The outgoing 2019 was an eventful year for the health sector in Nigeria and across the world.
Stories on appointments, controversies, medical breakthroughs, fatal outbreaks of disease and resurgence of some eliminated diseases in some countries made the headlines in the year. Below is a recap of some of the major ones.
1. Buhari rolls out Basic Health Care Provision Fund
The health sector in Nigeria started on a positive note as President Muhammadu Buhari, on January 8, rolled out the Basic Health Care Provision Fund (BHCPF) appropriated by the National Assembly in the 2018 budget.
The BHCPF is the one per cent of the federal government Consolidated Revenue and contributions from donor grants set aside to fund the basic health needs of Nigerians.
It is the fundamental funding provision under the National Health Act and was appropriated for the first time in the 2018 budget since the Act was signed in 2014.
The National Health Insurance Scheme (NHIS) is to receive 50 per cent of the fund, the National Primary Health Care Development Agency (NPHCDA) 45 per cent, and the health ministry will receive 5 per cent for outbreaks and emergency responses.
Other funds from which the health sector benefited in 2019 include the Save one million lives fund.
However, they had no substantial impact on health care services as most of the funds was either not disbursed or disbursed late.
2. Health ministry gets new ministers
On August 21, President Muhammadu Buhari inaugurated the new ministers for his second term which he had begun on May 29 after his reelection.
For the health ministry, he appointed Osagie Ehanire as the senior minister and Olorunnimbe Mamora as the minister of state.
Mr Ehanire served in the previous cabinet as minister of state for health. The two ministers, who are medical doctors, resumed duty the same day they were inaugurated.
Mr Ehanire, a few hours after his resumption, told journalists that they would execute the agenda of the president on delivery of quality healthcare to Nigerians.
3. Sporadic disease outbreaks
Nigeria recorded a series of disease outbreaks during the year. Some of these reached the epidemic level while some were quickly contained before they reached that level in the country.
The outbreaks include Lassa fever, Yellow fever, Measles, Cholera and Cerebrospinal Meningitis.
To contain the spread of some of these diseases, the federal government had to roll vaccinations campaigns. However, some of the disease that are not vaccine-preventable.
4. Buhari finally sacks NHIS boss, appoints replacement
President Muhammadu Buhari on July 1 sacked the controversial Executive Secretary of the National Health Insurance Scheme, Usman Yusuf.
This came 10 months after Mr Yusuf was suspended from office by the governing council of the agency.
Before he was kicked out, Mr Yusufwas at odds with the governing council and staff unions of the agency as well as the then minister of health, Isaac Adewole.
The leadership of the agency had been enmeshed in controversy since 2017. PREMIUM TIMES broke the story that the minister suspended Mr Yusuf for gross misconduct and fraud.
However, Mr Yusuf was reinstated by Mr Buhari after six months. The president eventually terminated Mr Yusuf’s appointment in July and approved the appointment of Mohammed Sambo as the new Executive Secretary of the agency.
5. Health workers task Nigeria’s new health minister on brain drain
Health workers raised concerns about the increasing mass emigration of their colleagues from the country.
Health workers have been leaving Nigeria in droves for greener pastures in other climes. This trend has been consistent for some years and there seems to be no solution in sight.
This has reduced the ratio of health professionals to patients in the country.
A special report by PREMIUM TIMES established that Nigeria gravely lacks doctors to address citizens’ health needs.
Data obtained by PREMIUM TIMES in February from the Medical and Dental Council of Nigeria (MDCN) showed that as of December 2017, Nigeria had 42,845 registered doctors, dentists and alternative medicine practitioners working in the country. Of these numbers, 39,912 are medical doctors.
6. Nigeria celebrates three years of wild poliovirus free
Nigeria achieved a milestone in polio eradication in 2019 as it celebrated three years without any record of wild poliovirus detected in the country. August 21 marks the third year of no wild polio case notification in the continent.
With this development, it is expected that Nigeria would be certified polio-free before mid-2020. This is a welcome development for the country and the World Health Organisation African Region as this implies that the region would be certified free of the deadly disease. The 47 countries in the WHO Africa Region are yet to be certified polio-free because of the polio case detected in Nigeria in August 2016.
However, procedures have begun for Nigeria to be certified free.
Speaking on the milestone achieved in polio eradication on the continent, WHO Regional Director for Africa, Matshidiso Moeti, said WHO is confident of soon trumpeting the certification that polio has been kicked out of Africa.
