By Adedapo Adesanya
The World Health Organization (WHO) has expressed its desire to support Nigeria in operationalising the National Health Insurance Authority (NHIA) Act 2022 signed by President Muhammadu Buhari in May 2022.
WHO’s Country Representative (WR), Dr Walter Kazadi Mulombo, made this pledge during a high-level meeting with the Secretary to the Government of the Federation (SGF), Mr Boss Mustapha, the Director General, National Health Insurance Authority (NHIA), Professor Mohammed Sambo, and a team of WHO Health Financing Mission delegates from the WHO Geneva, Africa Regional Office, and Nigeria.
The first ever high-level WHO Health Financing Mission to Nigeria, led by Dr Joseph Kutzin, was scheduled to provide sustainable health financing support to the country towards Universal Health Coverage (UHC) and health security while undertaking targeted advocacy to accelerate operationalization of the NHIA Act including the Vulnerable Group Fund (VGF).
This is in line with WHO’s goal of ensuring that all individuals and communities receive the quality health services they need without suffering financial hardship.
Dr Mulombo said President Buhari’s signing of the NHIA Bill into law will make health insurance mandatory for all legal residents in Nigeria and expands coverage to over 83 million poor and vulnerable people.
He expressed the optimism that government will prioritize immediate appropriation of the Special Intervention Fund in the Act to establish the Vulnerable Group Fund.
“Indeed, the task of ensuring that all citizens have access to the quality healthcare they need without falling into poverty is a deliberate political decision to achieve the cardinal objectives of population coverage, service coverage, and financial protection. I have no doubts that in a large federal nation like Nigeria, this milestone of appropriating the Special Intervention Fund will be achieved in the 2023 fiscal year”, he said.
In his remarks, Mr Mustapha appreciated WHO as the foremost development partner to Nigeria on health and lauded WHO’s invaluable guidance, particularly on the COVID-19 pandemic.
“WHO has demonstrated that it is an organization that cares for and caters for the health needs of the people. On the NHIA, let me commend the DG for his tenacity and determination to have this Act come to fruition. I want to thank WHO and other partners who supported in the drafting of the Bill. This modest attempt has provided basic health insurance coverage to the vulnerable, and making it mandatory will go a long way in assisting our people to manage their income and remain at work in terms of the depressed economy we are witnessing”.
The SGF further expressed the government’s commitment to appropriate the Special Intervention Fund (SIF) in the 2023 national budget for the establishment of the Vulnerable Group Fund (VGF).
“No family in Nigeria has economically survived catering for any of their own suffering from cancer. The health of our people is therefore topmost on our priorities despite competing demands”, he stated.
WHO, Edo Intensify Response to Combat Monkeypox
By Adedapo Adesanya
The World Health Organisation (WHO) and the Edo State government have intensified a coordinated response to contain the spread of the Monkeypox disease.
So far, Nigeria has reported 357 suspected cases with 133 confirmed monkeypox cases from 25 states – Lagos, Adamawa, Delta, Rivers, Edo, Bayelsa, Nasarawa Plateau FCT, Ondo, Anambra Cross River, Kwara, Borno, Taraba, Oyo, Imo, Kano, Katsina, Gombe, Niger Ogun, Kogi, Bauchi, Akwa Ibom and Abia.
Meanwhile, eight persons have so far tested positive for monkeypox in Edo state, and all the people diagnosed with the disease have recovered.
The Director, Public Health, Edo State Ministry of Health, Dr Ojeifo Stephenson, said it has become imperative to warn the residents of the state about the health risks that the virus poses and reiterate the need to be cautious and adhere to preventive measures.
He said the state Ministry of Health with support from the World Health Organization (WHO) and partners, has ramped up surveillance, diagnostics and other activities to curb the spread of infectious diseases.
“We have stepped up surveillance including prompt investigation of suspected cases, facilitating documentation of contacts, contact tracing and monitoring, as well as developed and disseminated public health advisory to raise awareness about the disease among residents of the state,” he said.
