For the health sector, the outgoing 2018 was eventful.
There were lots of issues, controversies, medical breakthroughs and disappointments.
The health sector started on a controversial note as one of the major health unions in the country called for the sack of the minister of health, Isaac Adewole.
The country also witnessed disease outbreaks.
On the positive side, there was the launching of various strategic plans to propel the health sector forward.
Budget 2019: Buhari proposes N315 billion recurrent health expenditure
Muhammadu Buhari, Nigeria’s president, proposed a recurrent expenditure of N 315.62 billion for the ministry of health in its 2019 appropriation bill summited to the National Assembly.
This is about 46.3 billion increase from last year’s recurrent expenditure, which was N 269.3 billion.
Mr Buhari said the allocation to the ministry represents significant increase over votes in previous budgets.
He said this underscores the federal government’s commitment to increase investment in national security and human capital development.
Mr Buhari said the government will also continue to strive to make Nigerians healthy and happy.
The president also included the 2019 fiscal year one per cent of the consolidated Revenue Fund (CRF) for the Basic Health Care Provision Fund (BHCPF).
This amounts to N51.22 billion from the nation’s CRF. This is however, lower than what was obtainable in 2018. The BHCPF in the 2018 appropriate bill was N55 billion.
PREMIUM TIMES had earlier reported that the non-release of the BHCPF have been affecting healthcare service delivery especially in the Primary Health Care Centres which is meant to benefit the fund.
Buhari signs bill establishing Nigeria Centre for Disease Control
Mr Buhari signed into law the bill establishing the Nigeria Centre for Disease Control (NCDC).
This has given the agency, which is in charge of disease surveillance, preparedness and control in Nigeria, the legislative backing to operate within the country.
The agency was established in 2011 prior to the Ebola outbreak, to respond to the challenges of public health emergencies and to enhance Nigeria’s preparedness and response to epidemics through prevention, detection and control of communicable diseases.
With the president appending his signature to the bill, the agency is empowered to carry out its mandate in disease control.
The new Act will establish NCDC as a full-fledged parastatal and will also ensure that its valuable work is sustained and supported.
This is a good development for disease control in the country.
Strike disrupts health service delivery
The Joint Health Sector Unions (JOHESU), a union comprising of all health workers in Nigeria, apart from medical doctors and dentists, in 2018, embarked on a nationwide strike which lasted for 44 days.
The action disrupted healthcare service delivery across the public secondary and tertiary health facilities across the country.
JOHESU went on strike to demand that the government honours the agreement it had with the Nigerian government in 2014.
The union, during the action, accused the Minister of Health, Isaac Adewole, of denying the agreement between it and the Nigerian government in 2014. They also called on the president to relieve Mr Adewole of his portfolio, accusing him of been bias and favouring just doctors.
JOHESU eventually agreed to shield their sword after the court took over negotiations.
Aside JOHESU, medical doctors across the country had also embarked on a strike, which crippled the health sector.
PREMIUM TIMES had reported how many hospitals across the country fared during the strike as many patients had to seek alternative means of health care services, most of which were expensive as they had to go to private hospitals.
NHIS Boss, Usman Yusuf, suspended again
The Executive Secretary of the National Health Insurance Scheme (NHIS), Usman Yusuf, was indefinitely suspended from office once again.
This time, not by the Minister of Health, Isaac Adewole, but by the Board of the Governing Council of the Insurance scheme.
The leadership of the agency had been in a controversial state since 2017, when PREMIUM TIMES broke the story that the minister suspended Mr Yusuf for gross misconduct and fraud.
PREMIUM TIMES also wrote on the findings of the panel set up by the minister to investigate into the allegation before he was suspended indefinitely.
However, the story took a new turn when Mr Yusuf was reinstated by Mr Buhari after six months suspension from the office last year.
This also led to the appointment of the Board of Governing Council for the insurance scheme.
However, a new twist which set the health sector agog was the re-suspension of Mr Yusuf by the chairperson of the governing council, Enyantu Ifenne.
Ms Ifenne, while announcing his suspension, said Mr Yusuf had several executive infractions that “we cannot ignore”.
Mr Yusuf, 54, took over the state -run health insurance provider on July 29, 2016 but his reign at the agency has been bedevilled by controversies.
Nigeria records highest Lassa fever outbreak in 2018
In 2018, Nigeria recorded its highest Lassa fever outbreak since the history of the disease in the country.
The Nigeria Centre for Disease Control confirmed that about 143 persons died of Lassa fever within the last 11 months in 22 states.
Between January and November 11, the number of suspected cases of Lassa fever was 3,016 out of which 559 cases were confirmed positive with 17 observed as probable cases and 2,440 cases confirmed negative.
Among the 22 states which have recorded at least one case of Lassa fever, three states: Edo, Ondo and Ebonyi top the chart with the highest reported cases.
Although Lassa fever outbreak in the country reached its peak this year, there were more deaths recorded from the cholera outbreak which ravaged 29 states in Nigeria.
In 2018, over 1,000 deaths was recorded in the country due to cholera outbreak. Most of the deaths were reported from Borno State.
