Children across the globe in their developmental stages have been exposed to a variety of feeding patterns in recent times.
However, advertising and other forms of food and beverage marketing to children are extensive and primarily concern products with a high content of fat, sugar or salt.
Evidence shows that television advertising influences children’s food preferences, purchase requests and consumption patterns.
Furthermore, a wide range of techniques are used to market these products, reaching children in schools, nurseries, and supermarkets; through television and the Internet; and in many other settings.
In the light of this imminent danger, health experts have called for efforts to ensure that children everywhere are protected against the impact of such marketing and given the opportunity to grow and develop in an enabling food environment — one that fosters and encourages healthy dietary choices and promotes the maintenance of healthy weight.
In an interview with BusinessDay, Edimasan Temiye, chairman, Nigerian Medical Association (NMA), Lagos Chapter, disclosed that poor diet is one of the four common factors associated with the four main noncommunicable diseases (cancers, diabetes, cardiovascular diseases and chronic lung diseases), which are responsible for around 60 percent of all deaths globally.
Temiye, who is also a consultant Paediatrician at Lagos University Teaching Hospital, Idi-Araba, noted that according to recent statistics, more than nine million deaths are premature (people dying before reaching 60 years of age) and this could have been prevented through low-cost measures at the world's disposal today, including measures to stop tobacco use, reduce the harmful use of alcohol, and to promote healthy diets and physical activity.
He said: "Non-communicable diseases (NCDs), such as cardiovascular diseases, cancers and diabetes, today represent a leading threat to human health and socioeconomic development. However, encouraging healthy dietary choices for children and promoting the maintenance of a healthy weight is critical in preventing occasions of coming down with non-communicable diseases."
Alexandra Anga, consultant Paediatrician, Lagos State University Teaching Hospital (LASUTH), disclosed that unhealthy diet is a key modifiable risk factor for NCDs. Anga stated that while deaths from NCDs primarily occur in adulthood, the risks associated with unhealthy diet begin in childhood and build up throughout life. She noted that obesity now ranks as the fifth leading risk for death globally.
According to Anga, “it is estimated that in 2010 more than 42 million children under the age of five years are overweight or obese, of which nearly 35 million are living in developing countries. Overweight during childhood and adolescence is associated not only with an increased risk of adult obesity and NCDs, but also with a number of immediate health-related problems, such as hypertension and insulin resistance. We must not lose consciousness of the fact that today’s food environment is quite different from that experienced by previous generations.
“Globally, an extensive variety of food and drink products are now available in most markets, offering palatability, convenience and novelty. But at the same time, the wide availability and heavy marketing of many of these products, and especially those with a high content of fat, sugar or salt, challenge efforts to eat healthily and maintain a healthy weight, particularly in children. Unless addressed, unhealthy diets, in conjunction with other risk factors, increase NCD prevalence in populations through raised blood pressure, raised blood glucose, abnormal blood lipids and overweight/obesity.”
To safeguard the future of younger generations in Nigeria and across the globe, there is the need to identify the most suitable policy approach, given national circumstances, and develop new and/ or strengthen existing policies that aim at reducing the impact on children, of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
For Ala Alwan, assistant director-general, Non-communicable Diseases and Mental Health, World Health Organisation, “there is the need to establish a system for monitoring and evaluating the implementation of the recommendations on the marketing of foods and non-alcoholic beverages to children.
“Also, active steps should be taken to establish intergovernmental collaboration in order to reduce the impact of cross-border marketing, not forgetting the co-operation of civil society, public and private stakeholders in implementing the set of recommendations on the marketing of foods and non-alcoholic beverages to children in order to reduce the impact of that marketing, while ensuring avoidance of potential conflicts of interest.”
Thursday, February 24, 2011
Nation’s polio eradication quest gets international boost
…As Bill Gate beams focus on Nigeria’s status
The nation’s status as one of the only four countries globally where the transmission of wild polio virus subsists, has over the years been a source of concern, not only to public health experts in the country, but to various international donor communities.
Only recently, Nigeria’s polio story took the centre stage at New York in the United States of America. This time, it wasn’t about the country’s failure to do something right, or how the rest of the world was leaving the country behind in its fight against the dreaded childhood killer disease; instead, it was to celebrate the remarkable achievement made by Nigeria as it strives to eradicate polio from circulating within its borders in 2011.
The event was the presentation of the 2011 Annual Lecture, entitled: "Polio Eradication, the power of vaccines: The Nigerian and Indian example" in New York, by Bill and Melinda Gates Foundation; a foundation which has devoted its resources towards combating polio.
Gates’ decision to bring Nigeria to the centre stage at the event beamed live via satellites and watched by millions of people across the globe, was his way of showing how impressed he was with Nigeria and the commitment of the National Primary Healthcare Development Agency (NPHCDA), towards ensuring that polio joins small pox as another “once upon a time” affliction of the human kind.
Addressing newsmen in Lagos, Muhammad Ali Pate, executive director, NPHCDA, hinted that 50 million children between the age of zero and five years were reached with polio vaccination during the Integrated Measles and Polio Campaign; and 31 million children aged from nine to 59 months for measles. Pate noted that among the four endemic countries that haven’t been able to stop the transmission of the wild polio virus, Nigeria hasn’t reported any polio case in 2011.
“We have increased coverage for polio and routine immunisation by 70 to 90 percent and 50 percent, respectively. Nigeria can win the fight against childhood killer diseases as many other countries have done. We have the tools and the know-how. Combined with political will and leadership, Nigerian children can claim their right to grow up healthy," Pate said.
Speaking on the efficacy of vaccines in eradicating polio, he explained that “due to the global childhood immunisation campaign, polio has been reduced to 99 percent and is on the threshold of becoming only the second disease ever eradicated.”
Lending his view, Aminu Magashi, a public health expert, disclosed that polio eradication is one public health initiative in Nigeria that almost everybody knows about due to its wide coverage, repeated national and state immunisation days as well as the controversy it generated in the past.
Magashi stated that at the Expert Review Committee (ERC) on Polio Eradication in Nigeria which held from the 4th to 5th October 2010, “the meeting observed some risks to completing the eradication, such as, those states that recorded wild polio virus in 2010; Borno (only proven WPV1 residual reservoir) and Kano & North West states (highest burden of WPV3).”
Explaining the disease, Magashi explained that poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children and is transmitted through contaminated food and water. He revealed that the virus multiplies in the intestine, from where it can invade the nervous system. The medical expert added that many infected people have no symptoms, but do excrete the virus in their faeces, hence, transmitting infection to others.
Taking a look at statistics, in 2009, there were 388 polio cases in the country. But by 2010, the number reduced to just 21(that is, 95 percent reduction). Going further, only two years ago, the World Health Assembly passed a resolution condemning Nigeria for its poor response to the polio threat despite the fact that the country was among the few in which new outbreaks of the disease was still being recorded.
While Nigeria’s fight against polio is aided by the momentum and exceptional attention from the international community such as the Rotary International, which has raised millions of dollars for polio vaccines and visionary partners, the Bill & Melinda Gates Foundation, UNICEF and the World Health Organisation, there is the need for national funding to enable the payment for vaccines, logistics, surveillance and community mobilisation required to reach every Nigerian child under five.
In Pate’s estimation, “In Nigeria, we have the vaccine technology and the knowledge to contribute to the worldwide mission to eliminate polio. Now, we need continued leadership to ensure our children are immunised. Polio eradication is a priority worthy of our investment. If Nigeria intensifies efforts, our nation can end polio transmission by mid-2011.
“I call on all leaders to support this campaign which we can all win. If we can eradicate polio, we prove that Nigerian leaders can deliver a historic milestone to all citizens. We must join together; act boldly and definitively, to show that Nigeria is serious about defeating polio once and for all.”
Recall that the Global Polio Eradication Initiative, which was launched globally in 1988, are hinged on the following pillars- interrupting transmission of the wild poliovirus as soon as possible, achieving certification of global polio eradication, contributing to health systems development and strengthening routine immunisation while improving surveillance for communicable diseases in a systematic way.
The nation’s status as one of the only four countries globally where the transmission of wild polio virus subsists, has over the years been a source of concern, not only to public health experts in the country, but to various international donor communities.
Only recently, Nigeria’s polio story took the centre stage at New York in the United States of America. This time, it wasn’t about the country’s failure to do something right, or how the rest of the world was leaving the country behind in its fight against the dreaded childhood killer disease; instead, it was to celebrate the remarkable achievement made by Nigeria as it strives to eradicate polio from circulating within its borders in 2011.
The event was the presentation of the 2011 Annual Lecture, entitled: "Polio Eradication, the power of vaccines: The Nigerian and Indian example" in New York, by Bill and Melinda Gates Foundation; a foundation which has devoted its resources towards combating polio.
Gates’ decision to bring Nigeria to the centre stage at the event beamed live via satellites and watched by millions of people across the globe, was his way of showing how impressed he was with Nigeria and the commitment of the National Primary Healthcare Development Agency (NPHCDA), towards ensuring that polio joins small pox as another “once upon a time” affliction of the human kind.
Addressing newsmen in Lagos, Muhammad Ali Pate, executive director, NPHCDA, hinted that 50 million children between the age of zero and five years were reached with polio vaccination during the Integrated Measles and Polio Campaign; and 31 million children aged from nine to 59 months for measles. Pate noted that among the four endemic countries that haven’t been able to stop the transmission of the wild polio virus, Nigeria hasn’t reported any polio case in 2011.
“We have increased coverage for polio and routine immunisation by 70 to 90 percent and 50 percent, respectively. Nigeria can win the fight against childhood killer diseases as many other countries have done. We have the tools and the know-how. Combined with political will and leadership, Nigerian children can claim their right to grow up healthy," Pate said.
Speaking on the efficacy of vaccines in eradicating polio, he explained that “due to the global childhood immunisation campaign, polio has been reduced to 99 percent and is on the threshold of becoming only the second disease ever eradicated.”
Lending his view, Aminu Magashi, a public health expert, disclosed that polio eradication is one public health initiative in Nigeria that almost everybody knows about due to its wide coverage, repeated national and state immunisation days as well as the controversy it generated in the past.
Magashi stated that at the Expert Review Committee (ERC) on Polio Eradication in Nigeria which held from the 4th to 5th October 2010, “the meeting observed some risks to completing the eradication, such as, those states that recorded wild polio virus in 2010; Borno (only proven WPV1 residual reservoir) and Kano & North West states (highest burden of WPV3).”
Explaining the disease, Magashi explained that poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children and is transmitted through contaminated food and water. He revealed that the virus multiplies in the intestine, from where it can invade the nervous system. The medical expert added that many infected people have no symptoms, but do excrete the virus in their faeces, hence, transmitting infection to others.
Taking a look at statistics, in 2009, there were 388 polio cases in the country. But by 2010, the number reduced to just 21(that is, 95 percent reduction). Going further, only two years ago, the World Health Assembly passed a resolution condemning Nigeria for its poor response to the polio threat despite the fact that the country was among the few in which new outbreaks of the disease was still being recorded.
While Nigeria’s fight against polio is aided by the momentum and exceptional attention from the international community such as the Rotary International, which has raised millions of dollars for polio vaccines and visionary partners, the Bill & Melinda Gates Foundation, UNICEF and the World Health Organisation, there is the need for national funding to enable the payment for vaccines, logistics, surveillance and community mobilisation required to reach every Nigerian child under five.
In Pate’s estimation, “In Nigeria, we have the vaccine technology and the knowledge to contribute to the worldwide mission to eliminate polio. Now, we need continued leadership to ensure our children are immunised. Polio eradication is a priority worthy of our investment. If Nigeria intensifies efforts, our nation can end polio transmission by mid-2011.
“I call on all leaders to support this campaign which we can all win. If we can eradicate polio, we prove that Nigerian leaders can deliver a historic milestone to all citizens. We must join together; act boldly and definitively, to show that Nigeria is serious about defeating polio once and for all.”
Recall that the Global Polio Eradication Initiative, which was launched globally in 1988, are hinged on the following pillars- interrupting transmission of the wild poliovirus as soon as possible, achieving certification of global polio eradication, contributing to health systems development and strengthening routine immunisation while improving surveillance for communicable diseases in a systematic way.
HCG to partner FG, private sector on cancer management
Cancer is a global issue and is rapidly becoming a major health problem in developed and developing countries. However, with research on newer techniques in cancer management, which is now providing hope and new arenas to patients seeking cure, cancer hospitals and centres in India have become a medical hub for patients across the globe, including Nigeria.
This is why Nigerian patients prefer travelling to India for their healthcare needs. Interestingly, waiting lists for surgery get longer as people increasingly seek specialised and personal medical attention abroad.
Hence, in a bid to reduce the growing incidence of Nigerians travelling to India for the treatment of cancer, the HealthCare Global Enterprises Ltd (HCG), South Asia's largest cancer care network, is set to partner the Federal Government and the private sector through developing innovative treatment methods, tailored at providing high quality, affordable and comprehensive cancer care to all segments of the society.
Speaking with newsmen in Lagos recently, Dinesh Madhavan, director of marketing, HCG, revealed that cancer is a leading cause of death even as more than 70 percent of all cancer deaths occur in low- and middle-income countries.
Madhavan stated that recent indications suggest that cancer, globally, are projected to continue rising, with an estimated 12 million deaths in 2030. He pointed out that the most frequent types of cancer globally are cancer of the lungs, stomach, liver, colorectal, oesophagus and prostate with cancer of the breast and cervix.
In his words: “In Nigeria, cancer of the cervix and breast as well as cancer of the prostrate are the most common forms of cancer we in HCG treat in India. Lots of Nigerians who come for treatment in India come with advanced stages of cancer. HCG has contributed significantly to establish high quality Cancer Care centres in India. We (HCG) have our presence at Kampala, in Uganda and in Tanzania. We have partnered with the government in these countries to do extensive research and develop innovative treatment methods to provide the finest cancer care in a bid to make cancer a manageable health condition and improve the quality of life of patients.
“Our plan to partner with the government in Nigeria and the private sector is aimed at training the capacity of Nigerian oncologists in the area of cancer care and management. We are committed to creating an environment that fosters the professional and personal achievements of each person who crosses the threshold of our centre. And by sharing these achievements across the network, the achievements of each centre, each physician, and each hospital are further heightened. HCG has been defining the future of cancer care in India by designing, building and managing cancer centres with a steadfast vision. This we want to replicate in the country and improve the lives of the Nigerians,” Madhavan concluded.
Explaining a recent technology deployed for the treatment of cancer, Susheela Sridhar, Consultant Radiation Oncologist, HCG, revealed that Cyberknife is the world's first non-invasive whole body robotic radiosurgery system. Sridhar disclosed that CyberKnife offers patients new hope for the treatment of tumours and lesions, including ones that previously have been diagnosed as untreatable with the existing technology.
“CyberKnife uses state-of-the-art real-time image guidance to precisely target tumours anywhere in the body with pinpoint accuracy and delivers high doses of radiation. Some forms of radiosurgery require rigid head-frames that are screwed into the patient’s skull to minimise any movement. The CyberKnife System does not require such extreme procedures to keep patients in place, and instead, relies on sophisticated tracking software, allowing for a much more comfortable and non-invasive treatment,” Sridhar stated.
He added that unlike some radiosurgery systems, which can only treat tumours in the head, the CyberKnife System has unlimited reach to treat a broad range of tumours throughout the body, including the prostate, lung, brain, spine, liver, pancreas, and kidney.
“The CyberKnife System can essentially ‘paint’ the tumour with radiation allowing it to precisely deliver treatment to the tumour alone, sparing surrounding healthy tissue. It is non-invasive and pain-less, treat inoperable tumours, significantly reduces treatment time to about 45-60 minutes, minimises side effects with little or no recovery time,” the consultant radiation oncologist concluded.
Taking a look at cancer management in Nigeria, it is worrisome to state that not all hospitals operate screening programmes for cervical cancer; they are poorly funded, unsystematic, and incomprehensive. However, problems of impeded access to health care, ignorance, poverty and a general lack of coordination of issues of health education complicate matters.
