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ERIC ARUBAYI & THE FAILURE OF NIGERIA’S HEALTH SYSTEM
Eric Arubayi – the charming smile, the personality, the finesse, the poise – one of Nigeria’s most prominent amazing voices. His music versatility complemented his down-to-earth humanity and pleasantness. I last saw him in Abuja in November, 2016. He spent the night before travelling to Delta for another concert. My consulting experiences over three years took me away from Lagos more and more, and ultimately House on The Rock choir where I had many friends. HOTR remains that family where people of all tribes and culture and background blend.
Studying Pubic Policy had been uppermost on my mind since 2012 when I gained admission to McCourt School in Georgetown University and the Lee Kuan Yew School (LKY School) in Singapore. For lack of sufficient funds, I was denied student visa to the Georgetown University and unfortunately, I had deferred my admission to the LKY School. Studying public policy became more convincing after two back-to-back rigorous political campaigns with Dr. Kayode Fayemi and Mallam Nasir Elrufai. I reapplied for MPA, got a full scholarship at the LKY School ultimately leading me to Singapore in 2015.
Counterfeit drugs have long been a problem for Nigeria, and a lack of data does not help us do justice to the perpetuation of fake drugs in our polity. A short documented history is found here
Nothing drives home the inefficiency of our institutions like the immigration system, the educational system and the Health System: three systems where most Nigerians have continuous interface with. The appalling level of unprofessionalism and mediocrity in these institutions are worthy of rigorous study and analysis. Here, I give a short analysis on the health institution.
Nigeria’s Human Development Indices – a strong indication of a nation’s human capital resourcefulness – stands at 156 out of 173 countries. Nigeria, a nation with population growth of 2.5% (meaning arguably 5.1 million births annually) has fewer medical institutions per capita, and where they exist, are massively under-equipped by competent staff and resources. The implication of Nigeria’s acute shortage of human and resourceful capital in health means that any Nigerian with serious medical condition stands more than 80% assurance of death.
Investment in health is acutely deficient. Nigeria’s healthcare expenditure is 5.6% of GDP, lowly when compared even to Burkina Faso 6.7% and the Democratic Republic of Congo 7.9%. Nigeria cannot boast of one world class medical institution, this is a nation of 193 million people (billed to reach 400 million by 2050) Under 5 child mortality annually is one million annually due mostly to neonatal causes followed by malaria and pneumonia. Maternal mortality is 560-814 per 100,000 live births (third highest globally) which is comparable to low-income countries such as Lesotho and Cameroon.
Most health facilities (where they exist) lack access to clean water and a reliable supply of electricity, face shortages of medical equipment, and are missing necessary medications or blood to treat their patients. Birth attended by skilled workers stands at 35% (sixth worst in Africa). Life expectancy stands at 56, below the African average. Nigeria’s out-of-pocket expenditure is third highest in Africa (after Sierra Leone and Guinea), this is a nation that earned over $400bn in 30 years from its oil extractive industry!
Nigeria’s medical tourism is at $1.6 billion annually, 47% of this goes to India ($260 million in 2014)
Having spent time in BEACONS DEVT. FOUNDATION, I was deeply aware of the failure of developing our human capital, and the imminent dangers it posed for our future. I arrived in Singapore with much optimism and hope, to find out how nations developed economically, and how they invest their resources in their most prized assets: human capital development. I was also keen to learn about Singapore’s renowned value- for-money policy principles. Among many shocks in Singapore after arrival was that I could not procure medicated drugs over the counter as it is in Nigeria.
In Singapore, like many advanced countries, all medicated drugs CAN ONLY be procured via prescription from certified personnel (doctors in this case). For me, it was stressful, it was in fact (at first) a needless prerequisite. Needless to say, that throughout my study at the LKY School, I resorted to the University health centre for diagnosis before I could be sold any medication.
Since then, not only have I consistently consulted my doctors for the simplest of fatigues, but I have paid due attention to my medications, checking expiry dates of medications as “harmless” as Panadol. Singapore’s method contrasts highly with Nigeria, where citizens procure medication over the counter, without checks, without verification, without hassles! Cheap and available medicated drugs predispose Nigerians to life threatening situations.
Nearly two-third of Nigerians live below the poverty line; 80% work in the informal sector. As the national health system mostly covers the formally employed only 3% of the population is covered by the NHIS. Private prepaid schemes are unreachable for the poor as premiums are unaffordable. With the overburdened public system unable to deliver, people have no option but to pay for health care out-of-pocket.
The late and beautiful Dora Akunyili fought corrupt health entrepreneurs and their fake drugs in our system till her death. Her enforcements of procedures for validating medications brought her enemies. Lack of funding in our health system leads to many inconsistencies in our policies, lack of trust in the medical system, and very low investment in resources: human and infrastructure. Bad roads are fast routes to accidents, and these accidents, without access to good hospitals or skilled health workers, are ultimate recipe for deaths. At the end, our lack of investment and commitment to standard healthcare kills us all.
Make no mistake about it. The deaths of our citizens, f some friends that I know – of Eric, of Deborah, of Hassan, of Salihu, – is the direct failure of our leadership, a direct failure of years of corruption and under-investment in our health institutions, of improper regulations and oversight of our health agencies. Nigeria has continuously and successfully politicized its institutions, rewarding politicians with little or no idea with critical positions in crucial institutions.
Rest on Eric Arubayi. Rest on many other Nigerians who have died from the carelessness and incompetence of our institutions and the failures of our leadership.
