There is no gainsaying the fact that the sustainability of any country’s economic and social growth largely depends on a vibrant healthcare sector. Perhaps in recognition of that fact, preventive medicine which formed the bedrock of the nation’s Primary Healthcare (PHC) system in 1978 was aimed at providing health services, improving the efficiency and effectiveness of service delivery and ensuring widespread coverage and access to basic care, particularly among the rural populace. But 32 years on, its implementation still generates mixed reactions among Nigerians.
A quick review of the nation’s health indices indicates that the infant mortality rate is put at 75 per 1000 deaths, and under-five mortality rates at 157 per 1000 deaths. Needless to say, the majority of these deaths stem from common ailments like malaria, respiratory tract infection, diarrhoea, etc, which could be prevented if all facets of the health sector deliver quality primary care services at optimal capacity. While critics believe that the government has been remiss in providing this all-important service over the years, others maintain that there is a need to revamp the system, which will definitely improve healthcare delivery in the country.
In a recent interview, Mohammed Pate, executive director, National Primary Healthcare Development Agency (NPHDA), said the poor state of healthcare at the PHC level is due to non-utilisation of the PHC platform for effective integration of services, inequality in the distribution of available health workforce staff, financial barriers to health, particularly at the community level, and the absence of an enabling act to guide the PHC implementation, culminating in poor to outright non-utilisation of PHC facilities, among others.
According to Pate, the sector-wide capacity constraints had steadily increased following the provision of PHC into the LGAs, and “it might be argued that the poor performance is associated with low levels of financial resources.” For Adepoju Olusegun, a public affairs analyst, the frequent sojourn of Nigerians abroad in search of quality treatment for minor ailments connotes the state of affairs in the health sector. Olusegun stated that if government officials were satisfied with and could boast of the quality of healthcare at the various health institutions, they should be confident enough to fall asleep under the influence of anesthesia in hospitals without any doubt on their minds.
“Nowadays, local government chairmen are enthralled by the pictures of established health centres which would be used for canvassing for votes at the polls, and not actually meeting the health needs of the host communities. The health services, based on primary healthcare, include education regarding prevailing health problems and the methods of preventing and controlling them, promotion of food supply, proper nutrition material and child care, as well as family planning immunisation against the major infectious diseases,” he said. Doubtless, the importance of the PHC system cannot be over-emphasised given the fact that PHC services which fall under the jurisdiction of the Local Government Areas cover approximately 60 percent of Nigerians living within the rural areas.
Proffering a solution to the problem, Onyebuchi Chukwu, minister for health, remarked that the passage of the National Health Bill would go a long way in addressing healthcare delivery in the country. According to the minister, the National Health Bill which has sailed through the Senate and gone through the first reading in the House of Representatives will ensure that responsibilities are assigned to all the tiers of government.
“Looking at the nation’s healthcare system, the bill is an all-encompassing document aimed at turning around the sector for good because our health indices are poor in relative spending. But there is lot more that can be done in terms of improving maternal mortality and other childhood diseases. The health bill will address these constraints. It will define roles and responsibilities of the three tiers of government as it relates to health. With this in place, Nigerians will know whom to hold responsible if a particular arm is not working,” Chukwu assured.
For Pate, aligning incentives for the implementation of PHC, improving accountability, strengthening inter governmental relations, effective expenditure management, among others, will go a long way in revamping the ailing system.
“What we need is a strong political commitment, increased investment in the health sector and clear policy and administrative guidelines that ensure health programmes are delivered through the Primary Health Systems at LGA levels in a horizontal and vertical manner,” said Pate.
By Alexander Chiejina
Friday, August 27, 2010
Monday, August 23, 2010
Is Nigeria on course to meet MDG target?
As the countdown to 2015 begins, reports reveal that the country is unlikely to meet the Millennium Development Goal (MDG) deadline for poverty eradication, as five out of every 10 Nigerians is adjudged to still live in poverty. Alexander Chiejina examines Nigeria's chances in this regard.
At the start of this millennium, world leaders were concerned about the poverty burden, particularly in developing nations across the globe. This concern was born out of poverty and the dearth of productive resources to ensure sustainable livelihoods in that category of nations. In a bid to address these challenges, the United Nations established the MDGs to help underdeveloped countries overcome the problems of illiteracy, poverty, poor health and quality of life.
Much emphasis was placed on the attainment of MDG targets in education because of its pivotal role in national development. The targets include education for all through 100 percent gross enrolment rate by 2015, gender equality in access to education opportunities, eradication of adult illiteracy, and improvement of the quality of education.
Other goals are: promoting gender equality and empowering women, reducing under-five mortality by two-thirds, improving maternal health, combating HIV/AIDS, malaria and other diseases, ensuring environmental sustainability and developing a global partnership for development. However, five years before 2015 rolls by, and in view of the next month's United Nations General Assembly meeting, during which countries will be assessed on their MDG achievements, calls have made on the Office of the Millennium Development Goals (MDGs) in the country to strengthen critical areas of development projects so as to actualise set targets.
While receiving the report of the Presidential Committee on the Assessment and Monitoring of the MDGs recently, Ima Niboro, senior special assistant to the President on Media and Publicity, advised that the committee should ensure that funds budgeted for various projects were adequately used to meet the yearnings and aspirations of Nigerians, especially in the health and education sectors.
"President Goodluck Jonathan identified the need for the committee to do more in the health sector to further reduce the maternal mortality rate. Also, the harmonisation and generation of a baseline data that will assist in proper monitoring and evaluation of all MDG-related projects is essential," remarked Niboro.
For Femi Akinwumi, public affairs analyst and medical expert at the University College Hospital (UCH), Ibadan, while MDGs 4, 5 and 6 seek to reduce child mortality rate, improve maternal health, combat HIV/AIDS, malaria, and other diseases, the non-effective Primary Health Care (PHC) system in the country which should cater for about 70 percent of the population's health needs has instead put good healthcare delivery in jeopardy.
According to him, "Very few Local governments (LGs) in the country have more than five medical doctors on their payroll managing the PHCs for the provision of basic but effective healthcare to the people in their domains. These LGs share up to 30 percent of monthly allocation from the federation account running into scores of millions of naira into the coffer of each LG. In view of this, we as a nation cannot realise the targets of MDGs without an adequately structured, properly managed and well-equipped PHC system."
In the meantime, evidence from the 2006 MDG report shows there is the likelihood of achieving three of the eight goals in Nigeria: achieving universal basic education, ensuring environmental sustainability and developing global partnership for development; while the health MDGs remain daunting challenges for Nigeria. However, a critical barrier to achieving the MDGS remains the unavailability of up-to-date data on most of the indicators. This is compounded by the limited funding available for data generation and management, as expressed by the report.
It would be recalled that while making a presentation at a three-day public hearing to assess the implementation of MDGs in Nigeria between 2007 and 2010, organised by the House of Representatives Committee on MDGs, Hajiya Amina Az-Zubair, senior special assistant to the president on MDGs, disclosed that the MDG project had gulped N1.04trillion since 2006.
Amina Az-Zubair explained that since 2006, $1 billion (about N150 billion) had been gathered from the Paris Club debt relief, out of which the Federal Government takes $750million (N112.50billion) and state governments $250million (about N375 billion). The SSA therefore emphasised the need to be on guard so that funds appropriated for the attainment of the MDGs, about $1 billion per annum were not misappropriated. "N20 billion was appropriated for her office in 2007, out of which N18.4 billion was allocated to the states under the Conditional Grant Scheme [CGS], and thatN300 million was returned to the treasury as unspent fund. In 2008, her office got N59.3 billion and gave N2.3 billion to states as CGS; while N15.5 billion was returned. In 2009, the office received N32.6 billion, spent N27.04 billion given to states under the CGS, while in 2010, it was appropriated N35.02 billion but was yet to make the CGS disbursements," she said, adding that 90 percent of Nigerian children under school age had been registered and attend school, which was a significant achievement as it translated to nine out of 10 children.
"11.6 million Nigerian school children benefit from better quality education from over 200,000 teachers retained through MDGs. Through the work we are doing, many remote communities across the country, some of which have never experienced any form of real development, now have access to primary healthcare centres, boreholes, classrooms and so on," she concluded.
Meanwhile, reports during a workshop on the validation of the 2010 MDGs report and five-year countdown strategy for Nigeria held in Abuja at the weekend state that MDGs implementation in the country over the past few years is a mixed-bag of modest and steady progress on many goals and slow progress on a few others.
The report further notes that out of the eight goals, Nigeria has recorded an average performance on five MDGs, with less satisfactory performance on three others. Listed under the less satisfactory performance are goals one, five and seven.
Goal 1 which is to eradicate extreme poverty and hunger by 2015; the report noted "although poverty has reduced since 2000, the reality is that among every ten Nigerians, five still live in poverty. Growth has not been sufficiently equitable or generated employment," adding however that nutrition has improved significantly. On goal five, improved maternal health, the report noted that there is sizeable reduction of maternal mortality ratio from 800/100,000 (2003) to 157/100,000 (2008). Proportion of births attended by skilled health personnel increased slightly from 36 percent (2003) to 39 percent (2008). The report also noted increase in contraceptive prevalence rate from 8.0 percent (2003) to 10.0 percent (2008).
One salient point is the fact that the timeline for the achievement of the MDGs is 2015, not 2020; hence the goals of the MDGs are a lot more modest and geared towards salvaging the less privileged. However, constitutional responsibility for implementation on almost all the goals rests with the states and local governments in Nigeria's federal structure. But despite remarkable strides at the federal level, appreciation of the requirements for meeting these goals, as well as institutional capacity remain relatively low at the other levels of government.
For Otive Igbuzor, new representative, Centre for Development and Population Activities country office in Nigeria, "there is the need to formulate and implement policies that will promote transparency and accountability, overcome institutional constraints, promote pro-poor growth, bring about structural change, enhance distributive equity, engender social and cultural re-orientation, engineer political transformation, promote human development, practise inclusive urban development, generate employment and transform power relations," Igbuzor concluded.
By Alexander Chiejina
At the start of this millennium, world leaders were concerned about the poverty burden, particularly in developing nations across the globe. This concern was born out of poverty and the dearth of productive resources to ensure sustainable livelihoods in that category of nations. In a bid to address these challenges, the United Nations established the MDGs to help underdeveloped countries overcome the problems of illiteracy, poverty, poor health and quality of life.
Much emphasis was placed on the attainment of MDG targets in education because of its pivotal role in national development. The targets include education for all through 100 percent gross enrolment rate by 2015, gender equality in access to education opportunities, eradication of adult illiteracy, and improvement of the quality of education.