Though there are no definite figures, the number of active radiotherapy centres across the country is few. Worse still, Imaging facilities for staging patients with cancer, such as computerised tomography (CT) and Magnetic Resonance Imaging (MRI), are difficult to come by, and when available, the cost of such studies are prohibitive – putting them out of reach of the average citizen.
Giving this initiative by HCG to develop experts in the management and care of
Nigerians suffering from this disease, it is believed that Nigerian clinicians would be at the winning side as would avail themselves of the latest technology deployed in the treatment of people with cancers and tumours.
For Wale Alabi, CEO, Global Resources and Project, “Factors likely to change the pattern and prevalence of cancer in Nigeria in the coming decades include- greater awareness of cancer and improved access to health care. In large parts of Africa, surgery and chemotherapy are usually reserved for those rich enough to seek specialised care abroad. In addition, diagnosis no longer has to be a death sentence, because one-third of cancers can be cured if detected early and treated properly.
“Admittedly, there is increasing awareness of modern palliative care and pain management in Nigeria, but we still need to build the capacity of our physicians which would in the long run improve medical tourism in the country.”
This is why Nigerian patients prefer travelling to India for their healthcare needs. Interestingly, waiting lists for surgery get longer as people increasingly seek specialised and personal medical attention abroad.
Hence, in a bid to reduce the growing incidence of Nigerians travelling to India for the treatment of cancer, the HealthCare Global Enterprises Ltd (HCG), South Asia's largest cancer care network, is set to partner the Federal Government and the private sector through developing innovative treatment methods, tailored at providing high quality, affordable and comprehensive cancer care to all segments of the society.
Speaking with newsmen in Lagos recently, Dinesh Madhavan, director of marketing, HCG, revealed that cancer is a leading cause of death even as more than 70 percent of all cancer deaths occur in low- and middle-income countries.
Madhavan stated that recent indications suggest that cancer, globally, are projected to continue rising, with an estimated 12 million deaths in 2030. He pointed out that the most frequent types of cancer globally are cancer of the lungs, stomach, liver, colorectal, oesophagus and prostate with cancer of the breast and cervix.
In his words: “In Nigeria, cancer of the cervix and breast as well as cancer of the prostrate are the most common forms of cancer we in HCG treat in India. Lots of Nigerians who come for treatment in India come with advanced stages of cancer. HCG has contributed significantly to establish high quality Cancer Care centres in India. We (HCG) have our presence at Kampala, in Uganda and in Tanzania. We have partnered with the government in these countries to do extensive research and develop innovative treatment methods to provide the finest cancer care in a bid to make cancer a manageable health condition and improve the quality of life of patients.
“Our plan to partner with the government in Nigeria and the private sector is aimed at training the capacity of Nigerian oncologists in the area of cancer care and management. We are committed to creating an environment that fosters the professional and personal achievements of each person who crosses the threshold of our centre. And by sharing these achievements across the network, the achievements of each centre, each physician, and each hospital are further heightened. HCG has been defining the future of cancer care in India by designing, building and managing cancer centres with a steadfast vision. This we want to replicate in the country and improve the lives of the Nigerians,” Madhavan concluded.
Explaining a recent technology deployed for the treatment of cancer, Susheela Sridhar, Consultant Radiation Oncologist, HCG, revealed that Cyberknife is the world's first non-invasive whole body robotic radiosurgery system. Sridhar disclosed that CyberKnife offers patients new hope for the treatment of tumours and lesions, including ones that previously have been diagnosed as untreatable with the existing technology.
“CyberKnife uses state-of-the-art real-time image guidance to precisely target tumours anywhere in the body with pinpoint accuracy and delivers high doses of radiation. Some forms of radiosurgery require rigid head-frames that are screwed into the patient’s skull to minimise any movement. The CyberKnife System does not require such extreme procedures to keep patients in place, and instead, relies on sophisticated tracking software, allowing for a much more comfortable and non-invasive treatment,” Sridhar stated.
He added that unlike some radiosurgery systems, which can only treat tumours in the head, the CyberKnife System has unlimited reach to treat a broad range of tumours throughout the body, including the prostate, lung, brain, spine, liver, pancreas, and kidney.
“The CyberKnife System can essentially ‘paint’ the tumour with radiation allowing it to precisely deliver treatment to the tumour alone, sparing surrounding healthy tissue. It is non-invasive and pain-less, treat inoperable tumours, significantly reduces treatment time to about 45-60 minutes, minimises side effects with little or no recovery time,” the consultant radiation oncologist concluded.
Taking a look at cancer management in Nigeria, it is worrisome to state that not all hospitals operate screening programmes for cervical cancer; they are poorly funded, unsystematic, and incomprehensive. However, problems of impeded access to health care, ignorance, poverty and a general lack of coordination of issues of health education complicate matters.
Though there are no definite figures, the number of active radiotherapy centres across the country is few. Worse still, Imaging facilities for staging patients with cancer, such as computerised tomography (CT) and Magnetic Resonance Imaging (MRI), are difficult to come by, and when available, the cost of such studies are prohibitive – putting them out of reach of the average citizen.
Giving this initiative by HCG to develop experts in the management and care of
Nigerians suffering from this disease, it is believed that Nigerian clinicians would be at the winning side as would avail themselves of the latest technology deployed in the treatment of people with cancers and tumours.
For Wale Alabi, CEO, Global Resources and Project, “Factors likely to change the pattern and prevalence of cancer in Nigeria in the coming decades include- greater awareness of cancer and improved access to health care. In large parts of Africa, surgery and chemotherapy are usually reserved for those rich enough to seek specialised care abroad. In addition, diagnosis no longer has to be a death sentence, because one-third of cancers can be cured if detected early and treated properly.
“Admittedly, there is increasing awareness of modern palliative care and pain management in Nigeria, but we still need to build the capacity of our physicians which would in the long run improve medical tourism in the country.”
Promoting TB drug research in Nigeria
...As world marks day
Tuberculosis (TB) is a major global health problem which has confronted human existence. Little wonder about nine million new cases of TB emerge and close to two million people die from the disease yearly, with the highest number of deaths in the African region.
With nations across the globe not free from this health puzzle, the worrisome situation is that, according to the World Health Organisation (WHO) estimates, the largest number of new TB cases in 2008 occurred in the South-East Asia Region.
The estimated incidence rate in sub-Saharan Africa is nearly twice that of the South-East Asia Region with over 350 cases per 100 000 population.
As Nigeria join the rest of the world to mark World TB Day, a day set aside to raise awareness about the global epidemic of tuberculosis (TB), the scope of the disease and how to prevent and cure it, health experts in the country have called for increased tuberculosis drug research activity in Nigeria which has been low in recent times.
In a recent interview with Folasade Ogunsola, head, Department of Medical Microbiology, College of Medicine, Lagos State University Teaching Hospital (LUTH), he disclosed that Tuberculosis is an infectious bacterial disease caused by Mycobacterium tuberculosis, which, most commonly, affects the lungs.
Ogunsola stated that though transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease, in healthy people, infection with Mycobacterium tuberculosis often causes no symptoms, since the person's immune system acts to “wall off” the bacteria.
According to her, “TB drug resistance is an issue that threatens the success of directly observed treatment (DOTS), which is WHO-recommended treatment approach for detection and cure of TB. Recently, strains of TB resistant to major anti-TB drugs have emerged due to inadequate capability for diagnosis and treatment of TB.
“A dangerous form of drug-resistant TB, multidrug-resistant TB (MDR-TB), resists the treatment of, at least, isoniazid and rifampicin, the two most powerful anti-TB drugs. The emergence of extensively drug-resistant (XDR) TB occurs particularly in settings where many TB patients are also infected with HIV, and this poses serious threat to TB control. Also, poor-quality drugs or incomplete drug regimens also give resistant TB bacteria time to arise, multiply, and infect others,” Ogunsola added.
For his part, Aderemi Kehinde, Consultant Medical Microbiologist, College of Medicine, University of Ibadan, revealed that Nigeria ranks 4th out of the 22 countries designated by the WHO with the highest burden of TB globally behind India, China and Indonesia.
Kehinde stated that TB research in Nigeria had not been active until recently, due to inadequate facilities arisen from poor funding as research activities were mainly carried by few individual researchers in academic environment.
In his words “TB drug research activity is low in Nigeria. This is as a result of low research funding. Majority of the funds come in form of individual grants from local research institutions, including universities. The recently awarded round 5 Global funds were used to scale-up DOTS expansion with very little funding left for research. Among the challenges include- equipment needed to carry out medical analysis which needs to be strengthened, requisite human capacity of physicians, researchers, lab scientists, nurses etc in TB drug research such as maintaining good clinical practice, good laboratory practice and ethics of research in human subjects among others.
Taking a look at the level of TB drug resistance activity in the country, it is noteworthy to state that the accessed funds from the round 5 Global Fund for AIDS, TB and Malaria were used to equip two National reference laboratories (Nigerian Institute of Medical Research (NIMR) Lagos TB training school, Zaria), one zonal reference laboratory in each of the six geopolitical zones of the country and a nationwide external quality assurance (EQA) system.
This initiative has created awareness and interest among academics to do research on TB. University College Hospital, Ibadan, houses the Southwest TB reference laboratory. It serves six states with population of about 35 million.
Recognising the scale of the problem, global targets for reductions in the burden of disease (measured as incidence, prevalence and mortality) caused by TB have been set within the context of the Millennium Development Goals (MDGs) and by the Stop TB Partnership. The target set within the MDGs is to halt and reverse the incidence of TB by 2015.
In addition, the MDGs included three other indicators for measurement of progress in TB control- prevalence and death rates, and the proportion of cases that are detected and cured in DOTS programmes with the Stop TB strategy aimed at dramatically reducing the global burden of TB by 2015 in line with the Millennium Development Goals.
Tuberculosis (TB) is a major global health problem which has confronted human existence. Little wonder about nine million new cases of TB emerge and close to two million people die from the disease yearly, with the highest number of deaths in the African region.
With nations across the globe not free from this health puzzle, the worrisome situation is that, according to the World Health Organisation (WHO) estimates, the largest number of new TB cases in 2008 occurred in the South-East Asia Region.
The estimated incidence rate in sub-Saharan Africa is nearly twice that of the South-East Asia Region with over 350 cases per 100 000 population.
As Nigeria join the rest of the world to mark World TB Day, a day set aside to raise awareness about the global epidemic of tuberculosis (TB), the scope of the disease and how to prevent and cure it, health experts in the country have called for increased tuberculosis drug research activity in Nigeria which has been low in recent times.
In a recent interview with Folasade Ogunsola, head, Department of Medical Microbiology, College of Medicine, Lagos State University Teaching Hospital (LUTH), he disclosed that Tuberculosis is an infectious bacterial disease caused by Mycobacterium tuberculosis, which, most commonly, affects the lungs.
Ogunsola stated that though transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease, in healthy people, infection with Mycobacterium tuberculosis often causes no symptoms, since the person's immune system acts to “wall off” the bacteria.
According to her, “TB drug resistance is an issue that threatens the success of directly observed treatment (DOTS), which is WHO-recommended treatment approach for detection and cure of TB. Recently, strains of TB resistant to major anti-TB drugs have emerged due to inadequate capability for diagnosis and treatment of TB.
“A dangerous form of drug-resistant TB, multidrug-resistant TB (MDR-TB), resists the treatment of, at least, isoniazid and rifampicin, the two most powerful anti-TB drugs. The emergence of extensively drug-resistant (XDR) TB occurs particularly in settings where many TB patients are also infected with HIV, and this poses serious threat to TB control. Also, poor-quality drugs or incomplete drug regimens also give resistant TB bacteria time to arise, multiply, and infect others,” Ogunsola added.
For his part, Aderemi Kehinde, Consultant Medical Microbiologist, College of Medicine, University of Ibadan, revealed that Nigeria ranks 4th out of the 22 countries designated by the WHO with the highest burden of TB globally behind India, China and Indonesia.
Kehinde stated that TB research in Nigeria had not been active until recently, due to inadequate facilities arisen from poor funding as research activities were mainly carried by few individual researchers in academic environment.
In his words “TB drug research activity is low in Nigeria. This is as a result of low research funding. Majority of the funds come in form of individual grants from local research institutions, including universities. The recently awarded round 5 Global funds were used to scale-up DOTS expansion with very little funding left for research. Among the challenges include- equipment needed to carry out medical analysis which needs to be strengthened, requisite human capacity of physicians, researchers, lab scientists, nurses etc in TB drug research such as maintaining good clinical practice, good laboratory practice and ethics of research in human subjects among others.
Taking a look at the level of TB drug resistance activity in the country, it is noteworthy to state that the accessed funds from the round 5 Global Fund for AIDS, TB and Malaria were used to equip two National reference laboratories (Nigerian Institute of Medical Research (NIMR) Lagos TB training school, Zaria), one zonal reference laboratory in each of the six geopolitical zones of the country and a nationwide external quality assurance (EQA) system.
This initiative has created awareness and interest among academics to do research on TB. University College Hospital, Ibadan, houses the Southwest TB reference laboratory. It serves six states with population of about 35 million.
Recognising the scale of the problem, global targets for reductions in the burden of disease (measured as incidence, prevalence and mortality) caused by TB have been set within the context of the Millennium Development Goals (MDGs) and by the Stop TB Partnership. The target set within the MDGs is to halt and reverse the incidence of TB by 2015.
In addition, the MDGs included three other indicators for measurement of progress in TB control- prevalence and death rates, and the proportion of cases that are detected and cured in DOTS programmes with the Stop TB strategy aimed at dramatically reducing the global burden of TB by 2015 in line with the Millennium Development Goals.
Tuesday, February 15, 2011
Lagos climate conference seeks effective adaptation plan
Across the African continent, the landscape is changing in recent times. With the snowy caps of Mount Kilimanjaro melting and the shorelines of lakes Chad, Tanganyika and Victoria receding, these and many other changes have led to unreliable farming seasons and low water supplies – a serious problem for a continent almost entirely dependent on rain for its agriculture. There is now a growing increase in the incidence of disease, declining agricultural productivity, and a rising number of heat waves.
Globally, the rising impact of climate change which experts describe as the most deadly threat to human existence, have resulted in 373 natural disasters experienced in different parts of the world in 2010. This has however led to an economic loss of about $110 billion. Within the same period for the same reason, about 300,000 lives were lost while 207 million others were affected.
Driving this matter home, there is glaring evidence that climate change is not only happening but it's changing our lives. Declining rainfall in already desert-prone areas in northern Nigeria is causing increasing desertification, even as the former food basket in central Nigeria seem empty, and people in the coastal areas who used to depend on fishing have seen their livelihoods destroyed by sea-level rise.
In view of these realities, experts at the just concluded 3rd Lagos State Summit on Climate Change with the theme “Charting a roadmap for combating climate change in Nigeria”, have called for the need to create effective, effective adaptation activities, synergy between policy makers, scientists and other stakeholders in a bid to improve climate information for the socioeconomic development of the country as well as ensure environment sustainability.
Delivering his keynote address titled ‘Markets in Weather Risks and Natural Disasters’, Kenny Tang, founder and chief executive officer, Oxbridge Weather Capital, UK, described 2010 as a year of disasters, noting that “there is a steep rise in natural disasters”. Tang, who is also a global thought leader in the field of sustainable environment finance’, stressed that changing weather conditions which brings about climate change, comes with a lot of risks to government such that government “is the insurer of the last resort” in cases of disaster.
Tang who stated that disaster risks reduction is not optional and unless we act now, people will experience more disasters due to unplanned urbanization and environmental degradation, revealed that about US $4 trillion were lost in Gross Domestic Product due to weather risks in 2010
Lending his view, Governor of Lagos State, Babatunde Fashola, disclosed that Nigeria’s developmental efforts must take cognizance of environmental sustainability, or it will amount to efforts in futility, noted that emerging indications point in the direction that current predications on climate change could be an underestimation of the actual potential calamity waiting to befall the world.
The Governor noted that it has become imperative for government at all levels to begin to implement recommendation packages arising from various international forums on climate change aimed at preventing further environmental damage and controlling devastating impact already being felt worldwide.
