the immediate enrollment of new NOA staff into the scheme.

The Providers’ Forum remains one of the strategic channels employed by SUNU Health to consistently engage healthcare providers, understand their operational challenges, introduce new software updates, and solidify partnerships aimed at fostering premium healthcare delivery across Nigeria.

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NAFDAC Announces Recall of WAP Sensual Enhancement Capsules

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WAP Sensual Enhancement Capsules

By Aduragbemi Omiyale

The National Agency for Food and Drug Administration and Control (NAFDAC) has announced the recall of a sexual enhancement product known as WAP Sensual Enhancement Capsules.

In a statement on Monday, the Nigerian agency disclosed that the recall is due to “undeclared pharmaceutical ingredients” in the product, whose country of origin is unknown, but is marketed and distributed online in the US through eBay.

It was emphasised that the recall is being “voluntarily” made by the manufacturer, Best Supplements Best Prices Company.

The detection of the undeclared pharmaceutical ingredients was made by the US Food and Drug Administration (FDA).

Laboratory analysis by the US FDA revealed that the product contained undeclared sildenafil, tadalafil, and flibanserin, which were not mentioned on the product label. Such substances may include phosphodiesterase type-5 (PDE-5) inhibitors or related compounds commonly used for the treatment of erectile dysfunction, the statement by NAFDAC stated.

Sildenafil and tadalafil are ingredients in FDA-approved prescription drugs used to treat erectile dysfunction.

It was noted that these undeclared ingredients may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates.

Flibanserin is the active ingredient in an FDA-approved prescription drug used to treat low sexual desire in women. Flibanserin can cause drowsiness, sedation, dangerously low blood pressure, and fainting, especially when combined with alcohol.

Consumers have been encouraged to report compromised products (medicines or medical devices) to the nearest NAFDAC office, call 0800-162-3322, or send an email to sf******@********ov.ng.

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