Additionally, Dr Benson Okwara, who works at UBTH, said WHO has been an invaluable partner in the response to monkeypox diagnosis and treatment in the facility.
Dr Okwara has five years of experience in managing patients with monkeypox.
He lamented that the disease spreads within the communities because of the poor health-seeking behaviour and late presentation of the case to the hospital.
“However, with WHO’s coordination, there is an early response following notification of suspected/confirmed cases with detailed case investigations using the monkeypox case investigation form (CIF) to collect data on patient contacts.
“There is a need for continuous risk messaging to educate people about infectious diseases and the importance of seeking medical care early and at appropriate health facilities to prevent the spread of diseases,” he said.
Across Nigeria, the Nigeria Centre for Disease Control (NCDC), supported by WHO, has activated Monkeypox Emergency Operations Centre to strengthen in-country preparedness and contribute to the global response to the outbreak.
Furthermore, WHO is supporting the coordination of technical assistance and operational support of partners, including the national One-health risk surveillance and information sharing (NOHRSIS) group, to facilitate timely information exchange on all prioritized zoonotic diseases.
Monkeypox is a zoonotic disease endemic in Nigeria and some parts of Africa.
However, there has been sporadic spread to other countries as more than 16,000 cases of monkeypox have been reported across more than 70 countries so far this year, and the number of confirmed infections rose 77 per cent from late June through early July.
The virus is being transmitted from animals to humans.
Recently, WHO activated its highest alert level for the growing monkeypox outbreak, declaring the virus a public health emergency of international concern.
Monkeypox: Russians Are Back With Cheap Health Publicity
By Kestér Kenn Klomegâh
With rising cases of the monkeypox virus, Russians are back seeking again cheap health publicity in Africa. Just as Foreign Minister Sergey Lavrov completed his four African-nation tours, Russia plans to send monkeypox test kits to Egypt, Uganda, Ethiopia and Congo.
Russian consumer health watchdog Rospotrebnadzor said in a media statement that Russian test systems to diagnose monkeypox would be provided to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July.
“Rospotrebnadzor is continuing to extend support to partner countries’ efforts to counter the spread of monkeypox. Test systems produced by Rospotrebnadzor’s Vector Research Center will be handed over to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July,” the press service said.
“Furthermore, Rospotrebnadzor specialists are arranging special workshops for colleagues from partner countries that deal with laboratory methods to diagnose monkeypox,” it said.
Rospotrebnadzor said earlier that the Vector Research Center had produced monkeypox test kits, and such testing is currently available in all Russian regions.
Monkeypox is a rare infectious disease, most common in remote parts of Central and West Africa. Its symptoms include nausea, fever, rash, itch and muscle pain.
On July 12, Rospotrebnadzor announced the first national case of monkeypox: the patient had returned from Portugal. His symptoms were mild and did not endanger the patient’s life. Rospotrebnadzor said that all his contacts had been promptly identified and were under medical monitoring. The threat of spread has been contained.
Faced with a surge in monkeypox cases, the World Health Organization (WHO) has already declared the outbreak of monkeypox as a global health emergency — the highest alarm it sounded. Monkeypox has affected over 15,800 people in 72 countries, according to a tally by the US Centers for Disease Control and Prevention (CDC) published on July 20.
WHO, however, warned against discrimination. “A failure to act will have grave consequences for global health,” Lawrence Gostin, the director of the WHO Collaborating Center on National and Global Health Law, said on Twitter.
Some experts have asked why Russians have not chosen African countries such as Nigeria, or regions such as Central and West Africa where the virus is currently spreading most. But have listed as priority countries that Sergey Lavrov visited on 24-27 July: Egypt, Ethiopia, Uganda and the Republic of the Congo.
Is COVID-19 Pandemic Over? How Nigeria Can Prepare for Possible Future Pandemics
Although COVID-19 cases dropped significantly in Nigeria within the past year, cases are beginning to rise again.