In his words “The approaching disasters, if sufficient care is not taken, will be more devastating than the first and second World wars combined. What we desperately need as global citizens is to retool our efforts and reinvent our strategies towards achieving the desired result. Ensuring environmental sustainability is a task that should be achieved before 2015 as entrenched in the Millennium Development Goals package as the seventh goal.”
Taking a close look at the issue of climate change, Nigeria’s development plan does not recognize the economical threat caused by the climate change. No doubt, all the main sectors of Nigeria’s economy will be impacted by climate change, but in particular agriculture. Infrastructure such as water, transport and power are also extremely susceptible and will result in knock on effects to other parts of the economy, especially wholesale and retail.
Going further, attaining the MDGs will also suffer as a result of climate change. In particular Goal 1 on hunger and poverty and Goal 7 on environmental sustainability will be affected in a major adverse way.
There is no gain saying that a lot needs to be done by the present government to place climate change high on the agenda of government. It is important to realise that the complex nature of climate change is beyond what government alone can handle. Hence, it calls for a public-private partnership in which the private sector actors and civil society partner together to address the various dimensions of climate change in the context of national sustainable development.
For Muiz Banire, Commissioner for the Environment, Lagos State, the magnitude of such loss in terms of lives, properties and the overall economy, can only be imagined and this ugly and imbalance scenario justifies Lagos’ foregrounding in responding to climate change challenge through awareness while unraveling the best mitigation and adaptation strategies.
In his words “That is why we must act fast as possible by exploring possible means to stop the rot in the environment. One of such advocacy is the launch of climate change clubs in Lagos schools in a bid to engage the younger generations in the worthy fight against global warming.”
“As a proactive government, we as a state have taken steps to address environmental problems. These include effective management of wastes, flood and coastal erosion. Our advocacy programmes include workshops, seminars, public lectures and media campaign on climate change, land reclamation, landscaping and beautification as well as campaign against desertification. We cannot ignore the vulnerability of the young ones to disasters as they have less capacity to respond to disasters. Hence the urgent need to train and teach them the rudiments of mitigative and adaptive measures is of paramount importance to the protection and preservation of our biodiversity.”
Since Nigeria doesn’t have the blueprint for addressing the climatic disasters ravaging the world, there is the need to reinvent strategies for better results which is indeed the main thrust for previous summit on climate change in Lagos state and beyond.
Globally, the rising impact of climate change which experts describe as the most deadly threat to human existence, have resulted in 373 natural disasters experienced in different parts of the world in 2010. This has however led to an economic loss of about $110 billion. Within the same period for the same reason, about 300,000 lives were lost while 207 million others were affected.
Driving this matter home, there is glaring evidence that climate change is not only happening but it's changing our lives. Declining rainfall in already desert-prone areas in northern Nigeria is causing increasing desertification, even as the former food basket in central Nigeria seem empty, and people in the coastal areas who used to depend on fishing have seen their livelihoods destroyed by sea-level rise.
In view of these realities, experts at the just concluded 3rd Lagos State Summit on Climate Change with the theme “Charting a roadmap for combating climate change in Nigeria”, have called for the need to create effective, effective adaptation activities, synergy between policy makers, scientists and other stakeholders in a bid to improve climate information for the socioeconomic development of the country as well as ensure environment sustainability.
Delivering his keynote address titled ‘Markets in Weather Risks and Natural Disasters’, Kenny Tang, founder and chief executive officer, Oxbridge Weather Capital, UK, described 2010 as a year of disasters, noting that “there is a steep rise in natural disasters”. Tang, who is also a global thought leader in the field of sustainable environment finance’, stressed that changing weather conditions which brings about climate change, comes with a lot of risks to government such that government “is the insurer of the last resort” in cases of disaster.
Tang who stated that disaster risks reduction is not optional and unless we act now, people will experience more disasters due to unplanned urbanization and environmental degradation, revealed that about US $4 trillion were lost in Gross Domestic Product due to weather risks in 2010
Lending his view, Governor of Lagos State, Babatunde Fashola, disclosed that Nigeria’s developmental efforts must take cognizance of environmental sustainability, or it will amount to efforts in futility, noted that emerging indications point in the direction that current predications on climate change could be an underestimation of the actual potential calamity waiting to befall the world.
The Governor noted that it has become imperative for government at all levels to begin to implement recommendation packages arising from various international forums on climate change aimed at preventing further environmental damage and controlling devastating impact already being felt worldwide.
In his words “The approaching disasters, if sufficient care is not taken, will be more devastating than the first and second World wars combined. What we desperately need as global citizens is to retool our efforts and reinvent our strategies towards achieving the desired result. Ensuring environmental sustainability is a task that should be achieved before 2015 as entrenched in the Millennium Development Goals package as the seventh goal.”
Taking a close look at the issue of climate change, Nigeria’s development plan does not recognize the economical threat caused by the climate change. No doubt, all the main sectors of Nigeria’s economy will be impacted by climate change, but in particular agriculture. Infrastructure such as water, transport and power are also extremely susceptible and will result in knock on effects to other parts of the economy, especially wholesale and retail.
Going further, attaining the MDGs will also suffer as a result of climate change. In particular Goal 1 on hunger and poverty and Goal 7 on environmental sustainability will be affected in a major adverse way.
There is no gain saying that a lot needs to be done by the present government to place climate change high on the agenda of government. It is important to realise that the complex nature of climate change is beyond what government alone can handle. Hence, it calls for a public-private partnership in which the private sector actors and civil society partner together to address the various dimensions of climate change in the context of national sustainable development.
For Muiz Banire, Commissioner for the Environment, Lagos State, the magnitude of such loss in terms of lives, properties and the overall economy, can only be imagined and this ugly and imbalance scenario justifies Lagos’ foregrounding in responding to climate change challenge through awareness while unraveling the best mitigation and adaptation strategies.
In his words “That is why we must act fast as possible by exploring possible means to stop the rot in the environment. One of such advocacy is the launch of climate change clubs in Lagos schools in a bid to engage the younger generations in the worthy fight against global warming.”
“As a proactive government, we as a state have taken steps to address environmental problems. These include effective management of wastes, flood and coastal erosion. Our advocacy programmes include workshops, seminars, public lectures and media campaign on climate change, land reclamation, landscaping and beautification as well as campaign against desertification. We cannot ignore the vulnerability of the young ones to disasters as they have less capacity to respond to disasters. Hence the urgent need to train and teach them the rudiments of mitigative and adaptive measures is of paramount importance to the protection and preservation of our biodiversity.”
Since Nigeria doesn’t have the blueprint for addressing the climatic disasters ravaging the world, there is the need to reinvent strategies for better results which is indeed the main thrust for previous summit on climate change in Lagos state and beyond.
Monday, February 7, 2011
Internet access in Nigeria; the hurdles truncating the process in Nigeria
In the wake of difficulty expressed by Nigerians who surf the internet various needs, Alexander Chiejina writes that investing in the extension of broadband infrastructure to criss-cross the country will go a long way at improving broadband internet services in Nigeria.
The computer age is one era that has been greeted with lots of inventions and display of human ingenuity which has revolutionised the global society, economy and technological systems. However, over the past century and a half, important technological developments have created a global environment which draws people across the globe closer and closer together.
The Internet, as an integrating force, has melded the technology of communications and computing to provide instant connectivity and global information services to all its users. This tool has no doubt made significant impact in the business world with applications such as e-commerce, online banking and e-payments, e-health, e-learning and e-government rapidly evolving. While some older people still struggle to embrace this emerging trend in ICT, most individuals across the globe can’t even imagine life without it.
However, as Nigeria continues in its quest to become one of the 20 leading economies by 2020, stakeholders in the Information and Communications Technology (ICT) sector are concerned about the current level of internet connectivity and penetration in the country. This is backdrop of speedy broadband penetration which experts believe is critical in nation building.
While some school of thought are of the opinion that the Nigerian Communications Commission (NCC), the telecom industry regulator, is not doing enough to encourage providers of fibre optic backbones that have since landed their submarine cables at the country's shores, others believe that improving broadband penetration will go a long way at increasing internet access in the country.
Speaking recently to Lanre Ajayi, Immediate Past President, Nigeria Internet Group (NIG), Ajayi revealed that last mile connectivity would make the difference as it will allow for broadband availability and penetration if operators are encouraged to take broadband to all nooks and crannies of the country. Ajayi noted that there is over 60 million telephone access and 20 million people have access for internet in Nigeria today which is a wide gap.
According to Ajayi, “The question to ask then is what about the people in the rural areas, are they not Nigerians? And how you will know that we are doing pretty well in the area of internet connection is when you compare the number of people who have access to internet to the number of people who have access to telephone services. We should not forget that the internet enables us to do more things than the telephone. Don’t forget that you can make phone calls on the internet, Voice over IP. How come that these people making calls on phones cannot have access to the internet. How can broadband accessibility be fast tracked in this circumstance?
“There are three segments to internet delivery: The international link, national backbone and the last mile. On the international link, we seem to be making some progress with the landing of Main One and the Glo 1. We now have three cables including the Sat 3 cables. Some others are still coming even as people have started foreseeing the possibility of gloat. The next one is the national backbone.
That is the fibre cable that will link all the major cities together. Some progress has been made but they are not good enough. I think that is where a whole lot of job is required to be done now. Then the last mile; this has to do with the connection between the Internet Service Providers (ISPs) institutions to homes and institutions. That one is the easiest part but we are having some challenges in that area. That area is better done by wireless spectrum. In doing this wireless technology, we require spectrum and our spectrum management,” he concluded.
Lending his view, Genevieve Anemelu, an IT expert at Zenith Bank, Lagos, stated that It is no more news that poor internet service is one of the major problem confronting Nigerian internet users (either for business or personal use). Anemelu stated that one can image when one have to wait several minutes to load a webpage.
According to Anemelu “If you use dial up services like GSM and Code Division Multiple Access (CDMA networks), they have their problems. The situation is this-it is either the internet service speed is terribly slow or too expensive or a horrible combination of both. These service providers are busy trying to out-do each other with adverts and promos, instead of concentrating on their core areas – quality service delivery and ultimately customer satisfaction. A solution to improved internet access is by having a broadband internet access in the country.”
Taking a cursory look at moves made by IT firms at improving broadband penetration in the country, it will be recalled that it was until 2009 that the national fixed-line provider Nitel was the major gatekeeper for international bandwidth provision to Nigeria with its SAT-3 undersea cable, which it holds along with 35 other providers from around the world. In July 2009, damage to the cable caused massive disruption to Internet access across the country, with 70 percent of connections affected.
Going further, in September 2009, the Glo-1 cable, owned by Second National Operator and mobile market number two, Globacom, made land at Lagos, and started rolling out services at the end of 2009. The Main One cable, owned by Nigerian firm Main Street Technologies, which stretches from Portugal to Nigeria and Ghana arrived Nigeria in June 2010 and began operations in July 2010.
In October 2009, mobile market leader MTN announced that it was joining with ten other operators in the West African Cable Systems (WACS) cable project, connecting South Africa, Nigeria and the UK. It was set to commence operations in December 2010. France Telecom’s African Coast to Europe (ACE) cable will connect Nigeria to France when it starts operating in 2011.
With firms erecting structures for broadband platforms and as the number of people online in Nigeria continues to grow, International Telecom Union (ITU), the world telecom regulatory body had tasked Nigerian government to drive broadband penetration in the country, insisting that broadband is the digital right of every citizen. This is because there are unlimited opportunities on the internet for Nigerians to tap into.
For Emmanuel Ekuwem, Immediate Past President, Association of Telecoms Companies of Nigeria (ATCON) Nigeria would achieve speedy development in 2011, if the country embrace broadband internet to its fullest. According to him, broadband internet access would enhance efforts at job creation, wealth creation and poverty alleviation.
“ICT will accelerate our meeting of the United Nations Millennium Development Goals (MDGs). It will engender an overall national economic growth and development. We will all gladly experience an ICT-based increase in our GDP. Who will not be happy to see a creative explosion of a feeling of national rebirth and well-being among the citizens of Nigeria? All these good things can only be possible when we have a ubiquitous availability of broadband services in Nigeria,” Ekuwem disclosed.
FACTS
Internet Usage Statistics:
23,982,200 Internet users as of December/2009; 16.1% of the population, according to International Telecommunication Union -ITU
Latest Population Estimate:
149,229,090 population for 2009, according to Census Bureau
The computer age is one era that has been greeted with lots of inventions and display of human ingenuity which has revolutionised the global society, economy and technological systems. However, over the past century and a half, important technological developments have created a global environment which draws people across the globe closer and closer together.
The Internet, as an integrating force, has melded the technology of communications and computing to provide instant connectivity and global information services to all its users. This tool has no doubt made significant impact in the business world with applications such as e-commerce, online banking and e-payments, e-health, e-learning and e-government rapidly evolving. While some older people still struggle to embrace this emerging trend in ICT, most individuals across the globe can’t even imagine life without it.
However, as Nigeria continues in its quest to become one of the 20 leading economies by 2020, stakeholders in the Information and Communications Technology (ICT) sector are concerned about the current level of internet connectivity and penetration in the country. This is backdrop of speedy broadband penetration which experts believe is critical in nation building.
While some school of thought are of the opinion that the Nigerian Communications Commission (NCC), the telecom industry regulator, is not doing enough to encourage providers of fibre optic backbones that have since landed their submarine cables at the country's shores, others believe that improving broadband penetration will go a long way at increasing internet access in the country.
Speaking recently to Lanre Ajayi, Immediate Past President, Nigeria Internet Group (NIG), Ajayi revealed that last mile connectivity would make the difference as it will allow for broadband availability and penetration if operators are encouraged to take broadband to all nooks and crannies of the country. Ajayi noted that there is over 60 million telephone access and 20 million people have access for internet in Nigeria today which is a wide gap.
According to Ajayi, “The question to ask then is what about the people in the rural areas, are they not Nigerians? And how you will know that we are doing pretty well in the area of internet connection is when you compare the number of people who have access to internet to the number of people who have access to telephone services. We should not forget that the internet enables us to do more things than the telephone. Don’t forget that you can make phone calls on the internet, Voice over IP. How come that these people making calls on phones cannot have access to the internet. How can broadband accessibility be fast tracked in this circumstance?
“There are three segments to internet delivery: The international link, national backbone and the last mile. On the international link, we seem to be making some progress with the landing of Main One and the Glo 1. We now have three cables including the Sat 3 cables. Some others are still coming even as people have started foreseeing the possibility of gloat. The next one is the national backbone.
That is the fibre cable that will link all the major cities together. Some progress has been made but they are not good enough. I think that is where a whole lot of job is required to be done now. Then the last mile; this has to do with the connection between the Internet Service Providers (ISPs) institutions to homes and institutions. That one is the easiest part but we are having some challenges in that area. That area is better done by wireless spectrum. In doing this wireless technology, we require spectrum and our spectrum management,” he concluded.
Lending his view, Genevieve Anemelu, an IT expert at Zenith Bank, Lagos, stated that It is no more news that poor internet service is one of the major problem confronting Nigerian internet users (either for business or personal use). Anemelu stated that one can image when one have to wait several minutes to load a webpage.
According to Anemelu “If you use dial up services like GSM and Code Division Multiple Access (CDMA networks), they have their problems. The situation is this-it is either the internet service speed is terribly slow or too expensive or a horrible combination of both. These service providers are busy trying to out-do each other with adverts and promos, instead of concentrating on their core areas – quality service delivery and ultimately customer satisfaction. A solution to improved internet access is by having a broadband internet access in the country.”
Taking a cursory look at moves made by IT firms at improving broadband penetration in the country, it will be recalled that it was until 2009 that the national fixed-line provider Nitel was the major gatekeeper for international bandwidth provision to Nigeria with its SAT-3 undersea cable, which it holds along with 35 other providers from around the world. In July 2009, damage to the cable caused massive disruption to Internet access across the country, with 70 percent of connections affected.
Going further, in September 2009, the Glo-1 cable, owned by Second National Operator and mobile market number two, Globacom, made land at Lagos, and started rolling out services at the end of 2009. The Main One cable, owned by Nigerian firm Main Street Technologies, which stretches from Portugal to Nigeria and Ghana arrived Nigeria in June 2010 and began operations in July 2010.