Other goals are: promoting gender equality and empowering women, reducing under-five mortality by two-thirds, improving maternal health, combating HIV/AIDS, malaria and other diseases, ensuring environmental sustainability and developing a global partnership for development. However, five years before 2015 rolls by, and in view of the next month's United Nations General Assembly meeting, during which countries will be assessed on their MDG achievements, calls have made on the Office of the Millennium Development Goals (MDGs) in the country to strengthen critical areas of development projects so as to actualise set targets.
While receiving the report of the Presidential Committee on the Assessment and Monitoring of the MDGs recently, Ima Niboro, senior special assistant to the President on Media and Publicity, advised that the committee should ensure that funds budgeted for various projects were adequately used to meet the yearnings and aspirations of Nigerians, especially in the health and education sectors.
"President Goodluck Jonathan identified the need for the committee to do more in the health sector to further reduce the maternal mortality rate. Also, the harmonisation and generation of a baseline data that will assist in proper monitoring and evaluation of all MDG-related projects is essential," remarked Niboro.
For Femi Akinwumi, public affairs analyst and medical expert at the University College Hospital (UCH), Ibadan, while MDGs 4, 5 and 6 seek to reduce child mortality rate, improve maternal health, combat HIV/AIDS, malaria, and other diseases, the non-effective Primary Health Care (PHC) system in the country which should cater for about 70 percent of the population's health needs has instead put good healthcare delivery in jeopardy.
According to him, "Very few Local governments (LGs) in the country have more than five medical doctors on their payroll managing the PHCs for the provision of basic but effective healthcare to the people in their domains. These LGs share up to 30 percent of monthly allocation from the federation account running into scores of millions of naira into the coffer of each LG. In view of this, we as a nation cannot realise the targets of MDGs without an adequately structured, properly managed and well-equipped PHC system."
In the meantime, evidence from the 2006 MDG report shows there is the likelihood of achieving three of the eight goals in Nigeria: achieving universal basic education, ensuring environmental sustainability and developing global partnership for development; while the health MDGs remain daunting challenges for Nigeria. However, a critical barrier to achieving the MDGS remains the unavailability of up-to-date data on most of the indicators. This is compounded by the limited funding available for data generation and management, as expressed by the report.
It would be recalled that while making a presentation at a three-day public hearing to assess the implementation of MDGs in Nigeria between 2007 and 2010, organised by the House of Representatives Committee on MDGs, Hajiya Amina Az-Zubair, senior special assistant to the president on MDGs, disclosed that the MDG project had gulped N1.04trillion since 2006.
Amina Az-Zubair explained that since 2006, $1 billion (about N150 billion) had been gathered from the Paris Club debt relief, out of which the Federal Government takes $750million (N112.50billion) and state governments $250million (about N375 billion). The SSA therefore emphasised the need to be on guard so that funds appropriated for the attainment of the MDGs, about $1 billion per annum were not misappropriated. "N20 billion was appropriated for her office in 2007, out of which N18.4 billion was allocated to the states under the Conditional Grant Scheme [CGS], and thatN300 million was returned to the treasury as unspent fund. In 2008, her office got N59.3 billion and gave N2.3 billion to states as CGS; while N15.5 billion was returned. In 2009, the office received N32.6 billion, spent N27.04 billion given to states under the CGS, while in 2010, it was appropriated N35.02 billion but was yet to make the CGS disbursements," she said, adding that 90 percent of Nigerian children under school age had been registered and attend school, which was a significant achievement as it translated to nine out of 10 children.
"11.6 million Nigerian school children benefit from better quality education from over 200,000 teachers retained through MDGs. Through the work we are doing, many remote communities across the country, some of which have never experienced any form of real development, now have access to primary healthcare centres, boreholes, classrooms and so on," she concluded.
Meanwhile, reports during a workshop on the validation of the 2010 MDGs report and five-year countdown strategy for Nigeria held in Abuja at the weekend state that MDGs implementation in the country over the past few years is a mixed-bag of modest and steady progress on many goals and slow progress on a few others.
The report further notes that out of the eight goals, Nigeria has recorded an average performance on five MDGs, with less satisfactory performance on three others. Listed under the less satisfactory performance are goals one, five and seven.
Goal 1 which is to eradicate extreme poverty and hunger by 2015; the report noted "although poverty has reduced since 2000, the reality is that among every ten Nigerians, five still live in poverty. Growth has not been sufficiently equitable or generated employment," adding however that nutrition has improved significantly. On goal five, improved maternal health, the report noted that there is sizeable reduction of maternal mortality ratio from 800/100,000 (2003) to 157/100,000 (2008). Proportion of births attended by skilled health personnel increased slightly from 36 percent (2003) to 39 percent (2008). The report also noted increase in contraceptive prevalence rate from 8.0 percent (2003) to 10.0 percent (2008).
One salient point is the fact that the timeline for the achievement of the MDGs is 2015, not 2020; hence the goals of the MDGs are a lot more modest and geared towards salvaging the less privileged. However, constitutional responsibility for implementation on almost all the goals rests with the states and local governments in Nigeria's federal structure. But despite remarkable strides at the federal level, appreciation of the requirements for meeting these goals, as well as institutional capacity remain relatively low at the other levels of government.
For Otive Igbuzor, new representative, Centre for Development and Population Activities country office in Nigeria, "there is the need to formulate and implement policies that will promote transparency and accountability, overcome institutional constraints, promote pro-poor growth, bring about structural change, enhance distributive equity, engender social and cultural re-orientation, engineer political transformation, promote human development, practise inclusive urban development, generate employment and transform power relations," Igbuzor concluded.
By Alexander Chiejina
Friday, August 20, 2010
Doctors’ strike, avoidable deaths
Vicious circle of skeletal health services
The outpatient ward at the Lagos State University Teaching Hospital (LASUTH) is filled, with scores of people waiting to be attended to. The story is the same at the paediatric ward of the teaching hospital, where medical staff move to and fro, trying to cope with the pressure associated with the influx of patients. At Gbagada, Isolo and other state-owned general hospitals in Lagos state, the same situation plays out on a daily basis. Patients are anxiously awaiting an end to the current standoff between the government and medical doctors, which has negatively impacted health services.
Curiously, besides nurses, ward aides, cleaners and a handful of non-medical staff, doctors who are acknowledged leaders of the medical team are conspicuously missing from their duty posts. This development has been making the rounds in some state-owned hospitals across the Federation since last week, and has spurred affected health institutions to offer skeletal healthcare services, even without doctors at their duty posts.
An overview of the nation’s health sector from January 2010 till date reveals that there have been several setbacks following incessant strikes by doctors. It is even more alarming when one considers that embarking on strike is equivalent to refusal to perform the most basic function of a medical doctor, which is to save lives, an act contrary to the medical profession’s famous Hippocratic Oath. Observers note that the impact of the series of strikes may not only deepen the problem of poor infrastructure in the nation’s healthcare system, but heighten the collapse of the far less impressive primary and secondary health care delivery systems in the country, if nothing is urgently done to check the trend. Worse still, others maintain, when innocent Nigerians lose their lives unnecessarily during these strikes, no one bears the repercussions. Indeed, who asks questions when there is no respect for the noble call to save lives? they ask.
As stated by a section of the public during a recent debate, although doctors command much respect within medical circles and society at large, their penchant to frequently utilise strike as a weapon whenever there is disagreement with their employers, notably government, is fast eroding the level of confidence their clients repose in them.
As some of the most respected professionals in the world, medical doctors are expected to toe the path of dialogue and exhaust all avenues for the sake of their patients. Just like the traditional saying which reads, “When two elephants fight the grass suffers,” The Nigerian masses have been at the receiving end since the strike in hospitals across the nation started. It is no longer news that the latest strike was sparked off by the recent Consolidated Medical Salary Structure (CONMESS) approved by the Federal Government for doctors in its employ. Since the approval, controversy has trailed the salary structure, as doctors in all the states across the Federation have been agitating that the scale be reflected in their own states.
In Lagos, the Medical Guild, representative organ of all doctors in the state and affiliate bodies that include the Association of Resident Doctors, LASUTH, the Medical and Dental Consultant Association of LASUTH and General Hospitals, embarked on strike last Thursday, over what it termed the state government’s insensitivity towards the implementation of CONMESS, among other sundry issues. Ayobode Williams, chairman, Medical Guild, Lagos, explained that “the congress decided to withdraw its services in all Lagos State government hospitals until all CONMESS arrears from January 2010 are paid immediately, All court processes against the Medical Guild must be withdrawn and no single member of the association should be victimised consequent to the industrial action.” At the other divide, the National Industrial Court enjoined the National Association of Resident Doctors and the Medical Guild to call off their strike action as a matter of urgency, just as it directed the Lagos State government to hold a meeting with representatives of the striking doctors within the week, with a view to resolving the issues in dispute.
Jide Lawal, public relations officer (PRO), Lagos State Ministry of Health, explained that the directive was pursuant to the provisions of Section 20 of the NIC Act in the suits number NIC/LA/28/2010 and NIC/LA/29/2010 between the Attorney General of Lagos State and the Association of Residents Doctors on one hand, and the Medical Guild on the other. Lawal disclosed that the court urged the government not to penalise or victimise any of the doctors for their participation in the strike action, but urged the striking doctors to avail themselves of the window provided by the court’s directives to both parties and toe the path of dialogue, in order to find an amicable solution to the present crisis.
Notable among these agitators are the Oyo, Ogun, and Katsina chapters of the Association of Resident Doctors. The affected state governments have, at a separate forum, stated that much as they would want to meet the demands of the doctors, they cannot afford to pay the huge wage bill that the new salary scale would amount to.
As the situation currently reflects, many states may be unable to meet up with the new scale. But sadly, as the strike action continues, the loser in the whole affair is the patient.
Consequently, concerned stakeholders and close observers of the health industry are now of the opinion that the state governments and Nigerian doctors are playing politics with the lives of helpless Nigerians who depend on them for their health needs.
Alexander chiejina
The outpatient ward at the Lagos State University Teaching Hospital (LASUTH) is filled, with scores of people waiting to be attended to. The story is the same at the paediatric ward of the teaching hospital, where medical staff move to and fro, trying to cope with the pressure associated with the influx of patients. At Gbagada, Isolo and other state-owned general hospitals in Lagos state, the same situation plays out on a daily basis. Patients are anxiously awaiting an end to the current standoff between the government and medical doctors, which has negatively impacted health services.
Curiously, besides nurses, ward aides, cleaners and a handful of non-medical staff, doctors who are acknowledged leaders of the medical team are conspicuously missing from their duty posts. This development has been making the rounds in some state-owned hospitals across the Federation since last week, and has spurred affected health institutions to offer skeletal healthcare services, even without doctors at their duty posts.
