Idowu Omisore
The poignant speech recently made by Bill Gates, the Co-Chair of Bill & Melinda Gates Foundation, opened the floodgates of discussions about pertinent issues bordering on the need for the government to truly invest in Nigerians. Health was the foremost issue that he dwelled on, reeling out statistics that could bring tears to the eyes of any right-thinking person. Gates’ great concern for the health and human capital development of the world’s most populous black nation comes to mind as the world marked World Health Day. This year’s celebration is more significant because it coincides with the World Health Organization’s seventieth anniversary. This is a momentous opportunity for every nation to take a critical look at the challenges in their health sector and address them with the seriousness it deserves. Universal health coverage is the theme for this year’s celebration.
According to Bill Gates, “in upper middle-income countries, the average life expectancy is 75 years. In lower middle-income countries, it’s 68. In low-income countries, it’s 62. In Nigeria, it is lower still: just 53 years. Nigeria is one of the most dangerous places in the world to give birth, with the fourth worst maternal mortality rate in the world, ahead of only Sierra Leone, Central African Republic and Chad. One in three Nigerian children is chronically malnourished.”
One becomes more apprehensive when one considers this statistics, our rising population figures and the wide-ranging definition of human health given by World Health Organization (WHO): “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” A reflection on these pops up a question: how healthy is the world’s most populous black nation? In getting an honest answer to this question, it’s perhaps wise to first listen to a foreigner who has invested about $1.6 billion in our dear country before paying attention to the government official or political office holder whose goal is probably to make the government look good.
This piece is not to criticize the government but to encourage those in the corridors of power to do more, to make them see reasons why the health sector deserves to be a priority on its agenda. Health, they say, is wealth. Healthy people will be highly productive and that means a healthy economy. This is in tandem with Mr. Gates’ line of thought – “The most important choice you can make is to maximize your greatest resource, the Nigerian people. Nigeria will thrive when every Nigerian is able to thrive. If you invest in their health, education, and opportunities—the “human capital” we are talking about today—then they will lay the foundation for sustained prosperity…What do I mean by investing in your people? I mean prioritizing health and education…” Doctors will stop going on strike and there would be no need to travel overseas for medical treatments when the health sector is adequately funded. How many Nigerians can even afford to travel abroad for medical care?
It was in the news lately that pregnant women in Ondo protested because ante natal fees were increased. In an oil-rich country like Nigeria, I do not see why pregnant women, infants and the elderly cannot receive free medical treatments. What really do we refer to as dividends of democracy? Who are the people enjoying these dividends? The elected or the electorate? When the people at the grassroots cannot access free healthcare, in what way are they enjoying dividends? One is bound to ask these questions. The day I saw a report that showed that Nigerian senators are the highest paid in the world, I shuddered in unbelief. Are the so-called dividends flowing down to the masses or flowing into the pockets of the elites? How many state governments have a standard health scheme for their employees and their families?
A few months from now, we will roll out drums, wear white and green stuffs and have a huge cake baked to celebrate our 59th independence anniversary. After about six decades of being a free nation, we are still struggling with something as basic as primary healthcare. Speaking of this, Mr. Gates recalled that “in 1978, Dr. Olikoye Ransome-Kuti, who later became the Nigerian minister of health, helped establish primary health care as the global standard. We now know that a strong primary care system takes care of 90 percent of people’s health needs. Tragically, 40 years after Dr. Ransome-Kuti helped other countries set a course for the future, the Nigerian primary health care system is broken. The evidence for this can be found in the epidemic of chronic malnutrition, or stunting. As the name suggests, chronic malnutrition is not a disease children catch. It is a condition that develops over time because they are deprived of a diverse diet and the services a strong primary health care system provides.”
Highlighting six features of a functioning primary health system, he mentioned “adequate funding, good facilities located in the right places, skilled and dedicated health workers, ample stocks of essential equipment and medicines, patients who know about the system and want to use it, and a mechanism for collecting the data needed to improve quality.”
Our population should be an asset to us but it is more of a liability because we have not been able to harness it to our advantage. Natural resources do not come near human resources when placed on the scale of significance.
This was echoed by Bill Gates when he advised that Nigerian leaders shift focus from physical capital to human capital. Basics such as food, shelter, health and education ought to be given a greater attention. Once these top priority needs are taken care of, productivity will increase and poverty will start thinning out. The government, NGOs, the media, religious bodies, the private sector, communities, families and indeed all of us must play our part to build a healthier Nigeria. Aside from engaging in charitable projects, becoming a philanthropist, we can sensitize people on how to lead healthy lifestyles. If a husband and a wife can pool resources together to invest in people across the world, then everyone of us can make a difference in our own little ways.
Omisore writes from Lagos.