In October 2009, mobile market leader MTN announced that it was joining with ten other operators in the West African Cable Systems (WACS) cable project, connecting South Africa, Nigeria and the UK. It was set to commence operations in December 2010. France Telecom’s African Coast to Europe (ACE) cable will connect Nigeria to France when it starts operating in 2011.
With firms erecting structures for broadband platforms and as the number of people online in Nigeria continues to grow, International Telecom Union (ITU), the world telecom regulatory body had tasked Nigerian government to drive broadband penetration in the country, insisting that broadband is the digital right of every citizen. This is because there are unlimited opportunities on the internet for Nigerians to tap into.
For Emmanuel Ekuwem, Immediate Past President, Association of Telecoms Companies of Nigeria (ATCON) Nigeria would achieve speedy development in 2011, if the country embrace broadband internet to its fullest. According to him, broadband internet access would enhance efforts at job creation, wealth creation and poverty alleviation.
“ICT will accelerate our meeting of the United Nations Millennium Development Goals (MDGs). It will engender an overall national economic growth and development. We will all gladly experience an ICT-based increase in our GDP. Who will not be happy to see a creative explosion of a feeling of national rebirth and well-being among the citizens of Nigeria? All these good things can only be possible when we have a ubiquitous availability of broadband services in Nigeria,” Ekuwem disclosed.
FACTS
Internet Usage Statistics:
23,982,200 Internet users as of December/2009; 16.1% of the population, according to International Telecommunication Union -ITU
Latest Population Estimate:
149,229,090 population for 2009, according to Census Bureau
Sunday, February 6, 2011
Experts make case for cancer care and management in Nigeria
…as the World makes ‘World Cancer Day’
For two years, Yinka Craig, an ace broadcaster, battled to stay alive. But on September 23, 2008, Craig who made his mark with the Nigerian Television Authority (NTA), died at the Mayo Clinic, Rochester, Minnesota, United States of America, where he was receiving treatment for cancer of the immune system.
For Sonny Okosun, one of Nigeria’s great musicians, his story isn’t different. He died May 24, 2008 aged 61, in the U.S after a prolonged battle with cancer. He had also gone to seek medical advice on his deteriorating health. Going further, Yusuf Jibo, former Zonal Director of NTA, who would have turned 55years of age today (February 4th, 2011), lost his live to colon cancer on the 2nd of December 2nd 2010.
Today, one could count prominent Nigerians who have been cut short by this hydra-headed monster. They include wife of former military president, Maryam Babangida, renowned activist and social crusader, Gani Fawehinmi, wife of Edo State Governor, Adams Oshiomole including indigent Nigerians to name but a few.
Presently, cancer has become one of the leading causes of death in the world,
especially in the developing countries. What is worrisome in a country like Nigeria with over 140 million people is that the detection of the killer disease is usually very late.
However, as the nation joins the rest of the world to mark World cancer day (every February 4th), calls have been made for a coordinated approach towards preparing a working document for national cancer research, and collaboration with stakeholders in cancer care and research, to facilitate national policy on cancer management in Nigeria.
Explaining the aetiology of the disease, Remi Ajekigbe, consultant radiotherapist and oncologist, Lagos University Teaching Hospital, Idi-araba, disclosed that cancer is an abnormal uncontrolled growth in the body that refuses to stop even when the initial trigger has been removed. The oncologist revealed that cancer can occur in any part of the body and spread to other areas as it is the only disease that spreads from the primary side of the body to the other part of the vital organs like the lungs, liver, kidney, heart and brain.
According to him “The spread of the disease to the adjacent and distant structures of the body is as a result of the excessive and progressive multiplication of cells. Don’t forget that the interaction between a person's genetic factors and three categories of external agents, including physical carcinogens, such as ultraviolet and ionizing radiation; chemical carcinogens, such as asbestos, components of tobacco smoke; and biological carcinogens, such as infections from certain viruses, bacteria or parasites can give rise to the growth of cancer cells.”
For his part, Innocent Ujah, Director General of Nigerian Institute for Medical Research (NIMR), Yaba Lagos stated that the current estimated 350,000 new cases of cancer diagnosed annually in Nigeria is far from the true cancer crisis in Nigeria.
Speaking at an inaugural meeting of the national Cancer Research Network (CRN) in Lagos last week, the DG stated that a large number of cancers are not detected as majority of Nigerians are poor and live in rural areas far removed from health facilities.
Ujah also noted that the attitude of Nigerians who deny the possibility of them having cancer because of faith and believe system also leaves large cases undetected until it becomes full blown adding that with inadequate research, the problem is even more complicated.
In his words, "Nigeria contributes almost negligible portion to the global body of literature on cancers and most of these are hospital based, perhaps representing the tip of the iceberg as we know that majority of Nigerians live in rural areas, largely poor, far from health facilities and unable to access the facilities. Cancer awareness efforts and screening methods to enhance early detection do not seem to have had much impact on the nation.”
Ujah explained that of the two cancers devastating women in Nigeria (cancers of the breast and the cervix), one has good prognosis if detected early while the other can be prevented but they continue to cost untold hardships and deaths" because of dearth of facilities and other constraints.
Taking a look at the cancer management in Nigeria, the problems of impeded access to health care, ignorance, poverty and a general lack of coordination of issues of health education complicate matters. Worse still, imaging facilities for staging patients with cancer, such as computerized tomography (CT) and Magnetic Resonance Imaging (MRI) are difficult to come by, and when available the cost of such studies put them out of reach of the average citizen.
Even of more concern is fact that clinical services for cancer are grossly inadequate and poorly distributed. Only a few centers have functioning radiotherapy equipment. Radiologic services are generally available, but access is seriously limited by high cost. The same argument of high cost applies to chemotherapy. While pathology services are generally available, the scope of services is limited.
Giving the obvious reality, it is obvious that health authorities in the country need to seek ways to facilitate training and re-training of all cadres of health care workers in cancer care and management he said.
For Ujah “there is the need to coordinate cancer research in the country, collaborate with all stakeholders in cancer care and research, facilitate national policy on cancer management based on research findings and conduct trainings and capacity development in cancer care and research. This is because research findings will in the long run influence national policy, processes and procedures on prevention, treatment and control of common cancers in Nigeria."
For Akin Osibogun, Chief Medical Director, LUTH, “education to help people recognize early signs of cancer and seek prompt medical attention for symptoms, which might include: lumps, sores, persistent indigestion, persistent coughing, and bleeding from the body's orifices is essential. Also, screening programmes to identify early cancer or pre-cancer before signs are recognizable, including mammography for breast cancer, and cytology (a "pap smear") for cervical cancer will further reduce the incidence of cancer related deaths in the country.”
For two years, Yinka Craig, an ace broadcaster, battled to stay alive. But on September 23, 2008, Craig who made his mark with the Nigerian Television Authority (NTA), died at the Mayo Clinic, Rochester, Minnesota, United States of America, where he was receiving treatment for cancer of the immune system.
For Sonny Okosun, one of Nigeria’s great musicians, his story isn’t different. He died May 24, 2008 aged 61, in the U.S after a prolonged battle with cancer. He had also gone to seek medical advice on his deteriorating health. Going further, Yusuf Jibo, former Zonal Director of NTA, who would have turned 55years of age today (February 4th, 2011), lost his live to colon cancer on the 2nd of December 2nd 2010.
Today, one could count prominent Nigerians who have been cut short by this hydra-headed monster. They include wife of former military president, Maryam Babangida, renowned activist and social crusader, Gani Fawehinmi, wife of Edo State Governor, Adams Oshiomole including indigent Nigerians to name but a few.
Presently, cancer has become one of the leading causes of death in the world,
especially in the developing countries. What is worrisome in a country like Nigeria with over 140 million people is that the detection of the killer disease is usually very late.
However, as the nation joins the rest of the world to mark World cancer day (every February 4th), calls have been made for a coordinated approach towards preparing a working document for national cancer research, and collaboration with stakeholders in cancer care and research, to facilitate national policy on cancer management in Nigeria.
Explaining the aetiology of the disease, Remi Ajekigbe, consultant radiotherapist and oncologist, Lagos University Teaching Hospital, Idi-araba, disclosed that cancer is an abnormal uncontrolled growth in the body that refuses to stop even when the initial trigger has been removed. The oncologist revealed that cancer can occur in any part of the body and spread to other areas as it is the only disease that spreads from the primary side of the body to the other part of the vital organs like the lungs, liver, kidney, heart and brain.
According to him “The spread of the disease to the adjacent and distant structures of the body is as a result of the excessive and progressive multiplication of cells. Don’t forget that the interaction between a person's genetic factors and three categories of external agents, including physical carcinogens, such as ultraviolet and ionizing radiation; chemical carcinogens, such as asbestos, components of tobacco smoke; and biological carcinogens, such as infections from certain viruses, bacteria or parasites can give rise to the growth of cancer cells.”
For his part, Innocent Ujah, Director General of Nigerian Institute for Medical Research (NIMR), Yaba Lagos stated that the current estimated 350,000 new cases of cancer diagnosed annually in Nigeria is far from the true cancer crisis in Nigeria.
Speaking at an inaugural meeting of the national Cancer Research Network (CRN) in Lagos last week, the DG stated that a large number of cancers are not detected as majority of Nigerians are poor and live in rural areas far removed from health facilities.
Ujah also noted that the attitude of Nigerians who deny the possibility of them having cancer because of faith and believe system also leaves large cases undetected until it becomes full blown adding that with inadequate research, the problem is even more complicated.
In his words, "Nigeria contributes almost negligible portion to the global body of literature on cancers and most of these are hospital based, perhaps representing the tip of the iceberg as we know that majority of Nigerians live in rural areas, largely poor, far from health facilities and unable to access the facilities. Cancer awareness efforts and screening methods to enhance early detection do not seem to have had much impact on the nation.”
Ujah explained that of the two cancers devastating women in Nigeria (cancers of the breast and the cervix), one has good prognosis if detected early while the other can be prevented but they continue to cost untold hardships and deaths" because of dearth of facilities and other constraints.
Taking a look at the cancer management in Nigeria, the problems of impeded access to health care, ignorance, poverty and a general lack of coordination of issues of health education complicate matters. Worse still, imaging facilities for staging patients with cancer, such as computerized tomography (CT) and Magnetic Resonance Imaging (MRI) are difficult to come by, and when available the cost of such studies put them out of reach of the average citizen.
Even of more concern is fact that clinical services for cancer are grossly inadequate and poorly distributed. Only a few centers have functioning radiotherapy equipment. Radiologic services are generally available, but access is seriously limited by high cost. The same argument of high cost applies to chemotherapy. While pathology services are generally available, the scope of services is limited.
Giving the obvious reality, it is obvious that health authorities in the country need to seek ways to facilitate training and re-training of all cadres of health care workers in cancer care and management he said.
For Ujah “there is the need to coordinate cancer research in the country, collaborate with all stakeholders in cancer care and research, facilitate national policy on cancer management based on research findings and conduct trainings and capacity development in cancer care and research. This is because research findings will in the long run influence national policy, processes and procedures on prevention, treatment and control of common cancers in Nigeria."
For Akin Osibogun, Chief Medical Director, LUTH, “education to help people recognize early signs of cancer and seek prompt medical attention for symptoms, which might include: lumps, sores, persistent indigestion, persistent coughing, and bleeding from the body's orifices is essential. Also, screening programmes to identify early cancer or pre-cancer before signs are recognizable, including mammography for breast cancer, and cytology (a "pap smear") for cervical cancer will further reduce the incidence of cancer related deaths in the country.”
Friday, January 21, 2011
National Policy; key in reducing Sickle Cell disorder burden
There is no gain saying that Sickle Cell Disorder (SCD), is a global health problem with psychosocial implications. This is due to the fact that despite the large number of people with SCD, the Nigerian society in general still has a negative image of SCD and reported negative perceptions and attitudes. This has in turn, created a scenario whereby those who cater for sufferers are faced with the burden of providing adequate care and support.
However, with the incidence of sickle cell anaemia in the country which is estimated at 150,000 births annually, survival of Nigerian children beyond childhood have largely depended on their access to appropriate care. And because most of them are born into poor under-privileged families, very few of them survive childhood.
In view of this starring reality, health experts in the country have tasked health authorities in the country to develop a well-resourced national policy and increased awareness which is believed would curtail the dissemination of unbiased public information and education about the disorder.
In a recent interview with BusinessDay, Olu Akinyanju, Chiarman, Sickle Cell Foundation revealed that the nation has the nation has no exact record of citizens suffering from the disorder in contrast to advanced countries of the world like the United States of America and United Kingdom.
This, according to him, has made it impossible for the country to provide for the needs of the patients in spite of the fact that the nation has the largest burden of the disorder in the world. Akinyanju stated that those with the disease suffer a higher than average frequency of illness and premature death, especially in infancy.
In his words “some of the challenges facing sickle cell patients in the country include the absence of dedicated sickle cell clinics in many hospitals across the federation, lack of funding for provision of healthcare to indigent patients, poor funding for capacity building, research and patient care as well as deployment of appropriate personnel and facilities in the nation’s infrastructures.”
He maintained that the Nigerian Sickle Cell Expert Advisory Committee has made important recommendations for improving the uniformity and standard of care delivered to patients, saying the implementation of the recommendations should significantly reduce avoidable illness and deaths among the affected people and thus, improve their quality of lives and average life expectancy.
For her part, Torinola Femi-Adebayo, Senior Medical Officer, Sickle Cell Foundation, noted that low level of awareness on SCD is fueling the misinformation, inappropriate treatment, frustration and stigmatisation. Femi Adebayo stated that the reason is that the affected children rarely survived childhood, and were, therefore, less likely to be encountered in secondary schools, universities and in the workplace.
According to her “having sickle cell disease means a lifelong battle against the health problems it can cause, such as pain, infections, anemia, and stroke. But many people are able to have a very good quality of life by learning to manage the disease. The sickling occurs because of a mutation in the haemoglobin gene.
“The most common signs and symptoms are linked to anaemia and pain while other signs and symptoms are linked to the disease’s complications. The pain from sickle-cell crisis can be acute or chronic, but acute pain is more common. Almost all people who have sickle-cell anaemia have painful crisis at some point in their lives. Your risk for a sickle-cell crisis increases if you are dehydrated, when your body does not have enough fluid. Drinking plenty of fluids can lower your risk for a painful crisis.
With SCD been a genetic disorder associated with excruciating pain, which occurs in different periods, there is the need for proper medical interventions in place to ensure sufferers don’t pass through trying times before accessing medical attention.
For Akinyanju, “The recommendations include the introduction of newborn, or at least, infant to screening for sickle cell disorder to enable early diagnosis. This is done in England and America not only for sickle cell, but also for other conditions. It also includes the training and development of a cadre of sickle cell specialist nurses in order to increase access to well-informed health workers.”
“Don’t forget that the average life expectancy of sickle cell patients in America rose to 53 with commensurate improvement in their quality of life due to their greater annual investment in sickle cell care which is higher than the average life expectancy of all Nigerians which currently stood at 47,” He concluded.
Lending his view, Olarewanju Ekujimi, National President, Association of Resident Doctors added that “regular checkups are an important part of life with this disease. People with sickle cell disease need a good working relationship with a doctor who is an expert in treating it. This is borne out of their painful episodes which sets off occasioned by high altitude, cigeratte smoke, etc. Also, since people with sickle cell disease and their families face ongoing stress, a support network can help ease stress and worry.”
Alexander Chiejina
However, with the incidence of sickle cell anaemia in the country which is estimated at 150,000 births annually, survival of Nigerian children beyond childhood have largely depended on their access to appropriate care. And because most of them are born into poor under-privileged families, very few of them survive childhood.
In view of this starring reality, health experts in the country have tasked health authorities in the country to develop a well-resourced national policy and increased awareness which is believed would curtail the dissemination of unbiased public information and education about the disorder.