An overview of the nation’s health sector from January 2010 till date reveals that there have been several setbacks following incessant strikes by doctors. It is even more alarming when one considers that embarking on strike is equivalent to refusal to perform the most basic function of a medical doctor, which is to save lives, an act contrary to the medical profession’s famous Hippocratic Oath. Observers note that the impact of the series of strikes may not only deepen the problem of poor infrastructure in the nation’s healthcare system, but heighten the collapse of the far less impressive primary and secondary health care delivery systems in the country, if nothing is urgently done to check the trend. Worse still, others maintain, when innocent Nigerians lose their lives unnecessarily during these strikes, no one bears the repercussions. Indeed, who asks questions when there is no respect for the noble call to save lives? they ask.
As stated by a section of the public during a recent debate, although doctors command much respect within medical circles and society at large, their penchant to frequently utilise strike as a weapon whenever there is disagreement with their employers, notably government, is fast eroding the level of confidence their clients repose in them.
As some of the most respected professionals in the world, medical doctors are expected to toe the path of dialogue and exhaust all avenues for the sake of their patients. Just like the traditional saying which reads, “When two elephants fight the grass suffers,” The Nigerian masses have been at the receiving end since the strike in hospitals across the nation started. It is no longer news that the latest strike was sparked off by the recent Consolidated Medical Salary Structure (CONMESS) approved by the Federal Government for doctors in its employ. Since the approval, controversy has trailed the salary structure, as doctors in all the states across the Federation have been agitating that the scale be reflected in their own states.
In Lagos, the Medical Guild, representative organ of all doctors in the state and affiliate bodies that include the Association of Resident Doctors, LASUTH, the Medical and Dental Consultant Association of LASUTH and General Hospitals, embarked on strike last Thursday, over what it termed the state government’s insensitivity towards the implementation of CONMESS, among other sundry issues. Ayobode Williams, chairman, Medical Guild, Lagos, explained that “the congress decided to withdraw its services in all Lagos State government hospitals until all CONMESS arrears from January 2010 are paid immediately, All court processes against the Medical Guild must be withdrawn and no single member of the association should be victimised consequent to the industrial action.” At the other divide, the National Industrial Court enjoined the National Association of Resident Doctors and the Medical Guild to call off their strike action as a matter of urgency, just as it directed the Lagos State government to hold a meeting with representatives of the striking doctors within the week, with a view to resolving the issues in dispute.
Jide Lawal, public relations officer (PRO), Lagos State Ministry of Health, explained that the directive was pursuant to the provisions of Section 20 of the NIC Act in the suits number NIC/LA/28/2010 and NIC/LA/29/2010 between the Attorney General of Lagos State and the Association of Residents Doctors on one hand, and the Medical Guild on the other. Lawal disclosed that the court urged the government not to penalise or victimise any of the doctors for their participation in the strike action, but urged the striking doctors to avail themselves of the window provided by the court’s directives to both parties and toe the path of dialogue, in order to find an amicable solution to the present crisis.
Notable among these agitators are the Oyo, Ogun, and Katsina chapters of the Association of Resident Doctors. The affected state governments have, at a separate forum, stated that much as they would want to meet the demands of the doctors, they cannot afford to pay the huge wage bill that the new salary scale would amount to.
As the situation currently reflects, many states may be unable to meet up with the new scale. But sadly, as the strike action continues, the loser in the whole affair is the patient.
Consequently, concerned stakeholders and close observers of the health industry are now of the opinion that the state governments and Nigerian doctors are playing politics with the lives of helpless Nigerians who depend on them for their health needs.
Alexander chiejina
Evaluating traditional medicine research in Nigeria
...Effective legislation, national policy key for its integration in the nation’s healthcare
Taking a cursory look at Nigeria’s healthcare sector, the contribution of natural-based products to orthodox medicines cannot be overlooked. This is in view of the fact that African Traditional Medicine (ATM) has over time been the mainstay of primary healthcare for majority of Nigerians living in rural areas (over 50 percent of the nation’s population).
However, even as some African countries have put in place mechanisms for registration of traditional medicines legislation, regulatory framework and institutional instruments for developing ATM and locally producing commercial quantities of standardized African traditional medicines (ASTM) and subsequently integrating traditional medicine (TM) into the public health care systems, experts believe the integration of TM into Nigeria’s healthcare sector will do a long way in the nation meeting the Millellium Development Goals (MDGs) target.
In an interview with BusinessDay, Tamuno Okujagu, Director-General, Nigeria Natural Medicine Development Agency (NNMDA) said that the role of traditional medicine in healthcare delivery in the developing countries is well known. He noted that in view of the vast healthcare delivery and economic potential of traditional medicine, countries like China, India and Germany, who had developed their traditional health systems, had supported agencies and universities on researches into traditional medicine.
Okujagu disclosed that several research works on traditional medicine have been documented in line with procedures of the World Health Organisation (WHO) as well as with an African Union (AU) directive. He noted that the AU, in recognition of the vast potential of traditional medicine and its immense contribution to health and poverty alleviation, directed that research on African traditional medicine should be made a priority.
“African countries such as South Africa, Ghana, Egypt and Morocco had keyed into the initiatives and maintained specific institutional mandates to fast-track the co-ordination of research and development, promotion and documentation of traditional medicine. WHO acknowledges this growing need and potential of natural medicine and has continued to encourage and support its promotion, documentation, research and development through several initiatives,” the Director General revealed.
Lending his view, Tony Akhimen, former President Pharmaceutical Society of Nigeria (PSN), stated that even as the efficacy and potency of herbal medicines are being scientifically investigated, acknowledged and documented, the challenge for the Nigerian government is to work out policies that will regulate the herbal medicine sector.
According to him, “the overriding interest must be how to integrate herbal medicine into the mainstream of national healthcare system, intellectual property rights protection for traditional medicine practitioners, proper registration and certification of traditional medicine practitioners, speedy passage of traditional medicine bill and government's support for documentation, standardisation and protection of herbal plants from extinction due to human activities. No doubt, herbal medicine is the future of pharmacy. It is the source of raw materials for most pharmaceutical drugs,” he concluded.
It is worthy to note that traditional medicine to state that global market for traditional therapies stands at US$ 60 billion a year and is steadily growing even as China and India usually record between two to five billion dollars. In developed countries, like France, it is believed that about 75 percent of its population use complementary medicine at least once; in Germany, about 77 percent of pain clinics provide acupuncture; and in the United Kingdom, expenditure on complementary or alternative medicine stands at US$ 2300 million per year.
Giving the enormous economic and health opportunity which traditional medicine offers, a holistic step to ensure that effective legislation, goals and strategies are in place in order to incorporate traditional medicine into Nigeria’s healthcare system. Already, the WHO’s strategy on traditional medicine provides a framework for policy to assist countries to regulate traditional or complementary/alternative medicine (TM/CAM) to make its use safer, more accessible to their populations and sustainable.
For Olukemi Odukoya, Professor of Pharmacognosy at the University of Lagos, pharmacognosy is the vital link between traditional and orthodox systems of medicine and has its facts in traditional systems of medicine and traditional use of traditional plants.
“Efforts have been spent by Nigerian researchers on scientific evaluation and validation of Nigeria's medicinal aromatic plants, healing arts and systems hence, the inclusion of traditional medicine into the country’s MDGs as directed by the WHO and the African Union will go a long way in attaining health for all by 2015 otherwise could be elusive,” Odukoya stated.
Doctors' strike; when will this impasse end?
Alexander Chiejina
The outpatient ward at the Lagos State University Teaching Hospital (LASUTH) is filled; scores of people waiting to be attended to. The same is the case at the paediatric ward where medical staffs are seen going to and fro, trying to cope with the pressure associated with influx of patients. This scenario is the same at Gbagada, Isolo and other state-owned general hospitals in Lagos state. Interestingly, patients are waiting anxiously for medical doctors and the government to settle their current differences which has impacted negatively on health services.
Intriguingly, apart from nurses, ward aides, cleaners and few non-medical staff, doctors who are acknowledged as leaders of the medical team were conspicuously missing. This development has played itself out several times over in some state-owned hospitals in the Federation including Lagos since last week. No doubt, this has necessitated affected health institutions to develop strategies on how to cope by offering skeletal healthcare services even without doctors at their duty posts.
Taking a brief look from January 2010 to date, the health sector has witnessed several setback following incessant strikes by Nigerian doctors. It is even more surprising if it is considered that embarking on strike is equivalent to refusal to perform the most basic function of a medical doctor, that is, to save lives first and foremost, an act contrary to the medical profession’s famous Hippocratic Oath which one swears to uphold.
Observers note that the impact of the series of strikes may not only deepened the problems of poor infrastructures in the health system, but worsened the collapse of the far less impressive primary and secondary health care delivery systems in the country if nothing urgent is done to check the trend.
Worse still, tongues have continued to wag that when many innocent Nigerians lose their lives unnecessarily during these strikes, no one bears the repercussions. Indeed, who asks questions when there is no respect for the noble call to save lives?
As stated by a section of the public during a recent debate, although doctors command much respect within medical circles and society at large, their penchant to frequently utilise strike as a weapon whenever there is disagreement with their employers, notably government, is fast eroding the level of confidence and trust that their clients have for them and their profession.
As some of the most respected professionals in the world, medical doctors are expected to toe the path of dialogue and to exhaust all avenues for the sake of their patients. Just like the traditional old sayings, “When two elephants fight the grass suffers” The Nigerian masses have been at the receiving end since the emergence of strike in all hospitals across the nation.
It is no longer secret that the latest strike was sparked off by the recent Consolidated Medical Salary Structure (CONMESS) approved by the Federal Government for doctors under their employment. Since the approval, controversy has trailed the salary structure as doctors in all the states have been agitating that the scale be reflected in their own states.
For Lagos state, the Medical Guild, the representative organ of all doctors in the service of Lagos state and made of affiliate bodies that includes the Association of Resident Doctors LASUTH, the medical and dental Consultant Association of LASUTH and General Hospitals embarked on a strike action last week Thursday over what it called insensitivity by the state Government towards the implementation of CONMESS among other sundry issues.
For Ayobode Williams, Chairman, Medical Guild, Lagos state, “the congress decided to withdraw its services in all Lagos state Government hospitals until CONMESS is paid to all doctors in Lagos State Government Service, all arrears from January 2010 are paid immediately, all court processes against the Medical Guild be withdrawn and that no single member of the association be victimized consequent to the industrial action.”
At the other divide, the National Industrial Court enjoined the National Association of Resident Doctors and the Medical Guild to call off their strike action as a matter of urgency just as it also directed the Lagos State government to hold a meeting with representatives of the striking doctors within the week with a view to resolving the issues in dispute.
Jide Lawal, Public Relations Officer (PRO), Lagos State Ministry of Health, explained that the directive was pursuant to the provisions of Section 20 of the NIC Act in the suits number NIC/LA/28/2010 and NIC/LA/29/2010 between the Attorney General of Lagos State and the Association of Residents Doctors on one hand and the Medical Guild on the other hand.