Aside Lassa fever and cholera outbreaks, Nigeria also witnessed outbreaks of diseases such yellow fever, measles, among others.
Nigeria doctors mass emigration
Nigerian doctors have been leaving the country in droves, seeking greener pastures in other climes.
In a special report done by PREMIUM TIMES, it was observed that many doctors are still planning to leave the country.
There has been a reported massive brain drain in the medical sector in recent years as many medical doctors are leaving the country on daily basis.
Nigerian doctors have been migrating to U.S, Canada, Saudi Arabia, the UK and many other nations across the globe, investigations reveal.
Doctors who spoke with PREMIUM TIMES said though the migration is not a new trend, it has only gotten worse because of the working conditions in the country.
Unfortunately, the Medical and Dental Council of Nigeria (MDCN), which is the agency in charge of conducting the activities of the medical professionals could not provide PREMIUM TIMES the data of how many Nigerian doctors still working in the country and those who have left.
PREMIUM TIMES also approached the Nigerian Medical Association, (NMA), for data on doctors in Nigeria and those who have left.
The effort was also not successful as the association’s authorities referred the reporter back to MDCN.
Statistics from General Medical Council (GMC) UK, as at July 2017 shows that over 4,765 Nigerian doctors are working in the UK. This is 1.7 per cent of the total of the UK’s medical workforce.
This trend has been having negative effects on Nigeria’s health sector. As a result of this, experts say, Nigeria is experiencing a shortage of doctors in most of its hospitals.
The mass exodus of the health professionals from the country has remain a challenge yet to be resolve as the government is yet to find a solution.
Nigeria conducts largest yellow fever vaccination campaign
The Federal Government of Nigeria, in collaboration with the World Health Organisation (WHO) and GAVI, the Vaccine Alliance, conducted a nationwide yellow fever reactive vaccination campaign in 2018.
The Immunisation drive was a response to the unprecedented yellow fever outbreak in some states in Nigeria.
The campaign is part of the global strategy to Eliminate Yellow Fever Epidemics (EYE) by 2026.
Since September 2017, when the first Yellow fever case was detected in Nigeria, the country has intensified efforts to protect its population.
The immunisation was done in two batches, with more than 32 million people age from 9 months and 44 years expected to be protected from the disease.
PREMIUM TIMES had reported that there was a large turnout of people to receive the vaccine in Abuja.
The reactionary vaccination campaign became necessary when the disease resurfaced in Nigeria in September 2017 after 21 years of silence, when it was discovered in a seven-year-old girl in Ifelodun Local Government Area of Kwara State.
Since then other cases of the disease have been confirmed in Edo state among others.
Federal Government yet to implement BHCPF
The federal government is yet to roll out the Basic Health Care Provision Fund (BHCPF) which was budgeted for in the 2018 budget.
The minister of health Isaac Adewole in December had said that the government will soon roll out the funds. He said six states will be the first beneficiaries of the funds. The states include Osun, Abia, Niger, Yobe, Borno and Edo.
Nigeria, for the first time, budgeted for the BHCPF in 2018. When the 2018 budget was passed, the National Assembly earmarked N 55 billion for the BHCPF, as stipulated by the Act. This is one per cent of the Consolidated Revenue for health funding.
Though approved in the budget, the fund is yet to be released and it again restored the argument over non-implementation of the Act to the front burner.
The fund is a basic provision under the National Health Act but was only appropriated this year for the first time since the Act was signed in 2014.
The Senior Technical Advisor for Development Research and Project Center (dRPC)-PAS, Emmanuel Abanida, said failure to release the money was having a negative effect on health care delivery in the country, especially in the rural areas as it could have been handy in the revitalisation of primary health care centres.
The fund is also envisaged to help reduce out of pocket spending on health care through the National Health Insurance Scheme.
Immunisation: GAVI extends funding support to Nigeria till 2028
Global Alliance for Vaccines Initiative (GAVI) has extended its funding support for immunisation in Nigeria until 2028.
The decision which followed a plea by Nigerian government will see the body, which is the largest global coalition of the public and private sector in the health sector, commit about $1.03 billion.
GAVI board approved the funding envelope and extension of transitional period from 2021 to 2028.
The funding agreement was to end in 2021 but Nigeria is not yet ready to shoulder the financial burden of its immunisation programme.
The new investment is worth $2.7 billion, with GAVI committing $1.03 billion while Nigerian Government counterpart contribution is in excess of $1.9 billion.
Federal government bans codeine
The Federal Ministry of Health in 2018, banned the importation of codeine as an active pharmaceutical ingredient in Nigeria.
The ban was as a result of the increasing abuse of codeine substance in drugs by Nigerians, especially the youth. This, they use to attain the state of ecstasy (highness).
To curtail the abuse, the National Agency for Food and Drug Administration and Control (NAFDAC) stopped issuing permits for the importation of codeine, implying that codeine related drugs are no longer to be imported or produced in the country.
Instead codeine containing cough syrup should be replaced with Dextromethorphan, which is less addictive.
PREMIUM TIMES investigation months after the ban revealed that the drugs are still sold in the market, though at a more expensive price.
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