In a recent interview with BusinessDay, Olu Akinyanju, Chiarman, Sickle Cell Foundation revealed that the nation has the nation has no exact record of citizens suffering from the disorder in contrast to advanced countries of the world like the United States of America and United Kingdom.
This, according to him, has made it impossible for the country to provide for the needs of the patients in spite of the fact that the nation has the largest burden of the disorder in the world. Akinyanju stated that those with the disease suffer a higher than average frequency of illness and premature death, especially in infancy.
In his words “some of the challenges facing sickle cell patients in the country include the absence of dedicated sickle cell clinics in many hospitals across the federation, lack of funding for provision of healthcare to indigent patients, poor funding for capacity building, research and patient care as well as deployment of appropriate personnel and facilities in the nation’s infrastructures.”
He maintained that the Nigerian Sickle Cell Expert Advisory Committee has made important recommendations for improving the uniformity and standard of care delivered to patients, saying the implementation of the recommendations should significantly reduce avoidable illness and deaths among the affected people and thus, improve their quality of lives and average life expectancy.
For her part, Torinola Femi-Adebayo, Senior Medical Officer, Sickle Cell Foundation, noted that low level of awareness on SCD is fueling the misinformation, inappropriate treatment, frustration and stigmatisation. Femi Adebayo stated that the reason is that the affected children rarely survived childhood, and were, therefore, less likely to be encountered in secondary schools, universities and in the workplace.
According to her “having sickle cell disease means a lifelong battle against the health problems it can cause, such as pain, infections, anemia, and stroke. But many people are able to have a very good quality of life by learning to manage the disease. The sickling occurs because of a mutation in the haemoglobin gene.
“The most common signs and symptoms are linked to anaemia and pain while other signs and symptoms are linked to the disease’s complications. The pain from sickle-cell crisis can be acute or chronic, but acute pain is more common. Almost all people who have sickle-cell anaemia have painful crisis at some point in their lives. Your risk for a sickle-cell crisis increases if you are dehydrated, when your body does not have enough fluid. Drinking plenty of fluids can lower your risk for a painful crisis.
With SCD been a genetic disorder associated with excruciating pain, which occurs in different periods, there is the need for proper medical interventions in place to ensure sufferers don’t pass through trying times before accessing medical attention.
For Akinyanju, “The recommendations include the introduction of newborn, or at least, infant to screening for sickle cell disorder to enable early diagnosis. This is done in England and America not only for sickle cell, but also for other conditions. It also includes the training and development of a cadre of sickle cell specialist nurses in order to increase access to well-informed health workers.”
“Don’t forget that the average life expectancy of sickle cell patients in America rose to 53 with commensurate improvement in their quality of life due to their greater annual investment in sickle cell care which is higher than the average life expectancy of all Nigerians which currently stood at 47,” He concluded.
Lending his view, Olarewanju Ekujimi, National President, Association of Resident Doctors added that “regular checkups are an important part of life with this disease. People with sickle cell disease need a good working relationship with a doctor who is an expert in treating it. This is borne out of their painful episodes which sets off occasioned by high altitude, cigeratte smoke, etc. Also, since people with sickle cell disease and their families face ongoing stress, a support network can help ease stress and worry.”
Alexander Chiejina
Monday, January 17, 2011
School closure: Sure end towards getting a credible voters’ registration in Nigeria?
Recently, the Federal Government announced the closure of schools across the Federation for a month over voters’ registration exercise. This has been greeted with mass protests from stakeholders as they ponder whether this would ensure an obstruction in the entire exercise writes Alexander Chiejina
In recent times, the issue that has dominated the print and electronic media in the country has been whether the Independent National Electoral Commission (INEC) would come to terms with the aspiration of Nigerians at home and Diaspora to conduct a free and fair election. This apprehension is as a result of electoral processes in the past which has been greeted with ill-will, rancor and violence.
Faced with this daunting challenge, the electoral body on its part are geared towards the forthcoming elections with the recent training of ad hoc staffs including corps members nationwide that will serve as electoral officers even during the voters’ registration exercise, procuring the Data Direct Capturing (DDC) machines as well as setting machineries on ground which would ensure a smooth electionary process.
However, in readiness for the voters’ registration exercise, the Federal Government recently announced the postponement of resumption date of all schools (primary and secondary) across the federation by one month. This move the FG say is to enable INEC, conduct a smooth voters’ registration exercise. The closure of schools was set to begin from January 10th and last till January 29th 2011.
Following this pronouncement to postpone school resumption, mixed reactions have been trailing the decision. While some schools are waiting to see the outcome of the directive before opening their gates, some are still holding meetings to decide on the next line of action. However, some school owners who may not come to terms with the disruption that the directive will unleash on their time-table are threatening to commence resumption formalities.
Just last week, school owners, under the aegis of National Association of Proprietors of Private Schools (NAPPS), protested the FG’s decision to close schools for the voters’ registration which began at the weekend.
The proprietors, who stormed the office of Lagos State Governor Babatunde Fashola at Alausa, Ikeja, carried placards with inscriptions like: Why close all?”; “Open our schools - they cost money”; “Education in Nigeria is injured already”, etc to name but a few. While frowning at the decision of the government, they appealed to the governor to prevail on the government to reopen schools.
Speaking to newsmen at Ikeja, NAPPS president, Elizabeth Kufeji, said that the closure was improper. Kufeji stated that it was necessary for the government to intervene since private schools in Ogun State would be opened during the exercise. According to her, besides the fact that NAPPS members were not privy to the decision, the exercise could be held on weekends.
While disclosing that for the three weeks the schools will be closed, the proprietors will pay workers’ salaries, Kufeji added that parents will not take the matter.
According to her “As educators, we are not going to sit back and let the future of our children be ruined. When is there no bomb blast? Was it during the voter registration that we will begin to have bomb blasts? As far as we are concerned, the security system in Lagos State is well structured. This is not the first time in Nigeria that private schools were on and public schools were shut down.
They know how to adjust the academic calendar. The Federal Government should not disturb the academic session because it is organising voter registration. The first 400 universities were shortlisted recently; no Nigerian university was listed. All these were due to frequent distortions of our academic calendar. Other private schools in neighbouring states did not close down their schools. There is no good reason schools in the country should be closed. This is not the first time we are organising voter registration in Nigeria.”
Also in disagreement with the decision to close down schools for a month due to political reasons is the Association for Formidable Educational development (AFED). Joe Ejenavi, President AFED said that those who conceived the idea didn’t have the interest of the Nigerian children at heart. Ejenavi noted that since they are not using teachers for the exercise and none of the students were eligible to vote, so why the decision to close down all the schools?
“Their children are not in Nigeria. They are all attending schools abroad, so why would they care about the poor? Right now, we are still looking at the issues involved before we take a stand. We insist that the decision is not in the best interest of the masses. The education sector is very critical to national development and subjecting it to any form of interference has to be reconsidered.”
Prior to the pronouncement, some school of thought are of the view that security of pupils was the major consideration for the extension of resumption for public and private schools in the country.
Only recently at a joint media briefing held in Abuja, INEC’s Chairman, Attahiru Jega and the Minister of State for Education, Kenneth Gbagi, attributed the growing but disturbing “do or die” attitude to politics in the country as a major reason for the extension.
The INEC boss said that the electoral body assessed the entire situation with regard to the preparations for the conduct of the registration, and requested the intervention to have schools closed within this period, in order to enable us have a successful voters’ registration exercise.
According to the INEC boss “The justifications for these are there are close to 120,000 polling units. We have done a thorough verification of the polling units, and as at the moment we know that for a fact, 119, 976 polling units are spread in public schools. In fact, in many schools, there are three to 10 polling units. Indeed, about 70 per cent of our public schools are either used as polling units or are going to be used as registration centres.
“Where we are going to store the equipment, such as DDC machines throughout the duration of the exercise and where we are going to count some of the personnel that are going to participate in the exercise. Obviously, in each school where these activities are going to take place, there is possible disruption of school activities, because thousands of people will be going into these schools to be registered and we felt that it is important that in order to avoid these disruptions, it is better that the schools are closed down during the period,” Jega stated.
No one can downplay the importance of the upcoming voter's registration. However, it is believed that INEC can achieve a successful voters' registration without closing down schools and disrupting the academic calendar.
There had been voters' registration exercises in the past and the organizers of those exercises did not have to use school premises. If such exercises were deficient in any way it was not because school compounds did not serve as venues but because the operators were insincere in the handling of the assignments.
There are civic centers, town halls and open spaces across the country where INEC can mount canopies and use as venues for the registration exercise. Even, if using schools is the only option available to the Commission, are they going to use all the classrooms in all the private and public primary and secondary schools in the country? In communities that have many schools, is the registration going to take place in all of them?
We do not see how students being at home will ensure the safety of registration materials unless the electoral body and the Federal Government are afraid that under age pupils and students in primary and junior secondary schools respectively could be, or have been, responsible for stealing election materials.
If the closure is on security grounds, it is amazing that government has assured that it will guarantee the security of students in the senior class three and cannot extend such protection to those at the lower levels.
In recent times, the issue that has dominated the print and electronic media in the country has been whether the Independent National Electoral Commission (INEC) would come to terms with the aspiration of Nigerians at home and Diaspora to conduct a free and fair election. This apprehension is as a result of electoral processes in the past which has been greeted with ill-will, rancor and violence.
Faced with this daunting challenge, the electoral body on its part are geared towards the forthcoming elections with the recent training of ad hoc staffs including corps members nationwide that will serve as electoral officers even during the voters’ registration exercise, procuring the Data Direct Capturing (DDC) machines as well as setting machineries on ground which would ensure a smooth electionary process.
However, in readiness for the voters’ registration exercise, the Federal Government recently announced the postponement of resumption date of all schools (primary and secondary) across the federation by one month. This move the FG say is to enable INEC, conduct a smooth voters’ registration exercise. The closure of schools was set to begin from January 10th and last till January 29th 2011.
Following this pronouncement to postpone school resumption, mixed reactions have been trailing the decision. While some schools are waiting to see the outcome of the directive before opening their gates, some are still holding meetings to decide on the next line of action. However, some school owners who may not come to terms with the disruption that the directive will unleash on their time-table are threatening to commence resumption formalities.
Just last week, school owners, under the aegis of National Association of Proprietors of Private Schools (NAPPS), protested the FG’s decision to close schools for the voters’ registration which began at the weekend.
The proprietors, who stormed the office of Lagos State Governor Babatunde Fashola at Alausa, Ikeja, carried placards with inscriptions like: Why close all?”; “Open our schools - they cost money”; “Education in Nigeria is injured already”, etc to name but a few. While frowning at the decision of the government, they appealed to the governor to prevail on the government to reopen schools.
Speaking to newsmen at Ikeja, NAPPS president, Elizabeth Kufeji, said that the closure was improper. Kufeji stated that it was necessary for the government to intervene since private schools in Ogun State would be opened during the exercise. According to her, besides the fact that NAPPS members were not privy to the decision, the exercise could be held on weekends.
While disclosing that for the three weeks the schools will be closed, the proprietors will pay workers’ salaries, Kufeji added that parents will not take the matter.
According to her “As educators, we are not going to sit back and let the future of our children be ruined. When is there no bomb blast? Was it during the voter registration that we will begin to have bomb blasts? As far as we are concerned, the security system in Lagos State is well structured. This is not the first time in Nigeria that private schools were on and public schools were shut down.
They know how to adjust the academic calendar. The Federal Government should not disturb the academic session because it is organising voter registration. The first 400 universities were shortlisted recently; no Nigerian university was listed. All these were due to frequent distortions of our academic calendar. Other private schools in neighbouring states did not close down their schools. There is no good reason schools in the country should be closed. This is not the first time we are organising voter registration in Nigeria.”
Also in disagreement with the decision to close down schools for a month due to political reasons is the Association for Formidable Educational development (AFED). Joe Ejenavi, President AFED said that those who conceived the idea didn’t have the interest of the Nigerian children at heart. Ejenavi noted that since they are not using teachers for the exercise and none of the students were eligible to vote, so why the decision to close down all the schools?
“Their children are not in Nigeria. They are all attending schools abroad, so why would they care about the poor? Right now, we are still looking at the issues involved before we take a stand. We insist that the decision is not in the best interest of the masses. The education sector is very critical to national development and subjecting it to any form of interference has to be reconsidered.”
Prior to the pronouncement, some school of thought are of the view that security of pupils was the major consideration for the extension of resumption for public and private schools in the country.
Only recently at a joint media briefing held in Abuja, INEC’s Chairman, Attahiru Jega and the Minister of State for Education, Kenneth Gbagi, attributed the growing but disturbing “do or die” attitude to politics in the country as a major reason for the extension.
The INEC boss said that the electoral body assessed the entire situation with regard to the preparations for the conduct of the registration, and requested the intervention to have schools closed within this period, in order to enable us have a successful voters’ registration exercise.
According to the INEC boss “The justifications for these are there are close to 120,000 polling units. We have done a thorough verification of the polling units, and as at the moment we know that for a fact, 119, 976 polling units are spread in public schools. In fact, in many schools, there are three to 10 polling units. Indeed, about 70 per cent of our public schools are either used as polling units or are going to be used as registration centres.
“Where we are going to store the equipment, such as DDC machines throughout the duration of the exercise and where we are going to count some of the personnel that are going to participate in the exercise. Obviously, in each school where these activities are going to take place, there is possible disruption of school activities, because thousands of people will be going into these schools to be registered and we felt that it is important that in order to avoid these disruptions, it is better that the schools are closed down during the period,” Jega stated.
No one can downplay the importance of the upcoming voter's registration. However, it is believed that INEC can achieve a successful voters' registration without closing down schools and disrupting the academic calendar.
There had been voters' registration exercises in the past and the organizers of those exercises did not have to use school premises. If such exercises were deficient in any way it was not because school compounds did not serve as venues but because the operators were insincere in the handling of the assignments.
There are civic centers, town halls and open spaces across the country where INEC can mount canopies and use as venues for the registration exercise. Even, if using schools is the only option available to the Commission, are they going to use all the classrooms in all the private and public primary and secondary schools in the country? In communities that have many schools, is the registration going to take place in all of them?
We do not see how students being at home will ensure the safety of registration materials unless the electoral body and the Federal Government are afraid that under age pupils and students in primary and junior secondary schools respectively could be, or have been, responsible for stealing election materials.
If the closure is on security grounds, it is amazing that government has assured that it will guarantee the security of students in the senior class three and cannot extend such protection to those at the lower levels.
How mismanagement disrupts poverty alleviation efforts
There is yet no respite for the nation's teeming poor as the coordinating agency of the federal government's poverty eradication activities remains embroiled in a controversy over alleged misappropriation of funds writes Alexander Chiejina
As another year begins with high hopes of deepening growth, the worry of economic planners would be how to improve on the prevailing high levels of poverty in the country.
Sadly, it is estimated that about 70 percent of Nigerians live below poverty line of less than a dollar a day. This is according to recent reports from the United Nations Programme (UNDP) and the World Bank.
This estimate is believed to make up more than the combined population of Ghana, Togo, Sierra Leone, Benin Republic, Liberia, Gambia, and Cote D'Ivoire which is about 67.3 million. It is on this premise that the federal government under the Olusegun Obasanjo's administration in 2001, in recognition of the economic woes of Nigerians, came up with an idea to eradicate poverty which according to analysts is caused by high levels of corruption that has dogged the nation since independence in 1960. The idea thus gave birth to the National Poverty Eradication Programme (NAPEP).
As the coordinating agency of the federal government for all poverty eradication activities in the country, NAPEP's key strategy is to ensure that strong winning partnerships are forged in the country so that well synergised and sustainable programmes could be implemented for the benefit of the people.
Other duties of the agency include assisting state and local governments develop direct anti-poverty programs that include micro-credit and micro-finance as well as building strategic public and private sector partnerships that should empower the disadvantaged.
However, while the people continue to wait for NAPEP to deliver on this mandate, the agency has of late remained embroiled in controversy, mostly bothering on corruption.