Lawal disclosed that the court urged government not to penalize or victimize any of the doctors for their participation in the strike action but urged the striking doctors to avail themselves of the window provided by the Court's directives to both parties and embrace the path of dialogue, allow a sense of fairness, good judgment and peace to prevail in order to find an amicable solution to the present crisis.
Notable amongst these agitators are the Oyo, Ogun, and Katsina states where the doctors are currently on strike. The affected State governments have at separate forum stated that as much as they would want to meet the demands of the doctors, they cannot afford to pay the huge wage bill that the new salary scale would amount to.
As the situation currently reflects, many states may be unable to meet up with the new scale. Sadly as the strike action continues, the loser in the whole affair is the patient.
Concerned stakeholders and close observers of the health industry are now of the opinion that the State governments and Nigerian doctors are playing politics with the lives of helpless Nigerians who depend on the services of the government owned hospitals for their health needs, and whose tax is the source of the doctors’ salaries. Even as it is, a fundamental question remains unanswered. Where lies the opinion of the Nigerian masses in all these?
By Alexander Chiejina
Taking a cursory look at Nigeria’s healthcare sector, the contribution of natural-based products to orthodox medicines cannot be overlooked. This is in view of the fact that African Traditional Medicine (ATM) has over time been the mainstay of primary healthcare for majority of Nigerians living in rural areas (over 50 percent of the nation’s population).
However, even as some African countries have put in place mechanisms for registration of traditional medicines legislation, regulatory framework and institutional instruments for developing ATM and locally producing commercial quantities of standardized African traditional medicines (ASTM) and subsequently integrating traditional medicine (TM) into the public health care systems, experts believe the integration of TM into Nigeria’s healthcare sector will do a long way in the nation meeting the Millellium Development Goals (MDGs) target.
In an interview with BusinessDay, Tamuno Okujagu, Director-General, Nigeria Natural Medicine Development Agency (NNMDA) said that the role of traditional medicine in healthcare delivery in the developing countries is well known. He noted that in view of the vast healthcare delivery and economic potential of traditional medicine, countries like China, India and Germany, who had developed their traditional health systems, had supported agencies and universities on researches into traditional medicine.
Okujagu disclosed that several research works on traditional medicine have been documented in line with procedures of the World Health Organisation (WHO) as well as with an African Union (AU) directive. He noted that the AU, in recognition of the vast potential of traditional medicine and its immense contribution to health and poverty alleviation, directed that research on African traditional medicine should be made a priority.
“African countries such as South Africa, Ghana, Egypt and Morocco had keyed into the initiatives and maintained specific institutional mandates to fast-track the co-ordination of research and development, promotion and documentation of traditional medicine. WHO acknowledges this growing need and potential of natural medicine and has continued to encourage and support its promotion, documentation, research and development through several initiatives,” the Director General revealed.
Lending his view, Tony Akhimen, former President Pharmaceutical Society of Nigeria (PSN), stated that even as the efficacy and potency of herbal medicines are being scientifically investigated, acknowledged and documented, the challenge for the Nigerian government is to work out policies that will regulate the herbal medicine sector.
According to him, “the overriding interest must be how to integrate herbal medicine into the mainstream of national healthcare system, intellectual property rights protection for traditional medicine practitioners, proper registration and certification of traditional medicine practitioners, speedy passage of traditional medicine bill and government's support for documentation, standardisation and protection of herbal plants from extinction due to human activities. No doubt, herbal medicine is the future of pharmacy. It is the source of raw materials for most pharmaceutical drugs,” he concluded.
It is worthy to note that traditional medicine to state that global market for traditional therapies stands at US$ 60 billion a year and is steadily growing even as China and India usually record between two to five billion dollars. In developed countries, like France, it is believed that about 75 percent of its population use complementary medicine at least once; in Germany, about 77 percent of pain clinics provide acupuncture; and in the United Kingdom, expenditure on complementary or alternative medicine stands at US$ 2300 million per year.
Giving the enormous economic and health opportunity which traditional medicine offers, a holistic step to ensure that effective legislation, goals and strategies are in place in order to incorporate traditional medicine into Nigeria’s healthcare system. Already, the WHO’s strategy on traditional medicine provides a framework for policy to assist countries to regulate traditional or complementary/alternative medicine (TM/CAM) to make its use safer, more accessible to their populations and sustainable.
For Olukemi Odukoya, Professor of Pharmacognosy at the University of Lagos, pharmacognosy is the vital link between traditional and orthodox systems of medicine and has its facts in traditional systems of medicine and traditional use of traditional plants.
“Efforts have been spent by Nigerian researchers on scientific evaluation and validation of Nigeria's medicinal aromatic plants, healing arts and systems hence, the inclusion of traditional medicine into the country’s MDGs as directed by the WHO and the African Union will go a long way in attaining health for all by 2015 otherwise could be elusive,” Odukoya stated.
Doctors' strike; when will this impasse end?
Alexander Chiejina
The outpatient ward at the Lagos State University Teaching Hospital (LASUTH) is filled; scores of people waiting to be attended to. The same is the case at the paediatric ward where medical staffs are seen going to and fro, trying to cope with the pressure associated with influx of patients. This scenario is the same at Gbagada, Isolo and other state-owned general hospitals in Lagos state. Interestingly, patients are waiting anxiously for medical doctors and the government to settle their current differences which has impacted negatively on health services.
Intriguingly, apart from nurses, ward aides, cleaners and few non-medical staff, doctors who are acknowledged as leaders of the medical team were conspicuously missing. This development has played itself out several times over in some state-owned hospitals in the Federation including Lagos since last week. No doubt, this has necessitated affected health institutions to develop strategies on how to cope by offering skeletal healthcare services even without doctors at their duty posts.
Taking a brief look from January 2010 to date, the health sector has witnessed several setback following incessant strikes by Nigerian doctors. It is even more surprising if it is considered that embarking on strike is equivalent to refusal to perform the most basic function of a medical doctor, that is, to save lives first and foremost, an act contrary to the medical profession’s famous Hippocratic Oath which one swears to uphold.
Observers note that the impact of the series of strikes may not only deepened the problems of poor infrastructures in the health system, but worsened the collapse of the far less impressive primary and secondary health care delivery systems in the country if nothing urgent is done to check the trend.
Worse still, tongues have continued to wag that when many innocent Nigerians lose their lives unnecessarily during these strikes, no one bears the repercussions. Indeed, who asks questions when there is no respect for the noble call to save lives?
As stated by a section of the public during a recent debate, although doctors command much respect within medical circles and society at large, their penchant to frequently utilise strike as a weapon whenever there is disagreement with their employers, notably government, is fast eroding the level of confidence and trust that their clients have for them and their profession.
As some of the most respected professionals in the world, medical doctors are expected to toe the path of dialogue and to exhaust all avenues for the sake of their patients. Just like the traditional old sayings, “When two elephants fight the grass suffers” The Nigerian masses have been at the receiving end since the emergence of strike in all hospitals across the nation.
It is no longer secret that the latest strike was sparked off by the recent Consolidated Medical Salary Structure (CONMESS) approved by the Federal Government for doctors under their employment. Since the approval, controversy has trailed the salary structure as doctors in all the states have been agitating that the scale be reflected in their own states.
For Lagos state, the Medical Guild, the representative organ of all doctors in the service of Lagos state and made of affiliate bodies that includes the Association of Resident Doctors LASUTH, the medical and dental Consultant Association of LASUTH and General Hospitals embarked on a strike action last week Thursday over what it called insensitivity by the state Government towards the implementation of CONMESS among other sundry issues.
For Ayobode Williams, Chairman, Medical Guild, Lagos state, “the congress decided to withdraw its services in all Lagos state Government hospitals until CONMESS is paid to all doctors in Lagos State Government Service, all arrears from January 2010 are paid immediately, all court processes against the Medical Guild be withdrawn and that no single member of the association be victimized consequent to the industrial action.”
At the other divide, the National Industrial Court enjoined the National Association of Resident Doctors and the Medical Guild to call off their strike action as a matter of urgency just as it also directed the Lagos State government to hold a meeting with representatives of the striking doctors within the week with a view to resolving the issues in dispute.
Jide Lawal, Public Relations Officer (PRO), Lagos State Ministry of Health, explained that the directive was pursuant to the provisions of Section 20 of the NIC Act in the suits number NIC/LA/28/2010 and NIC/LA/29/2010 between the Attorney General of Lagos State and the Association of Residents Doctors on one hand and the Medical Guild on the other hand.
Lawal disclosed that the court urged government not to penalize or victimize any of the doctors for their participation in the strike action but urged the striking doctors to avail themselves of the window provided by the Court's directives to both parties and embrace the path of dialogue, allow a sense of fairness, good judgment and peace to prevail in order to find an amicable solution to the present crisis.
Notable amongst these agitators are the Oyo, Ogun, and Katsina states where the doctors are currently on strike. The affected State governments have at separate forum stated that as much as they would want to meet the demands of the doctors, they cannot afford to pay the huge wage bill that the new salary scale would amount to.
As the situation currently reflects, many states may be unable to meet up with the new scale. Sadly as the strike action continues, the loser in the whole affair is the patient.
Concerned stakeholders and close observers of the health industry are now of the opinion that the State governments and Nigerian doctors are playing politics with the lives of helpless Nigerians who depend on the services of the government owned hospitals for their health needs, and whose tax is the source of the doctors’ salaries. Even as it is, a fundamental question remains unanswered. Where lies the opinion of the Nigerian masses in all these?
By Alexander Chiejina
Wednesday, August 18, 2010
Motivational Sayings
Why read motivational sayings? For motivation! You might need a bit, if you can use last year's list of goals this year because it's as good as new. All of us can benefit from inspirational thoughts, so here are ten great ones.
"Be more concerned with your character than with your reputation. Your character is what you really are while your reputation is merely what others think you are." - Dale Carnegie
"Do not wait; the time will never be 'just right.' Start where you stand, and work with whatever tools you may have at your command, and better tools will be found as you go along." - Napoleon Hill
"What lies behind us and what lies before us are tiny matters compared to what lies within us." - Ralph Waldo Emerson
"Some men see things as they are and say, "Why?" I dream of things that never were and say, "Why not?" - George Bernard Shaw
"A small trouble is like a pebble. Hold it too close to your eye and it fills the whole world and puts everything out of focus. Hold it at a proper distance and it can be examined and properly classified. Throw it at your feet and it can be seen in its true setting, just one more tiny bump on the pathway of life." - Celia Luce
"Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending." - Carl Bard
"I'm not telling you it is going to be easy - I'm telling you it's going to be worth it" - Art Williams
Motivational Sayings - Attitude
Attitude "There is little difference in people, but that little difference makes a big difference. The little difference is attitude. The big difference is whether it is positive or negative." - W. Clement Stone
"Nothing on earth can stop the man with the right mental attitude from achieving his goal; nothing on earth can help the man with the wrong mental attitude." - Thomas Jefferson
"A person cannot directly choose his circumstances, but he can choose his thoughts, and so indirectly, yet surely, shape his circumstances." - James Allen
"Man often becomes what he believes himself to be. If I keep on saying to myself that I cannot do a certain thing, it is possible that I may end by really becoming incapable of doing it. On the contrary, if I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning." - Mohandas Karamchand (Mahatma) Gandhi
These are quotes that mean something to me. Hopefully one or two of them are also inspiring to you. If not, maybe they will motivate you to create your own motivational sayings.
