Yesterday, Monday, 19th July 2021, England, as most of the UK, was celebrating “Freedom Day” with the lifting of COVID-19 restrictions of social distancing and mask wearing. This has been made possible with an aggressive vaccination campaign with over 46 million people (nearly 90% of the adult population) taking their first dose of a coronavirus vaccine with over 70% taking a double jab! Though many are apprehensive of the move and even criticised it, Professor Sir Andrew Pollard, director of the Oxford Vaccine Group, said that death rates will remain low because of the jab and the effectiveness of the vaccines against severe disease and hospitalisation and death remains extremely high against the variants which are around in the UK. Reported deaths from COVID-19 in the UK are currently just one sixteenth of the level seen during similar infection rates in previous Covid waves, the latest figures show.
The effectiveness of the vaccination campaign that has led to the UK lifting the COVID-19 restrictions cannot be said to be same for the African continent, particularly Nigeria. Aside from the widespread apathy to the vaccines no thanks to a well-coordinated and oiled anti-vaccine conspiracy, Nigeria simply has not had enough vaccine doses for the nearly 150 million adult population. Back in March 2021, Nigeria received nearly 4 million her first batch of doses of the AstraZeneca COVID-19 vaccines and nothing more has been received since then. Only last week, the regulator – National Agency for Food and Drug Administration and Control (NAFDAC) – approved emergency use of three additional Covid-19 vaccines for Nigeria – the Moderna (Rovi Pharma Madrid, Spain) AstraZeneca AZD1222 [SK Bioscience Co Limited (Republic of Korea)] Sputnik V (Gamaleya National Centre of Epidemiology and Microbiology, Russia). About 41 million doses are expected by September 2021.
Aside from the vaccines, COVID-19 exposed the inadequacies in the healthcare delivery system of African nations, particularly Nigeria. Nigeria with a population of over 200 million (the largest black population in the world) has administered 2.4 million COVID-19 tests (about 1% of the population) of which 169,532 tested positive (an infection rate of 7%) with 2,127 deaths (death rate of 1.2%) based on the latest data released by the Nigeria Centre for Disease Control (NCDC). In comparison the UK with a population of about 67 million, there have been about 5.5 million positive tests and over 150,000 deaths (death rate of 2.7% which is double that of Nigeria’s). Even with the smaller rate of infection, Nigeria’s healthcare system was stretched beyond limits. The Chief of Staff to the President had to be flown to Lagos meaning there was no adequate medical facility in the entire federal capital to provide him with the expert medical attention he needed. His boss the President also travels to the UK for even routine medical checks.
Lessons learnt – Looking beyond COVID
If there is anything positive that African countries particularly Nigeria will learn from the COVID-19 pandemic is that it has tested the medical preparedness and adequacy and found it wanting and African nations now have a second chance to get it right. A healthy population is a sine qua non for a healthy economy. Therefore, nations that are building strong economies around the world do not pay lip service or treat with levity matters that relate to the healthcare delivery for their citizens. The UK spent £269 billion ($368 billion) which was 12.8% of GDP on healthcare in the year 2020 alone! In comparison Nigeria’s TOTAL Federal Government budget for all recurrent and capital expenditure is a miserly $35 billion of which less than $1 billion is earmarked for healthcare! Considering that both the UK and Nigeria are buying from the same market healthcare equipment, drugs and other supplies, the current funding of the healthcare system in Nigeria cannot guarantee qualitative and quantitative healthcare delivery to a population of over 200 million people! The lack of priority placed on healthcare delivery in Nigeria is a kneel placed on the neck of the nation’s economy!!! With a budget of $368 billion, the UK provides universal FREE healthcare services at the primary, secondary and tertiary levels to all citizens while Nigeria’s $1 billion simply abandons the citizens to their own peril for even the commonest of ailments.
- African countries particularly Nigeria with the largest population must learn lessons from countries such as India and Brazil who treated COVID-19 with levity and it came back to hurt them! African countries must immediately begin major funding plan of action for expansive and progressive healthcare delivery across the continent. Enough of lip service, this is the time for action to ensure COVID-19 or any other major health crisis is thwarted from making a landfall resulting in high death toll on the continent.
- There are basic infrastructures that need to be in place for example an emergency number that mobilises ambulances, fire engines and the police to the aid of citizens who are in crisis. To think that a country such as Nigeria with a high penetration of mobile telephone services does not have as simple as a national emergency dialing code linked to all the mobile networks such that citizens can seek for help with a simple dial of a 3-digit code on the phones is a big shame! This system must be installed immediately for citizens to report emergencies including medical ones for fast-track response by the emergencies services.
- The emergency number when linked to the ambulance services brings healthcare to the doorsteps of citizens. There is an anomalous situation in Nigeria where ambulances with sirens blaring carry corpses to burial whereas the sick in emergency conditions are ferried on human backs, okadas (motorcycles), back of pickup vans and other unsuitable modes of transport to medical facilities. In countries with more effective healthcare delivery services, it is the other way round with ambulances ferrying those in critical conditions to hospitals while hearses convey corpses to funeral services and cemeteries.
- Nigeria must shore up her revenues to be equipped to fund the healthcare budget adequately. To do this, Nigeria must take the following steps:
A. Generate new sources of revenue including bringing the rich into the tax net and making them to pay their fair share of taxes! The recent display of wealth at a burial in Anambra state should be the occasions the tax authorities need as triggers to go after the attendees to ensure they pay their fair share of taxes on the incomes they earned and sprayed so extravagantly at the occasion.
B. Eliminate areas of waste by a significant reduction in the cost of running government at all levels. Immediate stoppage of drainpipes such as subsidies on petrol and the dollar to save the money for more essential services such as healthcare and education.
C. The FG to scrap the following ministries and in their place create regulatory agencies to provide oversight on the private sector who are to takeover the activities of these ministries and run them on commercial basis:
There can be no economy without a comprehensive and efficient healthcare delivery system for all citizens! African governments must be committed to adequate budget provisioning for the healthcare sector if the continent is to escape from another wave of COVID-19 and any other major health crisis that may show up in time to come! There is a maxim that – HEALTH IS WEALTH!!!