For instance, a deepening crisis in the management of the poverty alleviation instruments has so far attracted the attention of many government agencies including the Economic and Financial Crimes Commission (EFFCC), a Senate investigative committee and internal panels of inquiry that had all probed allegations of corruption in the agency. The issues had centred on mismanagement, especially in the alleged diversion of N417 million of NAPEP fund as well as setting up of parallel phoney companies to ape and appropriate the functions of the agency for the benefit of few corrupt officials.
Early 1999, some officials of the agency had appeared before the Senate Committee on Public Accounts to account for how the N2.4 billion contract awarded by it for the supply of 5, 000 tricycles (KEKE NAPEP) and spare parts in 2003 was executed.
The Senate investigation followed an audit query by the Auditor-General of the Federation over disbursement of the agency's fund.
"From investigations, said the Senate report: "it is established that despite the sum of N1.850 billion provided between 2006 and 2008 on Monitoring and Evaluation, this aspect of the programmes was very weak and ineffective."
It added that most of the anomalies identified in various states of the federation were as a result of the nonchalant attitude of the Monitoring Unit of NAPEP at the National and State levels".
The Senate report further accused the Magnus Kpakol-led NAPEP leadership of funds misapplication, adding that some decisions taken affected Nigerians negatively. According to the report: "the committee established that relationships between NAPEP and Intercontinental Bank Plc and Oceanic International Bank Plc were skewed in favour of the banks.
"It is observed that the funds meant for Village Economic Development Solution (VEDS) and cope programmes- Five billion (N5bn) and two billion two hundred and sixty-five million (N2.265m) naira respectively were managed to the disadvantage of NAPEP and poor Nigerians. The banks in collaboration with NAPEP officials left the fund idle in various accounts with no interest paid by the banks. It also equally established a situation where one of the banks charged commission on turnover (COT) on NAPEP (Government) accounts against the directives of the central Bank of Nigeria."
It especially pointed out the lack of proper monitoring and evaluation despite the availability of N1.8billion provided between 2006 and 2008 for that purpose as well as poor management of funds by NAPEP.
The senate Committee also observed that NAPEP officials in their submission to the committee provided fake names and unverifiable addresses of beneficiaries, ostensibly to cover their tracks.
With poverty still endemic and with no clear programme for lifting the millions of Nigerians trapped in its bosom, it will be merely stating the obvious to say that those who conceived the idea would be hugely disappointed by the failure of the managers of the programme to interpret the poverty alleviation vision in a manner that would benefit the targeted poor.
A recent visit of an internal NAPEP panel to the offices of Autobahn Techniques and Keke Owners and Riders Association of Nigeria (KORAN) which is the official distributor of the tricycles also revealed more sordid details of official corruption going on in the entire NAPEP establishment.
Besides discovering the alleged diversion of N417million belonging to the Agency the visitation panel also observed the clandestine setting up of a parallel company that hides under the cover of an authorised agency to assemble and deliver the tricycles to its own unofficial clients.
The panel said in their report: "Another observation of the team was that, this new company, Trimidan Limited was currently assembling KEKE tricycles, painted them in national colours and entitled it as KEKE NAPEP, yet NAPEP as a government agency was not aware of such assemblage…"
While many continue to point accusing fingers on NAPEP management for the failure of the poverty alleviation programme, the agency had dismissed the claims as 'unnecessary diversion.'
NAPEP's Publicity Secretary, Phil Oshodin in a statement which was recently made available to journalists stressed that NAPEP was on course towards realising its mandate.
Attributing the problems of the agency to the ploy of some of its stakeholders with 'self-serving interests', Oshodin warned that distracting the agency would keep the country and its poor in the middle of nowhere.
According to her "Recently, vituperative attacks have been directed at the NAPEP and its National Coordinator and Senior Special Assistant to the President, Magnus Kpakol, with the usual call for his removal."
Business Day gathered that Ofili Okonkwo, the chief executive officer of Autobahn Technique suppliers of the tricycle had tried to exonerate his firm from any blame in the problems of NAPEP claiming that Autobahn has fulfilled its side of the bargain, having supplied 4,000 units in the first two phases of the contract. He however blamed the failure to deliver all the tricycles on the third phase of the project on schedule to logistics problems and delayed payment on the part of NAPEP.
In disagreeing with this claim, Oshodin argued that the firm had no reason to default despite having been paid fully by NAPEP. She said: "Regrettably, this is happening even when Autobhan Techniques Limited, the defaulter in a contract that was signed on February 16, 2007 to supply 5, 000 units of three wheeler tricycles called "Keke NAPEP" to NAPEP for distribution to various states for a hefty sum of N2.4 billion has brazenly failed to deliver 1,310 units of the tricycles worth N589, 500, 000 till today despite full payment made and the long expiration of the last delivery date on August 21, 2008."
A National Assembly member who pleaded anonymity wants the government to immediately set up a panel to "review and advise it on the findings of the two available Reports by the Visitation Panel and the Senate Committee on National Planning and Poverty Eradication."
As another year begins with high hopes of deepening growth, the worry of economic planners would be how to improve on the prevailing high levels of poverty in the country.
Sadly, it is estimated that about 70 percent of Nigerians live below poverty line of less than a dollar a day. This is according to recent reports from the United Nations Programme (UNDP) and the World Bank.
This estimate is believed to make up more than the combined population of Ghana, Togo, Sierra Leone, Benin Republic, Liberia, Gambia, and Cote D'Ivoire which is about 67.3 million. It is on this premise that the federal government under the Olusegun Obasanjo's administration in 2001, in recognition of the economic woes of Nigerians, came up with an idea to eradicate poverty which according to analysts is caused by high levels of corruption that has dogged the nation since independence in 1960. The idea thus gave birth to the National Poverty Eradication Programme (NAPEP).
As the coordinating agency of the federal government for all poverty eradication activities in the country, NAPEP's key strategy is to ensure that strong winning partnerships are forged in the country so that well synergised and sustainable programmes could be implemented for the benefit of the people.
Other duties of the agency include assisting state and local governments develop direct anti-poverty programs that include micro-credit and micro-finance as well as building strategic public and private sector partnerships that should empower the disadvantaged.
However, while the people continue to wait for NAPEP to deliver on this mandate, the agency has of late remained embroiled in controversy, mostly bothering on corruption.
For instance, a deepening crisis in the management of the poverty alleviation instruments has so far attracted the attention of many government agencies including the Economic and Financial Crimes Commission (EFFCC), a Senate investigative committee and internal panels of inquiry that had all probed allegations of corruption in the agency. The issues had centred on mismanagement, especially in the alleged diversion of N417 million of NAPEP fund as well as setting up of parallel phoney companies to ape and appropriate the functions of the agency for the benefit of few corrupt officials.
Early 1999, some officials of the agency had appeared before the Senate Committee on Public Accounts to account for how the N2.4 billion contract awarded by it for the supply of 5, 000 tricycles (KEKE NAPEP) and spare parts in 2003 was executed.
The Senate investigation followed an audit query by the Auditor-General of the Federation over disbursement of the agency's fund.
"From investigations, said the Senate report: "it is established that despite the sum of N1.850 billion provided between 2006 and 2008 on Monitoring and Evaluation, this aspect of the programmes was very weak and ineffective."
It added that most of the anomalies identified in various states of the federation were as a result of the nonchalant attitude of the Monitoring Unit of NAPEP at the National and State levels".
The Senate report further accused the Magnus Kpakol-led NAPEP leadership of funds misapplication, adding that some decisions taken affected Nigerians negatively. According to the report: "the committee established that relationships between NAPEP and Intercontinental Bank Plc and Oceanic International Bank Plc were skewed in favour of the banks.
"It is observed that the funds meant for Village Economic Development Solution (VEDS) and cope programmes- Five billion (N5bn) and two billion two hundred and sixty-five million (N2.265m) naira respectively were managed to the disadvantage of NAPEP and poor Nigerians. The banks in collaboration with NAPEP officials left the fund idle in various accounts with no interest paid by the banks. It also equally established a situation where one of the banks charged commission on turnover (COT) on NAPEP (Government) accounts against the directives of the central Bank of Nigeria."
It especially pointed out the lack of proper monitoring and evaluation despite the availability of N1.8billion provided between 2006 and 2008 for that purpose as well as poor management of funds by NAPEP.
The senate Committee also observed that NAPEP officials in their submission to the committee provided fake names and unverifiable addresses of beneficiaries, ostensibly to cover their tracks.
With poverty still endemic and with no clear programme for lifting the millions of Nigerians trapped in its bosom, it will be merely stating the obvious to say that those who conceived the idea would be hugely disappointed by the failure of the managers of the programme to interpret the poverty alleviation vision in a manner that would benefit the targeted poor.
A recent visit of an internal NAPEP panel to the offices of Autobahn Techniques and Keke Owners and Riders Association of Nigeria (KORAN) which is the official distributor of the tricycles also revealed more sordid details of official corruption going on in the entire NAPEP establishment.
Besides discovering the alleged diversion of N417million belonging to the Agency the visitation panel also observed the clandestine setting up of a parallel company that hides under the cover of an authorised agency to assemble and deliver the tricycles to its own unofficial clients.
The panel said in their report: "Another observation of the team was that, this new company, Trimidan Limited was currently assembling KEKE tricycles, painted them in national colours and entitled it as KEKE NAPEP, yet NAPEP as a government agency was not aware of such assemblage…"
While many continue to point accusing fingers on NAPEP management for the failure of the poverty alleviation programme, the agency had dismissed the claims as 'unnecessary diversion.'
NAPEP's Publicity Secretary, Phil Oshodin in a statement which was recently made available to journalists stressed that NAPEP was on course towards realising its mandate.
Attributing the problems of the agency to the ploy of some of its stakeholders with 'self-serving interests', Oshodin warned that distracting the agency would keep the country and its poor in the middle of nowhere.
According to her "Recently, vituperative attacks have been directed at the NAPEP and its National Coordinator and Senior Special Assistant to the President, Magnus Kpakol, with the usual call for his removal."
Business Day gathered that Ofili Okonkwo, the chief executive officer of Autobahn Technique suppliers of the tricycle had tried to exonerate his firm from any blame in the problems of NAPEP claiming that Autobahn has fulfilled its side of the bargain, having supplied 4,000 units in the first two phases of the contract. He however blamed the failure to deliver all the tricycles on the third phase of the project on schedule to logistics problems and delayed payment on the part of NAPEP.
In disagreeing with this claim, Oshodin argued that the firm had no reason to default despite having been paid fully by NAPEP. She said: "Regrettably, this is happening even when Autobhan Techniques Limited, the defaulter in a contract that was signed on February 16, 2007 to supply 5, 000 units of three wheeler tricycles called "Keke NAPEP" to NAPEP for distribution to various states for a hefty sum of N2.4 billion has brazenly failed to deliver 1,310 units of the tricycles worth N589, 500, 000 till today despite full payment made and the long expiration of the last delivery date on August 21, 2008."
A National Assembly member who pleaded anonymity wants the government to immediately set up a panel to "review and advise it on the findings of the two available Reports by the Visitation Panel and the Senate Committee on National Planning and Poverty Eradication."
Friday, January 14, 2011
Effective financing critical to revamping Nigeria’s health sector
Across the globe, healthcare is a necessity and a basic human need. This is in view of the invaluable nature it confers. It is in recognition of this that the Alma Ata Declaration of 1979 in Kazakhstan called on all governments, all health and development workers, and the world community to protect and promote the health of all viz-a-viz ensuring the basic needs, including health and food are met.
Sadly however, for most developing nations, the prospects of achieving even a minimal level of adequacy in health services remain a mirage. While healthcare needs are increasing, government expenditure on health in developing countries is declining. This has resulted in a situation whereby as populations get older, as more people suffer chronic diseases, and as new and more expensive treatments appear, health costs seem to soar.
In Nigeria, healthcare sector hasn’t fared much better on the World Health Organisation’s measures for individual contribution to healthcare. This is because effective financing which is critical to revamping the health sector is lacking. ‘Out-of-pocket’ expenditure as percentage of private expenditure on health is put at 90 percent in Nigeria compared with 79 percent in Ghana and 24 percent in the United States of America.
This data show the nascent state of the health insurance scheme in Nigeria as patients bear the full and direct brunt of their medical expenses without any significant assistance from the company or institution they work for (if not enrolled in the National Health Insurance Scheme-NHIS)
Going further, WHO ’s report of 2005 revealed that per capital government expenditure on health in Nigeria was $14 compared to $32 (Ghana) and $2,861 (USA). In the same period, total expenditure on health as a percentage of Gross Domestic Product was put at 3.9 percent compared to 6.5 percent in Ghana and 15 percent in USA.
Furthermore, the total government expenditure on health as a percentage of total government expenditure in 2005 was 3.5 per cent compared to 6.9 percent (Ghana), and 18.7 per cent (USA).
Giving this reality, health experts have called for increased budgetary allocation for the health sector in Nigeria if the sector wants to operate at optimal capacity and deliver healthcare to millions of Nigerians
Speaking to BusinessDay, Saheed Babajide, Secretary General, Association of Resident Doctors, Lagos State University Teaching Hospital (LASUTH) disclosed that the health sector collects less than four per cent of the national’s budget which is inadequate in delivering the minimum health delivery.
Babajide stated that it the sector can get 25 per cent of budget allocations, it will go a long way in improving healthcare delivery in all tiers of government-Local, State and Federal in the sense that one won’t to travel outside the country for medical attention.
According to him “In this case, all levels of healthcare –from the primary, secondary and tertiary levels will be improved. Don’t forget that adequate equipment and the enabling environment for better health care delivery will be provided with these funds which will in turn reduce mortality rates in the country. Don’t forget that this will also improve health research which is currently been underfunded by the government and has left some of these research centres at the mercies of foreign agencies and grants.”
For Edamisan Temiye, Chairman, Nigerian Medical Association (NMA), Lagos state Branch, Nigeria has not able to meet the African heads of state commitment in Abuja in 2000 to spend 15 percent of their national budgets on health, since only N34 billion representing about seven percent has been proposed in the 2011 budget.
Temiye stated that it is believed that 70 percent of the nation’s health budget spent in urban areas where about 30 percent of the population resides. He noted that to actualize the goals of the Millennium Development Goals and solve most of health care problems, Nigeria is expected to spend 15 percent of its total budget on health.
In his words “Nigeria’s allocation to the health sector in the 2009 budget was N39.6 billion (out of N796 billion earmarked for capital expenditure the same year). If you cast your mind back, N114billion has been spent by Bill Gates in eradicating Polio in Nigeria. Gates have spent N1.2 Trillion on polio eradication globally. This amount is one-third of Nigeria’s 2010 budget of N4.079 Trillion.
No doubt, there is the need for increase in budgetary allocation which currently hovers between six and seven percent. Though there have been health reforms in the past as well as the exploration of e-health and m-health [electronic and mobile health] tools in the country, expectations of our people have not completely in providing care and ensuring that our people benefit from good health care. There is room for improvements in budgetary provisions to the health sector. The current health minister Onyebuchi Chukwu must be commended in with regards to reforms in the sector but there’s room for improvement.”
With the year set to meet the MDGs inch close and the nation’s worrisome indices, healthcare financing must not be left in the hands of government alone. At the moment, countries like Japan that manage to ensure health services are available to the entire population have done so by reducing dependence on direct, out of pocket payments and increasing prepayment - generally through insurance or taxes or a mix of the two.
The funds raised are then pooled, so that it is not just those who are unlucky enough to get sick that bear the financial burden. This is the model used in many European countries, with Chile, Colombia, Mexico, Rwanda, Thailand and Turkey all making significant progress in the last decade - along with Brazil, China, Costa Rica, Ghana and Kyrgyzstan.
For Femi Ajayi, Chairman, Olabisi Teaching University Teaching Hospital, Sagamu, given that most governments (even in more efficiently run countries) have shown that they cannot do better than the markets in terms of healthcare administration, it becomes imperative that Nigeria must redefine its policy to healthcare administration. The private sector must be allowed (indeed, encouraged) to lead development in this area.
“Government's role should not be in the provision of healthcare; instead, it should be to work with the private sector to ensure that policies are designed to meet the needs of consumers. Also, public private partnerships should be encouraged”, Ajayi concluded.
