Why Nigeria might not be ready for next epidemic – NSSF boss

In this interview, FELIX OLOYEDE speaks with Mrs. Oghenefejiro Chinye-Nwoko, the Chief Executive Officer of the Nigeria Solidarity Support Fund, on the underfunding of the healthcare sector and the effects of immigration on the nation's healthcare system.

The mission of your organisation is to provide high-quality healthcare to all Nigerians. How far along are you in accomplishing this?

The National Primary Health Care Development Agency received financial support from us to increase the COVID-19 vaccination campaign, which resulted in 12 million people being reached through the vaccine advocacy programme, over 4.9 million people receiving at least one dose of the vaccine, and 12,000 healthcare workers receiving training on safe immunisation practices.
Through a project named Strengthening the Conduct and Supervision of Optimised Outreach Sessions for Routine Immunisation, we also gave the NPHCDA financial and technical support. By doing this, we hope to strengthen the foundation for leadership and coordination of routine immunisation campaigns and lower the incidence of Under-5 mortalities due to diseases that can be prevented by vaccination. By ensuring that vaccines reach the final mile, the project will give underprivileged people access to healthcare. In order to guarantee the quality of service delivery, it will also make sure that immunisation outreach initiatives are monitored and overseen by appropriate organisations at the ward, local government, state, and federal levels. States can improve the calibre of vaccination programmes and the quantity of routine immunisation outreach programmes by utilising our assistance.
In three advocacy projects, we have also promoted young involvement. Our campaigns have involved almost 2,000 young people. We have moreover spearheaded advocacy conversations concerning enhanced healthcare and immunisation initiatives with significant stakeholders.

We have raised more than N1.2 billion to assist the government in funding the healthcare industry.

There is a significant manpower shortage in the healthcare industry as a result of the country's medical professional exodus. How might this trend be stopped?

One of the biggest issues facing Nigeria's healthcare industry is the outflow of medical professionals, which has left a huge gap in the country's healthcare system. The so-called "brain drain" tendency has grown to be an urgent problem that requires creative measures to stop.
The pull factors, or factors that contribute to this brain drain, can be divided into three main categories: Living in Nigeria presents challenges. inadequate compensation and late wage payments, an unreliable power source, deteriorating healthcare facilities, low job satisfaction, little opportunity for career growth, and instability.

Absence of government assistance includes antiquated regulations governing the healthcare industry, inadequate money for it, and a lack of cooperation between the Nigerian government and its diaspora citizens.

The actual state of the skills and knowledge gaps: Via a number of initiatives, the Nigerian government has pledged to decrease the migration of HRH out of the country. Enhanced welfare packages, increased health financing, and compensation that is proportionate with work dangers are a few of these approaches.
Since data is essential for solving other issues and is entwined with them, it is imperative that information be made available and used appropriately. To offer the components for mapping, Nigeria must have a repository with precise information regarding the number of healthcare workers it employs at any given time, as well as their locations and areas of expertise. This can be carried out in cooperation with the many healthcare worker associations that are now in place. A detailed picture of the distribution of healthcare workers around the nation would be provided to stakeholders via mapping, which would also help determine the best HRH allocation for maximum coverage. Additionally, the Federal Ministry of Health should map and gather detailed data on the health requirements of the Nigerian populace and share it with others. Accurate and real-time information on the concentration and spread of various health needs across the country is essential for rational decision-making and management of healthcare resources, especially HRH. It became glaring during the COVID-19 pandemic that there is a vacuum in the health sector, which needs to be filled by trained professionals to improve the quality of care provided. Mapping healthcare workers and health needs in Nigeria would provide information on areas that have not been prioritised and create a demand for healthcare workers where there has been none.
Improved health indicators and outcomes for all people would result from a budget that appropriately addresses the demands of the health system and guarantees that resources are directed to the appropriate areas. In addition to providing for the upgrades that healthcare professionals need to carry out their jobs effectively, a complete budget would take into account the current state of Nigeria's health system. The perks and wellbeing of healthcare workers must also be included in the budget, since they are crucial to maintaining job satisfaction and increasing employee retention.

The nation's health sector faces significant funding challenges. How can this be made better?
In order to maximise population health in Nigeria, the main obstacles in the healthcare sector must be addressed. These include raising the national budget allocation for healthcare (which is currently between 4% and 5% of GDP) to meet international standards, growing the national healthcare programme to lower out-of-pocket costs, investing in the training of additional medical staff to relieve current facility burdens, giving continuous medical education for healthcare staff a high priority in order to increase their knowledge base, and enhancing public awareness campaigns regarding healthcare advice.


To what extent is the nation ready for a large pandemic or epidemic?

Nigeria is unprepared for the upcoming pandemic. Although they have demonstrated a commitment to enhancing readiness, an epidemic might result in a tragic loss of life and damage political and economic stability.
A midterm Joint External Evaluation was held on November 18, 2020 by the Nigeria Centre for Disease Control and external assessors, which included the WHO Nigeria Country Office, Public Health England, the United States Centres for Disease Control and Prevention, and Resolve to Save Lives. This was an extension of the June 2017 JEE that was first held. Nigeria's Ready Score moved from 39 to 46, moving it from the Not Ready category into the Work to Do category, in recognition of the consistent investments the country has made in its systems to detect, contain, and prevent epidemics. There was a rise in a number of areas, such as disaster preparedness, zoonotic disease, risk communication, policy and funding, and law.


The health industry depends heavily on research and development. How is the nation doing?
The research capabilities and prospects at our medical institutions have been restricted by inadequate administrative support and funding, inadequate facilities, and weak research capacity. The quality of graduates, teaching, and learning are all enhanced by good research, which also generates chances for educating the next generation of researchers. Nigeria launched the second JEE version in 2023 with the goal of evaluating its required core competencies in accordance with the International Health Regulations. Nigeria's commitment to strengthening its health security capabilities and improving its capacity to handle public health emergencies was demonstrated by this second JEE.

Due to the depreciation of the naira, the cost of pharmaceuticals has increased dramatically, placing a strain on Nigerians, particularly those who are taking care of various medical conditions. In what ways might the government assist with this?
The price of medications in Nigeria is determined by two factors. First of all, almost everything is imported, including completed goods and raw materials. Thus, a major motivator is the exchange rate model and its stability. The fluctuating value of the dollar relative to the naira causes importers of completed goods and raw materials to overestimate, which raises prices. Commodity prices will decrease if the exchange rate is stable and favourable.

Second, if the government is successful in reducing the number of hierarchies inside the pharmaceutical system, drug prices will likewise decrease. An additional layer of distribution is being added to the open drug market by the emergence of unconventional distributors. The activities of the distributors in major markets around the country create artificial scarcity and an increase in drug prices.

An increase in the prices of drugs would encourage the sales of fake and adulterated medicines, consequently leading to low therapeutic effects and more disease complications.
In Nigeria, the price of medications is determined by two factors. First of all, almost everything—from raw materials to completed goods—is imported. Thus, one of the main drivers is the exchange rate model and its stability. Importers of finished goods and raw materials overestimate, which raises prices, as a result of the dollar's volatile value relative to the naira. Commodity prices will decline in the event of a steady and favourable exchange rate.

Second, in order to lower the cost of medications, the government must succeed in breaking down the several hierarchies inside t