Alexander Chiejina
"Be more concerned with your character than with your reputation. Your character is what you really are while your reputation is merely what others think you are." - Dale Carnegie
"Do not wait; the time will never be 'just right.' Start where you stand, and work with whatever tools you may have at your command, and better tools will be found as you go along." - Napoleon Hill
"What lies behind us and what lies before us are tiny matters compared to what lies within us." - Ralph Waldo Emerson
"Some men see things as they are and say, "Why?" I dream of things that never were and say, "Why not?" - George Bernard Shaw
"A small trouble is like a pebble. Hold it too close to your eye and it fills the whole world and puts everything out of focus. Hold it at a proper distance and it can be examined and properly classified. Throw it at your feet and it can be seen in its true setting, just one more tiny bump on the pathway of life." - Celia Luce
"Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending." - Carl Bard
"I'm not telling you it is going to be easy - I'm telling you it's going to be worth it" - Art Williams
Motivational Sayings - Attitude
Attitude "There is little difference in people, but that little difference makes a big difference. The little difference is attitude. The big difference is whether it is positive or negative." - W. Clement Stone
"Nothing on earth can stop the man with the right mental attitude from achieving his goal; nothing on earth can help the man with the wrong mental attitude." - Thomas Jefferson
"A person cannot directly choose his circumstances, but he can choose his thoughts, and so indirectly, yet surely, shape his circumstances." - James Allen
"Man often becomes what he believes himself to be. If I keep on saying to myself that I cannot do a certain thing, it is possible that I may end by really becoming incapable of doing it. On the contrary, if I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning." - Mohandas Karamchand (Mahatma) Gandhi
These are quotes that mean something to me. Hopefully one or two of them are also inspiring to you. If not, maybe they will motivate you to create your own motivational sayings.
Alexander Chiejina
Monday, August 16, 2010
Tobacco marketing and challenges of public-smoking bill
Following health risks associated with tobacco consumption, which according to experts, is the second leading cause of deaths globally (after hypertension) and currently responsible for the death of one in every 10 adults worldwide, experts are of the view that enacting effective policies toward reducing tobacco consumption in Nigeria will go a long way at saving people’s lives.
This is coming in view of recent reports by the World Health Organisation (WHO), which states that an estimated 5.4 million people die annually due to tobacco-related diseases, with majority of these deaths happening in developing countries.
In a recent interview with BusinessDay, Akinbode Oluwafemi, programme manager, Environmental Rights in Nigeria/Friends of the Earth, lamented over what he called the latest trend of marketing tobacco to women and young girls as a major strategy of boosting the tobacco industry. Akinbode regretted that about 250 million women worldwide now smoke and for low income countries like Nigeria, it is bad news because the rate that once stood at nine percent had gone up.
According to him, “a recent Global Youth Tobacco Survey (GYTS) indicates an alarming increase in the number of girls who smoke and those who considered smoking to boys. In Nigeria, women have consistently been a source of marketing tobacco products. Also, several young girls are involved in the promotions of a tobacco firm in the country (for instance the Experience IT promotion in 2003, Experience Freshness promo in 2008, etc).”
The programme manager noted further that young people were highly impressionistic and tended to gravitate towards anything that produced the image of sophistication and glamour, believing that the tobacco industry had used this ploy to “catch them young” and turn them into lifelong replacement smokers.
“The effect of the marketing which happened especially between 2001 and 2005, and still continues illegally through illegal cigarette promotions and secret smoking parties, has been enormous. Recent statistics show an alarming increase in young people who are taking up smoking in Nigeria. If tobacco industry can addict more young people, they will serve as replacement smokers for the older customers that have died off due to their deadly habit,” Akinbode disclosed.
For Kemi Odukoya, a public health expert at the Lagos University Teaching Hospital (LUTH) Idi-araba, tobacco consumption causes reproductive damage, premature menopause, breakdown of hormone system, painful and/or irregular menstruation, and damages the foetus in pregnant women.
“Preventing female smoking, especially in low income countries, will have a positive impact in global health than any other single intervention. There is the need to nip the issue of tobacco consumption in the bud following a number of chronic diseases including lung diseases, and cardiovascular diseases associated with tobacco use,” Odukoya concluded.
No doubt, the impact of second-hand smoking cannot be overemphasised considering the fact that it is responsible for one in every six tobacco related deaths in the world. However, enacting stringent measures aimed at reducing public smoking would go a long way in reducing public health related issues.
Currently, the Federal Capital Territory Abuja has declared its territory smoke free and is putting in place measures for effective implementation of its smoke-free policies. Osun State has an effective and comprehensive public places smoke-free law in place, which was signed into law in April 2010 by the governor, Olagunsoye Oyinlola.
In the words of Akinbode: “The proposed National Tobacco Control Bill (NTCB) at the National Assembly is sponsored by Olorunnibe Mamora, who is a Senate member of the National Assembly. The Bill provided for comprehensive smoke-free public places all over Nigeria. The bill is currently with the Senate Committee on Health headed by Iyabo Obasanjo-Bello and is still expected to be returned to the Senate plenary. When passed, we would have been able to comprehensively reduce the problem of second-hand smoking in Nigeria”.
The bill is a life saver for Nigerians and the future generations, as it will help cut down spending on our healthcare. However, the National Assembly and Senate Committee on Health should expedite action on that bill so that Nigerians would less be exposed to this health hazard. Already, there are stringent measures in place to reduce smoking in Europe and America; Nigeria should borrow a leaf from that.
By Alexander Chiejina
This is coming in view of recent reports by the World Health Organisation (WHO), which states that an estimated 5.4 million people die annually due to tobacco-related diseases, with majority of these deaths happening in developing countries.
In a recent interview with BusinessDay, Akinbode Oluwafemi, programme manager, Environmental Rights in Nigeria/Friends of the Earth, lamented over what he called the latest trend of marketing tobacco to women and young girls as a major strategy of boosting the tobacco industry. Akinbode regretted that about 250 million women worldwide now smoke and for low income countries like Nigeria, it is bad news because the rate that once stood at nine percent had gone up.
According to him, “a recent Global Youth Tobacco Survey (GYTS) indicates an alarming increase in the number of girls who smoke and those who considered smoking to boys. In Nigeria, women have consistently been a source of marketing tobacco products. Also, several young girls are involved in the promotions of a tobacco firm in the country (for instance the Experience IT promotion in 2003, Experience Freshness promo in 2008, etc).”
The programme manager noted further that young people were highly impressionistic and tended to gravitate towards anything that produced the image of sophistication and glamour, believing that the tobacco industry had used this ploy to “catch them young” and turn them into lifelong replacement smokers.
“The effect of the marketing which happened especially between 2001 and 2005, and still continues illegally through illegal cigarette promotions and secret smoking parties, has been enormous. Recent statistics show an alarming increase in young people who are taking up smoking in Nigeria. If tobacco industry can addict more young people, they will serve as replacement smokers for the older customers that have died off due to their deadly habit,” Akinbode disclosed.
For Kemi Odukoya, a public health expert at the Lagos University Teaching Hospital (LUTH) Idi-araba, tobacco consumption causes reproductive damage, premature menopause, breakdown of hormone system, painful and/or irregular menstruation, and damages the foetus in pregnant women.
“Preventing female smoking, especially in low income countries, will have a positive impact in global health than any other single intervention. There is the need to nip the issue of tobacco consumption in the bud following a number of chronic diseases including lung diseases, and cardiovascular diseases associated with tobacco use,” Odukoya concluded.
No doubt, the impact of second-hand smoking cannot be overemphasised considering the fact that it is responsible for one in every six tobacco related deaths in the world. However, enacting stringent measures aimed at reducing public smoking would go a long way in reducing public health related issues.
Currently, the Federal Capital Territory Abuja has declared its territory smoke free and is putting in place measures for effective implementation of its smoke-free policies. Osun State has an effective and comprehensive public places smoke-free law in place, which was signed into law in April 2010 by the governor, Olagunsoye Oyinlola.
In the words of Akinbode: “The proposed National Tobacco Control Bill (NTCB) at the National Assembly is sponsored by Olorunnibe Mamora, who is a Senate member of the National Assembly. The Bill provided for comprehensive smoke-free public places all over Nigeria. The bill is currently with the Senate Committee on Health headed by Iyabo Obasanjo-Bello and is still expected to be returned to the Senate plenary. When passed, we would have been able to comprehensively reduce the problem of second-hand smoking in Nigeria”.
The bill is a life saver for Nigerians and the future generations, as it will help cut down spending on our healthcare. However, the National Assembly and Senate Committee on Health should expedite action on that bill so that Nigerians would less be exposed to this health hazard. Already, there are stringent measures in place to reduce smoking in Europe and America; Nigeria should borrow a leaf from that.
By Alexander Chiejina
Nigeria’s sickle cell indices worry health experts
If recent national statistics on children born with Sickle Cell Disorder (SCD) are anything to go by, then the quest to reduce under-five mortality by two-thirds, which is in line with the Millennium Development Goals (MDG), may remain a Herculean task.
This is because recent data released by the World Health Organisation (WHO) reveal that an average of 150,000 infants are born with SCD in Nigeria, which has an annual infant death figure of 100,000. Hence, the high incidence of sickle cell cases, experts insist, calls for a holistic approach targeted at evolving strategies that will keep the disorder in check.
Torinola Femi-Adebayo, senior medical officer, National Sickle Cell Centre, Idi-araba, Lagos, while speaking with BusinessDay, explained that sickle-cell anaemia (also known as sickle-cell disorder or sickle-cell disease), a genetic condition, stems from inheritance of mutant haemoglobin genes from both parents.
Femi-Adebayo hinted that though a single abnormal gene may protect against malaria, inheritance of two abnormal genes results in sickle-cell anaemia, and is a major cause of ill-health and death among children. According to the medical expert, the public health implications of sickle-cell anaemia are significant, since not all deaths occur in the first year of life. “The management of sickle cell in Nigeria remains inadequate, as no coordinated policy and national control programmes on the… disorder exist. Systematic screening is not a common practice, and more often than not, diagnosis is usually made when a patient presents a severe complication,” she observed.