Alexander Chiejina
Sadly however, for most developing nations, the prospects of achieving even a minimal level of adequacy in health services remain a mirage. While healthcare needs are increasing, government expenditure on health in developing countries is declining. This has resulted in a situation whereby as populations get older, as more people suffer chronic diseases, and as new and more expensive treatments appear, health costs seem to soar.
In Nigeria, healthcare sector hasn’t fared much better on the World Health Organisation’s measures for individual contribution to healthcare. This is because effective financing which is critical to revamping the health sector is lacking. ‘Out-of-pocket’ expenditure as percentage of private expenditure on health is put at 90 percent in Nigeria compared with 79 percent in Ghana and 24 percent in the United States of America.
This data show the nascent state of the health insurance scheme in Nigeria as patients bear the full and direct brunt of their medical expenses without any significant assistance from the company or institution they work for (if not enrolled in the National Health Insurance Scheme-NHIS)
Going further, WHO ’s report of 2005 revealed that per capital government expenditure on health in Nigeria was $14 compared to $32 (Ghana) and $2,861 (USA). In the same period, total expenditure on health as a percentage of Gross Domestic Product was put at 3.9 percent compared to 6.5 percent in Ghana and 15 percent in USA.
Furthermore, the total government expenditure on health as a percentage of total government expenditure in 2005 was 3.5 per cent compared to 6.9 percent (Ghana), and 18.7 per cent (USA).
Giving this reality, health experts have called for increased budgetary allocation for the health sector in Nigeria if the sector wants to operate at optimal capacity and deliver healthcare to millions of Nigerians
Speaking to BusinessDay, Saheed Babajide, Secretary General, Association of Resident Doctors, Lagos State University Teaching Hospital (LASUTH) disclosed that the health sector collects less than four per cent of the national’s budget which is inadequate in delivering the minimum health delivery.
Babajide stated that it the sector can get 25 per cent of budget allocations, it will go a long way in improving healthcare delivery in all tiers of government-Local, State and Federal in the sense that one won’t to travel outside the country for medical attention.
According to him “In this case, all levels of healthcare –from the primary, secondary and tertiary levels will be improved. Don’t forget that adequate equipment and the enabling environment for better health care delivery will be provided with these funds which will in turn reduce mortality rates in the country. Don’t forget that this will also improve health research which is currently been underfunded by the government and has left some of these research centres at the mercies of foreign agencies and grants.”
For Edamisan Temiye, Chairman, Nigerian Medical Association (NMA), Lagos state Branch, Nigeria has not able to meet the African heads of state commitment in Abuja in 2000 to spend 15 percent of their national budgets on health, since only N34 billion representing about seven percent has been proposed in the 2011 budget.
Temiye stated that it is believed that 70 percent of the nation’s health budget spent in urban areas where about 30 percent of the population resides. He noted that to actualize the goals of the Millennium Development Goals and solve most of health care problems, Nigeria is expected to spend 15 percent of its total budget on health.
In his words “Nigeria’s allocation to the health sector in the 2009 budget was N39.6 billion (out of N796 billion earmarked for capital expenditure the same year). If you cast your mind back, N114billion has been spent by Bill Gates in eradicating Polio in Nigeria. Gates have spent N1.2 Trillion on polio eradication globally. This amount is one-third of Nigeria’s 2010 budget of N4.079 Trillion.
No doubt, there is the need for increase in budgetary allocation which currently hovers between six and seven percent. Though there have been health reforms in the past as well as the exploration of e-health and m-health [electronic and mobile health] tools in the country, expectations of our people have not completely in providing care and ensuring that our people benefit from good health care. There is room for improvements in budgetary provisions to the health sector. The current health minister Onyebuchi Chukwu must be commended in with regards to reforms in the sector but there’s room for improvement.”
With the year set to meet the MDGs inch close and the nation’s worrisome indices, healthcare financing must not be left in the hands of government alone. At the moment, countries like Japan that manage to ensure health services are available to the entire population have done so by reducing dependence on direct, out of pocket payments and increasing prepayment - generally through insurance or taxes or a mix of the two.
The funds raised are then pooled, so that it is not just those who are unlucky enough to get sick that bear the financial burden. This is the model used in many European countries, with Chile, Colombia, Mexico, Rwanda, Thailand and Turkey all making significant progress in the last decade - along with Brazil, China, Costa Rica, Ghana and Kyrgyzstan.
For Femi Ajayi, Chairman, Olabisi Teaching University Teaching Hospital, Sagamu, given that most governments (even in more efficiently run countries) have shown that they cannot do better than the markets in terms of healthcare administration, it becomes imperative that Nigeria must redefine its policy to healthcare administration. The private sector must be allowed (indeed, encouraged) to lead development in this area.
“Government's role should not be in the provision of healthcare; instead, it should be to work with the private sector to ensure that policies are designed to meet the needs of consumers. Also, public private partnerships should be encouraged”, Ajayi concluded.
Alexander Chiejina
Any end in sight for illicit drug trading in Nigeria?
Taking a holistic look at pharmaceutical drugs, its use is critical for the health and well-being of individuals. Their access and consumption can however be likened to a double-edged sword: they alleviate the manifestation of disease in an ailing person and on the other hand, if consumed wrongly without the prescription of a physician, can be injurious to one’s health system.
It is no longer news that pharmaceutical products, genuine and counterfeit are openly sold and marketed in the streets, markets, private and public places and un-licensed outlets across in Nigeria. What is rather worrisome is how those involved in the trade have been able to so successfully sustain it under the noses of relevant government agencies including the National Agency for Food and Drug Administration and Control (NAFDAC), Pharmaceutical Society of Nigeria (PSN) in major cities in the country.
In Lagos as indeed it is in some parts of the country, drugs are openly marketed and sold in streets, public places, commercial buses by unqualified personnel who see this as a lucrative business. Findings show that majority of those involved in the trade are people out of employment. A recent visit to Obalende, Ijora, CMS, bus stops in Lagos reveal that these medicine dealers in a bid to market these drugs claims they are potent enough to cure every ailment.
This business has been on-going for a while without the relevant agency saddled with prohibiting the public sale of drug from apprehending and prosecuting such individuals.
In a chat with Bose Adebiyi, a commuter plying Obalende-Oshodi route, she stated that had purchased drugs at different occasion from bus stops without thinking of the dangers associated with consuming the drugs. She noted that due to the cost of purchasing drugs from pharmaceutical shops, people are left with no option than to purchase such drugs at a cheaper rate without having to bother about the efficacy of the drug.
Benedict Okonkwo, a pharmacist who spoke with BusinessDay, noted that ignorance of some Nigerians has contributed in making people purchase drugs from unqualified personnel. Okonkwo noted that lack of adequate medical facilities in most areas has led people to look for alternatives.
According to the pharmacist, “the society is now overwhelmed by greediness and avarice. Nobody cares about the consequence unwholesome practice provided in a bid to make quick and cheap money out of the sale of drugs. People should be enlightened on the dangers of purchasing medications and drugs from drug hawkers.”
It is noteworthy to state that The Counterfeit and Fake drugs Act, Cap 73 of 1990 prohibits the production, importation, manufacture, sale and distribution of any counterfeit, adulterated, banned or fake drugs. Specifically, Act 25 of 1999 prohibits the sales of drugs in an unauthorized place including the open drug markets.
In the same vein, the Food and Drugs Act Cap 150 of 1990, among other provisions, prohibits practices such as misleading packaging, labeling and advertising, as well as manufacturing food and drugs in unsanitary conditions. These laws were made in recognition of the citizens’ right to good health and access to genuine medicines that are safe, effective and affordable. Unfortunately and for many years, some members of the public (Nigerians and non-Nigerians) in the name of business have treated these laws with reckless abandon and have continued to endanger the lives of many Nigerians.
No doubt, it is the duty of government, professional bodies and all members of the society to ensure that people are saved from untimely deaths and trauma inflicted on them by drug hawkers. More importantly, existing laws regarding the sale of drugs if enforced would check the activities of persons not authorised to be in the business of selling drugs.
Paul Orhii, Director General, NAFDAC, in an interview with BusinessDay noted that “the Agency is currently working with many stakeholders, including states like Kano and many Local Government councils across the country, Association of Patent Medicine Dealers and the general public with a few to proving the useful information which would lead to arrest of such dealers.”
For Okonkwo “Regulatory agencies like NAFDAC should redouble their efforts in supervision and ensure strict penalties for non-compliers. The Pharmaceutical Society of Nigeria and the states ministries of health should ensure that only qualified personnel are licensed to operate pharmacy shops. In addition, the government should provide more health centres especially in the rural areas and adequately manned by trained personnel so that people will have easy access to consultation and treatment. Also, health centres should have essential drugs so that patients can purchase their drugs from hospital pharmacy instead of chemist’s shops.”
Alexander Chiejina
It is no longer news that pharmaceutical products, genuine and counterfeit are openly sold and marketed in the streets, markets, private and public places and un-licensed outlets across in Nigeria. What is rather worrisome is how those involved in the trade have been able to so successfully sustain it under the noses of relevant government agencies including the National Agency for Food and Drug Administration and Control (NAFDAC), Pharmaceutical Society of Nigeria (PSN) in major cities in the country.
In Lagos as indeed it is in some parts of the country, drugs are openly marketed and sold in streets, public places, commercial buses by unqualified personnel who see this as a lucrative business. Findings show that majority of those involved in the trade are people out of employment. A recent visit to Obalende, Ijora, CMS, bus stops in Lagos reveal that these medicine dealers in a bid to market these drugs claims they are potent enough to cure every ailment.
This business has been on-going for a while without the relevant agency saddled with prohibiting the public sale of drug from apprehending and prosecuting such individuals.
In a chat with Bose Adebiyi, a commuter plying Obalende-Oshodi route, she stated that had purchased drugs at different occasion from bus stops without thinking of the dangers associated with consuming the drugs. She noted that due to the cost of purchasing drugs from pharmaceutical shops, people are left with no option than to purchase such drugs at a cheaper rate without having to bother about the efficacy of the drug.
Benedict Okonkwo, a pharmacist who spoke with BusinessDay, noted that ignorance of some Nigerians has contributed in making people purchase drugs from unqualified personnel. Okonkwo noted that lack of adequate medical facilities in most areas has led people to look for alternatives.
According to the pharmacist, “the society is now overwhelmed by greediness and avarice. Nobody cares about the consequence unwholesome practice provided in a bid to make quick and cheap money out of the sale of drugs. People should be enlightened on the dangers of purchasing medications and drugs from drug hawkers.”
It is noteworthy to state that The Counterfeit and Fake drugs Act, Cap 73 of 1990 prohibits the production, importation, manufacture, sale and distribution of any counterfeit, adulterated, banned or fake drugs. Specifically, Act 25 of 1999 prohibits the sales of drugs in an unauthorized place including the open drug markets.
In the same vein, the Food and Drugs Act Cap 150 of 1990, among other provisions, prohibits practices such as misleading packaging, labeling and advertising, as well as manufacturing food and drugs in unsanitary conditions. These laws were made in recognition of the citizens’ right to good health and access to genuine medicines that are safe, effective and affordable. Unfortunately and for many years, some members of the public (Nigerians and non-Nigerians) in the name of business have treated these laws with reckless abandon and have continued to endanger the lives of many Nigerians.
No doubt, it is the duty of government, professional bodies and all members of the society to ensure that people are saved from untimely deaths and trauma inflicted on them by drug hawkers. More importantly, existing laws regarding the sale of drugs if enforced would check the activities of persons not authorised to be in the business of selling drugs.
Paul Orhii, Director General, NAFDAC, in an interview with BusinessDay noted that “the Agency is currently working with many stakeholders, including states like Kano and many Local Government councils across the country, Association of Patent Medicine Dealers and the general public with a few to proving the useful information which would lead to arrest of such dealers.”
For Okonkwo “Regulatory agencies like NAFDAC should redouble their efforts in supervision and ensure strict penalties for non-compliers. The Pharmaceutical Society of Nigeria and the states ministries of health should ensure that only qualified personnel are licensed to operate pharmacy shops. In addition, the government should provide more health centres especially in the rural areas and adequately manned by trained personnel so that people will have easy access to consultation and treatment. Also, health centres should have essential drugs so that patients can purchase their drugs from hospital pharmacy instead of chemist’s shops.”
Alexander Chiejina
How law threatens reproductive health
There is no gain saying that unwanted pregnancy, unsafe abortion and terrible abortion laws are serious issues in women reproductive health/ rights in Nigeria. With an estimated 600, 000 abortions performed yearly, teenagers who constitute about 20 percent of the population are worse hit.
Demographic statistics reveal that teenagers between the ages of 15 and 21 years are responsible for about 60 percent of abortion cases in the country hence making unsafe abortions a major contributory factor to maternal deaths in Nigeria.
A major factor which is limiting safe abortion is the restrictive abortion law in Nigeria which only allows termination of pregnancy to save the life of the mother. The major drawback in the law is its inability to specify who should carry out an abortion, a practice still being regarded as unlawful despite being enshrined in the country’s laws and international documents to which Nigeria was a member.
There are laws and policies such as the Vienna Declaration on Human Rights 1993, the International Conference on Population and Development (ICPD) Programme of Action of 1994, the Beijing Platform for Action (BPFA) of 1995 and Beijing + 5 Outcomes Document 2000, the Nigerian Constitution of 1999, the Criminal Code and Penal Code Laws of Nigeria, the Matrimonial Causes Act (1990), the National Policy on Women (2001), the National Health Policy., the Social Development Policy (1989), the Millennium Development Goals and the Criminal Code Section 228 to 230 among others, all supporting safe abortions and maternal health at large.
For Okpete Kanu, President, African Foundation for Pro-Life Education, Counselling and Care (FLECC), the Assembly of the African Union in meeting in Maputo, Mozambique in July 2003 adopted a document titled “Protocol to the African Charter on Human and People’s Right of women in Africa.”
Otherwise known as the Maputo Agreement, a treaty which came in to effect November 2005 and as at June 2007, 43 nations signed and 21 have formally ratified including Nigeria, Kanu stated that the Maputo Protocol passed a referendum on female genital mutilation (FGM), certain parts of the charter x-rayed abortion and its legal implications
In her words” abortion is the intentional or unintentional expulsion of the pre-born child from the womb at anytime after conception (fertilization) and before the natural birth process is completed. However, it is intentional when it is purposefully induced. It is also unintentional when it is not willfully induced as in the case of miscarriage. What is medically referred to as an inevitable abortion is a condition in pregnancy marked by vaginal bleeding and dilation of the cervix that indicates an impending unpreventable miscarriage”
Taking a cursory look at the entire scenario, safe abortion in Nigeria is still regarded as a taboo. This is coming at the heels of the fact that several policy documents were adopted in the last five years on sexual and reproductive health and rights. Though commendable as this may be, it does not constitute legally enforceable standards.
However, they merely serve as administrative guidelines promising much, but need a lot of government’s commitment and political will to interpret the realities of maternal health in the country positively.
Going further, the call for genuine political will expressed in adequate interventions is lacking. No doubt, the absence of political will on the part of Government will only continue to send our women to their early graves in large numbers. But despite all these, medical service providers, journalists and lawmakers, should ensure that that the obnoxious law is reversed to save the women.
The legal indication for abortion is quite restrictive, therefore making unsafe abortion a silent and persistent pandemic. The need make access to abortion services important for women and girls who are victims of sexual violence, rape and incest is desired.
A review of the restrictive abortion laws due to the human rights implications of unsafe abortion is a must. The Criminal Code Section 228 to 230 regards abortion as a felony, crime against the country. The code reads in part: “Any person who, with intent to procure miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind or uses any other means whatever, is guilty of a felony, and is liable to imprisonment for seven years. Any person who unlawfully supplies to or procures for any person anything whatever, knowing that it is intended to be unlawfully used to procure the miscarriage of a woman, whether she is or is not with child, is guilty of a felony, and is liable to imprisonment for three years.”
No doubt, social stigma and political pressure render many health care providers unwilling to offer abortion services even within the limits of the law. Calls have been made in recent times by change agents under the reproductive-health networks and partnerships that have been functional to ensure that abortion law is reformed to include additional legal indications such as rape, incest and protection of the health of the woman.