However, the fight is not yet over because the continent is faced with the new challenge of circulating vaccine-derived polio. This is as a result of low immunisation culture and non-compliance with vaccination routine.
7. Nigeria’s HIV survey and report
Earlier in the year, the result of the biggest HIV/AIDS survey conducted in Nigeria was released to the public.
The survey was launched in June 2018 to determine the true distribution of HIV and AIDS, Hepatitis B and Hepatitis C in the country. It was conducted between July and December 2018.
Tagged as Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), it was the largest survey ever in the history of the global response to the HIV epidemic and it was conducted with the aim of having an accurate statistics of Nigerians living with the disease in the country.
The survey covered over 200,000 people and cost approximately $100 million to conduct. The result was released in March. The results indicated that Nigeria has made a tremendous improvement in its fight against the scourge.
While there is still room for improvement, it was observed that there has been a shift in the states with the highest prevalence of the disease in the country.
According to the result from NAIIS, Akwa Ibom now tops the chart with the state having the highest prevalence of HIV cases in Nigeria.
8. Buhari appoints new NACA boss, renews tenure of NCDC DG
On July 2, President Muhammadu Buhari approved the appointment of Gambo Gumel Aliyu as the Director-General of the National Agency for the Control of HIV/Aids (NACA) for an initial term of four years.
The development was against the backdrop of the resignation of Sani Aliyu from the position to vie for the post of Executive Director of UNAIDS, which he unfortunately lost.
Also, the president extended the tenure of the Executive Director, Nigeria Centre for Disease Control (NCDC), Chikwe Ihekweazu. Mr Ihekweazu had served a four-year initial term before Mr Buhari reappointed him.
9. PREMIUM TIMES held second National Health Dialogue
PREMIUM TIMES held the second edition of its National Health Dialogue in Abuja. The two-day event explored how Nigeria can achieve Universal Health Coverage (UHC). In attendance were the minister of health, Osagie Ehanire, health experts, health practitioners and civil society organisations, among others.
Some of the resolution at the event was to ensure consistent monitoring of health services, the disbursement of budgetary allocation and utilisation of health funds in the country.
10. Ebola outbreak and vaccine breakthrough
Substantial gains were made in 2019 in the response to the world second largest Ebola epidemic on record in the Democratic Republic of Congo.
The epidemic which started August 2018 is the 10th Ebola Outbreak and largest – ever reported in the country. The outbreak was declared a Public Health Emergency of International Concern by WHO on July 17. As of December 26, a total of 3366 cases was reported (3248 confirmed and 118 probable), including 2227 deaths, 1098 survivors, and patients still under care.
Though the outbreak is still ongoing, the spread of the virus has slowed down within the DRC, the virus having been effectively contained from spreading to the neigbouring countries.
A good news from the outbreak is the innovation of the Ebola vaccines. WHO prequalified the Ebola vaccine in record time, and landmark advances were made in care and treatment.
11. Algeria and Argentina certified malaria-free by WHO
Algeria and Argentina were officially recognised by World Health Organisation as malaria-free. The certification is granted when a country proves that it has interrupted indigenous transmission of the disease for at least three consecutive years.
The disease is still endemic in many countries and kills over 400,000 people each year. The worst affected are pregnant women and children in sub-Saharan Africa.
Algeria is the second country in the WHO African Region to be officially recognized as malaria-free, after Mauritius, which was certified in 1973. Argentina is the second country in the WHO Region of the Americas to be certified in 45 years, after Paraguay in June 2018.
Algeria and Argentina reported their last cases of indigenous malaria in 2013 and 2010 respectively.
Also, to reduce the burden of the disease in Africa, the world’s first malaria vaccine was piloted in Ghana, Kenya and Malawi.
12. Disease resurgence in eliminated countries
Health achievement suffered a major setback in 2019 with the resurgence of polio and measles in some countries where these diseases have been eliminated.
The global measles report showed that there was a spike in measles cases in 2019 and some cases of resurgence in some countries. This led to four countries (Albania, Czech Republic, Greece and the United Kingdom) losing their measles elimination status. This is the first time such is happening since the verification process began in 2012. There were also large outbreaks in many regions across the globe.
Also, polio eradication suffered a setback as some countries such as Malaysia and the Philippines where the disease had been eradicated reported case of circulating vaccine-derived polio.
Health experts blamed the resurgence on the low compliance to vaccination, vaccine hoax, vaccine hesitancy and low immunisation culture.