The medical expert however noted that the National Sickle Cell Centre had established sickle cell clinics in Kano, Delta, Edo and Lagos States, which have so far recorded tremendous success: “People with sickle cell disorder go there to receive treatment free of charge. There is a coordinated plan in place whereby such individuals are made to go for medical checks every three months.”
Minister of Health Onyebuchi Chukwu, while speaking at the recent World Sickle Cell Day campaign with the theme ‘Sickle Cell Disease, 1910 - 2010: 100 Years of Science, Still Seeking Global Solutions”, disclosed that the high incidence of the condition calls for far-reaching control measures. This, she explained, is why the ministry has collaborated with many organisations to scale up SCD management in the country. “Our collaboration with the London Focus Sickle Cell Africa (based in Zankli Clinic, Abuja) has brought about accurate screening and diagnosis of sickle cell disease variants and other forms of haemoglobin abnormalities, both in adults and newborns. The Sickle Cell Foundation of Nigeria has also helped in managing Sickle Cell Centres in communities, mobilising resources and providing telemedicine facilities, including a well-equipped library in Lagos,” the health minister stated.
In view of the public health implications of sickle cell, a coordinated policy on its management in Nigeria should be put in place. The management of the disorder should cover prevention and counselling, early detection and treatment, surveillance and research, including community education and partnership.
Likewise, dedicated centres should be established to guarantee adequate services for prevention and treatment. Ideally, the disease should be identified at birth as part of a screening programme or neonatal diagnosis, and affected individuals urged to visit a centre periodically for evaluation. Besides, management of patients with sickle-cell anaemia should be at the primary health-care level, with emphasis on programmes that use simple, affordable technology and reach a large section of the community. Examples of such programmes include: public education, detection of genetic risks in the community, health and genetic counselling, as well as immunisation against infections.
Finally, a stepwise approach to monitoring of sickle-cell anaemia and its risk factors is required to collect data for better decision-making and technical collaboration, as are partnerships at local, state and national levels which will ensure every stakeholder in the health sector is fully aware of the extent of the problem.
By Alexander Chiejina
This is because recent data released by the World Health Organisation (WHO) reveal that an average of 150,000 infants are born with SCD in Nigeria, which has an annual infant death figure of 100,000. Hence, the high incidence of sickle cell cases, experts insist, calls for a holistic approach targeted at evolving strategies that will keep the disorder in check.
Torinola Femi-Adebayo, senior medical officer, National Sickle Cell Centre, Idi-araba, Lagos, while speaking with BusinessDay, explained that sickle-cell anaemia (also known as sickle-cell disorder or sickle-cell disease), a genetic condition, stems from inheritance of mutant haemoglobin genes from both parents.
Femi-Adebayo hinted that though a single abnormal gene may protect against malaria, inheritance of two abnormal genes results in sickle-cell anaemia, and is a major cause of ill-health and death among children. According to the medical expert, the public health implications of sickle-cell anaemia are significant, since not all deaths occur in the first year of life. “The management of sickle cell in Nigeria remains inadequate, as no coordinated policy and national control programmes on the… disorder exist. Systematic screening is not a common practice, and more often than not, diagnosis is usually made when a patient presents a severe complication,” she observed.
The medical expert however noted that the National Sickle Cell Centre had established sickle cell clinics in Kano, Delta, Edo and Lagos States, which have so far recorded tremendous success: “People with sickle cell disorder go there to receive treatment free of charge. There is a coordinated plan in place whereby such individuals are made to go for medical checks every three months.”
Minister of Health Onyebuchi Chukwu, while speaking at the recent World Sickle Cell Day campaign with the theme ‘Sickle Cell Disease, 1910 - 2010: 100 Years of Science, Still Seeking Global Solutions”, disclosed that the high incidence of the condition calls for far-reaching control measures. This, she explained, is why the ministry has collaborated with many organisations to scale up SCD management in the country. “Our collaboration with the London Focus Sickle Cell Africa (based in Zankli Clinic, Abuja) has brought about accurate screening and diagnosis of sickle cell disease variants and other forms of haemoglobin abnormalities, both in adults and newborns. The Sickle Cell Foundation of Nigeria has also helped in managing Sickle Cell Centres in communities, mobilising resources and providing telemedicine facilities, including a well-equipped library in Lagos,” the health minister stated.
In view of the public health implications of sickle cell, a coordinated policy on its management in Nigeria should be put in place. The management of the disorder should cover prevention and counselling, early detection and treatment, surveillance and research, including community education and partnership.
Likewise, dedicated centres should be established to guarantee adequate services for prevention and treatment. Ideally, the disease should be identified at birth as part of a screening programme or neonatal diagnosis, and affected individuals urged to visit a centre periodically for evaluation. Besides, management of patients with sickle-cell anaemia should be at the primary health-care level, with emphasis on programmes that use simple, affordable technology and reach a large section of the community. Examples of such programmes include: public education, detection of genetic risks in the community, health and genetic counselling, as well as immunisation against infections.
Finally, a stepwise approach to monitoring of sickle-cell anaemia and its risk factors is required to collect data for better decision-making and technical collaboration, as are partnerships at local, state and national levels which will ensure every stakeholder in the health sector is fully aware of the extent of the problem.
By Alexander Chiejina
Inadequate funding stalls anti-malaria research efforts
...Experts insist achievement of MDGs hinged on ground-breaking findings
In the face of the sweeping malaria scourge which results in the deaths of about one million people annually, most of them in sub Saharan Africa, leaders across the continent have evolved strategies which they believe would bring about maximum prevention.
Worthy of note is the African Summit on ‘Roll Back Malaria’ which held in Abuja April 25, 2000, and was attended by representatives of 44 countries across the world. They all agreed to develop mechanisms that would facilitate the provision of reliable information on malaria to decision-makers at household, community, district and national levels, to enable them take appropriate actions.
Other key decisions included reducing/waiving taxes and tariffs for mosquito nets and materials, insecticides, anti-malaria drugs and other recommended goods and services needed for malaria control strategies; increasing support for research (including operational research) to develop a vaccine and improve existing ones. However, with malaria remaining one of the three infant killers in Nigeria and accounting for about 60 percent of outpatient visits and 30 percent of hospitalisations, experts have called for an integrated system of management and research funding for malaria prevention in the country.
Wellington Oyibo, consultant medical parasitologist, College of Medicine, University of Lagos, while speaking with BusinessDay, described malaria as a major threat to public health and economic development in Nigeria. Oyibo disclosed that even as efforts towards eradicating malaria had continued, parasite resistance to the most commonly used and affordable anti-malaria drugs were developing rapidly, adding that insecticide resistance to the vector was also an evolving problem.
He hinted that of all the malaria vaccines - RTSS, which was created in 1987 and clinical evaluation, which began in 1992 and is ongoing in some East African countries, had been recording some level of success. “Funding malaria research amounts to millions of dollars. However, developed nations, through the support of government, international agencies and the Bill & Melinda Gates Foundation, have continued to fund the development of malaria vaccine for malaria endemic countries. Sadly, such funds are far less when compared to funds budgeted to support the treatment of illnesses like cardiovascular diseases, diabetes, etc,” he said. Vaccine trials are conducted in countries like Kenya, Tanzania and Senegal. But that is not the case with Nigeria, where inadequate infrastructure (like power) makes research difficult. Also, in countries where such trials for malaria are conducted, medical research institutes derive huge benefits because they receive all the assistance they need to effectively carry out research.
For Shilaj Chakravorty, consultant pathologist, BT Health and Diagnostic Centre, Lagos State University Teaching Hospital (LASUTH), Ikeja, investment in malaria control is saving lives and reaping far-reaching benefits for countries where the malaria parasite is endemic. “Factors such as increasing urbanisation disproportionate to infrastructure, drug-resistant malaria, insecticide-resistant mosquitoes, inadequate vector control operations and public health practices encourage the increase of malaria parasite,” added Chakravorty, while maintaining that without sustained funding and continuous research, the significant contribution of malaria control towards the achievement of the Millennium Development Goals (MDG) could be reversed.
It would be recalled that the Global Fund to Fight AIDS, Tuberculosis and Malaria and the nation’s Federal Ministry of Health, in October 2009, signed a malaria grant to the tune of $285 million over a two-year period. The Global Fund took a flexible approach by signing, in July 2009, an interim agreement to allow for the timely distribution of 3.4 millions bed nets in line for a mass distribution campaign planned for December, 2010. Other contributors include the World Bank, DFID, USAID, UNITAID, and UNICEF. With these funds committed to fighting malaria in Nigeria, reducing the malaria burden by 50 percent this year and 75 percent by 2015 should be achieveable.
Folake Ademola- Majekodunmi, national coordinator, National Malaria Control Programme (NMCP), Federal Ministry of Health, stated that providing health information and education would enable Nigerians make the right decisions about their health. “We are placing two mosquito nets in every household in Nigeria. These are not just the traditional mosquito nets as we used to know it. They are long-lasting nets that have been treated with insecticides. The major difference that the nets offer is that they do not just repel mosquitoes, they kill mosquitoes’ dead. They are called LLIN (Long Lasting Insecticidal Nets),” Ademola-Majekodunmi stated. Meanwhile, there is indeed hope if African malaria researchers could become more adept at not only providing global leadership in malaria research and mentoring young scientists for the next generation, but also at taking advantage of the current funding opportunities to propose ground-breaking projects that are internationally competitive for long-term sustainability.
True, the control of malaria is a long-term objective and the sharing of resources and competencies is crucial to its achievement, but a massive infusion of funds for capacity-building, infrastructural development and day-to-day research activities from the governments and international donor agencies will foster an environment for synergy with a common goal: the control of malaria.
On the community front, environmental management to deal with mosquitoes will ensure they do not breed in water logged areas. Perhaps, proper hygiene and sanitation around dwelling places can be employed. Also, massive investment in mass mobilisation and communication will ensure people do what is right in their localities. That way, mosquitoes will have no habitat where they can breed.
By Alexander Chiejina
In the face of the sweeping malaria scourge which results in the deaths of about one million people annually, most of them in sub Saharan Africa, leaders across the continent have evolved strategies which they believe would bring about maximum prevention.
Worthy of note is the African Summit on ‘Roll Back Malaria’ which held in Abuja April 25, 2000, and was attended by representatives of 44 countries across the world. They all agreed to develop mechanisms that would facilitate the provision of reliable information on malaria to decision-makers at household, community, district and national levels, to enable them take appropriate actions.
Other key decisions included reducing/waiving taxes and tariffs for mosquito nets and materials, insecticides, anti-malaria drugs and other recommended goods and services needed for malaria control strategies; increasing support for research (including operational research) to develop a vaccine and improve existing ones. However, with malaria remaining one of the three infant killers in Nigeria and accounting for about 60 percent of outpatient visits and 30 percent of hospitalisations, experts have called for an integrated system of management and research funding for malaria prevention in the country.
