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Nigeria, 43 Others Agree On Providing Universal Health Coverage

Posted: Sep 20, 2015 at 12:01 am   /   by   /   comments (0)

Yinka Shokunbi Lagos

Nigeria and 43 other countries at the weekend issued an Economists’ Declaration on Universal Health Coverage (UHC) to demand that every world leader increase spending on universal health coverage for their people.

Cardiac and Renal Centre, Gbagada General Hospital, Lagos

Cardiac and Renal Centre, Gbagada General Hospital, Lagos

The Economists gathered at the instance of The Rockefeller Foundation and led by Lawrence H. Summers, Charles W. Eliot University Professor and President Emeritus at Harvard University as global leaders prepare to enact the Sustainable Development Goals (SDGs) for the next 15 years that includes universal health coverage among its targets.

They declare that investments in UHC will ensure health systems can withstand shocks from disease outbreaks like Ebola, and prevent millions of people from falling into poverty paying for the health services they need and that everyone being able to obtain high quality essential health services without suffering financial hardship is right, smart and affordable.

The Nigerian Economists who were part of the 267 signatories include Ayodeji Ajiboye, Shehu Rano Aliyu, Nkata Chuku, Musa Ibrahim Jega, Kenneth Ojo, Olumide Okunola, Obinna Onwujekwe, Chibuzo Opara, Afees Adebare Salisu and Francis Nwachukwu Ukwuije.

Other signatories include: Nobel Laureates Joseph Stiglitz, Kenneth Arrow, Alvin Roth, Vernon Smith and Christopher Pissarides; the current and former chief economists of the World Bank, Kaushik Basu and Justin Yifu Lin; noted health economists Anne Mills and Victor Fuchs; and renowned economic thinkers Thomas Piketty, Linah Mohohlo, Bjørn Lomborg, Tony Atkinson, John Irons and Paul Collier.

The economists are concerned that the United Nations will adopt the Sustainable Development Goals – an ambitious new agenda set to be ratified next week – without considering what’s affordable, achievable, and most valuable.

Universal health coverage means ensuring that everyone can obtain essential health services at high quality without suffering financial hardship.

Published in the Lancet Journal, the Economists declared as follows:

Health is essential to eradicating extreme poverty and promoting growth of well-being.  Over the past decade, health improvements – measured by the value of life-years gained – constituted 24% of full income growth in low- and middle-income countries;

Health systems oriented toward universal health coverage, immensely valuable in their own right, produce an array of benefits: in times of crisis, they mitigate the impact of shocks on communities; in times of calm, they foster more cohesive societies and productive economies;

That the economic benefits of investment in grand convergence are estimated to be more than 10 times greater than costs – meaning that early stages on the pathway to universal health coverage, focused on high-payoff convergence interventions, will have high value relative to the cost of raising revenue, including the deadweight (or welfare) cost of taxation, or (in most cases) to the value of its use in other sectors.

The economists argued that the success of the next development chapter hinges on the ability to actually deliver proven health solutions to the poorest and most marginalized populations; and that every country has the opportunity to achieve universal health coverage.

Already, more than 100 countries across the development spectrum are said to have begun working toward universal health coverage – testing and increasingly demonstrating its feasibility.

Development assistance for health will play an essential part in achievement of a grand convergence in global health and universal health coverage.

The Economists therefore urged that:

Heads of government increase domestic funds for global health convergence and provide vocal political leadership to implement policy reforms toward pro-poor universal health coverage;

Donor countries meet their pledges for international development assistance and commit to investing in the global functions of development assistance for health, particularly research and development for diseases of poverty;

Development financing discussions explicitly address equity, including who pays domestically and who benefits;

National policymakers embrace universal health coverage, as defined above, as an integrated approach for measuring progress toward health targets in the post-2015 global development framework.

Already Nigeria’s new Health Act (2014) provides for universal health coverage for every Nigeria as a matter of right. Among the rights guaranteed by the Health Act include: Right to protection from disease outbreak, Right to care within the 1st 28 days of birth, Right to care for an accident victim or other forms of trauma, Right to care from NCDs such as Sickle Cell Disease, a. sickle cell disease, cancers, diabetes, cardiovascular diseases, hypertension, and mental health among others.

The right to access to Health as guaranteed by the NHAct also entails important governance issues for the Health Sector. Such issues include mandatory response to epidemics and Health emergencies despite non-availability of financial appropriation and other resources:

This right also means the right to Health Security: including health security at the borders.

According to Director, Health Planning, Research and Statistics, Federal Ministry of Health, Dr. Ngozi Azodoh at a recent Health Reporting Academy lecture, organised by Roche Nigeria Limited in collaboration with the School of Media Communication, Pan Atlantic University, Lagos “Government funding for the health sector has remained around 6-7% of total government budgets – below the 15% agreed by African Heads of States in Abuja in 2001 with the scenario affecting annual capital allocation to the health sector over the years.

For instance in 2012, the proposed budget for health was N17.233bn; N14.538bn was approved out of which only N8.583bn was released with a funding gap of N5.955bn.

In 2013, a total of N11, 196,000,000 was budgeted for healthcare but only N7, 992bn was approved out of which N4, 509bn was released leaving a funding gap of N3. 483bn.

In 2014, a budget of N9.131 was proposed but the sum of N5.704 was approved while only N2.289bn was released for implementing various health programmes leaving a funding gap of N3.414bn.

And by the 2015 budget proposal, the health sector budgeted the sum of N5.996bn while N4.545 was approved but as at September 2015, nothing has been released to the ministry for executing any programme.