Just recently, the Nigeria Centre for Disease Control (NCDC) recently reported 347 cases of COVID-19 and Lagos alone accounts for 265 (76%). This begs the question of how ready Lagos and the entire country are to quickly curb the spread of the virus or any other epidemic that may arise.
The initial outbreak of the Covid-19 pandemic and the resultant lockdown showed how unprepared and unequipped the Nigerian health sector was.
Although the NCDC responded remarkably well, much more could have been better if we were prepared. At a health security policy dialogue put together by Nigerian Health Watch in Abuja recently, Peter Hawkins Country Representative of UNICEF made an impressive remark on NCDC’s response.
He said, “We can affirm that Nigeria did a remarkable job to contain the COVID-19 pandemic. NCDC for instance stretched and brought on its a-game despite the challenges in the sector. Also, many initiatives like the Coalition Against COVID-19 (CACOVID) were timely interventions by the Federal Government and private institutions.”
He also added that “whilst we got several things right, much more could have been done. Knowing that the pandemic is not over, and we might be at the beginning of many other, there is a need to tighten efficiency within the sector.”
According to a WHO report, the devastating human, economic, and social cost of COVID-19 has highlighted the urgent need for coordinated action to build stronger health systems and mobilize additional resources for pandemic prevention, preparedness, and response (PPR).
World Bank’s Board of Executive Directors have also approved the establishment of a financial intermediary fund (FIF) that will finance critical investments to strengthen pandemic PPR capacities at national, regional, and global levels, with a focus on low- and middle-income countries.
It is believed that the fund will bring additional, dedicated resources for PPR, incentivize countries to increase investments, enhance coordination among partners, and serve as a platform for advocacy. This is indeed a welcome initiative!
Whilst the rest of the world is girding up and investing in the health sector to get prepared for a possible future pandemic outbreak, Nigeria must not be left behind. Here are three key things we must consider:
Increase funding for epidemic preparedness: Ifeanyi Nsofor, a public health doctor and Senior New Voices Fellow at the Aspen Institute, Washington DC. Recently opined that indeed, it is cheaper to prevent and detect than to respond to an infectious disease outbreak.
COVID-19 has shown how the impacts of pandemics go beyond the health sector. He believes that a simple way to implement this is via a budget line item called “epidemic preparedness” and then defines what that covers.
He stated that, “For example, in local councils, it could cover the cost of provision of clean water in health facilities, setting up a good waste disposal system for communities, stipends for community health volunteers who are the first line in reporting infectious disease outbreaks.
“The state government’s epidemic preparedness budget could cover recruitment and deployment of different cadres of health workers to last-mile health facilities, setting up and equipping state government-owned laboratories, health communications, advocacy interventions, etc.
“The federal government should budget and allocate more funds to NCDC to support its efforts to prevent and detect infectious disease outbreaks.”
Invest in Human resources: The level of brain drain, and the massive exodus of doctors and other medical practitioners is worrisome, especially at a time like this. The president of the Nigerian Medical Association in an interview revealed that “Over 50 per cent of our doctors are outside the country, we estimate that about 80 thousand Nigerians have been trained as doctors but only about 40 thousand are at home. And these surely are not enough and adequate.”
This is a scary figure for a country looking to improve its health sector. Also at the just concluded policy dialogue by Nigeria Health Watch, many medical experts alluded to the fact that sealing the big black hole in managing human resources in the sector is a critical part to look at as Nigeria is losing its key health personnel to other nations.
Set up an accountability structure across all levels: Medical experts present at the policy dialogue by Nigeria Health Watch also made a charge for setting a proper accountability structure across the national and sub-national levels. It is believed that all hands must be on deck to get Nigeria Pandemic Prepared.
For instance, Ifeanyi Nsofor said “It’s both sad and amusing when you hear Nigerians rant about the health sector. The belief that only the federal government is responsible for the workings of the health sector is a great disservice to us as a nation. We must realize that Nigeria is a federation and all levels including states and local councils must be held accountable.”
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