Wellington Oyibo, consultant medical parasitologist, College of Medicine, University of Lagos, while speaking with BusinessDay, described malaria as a major threat to public health and economic development in Nigeria. Oyibo disclosed that even as efforts towards eradicating malaria had continued, parasite resistance to the most commonly used and affordable anti-malaria drugs were developing rapidly, adding that insecticide resistance to the vector was also an evolving problem.
He hinted that of all the malaria vaccines - RTSS, which was created in 1987 and clinical evaluation, which began in 1992 and is ongoing in some East African countries, had been recording some level of success. “Funding malaria research amounts to millions of dollars. However, developed nations, through the support of government, international agencies and the Bill & Melinda Gates Foundation, have continued to fund the development of malaria vaccine for malaria endemic countries. Sadly, such funds are far less when compared to funds budgeted to support the treatment of illnesses like cardiovascular diseases, diabetes, etc,” he said. Vaccine trials are conducted in countries like Kenya, Tanzania and Senegal. But that is not the case with Nigeria, where inadequate infrastructure (like power) makes research difficult. Also, in countries where such trials for malaria are conducted, medical research institutes derive huge benefits because they receive all the assistance they need to effectively carry out research.
For Shilaj Chakravorty, consultant pathologist, BT Health and Diagnostic Centre, Lagos State University Teaching Hospital (LASUTH), Ikeja, investment in malaria control is saving lives and reaping far-reaching benefits for countries where the malaria parasite is endemic. “Factors such as increasing urbanisation disproportionate to infrastructure, drug-resistant malaria, insecticide-resistant mosquitoes, inadequate vector control operations and public health practices encourage the increase of malaria parasite,” added Chakravorty, while maintaining that without sustained funding and continuous research, the significant contribution of malaria control towards the achievement of the Millennium Development Goals (MDG) could be reversed.
It would be recalled that the Global Fund to Fight AIDS, Tuberculosis and Malaria and the nation’s Federal Ministry of Health, in October 2009, signed a malaria grant to the tune of $285 million over a two-year period. The Global Fund took a flexible approach by signing, in July 2009, an interim agreement to allow for the timely distribution of 3.4 millions bed nets in line for a mass distribution campaign planned for December, 2010. Other contributors include the World Bank, DFID, USAID, UNITAID, and UNICEF. With these funds committed to fighting malaria in Nigeria, reducing the malaria burden by 50 percent this year and 75 percent by 2015 should be achieveable.
Folake Ademola- Majekodunmi, national coordinator, National Malaria Control Programme (NMCP), Federal Ministry of Health, stated that providing health information and education would enable Nigerians make the right decisions about their health. “We are placing two mosquito nets in every household in Nigeria. These are not just the traditional mosquito nets as we used to know it. They are long-lasting nets that have been treated with insecticides. The major difference that the nets offer is that they do not just repel mosquitoes, they kill mosquitoes’ dead. They are called LLIN (Long Lasting Insecticidal Nets),” Ademola-Majekodunmi stated. Meanwhile, there is indeed hope if African malaria researchers could become more adept at not only providing global leadership in malaria research and mentoring young scientists for the next generation, but also at taking advantage of the current funding opportunities to propose ground-breaking projects that are internationally competitive for long-term sustainability.
True, the control of malaria is a long-term objective and the sharing of resources and competencies is crucial to its achievement, but a massive infusion of funds for capacity-building, infrastructural development and day-to-day research activities from the governments and international donor agencies will foster an environment for synergy with a common goal: the control of malaria.
On the community front, environmental management to deal with mosquitoes will ensure they do not breed in water logged areas. Perhaps, proper hygiene and sanitation around dwelling places can be employed. Also, massive investment in mass mobilisation and communication will ensure people do what is right in their localities. That way, mosquitoes will have no habitat where they can breed.
By Alexander Chiejina
Friday, August 6, 2010
HCG ASIA comes to the rescue of cancer patients in Nigeria.
Succour is on the way for cancer patients in Nigeria as Healthcare Global Enterprises (HCG), a South Asia’s largest cancer care network is expected in the country with the intent of partnering Nigerian health care practitioners on advanced cancer care.
In a statement made available to BusinessDay, Wale Alabi, Chief Executive, Global Resources & Project West Africa and representative of HCG in Nigeria, said the group plans to transform cancer care environment in Nigeria and has concluded plans to bring in core clinical services to a central unit.
According to Alabi, the HCG is expected to launch its first clinic in Lagos by August 17th. However, Ajai kumar, Chairman of HCG, one of India’s authorities in Radio and Medical oncology, is expected in the country this month even as cancer experts in the country are ready to collaborate with stakeholders both in private and public sectors.
Explaining the rationale behind their coming to Nigeria, he stated that following HCG’s activities in India, it was observed that most Nigerian patients treated in India always present late.
“We noticed the inconsistent quality of care given to cancer patients in Nigeria. Currently, investigations by the group showed that there are inadequate regulations, dearth of clinical experience and expertise and few oncologists in Nigeria to attend to the needs of cancer patients. There is also lack of awareness and late presentation of cases.
However, we are ready to share our clinical experience, expertise on management of cancers. We want to also help in providing affordable treatment opportunities in the country. We will also be providing oncology training nationwide and build capacity of local health care professionals,” Alabi concluded.
HCG has in the last five years defined the future of cancer care in India by designing, building and managing cancer centers in India, with 20 oncology centres and now spreading to Africa. HCG is a reference centre in Asia with over six Cyberknife Robotic Radiosurgery Systems.
Cyberknife is the first and only Robotic radio-surgery system designed to treat tumors anywhere in the body, including the brain, spine, lung, liver, pancreas and prostate.
By Alexander Chiejina
In a statement made available to BusinessDay, Wale Alabi, Chief Executive, Global Resources & Project West Africa and representative of HCG in Nigeria, said the group plans to transform cancer care environment in Nigeria and has concluded plans to bring in core clinical services to a central unit.
According to Alabi, the HCG is expected to launch its first clinic in Lagos by August 17th. However, Ajai kumar, Chairman of HCG, one of India’s authorities in Radio and Medical oncology, is expected in the country this month even as cancer experts in the country are ready to collaborate with stakeholders both in private and public sectors.
Explaining the rationale behind their coming to Nigeria, he stated that following HCG’s activities in India, it was observed that most Nigerian patients treated in India always present late.
“We noticed the inconsistent quality of care given to cancer patients in Nigeria. Currently, investigations by the group showed that there are inadequate regulations, dearth of clinical experience and expertise and few oncologists in Nigeria to attend to the needs of cancer patients. There is also lack of awareness and late presentation of cases.
However, we are ready to share our clinical experience, expertise on management of cancers. We want to also help in providing affordable treatment opportunities in the country. We will also be providing oncology training nationwide and build capacity of local health care professionals,” Alabi concluded.
HCG has in the last five years defined the future of cancer care in India by designing, building and managing cancer centers in India, with 20 oncology centres and now spreading to Africa. HCG is a reference centre in Asia with over six Cyberknife Robotic Radiosurgery Systems.
Cyberknife is the first and only Robotic radio-surgery system designed to treat tumors anywhere in the body, including the brain, spine, lung, liver, pancreas and prostate.
By Alexander Chiejina
Pfizer supports cardiovascular issues in Nigeria
… as experts groan over increasing cases of CVD in the country
Recent indications have emerged that Nigerians are now at great risk of developing cardiovascular (heart) disease which currently accounts for one-third of all deaths worldwide and has been shown to form the bulk of admissions in Nigerian hospitals. No doubt, this development follows the steady rise in incidence of hypertension, diabetes, high cholesterol, obesity and other unhealthy lifestyle conditions in the country in recent times.
It is on this premise that medical experts during the 3rd cardiovascular summit organised by multinational pharmaceutical company Pfizer Specialties Nigeria Ltd in Lagos recently, are concerned giving the growing trend of the disease conditions been reported in the country even as economic management of this disease remains a herculean challenge.
Speaking at the summit, Enricco Liggeri, Country Manager, Pfizer Specialties stated that the company pledged to team up with the Nigerian medical professionals, the media and other stakeholders to ensure that cardiovascular health is given its deserved attention in the country in order to avert further deaths and ill health among Nigerians.
“We are pleased to note that care givers in the country are not only aware of the threats posed by CVD, there’s an overwhelming consensus among them on the need for urgent action to stem the current unacceptable growing incidence of the risk factors. CVDs and related morbidity/mortality are becoming a very relevant and underestimated issue in Africa,” Liggeri disclosed.
In an interview with BusinessDay, Olufemi Fasanmade, Consultant Endocrinologist, Lagos University Teaching Hospital, (LUTH) Idi-araba, Lagos said that cardiovascular disease (CVD) is an umbrella term that refers to any of a number of diseases affecting the heart and blood vessels. Fasanmade disclosed that the increase of CVD burden in Nigeria and other developing countries is due to prevalence of risk factors and lack of access to interventions.
While citing a recent study, he noted that five risk factors -tobacco use, hypertension, diabetes, abdominal obesity and dyslipidaemia were responsible for a great percent of risk of interruption of blood supply to part of the heart, causing heart cells to die in Africa.
"These data confirm that people from Africa who are exposed to these major cardiovascular risk factors are at risk of acute myocardial infarction (AMI) - interruption of blood flow to part of the heart as against other people across the globe. However, the more the risk factors, the greater the chance of developing cardiovascular disease and the effect is multiplicative,” Fasanmade concluded
For Peter Lansberg, a renowned cardiologist at Academic Medical Center, Amsterdam, in the Netherlands, high cholesterol and obesity are dangerous CVD risk factors. Lansberg noted that the impact of cholesterol on the heart was neglected for almost 50 years until the development of the new “statin” group of cholesterol-lowering drugs a few years back.
According to him, CVD is not a ‘physiological’ disease but a condition caused by changes in lifestyle, which explains why it is closely linked with metabolic conditions like diabetes.
“Somebody once said 'genetic points the gun but environment pulls the trigger as the prevalence of cardiovascular disease in societies across the world is synonymous with changes in lifestyle and a switch from diets based on natural foods that are rich in high fibre, minerals and vitamins, low in calories, salt and sugar to diets based on fatty foods with high calories. However, going for obesity or high weight really translate to a higher risk of cardiovascular disease as the ability to low cholesterol would automatically lead to a reduction in CVD risk,” Lansberg revealed.
Lansberg hinted that since one doesn't see high cholesterol, people don’t see the need to seek medical attention. He however urged doctors to commence aggressive treatment of high cholesterol as soon as it is detected so as to prevent the complications of CVD.
Bringing the economic management of CVD in Nigeria to bear, Amam Mbakwem, a medical expert in the Department of Medicine, College of Medicine, LUTH, Lagos, revealed that based on the data of 98 patients hospitalised before 2009 at LUTH, the cost of hospitalisation was put at sixty eight thousand, seven hundred and sixty five Naira (N68, 765. 89), cost of extra medication- twenty five thousand, one hundred and ninety seven Naira (N25, 197), just to name but a few.
Mbakwem stated that following recent wave of increase of CVD expected from middle and low income countries, new and more expensive merging therapies are emerging. However, reducing the burden should be elementary as Nigerians should live healthy lifestyles.
No doubt, the summit has created an avenue for clinicians, specialists and other healthcare professionals to share ideas on the need for intensive lipid lowering, hypertension/diabetes dynamics and the patient's role in the management of CVD.
Given the increasing number of Nigerians developing CVDs, there is the need for national and international professional associations and non-governmental organisations to increase awareness of CVD by organizing seminars and workshops to educate Nigerians how to manage CVDs.
For Solomon Kadiri, consultant physician, University College Hospital, (UCH) Ibadan, “difficulties such as underfunding, poor infrastructure, inadequate access to cheap generic drugs and fixed dose combinations, and lack of public recognition and acceptance of the importance of cardiovascular disease continues to hinder the effective implementation of both population based health programmes and those aimed as people at high risk. Nigerians need education on healthier lifestyles such as weight reduction, smoking cessation, and greater physical activity. With this, the prevalence of people suffering from CVD would reduce,” Kadiri concluded.
.....BY Alexander Chiejina
Recent indications have emerged that Nigerians are now at great risk of developing cardiovascular (heart) disease which currently accounts for one-third of all deaths worldwide and has been shown to form the bulk of admissions in Nigerian hospitals. No doubt, this development follows the steady rise in incidence of hypertension, diabetes, high cholesterol, obesity and other unhealthy lifestyle conditions in the country in recent times.
It is on this premise that medical experts during the 3rd cardiovascular summit organised by multinational pharmaceutical company Pfizer Specialties Nigeria Ltd in Lagos recently, are concerned giving the growing trend of the disease conditions been reported in the country even as economic management of this disease remains a herculean challenge.
Speaking at the summit, Enricco Liggeri, Country Manager, Pfizer Specialties stated that the company pledged to team up with the Nigerian medical professionals, the media and other stakeholders to ensure that cardiovascular health is given its deserved attention in the country in order to avert further deaths and ill health among Nigerians.
“We are pleased to note that care givers in the country are not only aware of the threats posed by CVD, there’s an overwhelming consensus among them on the need for urgent action to stem the current unacceptable growing incidence of the risk factors. CVDs and related morbidity/mortality are becoming a very relevant and underestimated issue in Africa,” Liggeri disclosed.
In an interview with BusinessDay, Olufemi Fasanmade, Consultant Endocrinologist, Lagos University Teaching Hospital, (LUTH) Idi-araba, Lagos said that cardiovascular disease (CVD) is an umbrella term that refers to any of a number of diseases affecting the heart and blood vessels. Fasanmade disclosed that the increase of CVD burden in Nigeria and other developing countries is due to prevalence of risk factors and lack of access to interventions.
While citing a recent study, he noted that five risk factors -tobacco use, hypertension, diabetes, abdominal obesity and dyslipidaemia were responsible for a great percent of risk of interruption of blood supply to part of the heart, causing heart cells to die in Africa.
"These data confirm that people from Africa who are exposed to these major cardiovascular risk factors are at risk of acute myocardial infarction (AMI) - interruption of blood flow to part of the heart as against other people across the globe. However, the more the risk factors, the greater the chance of developing cardiovascular disease and the effect is multiplicative,” Fasanmade concluded
For Peter Lansberg, a renowned cardiologist at Academic Medical Center, Amsterdam, in the Netherlands, high cholesterol and obesity are dangerous CVD risk factors. Lansberg noted that the impact of cholesterol on the heart was neglected for almost 50 years until the development of the new “statin” group of cholesterol-lowering drugs a few years back.
According to him, CVD is not a ‘physiological’ disease but a condition caused by changes in lifestyle, which explains why it is closely linked with metabolic conditions like diabetes.
“Somebody once said 'genetic points the gun but environment pulls the trigger as the prevalence of cardiovascular disease in societies across the world is synonymous with changes in lifestyle and a switch from diets based on natural foods that are rich in high fibre, minerals and vitamins, low in calories, salt and sugar to diets based on fatty foods with high calories. However, going for obesity or high weight really translate to a higher risk of cardiovascular disease as the ability to low cholesterol would automatically lead to a reduction in CVD risk,” Lansberg revealed.
Lansberg hinted that since one doesn't see high cholesterol, people don’t see the need to seek medical attention. He however urged doctors to commence aggressive treatment of high cholesterol as soon as it is detected so as to prevent the complications of CVD.
Bringing the economic management of CVD in Nigeria to bear, Amam Mbakwem, a medical expert in the Department of Medicine, College of Medicine, LUTH, Lagos, revealed that based on the data of 98 patients hospitalised before 2009 at LUTH, the cost of hospitalisation was put at sixty eight thousand, seven hundred and sixty five Naira (N68, 765. 89), cost of extra medication- twenty five thousand, one hundred and ninety seven Naira (N25, 197), just to name but a few.
Mbakwem stated that following recent wave of increase of CVD expected from middle and low income countries, new and more expensive merging therapies are emerging. However, reducing the burden should be elementary as Nigerians should live healthy lifestyles.
No doubt, the summit has created an avenue for clinicians, specialists and other healthcare professionals to share ideas on the need for intensive lipid lowering, hypertension/diabetes dynamics and the patient's role in the management of CVD.
Given the increasing number of Nigerians developing CVDs, there is the need for national and international professional associations and non-governmental organisations to increase awareness of CVD by organizing seminars and workshops to educate Nigerians how to manage CVDs.
For Solomon Kadiri, consultant physician, University College Hospital, (UCH) Ibadan, “difficulties such as underfunding, poor infrastructure, inadequate access to cheap generic drugs and fixed dose combinations, and lack of public recognition and acceptance of the importance of cardiovascular disease continues to hinder the effective implementation of both population based health programmes and those aimed as people at high risk. Nigerians need education on healthier lifestyles such as weight reduction, smoking cessation, and greater physical activity. With this, the prevalence of people suffering from CVD would reduce,” Kadiri concluded.
.....BY Alexander Chiejina
Experts advocates new WHO recommendation for HIV + mothers and infants
Even as the fight towards preventing mother to child transmission (PTMCT) of HIV/AIDS continues, recent indices from the World Health Organisation (WHO) reveal that approximately 400, 000 infants globally acquire HIV infection annually as a result of mother-to-child transmission.
Given this alarming index, experts at a recent program organized by Journalist against AIDS (JAAIDS) in Lagos have called for proper counseling for women as well as advocated for women with HIV to receive antiretroviral drugs with the view to reducing new HIV infections in women during pregnancy, delivery or breastfeeding to the newborn infants.
Speaking at the event, Nkiru David, Consultant Paediatrician, Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, stated that breast milk provides the nutrients needed during the first few months of life as it contains substances which offers protection to babies against common childhood illnesses such as diarrhoea and respiratory infections.
David stated that the Baby Friendly Hospital Initiative (BFHI) which was launched by WHO and UNICEF in 1991 were aimed at promoting policies and structures that support breastfeeding. However, latest research on HIV reveals that the virus can be found in breast milk thus if a HIV positive mother breastfeed, there is a significant chance of passing the virus to the new born.
According to her, “Inadequate counselling of expectant and nursing HIV positive women, non disclosure to partner/family and stigma have led some mothers to breastfeed their babies thus transmitting the virus to the newborn. Don’t forget that inflammations of the breast like mastitis, abscesses, bleeding nipples can make these infants to develop lesions around their mouth region during breastfeeding over a period of time.”
David further disclosed that in a bid to safeguard newborn infants from getting infected with HIV/AIDS, individual mothers should get appropriate conselling from a physician prior to delivery so as to know what feeding option most appropriate for the newborn. She added that if EBMS is chosen, she must be counselled on appropriate and hygienic way of preparing and feeding her baby to protect the baby from diarrhoea and other childhood infections.
Already, EBMS (EFF) has proved a resounding success in developed nations, (a success which has been reproduced at the NIMR HIV clinic and some other sites in Nigeria). EBMS is expensive and donor agencies that previously funded it are now cutting down costs.
Lending his view, Olalekun Adebimpe, PTMCT/ Reproductive Health Officer, Action Health Nigeria Institute, disclosed that prolonged use of ARVs as spelt out by WHO recommendations goes a long way in reducing the risk of mother-to-child transmission of HIV. He stated that for the first time, WHO recommended that HIV-positive mothers or their infants take ARVs(anti retroviral drugs) while breastfeeding to prevent HIV transmission.
In his words “with an estimated 33.4 million people living with HIV/AIDS and HIV/AIDS, been the leading cause of mortality among women of reproductive age, there is the need for people to learn of their health status. However, pregnancy in the HIV positive woman is an indication for prophylactic anti retroviral therapy (ART) irrespective of CD4 count, viral load or clinical stage of the disease. So, efforts should be made to ensure that all HIV positive pregnant women have access to ART.
However, all patients placed on ART should be monitored clinically, biochemically and immunologically. If facility for CD4count is not available, the client should be referred or client’s specimen sent to the nearest centre with such facility,” Olalekun concluded.
On his part, Oliver Ezechi, Chief Research Officer, Obstetrics and Gynaecology Health, NIMR, Yaba, stated that the new WHO recommendations, which is based on latest scientific research have the potential to reduce mother-to-child HIV transmission risk. He hinted that when combined with improved infant feeding practices, the recommendations can help to improve child survival.
“Expansion of ART and PMTCT services is hindered by weak infrastructure, limited human and financial resources, and poor integration of HIV-specific interventions within broader maternal and child health services. Another challenge lies in encouraging more people to receive voluntary HIV testing and counselling before they have symptoms.
Many HIV-positive people wait too long to seek treatment, usually when their CD4 count falls below 200 cells/mm3. However, the benefits of early treatment should encourage more people to undergo HIV testing and counselling and learn of their HIV status,” Ezechi concluded.
Since several clinical trials have shown the efficacy of ARVs in preventing transmission to the infant while breastfeeding, promoting the use of ARVs earlier in pregnancy, starting at 14 weeks and continuing through the end of the breastfeeding period will no doubt go a long way in reducing the risk of HIV transmission and improve the infant's chance of survival.
Also, strategies should be put in place by health authorities in the country to adopt and implement the revised guidelines on the new prevention of mother to child transmission (PMTCT). It is believed that when implemented at a wide scale will improve the health of people living with HIV as well as reduce the number of new HIV infections and save lives.
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