Exerts said improved access to safe, legal services would greatly reduce the number of woman’s deaths and injuries caused by unsafe abortion. Efforts were made by IPAS, a woman reproductive health/ rights in 1987, when it introduced Manual Vacuum Aspiration (MVA) into public teaching hospital and the private sector.
The body had previously in 1996 worked with the Federal Government officials and colleagues to develop a national strategy for expanding Post-Abortion Care (PAC) services and to set up a team to establish and manage the PAC net. This coalition of representatives from government, Non-Governmental Organizations (NGOs) and civil society groups meets regularly to share knowledge and discuss tactics to improve the reproductive health and rights of women.
It is noteworthy to state that the criminal codes of the southern states and the penal codes of the Northern States are the major statutes about abortion in the country. The codification of Sharia Law in 1999, most Penal Codes has been amended to reflect Sharia-based values and standards.
Alexander Chiejina
Demographic statistics reveal that teenagers between the ages of 15 and 21 years are responsible for about 60 percent of abortion cases in the country hence making unsafe abortions a major contributory factor to maternal deaths in Nigeria.
A major factor which is limiting safe abortion is the restrictive abortion law in Nigeria which only allows termination of pregnancy to save the life of the mother. The major drawback in the law is its inability to specify who should carry out an abortion, a practice still being regarded as unlawful despite being enshrined in the country’s laws and international documents to which Nigeria was a member.
There are laws and policies such as the Vienna Declaration on Human Rights 1993, the International Conference on Population and Development (ICPD) Programme of Action of 1994, the Beijing Platform for Action (BPFA) of 1995 and Beijing + 5 Outcomes Document 2000, the Nigerian Constitution of 1999, the Criminal Code and Penal Code Laws of Nigeria, the Matrimonial Causes Act (1990), the National Policy on Women (2001), the National Health Policy., the Social Development Policy (1989), the Millennium Development Goals and the Criminal Code Section 228 to 230 among others, all supporting safe abortions and maternal health at large.
For Okpete Kanu, President, African Foundation for Pro-Life Education, Counselling and Care (FLECC), the Assembly of the African Union in meeting in Maputo, Mozambique in July 2003 adopted a document titled “Protocol to the African Charter on Human and People’s Right of women in Africa.”
Otherwise known as the Maputo Agreement, a treaty which came in to effect November 2005 and as at June 2007, 43 nations signed and 21 have formally ratified including Nigeria, Kanu stated that the Maputo Protocol passed a referendum on female genital mutilation (FGM), certain parts of the charter x-rayed abortion and its legal implications
In her words” abortion is the intentional or unintentional expulsion of the pre-born child from the womb at anytime after conception (fertilization) and before the natural birth process is completed. However, it is intentional when it is purposefully induced. It is also unintentional when it is not willfully induced as in the case of miscarriage. What is medically referred to as an inevitable abortion is a condition in pregnancy marked by vaginal bleeding and dilation of the cervix that indicates an impending unpreventable miscarriage”
Taking a cursory look at the entire scenario, safe abortion in Nigeria is still regarded as a taboo. This is coming at the heels of the fact that several policy documents were adopted in the last five years on sexual and reproductive health and rights. Though commendable as this may be, it does not constitute legally enforceable standards.
However, they merely serve as administrative guidelines promising much, but need a lot of government’s commitment and political will to interpret the realities of maternal health in the country positively.
Going further, the call for genuine political will expressed in adequate interventions is lacking. No doubt, the absence of political will on the part of Government will only continue to send our women to their early graves in large numbers. But despite all these, medical service providers, journalists and lawmakers, should ensure that that the obnoxious law is reversed to save the women.
The legal indication for abortion is quite restrictive, therefore making unsafe abortion a silent and persistent pandemic. The need make access to abortion services important for women and girls who are victims of sexual violence, rape and incest is desired.
A review of the restrictive abortion laws due to the human rights implications of unsafe abortion is a must. The Criminal Code Section 228 to 230 regards abortion as a felony, crime against the country. The code reads in part: “Any person who, with intent to procure miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind or uses any other means whatever, is guilty of a felony, and is liable to imprisonment for seven years. Any person who unlawfully supplies to or procures for any person anything whatever, knowing that it is intended to be unlawfully used to procure the miscarriage of a woman, whether she is or is not with child, is guilty of a felony, and is liable to imprisonment for three years.”
No doubt, social stigma and political pressure render many health care providers unwilling to offer abortion services even within the limits of the law. Calls have been made in recent times by change agents under the reproductive-health networks and partnerships that have been functional to ensure that abortion law is reformed to include additional legal indications such as rape, incest and protection of the health of the woman.
Exerts said improved access to safe, legal services would greatly reduce the number of woman’s deaths and injuries caused by unsafe abortion. Efforts were made by IPAS, a woman reproductive health/ rights in 1987, when it introduced Manual Vacuum Aspiration (MVA) into public teaching hospital and the private sector.
The body had previously in 1996 worked with the Federal Government officials and colleagues to develop a national strategy for expanding Post-Abortion Care (PAC) services and to set up a team to establish and manage the PAC net. This coalition of representatives from government, Non-Governmental Organizations (NGOs) and civil society groups meets regularly to share knowledge and discuss tactics to improve the reproductive health and rights of women.
It is noteworthy to state that the criminal codes of the southern states and the penal codes of the Northern States are the major statutes about abortion in the country. The codification of Sharia Law in 1999, most Penal Codes has been amended to reflect Sharia-based values and standards.
Alexander Chiejina
Global strategy to detect Tuberculosis underway
Over the years, health experts have been faced with the challenge of reducing the incidence of Tuberculosis (TB), a contagious disease caused by a bacterium known as Mycobacterium tuberculosis, which mostly affects the lungs. According to recent statistics, it is estimated that one-third of the world's population is currently infected with the TB bacillus.
It is believed that about 5 to 10 percent of people infected with TB bacilli (but who are not infected with Human Immuno Virus (HIV) ) become sick or infectious at some time during their life even as people with HIV and TB infection are much more likely to develop TB.
Like the common cold, the infection spreads from infectious individuals who cough, sneeze, talk or spit hereby propelling TB germs, known as bacilli, into the air. However, an individual needs only to inhale a small number of these to be infected.
As various countries across the globe continues its quest to reach Millennium Development Goal for TB incidence and the Stop TB Partnership 2015 target for mortality especially in Africa and Eastern Europe, the World Health Organization (WHO) recently endorsed a new and novel rapid test for tuberculosis especially relevant in countries most affected by the disease.
The test is expected to revolutionize TB care and control by providing an accurate diagnosis for many patients in about 100 minutes, compared to current tests that can take up to three months to obtain the results.
WHO's endorsement of the rapid test, which is a fully automated NAAT (nucleic acid amplification test), follows 18 months of rigorous assessment of its field effectiveness in the early diagnosis of TB, as well as multidrug-resistant TB (MDR-TB) and TB complicated by HIV infection, which are more difficult to diagnose.
The health body also released recommendations and guidance for countries to incorporate this test in their programs which includes testing protocols (or algorithms) to optimize the use and benefits of the new technology in those persons where it is needed most.
Evidence to date indicates that implementation of this test could result in a three-fold increase in the diagnosis of patients with drug-resistant TB and a doubling in the number of HIV-associated TB cases diagnosed in areas with high rates of TB and HIV.
In an interview with Folasade Ogunsola, Head, Department of Medical Microbiology, college of medicine, Lagos State University Teaching Hospital (LUTH), Ogunsola disclosed that TB drug resistance is a major public health problem which may threaten the success of directly observed treatment (DOTS), which is the WHO-recommended treatment approach for detection and cure of TB. The medical expert noted that currently, strains of TB resistant to major anti-TB drugs have emerged which is traceable to improper use of antibiotics in chemotherapy of drug-susceptible TB patients.
According to her, “a dangerous form of drug-resistant TB, multidrug-resistant TB (MDR-TB), resists the treatment of at least isoniazid and rifampicin, the two most powerful anti-TB drugs. The emergence of extensively drug-resistant (XDR) TB occurs particularly in settings where many TB patients are also infected with HIV, and this poses serious threat to TB control.
The challenge of detecting the etiological agent M. tuberculosis is that many countries still rely principally on sputum smear microscopy, a diagnostic method that was developed over a century ago. But this new 'while you wait' test incorporates modern DNA technology that can be used outside of conventional laboratories. It also benefits from being fully automated and therefore easy and safe to use.”
For Giwa Temidayo, a health expert, some teaching hospitals as well as medical laboratories though might be aware of the rapid test for TB, medical facilities to conduct such diagnosis is not operational in most laboratories where such TB tests are carried out.
According to Temidayo “few hospitals in the country may possess the equipment to conduct this rapid TB tests. If teaching hospitals where lots of medical personnel are produced don’t have equipment to conduct this kind of test then, latent TB cases may be difficult to ascertain. Though there have been major improvements in TB care and control, there is the need for in improving access to diagnosis and treatment, and also in the scale up of TB/HIV intervention as well as laboratory strengthening.”
Even as the world health body (WHO) is calling for the fully automated NAAT to be rolled out under clearly defined conditions and as part of national plans for TB and MDR-TB care and control, affordability of facilities for NAAT has been a major concern.
Just before the end of 2010, co-developer FIND (the Foundation for Innovative and New Diagnostics) announced that it has negotiated with the manufacturer, Cepheid, a 75 percent reduction in the price for countries most affected by TB, compared to the current market price. Health experts are of the believe that preferential pricing will be granted to 116 low- and middle- income countries where TB is endemic, with additional reduction in price once there is significant volume of demand.
For Giorgio Roscigno, FIND's Chief Executive Officer, “There has been a strong commitment to remove any obstacles, including financial barriers that could prevent the successful roll-out of this new technology. For the first time in TB control, we are enabling access to state-of-the-art technology simultaneously in low, middle and high income countries. The technology also allows testing of other diseases, which should further increase efficiency.”
Alexander Chiejina
It is believed that about 5 to 10 percent of people infected with TB bacilli (but who are not infected with Human Immuno Virus (HIV) ) become sick or infectious at some time during their life even as people with HIV and TB infection are much more likely to develop TB.
Like the common cold, the infection spreads from infectious individuals who cough, sneeze, talk or spit hereby propelling TB germs, known as bacilli, into the air. However, an individual needs only to inhale a small number of these to be infected.
As various countries across the globe continues its quest to reach Millennium Development Goal for TB incidence and the Stop TB Partnership 2015 target for mortality especially in Africa and Eastern Europe, the World Health Organization (WHO) recently endorsed a new and novel rapid test for tuberculosis especially relevant in countries most affected by the disease.
The test is expected to revolutionize TB care and control by providing an accurate diagnosis for many patients in about 100 minutes, compared to current tests that can take up to three months to obtain the results.
WHO's endorsement of the rapid test, which is a fully automated NAAT (nucleic acid amplification test), follows 18 months of rigorous assessment of its field effectiveness in the early diagnosis of TB, as well as multidrug-resistant TB (MDR-TB) and TB complicated by HIV infection, which are more difficult to diagnose.
The health body also released recommendations and guidance for countries to incorporate this test in their programs which includes testing protocols (or algorithms) to optimize the use and benefits of the new technology in those persons where it is needed most.
Evidence to date indicates that implementation of this test could result in a three-fold increase in the diagnosis of patients with drug-resistant TB and a doubling in the number of HIV-associated TB cases diagnosed in areas with high rates of TB and HIV.
In an interview with Folasade Ogunsola, Head, Department of Medical Microbiology, college of medicine, Lagos State University Teaching Hospital (LUTH), Ogunsola disclosed that TB drug resistance is a major public health problem which may threaten the success of directly observed treatment (DOTS), which is the WHO-recommended treatment approach for detection and cure of TB. The medical expert noted that currently, strains of TB resistant to major anti-TB drugs have emerged which is traceable to improper use of antibiotics in chemotherapy of drug-susceptible TB patients.
According to her, “a dangerous form of drug-resistant TB, multidrug-resistant TB (MDR-TB), resists the treatment of at least isoniazid and rifampicin, the two most powerful anti-TB drugs. The emergence of extensively drug-resistant (XDR) TB occurs particularly in settings where many TB patients are also infected with HIV, and this poses serious threat to TB control.
The challenge of detecting the etiological agent M. tuberculosis is that many countries still rely principally on sputum smear microscopy, a diagnostic method that was developed over a century ago. But this new 'while you wait' test incorporates modern DNA technology that can be used outside of conventional laboratories. It also benefits from being fully automated and therefore easy and safe to use.”
For Giwa Temidayo, a health expert, some teaching hospitals as well as medical laboratories though might be aware of the rapid test for TB, medical facilities to conduct such diagnosis is not operational in most laboratories where such TB tests are carried out.
According to Temidayo “few hospitals in the country may possess the equipment to conduct this rapid TB tests. If teaching hospitals where lots of medical personnel are produced don’t have equipment to conduct this kind of test then, latent TB cases may be difficult to ascertain. Though there have been major improvements in TB care and control, there is the need for in improving access to diagnosis and treatment, and also in the scale up of TB/HIV intervention as well as laboratory strengthening.”
Even as the world health body (WHO) is calling for the fully automated NAAT to be rolled out under clearly defined conditions and as part of national plans for TB and MDR-TB care and control, affordability of facilities for NAAT has been a major concern.
Just before the end of 2010, co-developer FIND (the Foundation for Innovative and New Diagnostics) announced that it has negotiated with the manufacturer, Cepheid, a 75 percent reduction in the price for countries most affected by TB, compared to the current market price. Health experts are of the believe that preferential pricing will be granted to 116 low- and middle- income countries where TB is endemic, with additional reduction in price once there is significant volume of demand.
For Giorgio Roscigno, FIND's Chief Executive Officer, “There has been a strong commitment to remove any obstacles, including financial barriers that could prevent the successful roll-out of this new technology. For the first time in TB control, we are enabling access to state-of-the-art technology simultaneously in low, middle and high income countries. The technology also allows testing of other diseases, which should further increase efficiency.”
Alexander Chiejina
How Poor implementation of Health insurance scheme impedes economic development
Health is Wealth. So goes a popular saying and therefore in every country, the health sector is critical to social and economic development with ample evidence linking productivity to quality of health care. In Nigeria, the vision of becoming one of the leading 20 economies of the world by the year 2020 is closely tied to the development of its human capital through the health sector.
Given this lofty dream, the nation’s quest for rapid economic development could be a mirage unless federal government intervenes in the current operations of the National Health Insurance Scheme (NHIS), charged with the responsibility of providing easy access to health care to all Nigerians.
This is so because the 11 year old scheme which is to provide health care at affordable prices to Nigerians, who, will in turn contribute to the nation’s Gross Domestic Product (GDP) are being denied under the pretext that the current 15 percent deductions from workers salaries is not enough to avail them of the necessary health care services.
The Scheme, which was established under Act 35 of 1999 by the Federal Government of Nigeria, is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems.
Under the scheme, employers contribute 10 percent while employees make it up with the 5 percent monthly. Health insurance is a social security system that guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals.
GDP is the total market value of all final goods and services produced by labour in a country within a given year. It can be estimated, in theory, on expenditure basis, which is how much money was spent, output, how many goods and services were sold and Income basis, how much income (profit) was earned within that period.
Being as it may, economists use GDP indices to measure the overall growth or decline of a nation's economy among others.
Although most of the stakeholders who spoke with Business Day agreed that capitation, which is the monthly payment of between N500 and N550 per head by Health Management Organizations (HMOs) to primary health care providers (Hospitals) is too meager, they deplored activities of the two parties which embark on delay tactics, thereby frustrating the patients. The essence is to maximize gains from the contributions as 62 percent of the capitation is expected to be expended on the patients.
The hospitals make recourse to HMOs on complicated ailments or those that require attention of specialists for authorization before proceeding to treat the patients. In most cases, the HMOs would foot drag in sending the needed code that will enable the hospital access to funds on treating the patients. Hospitals, on the other hand, resort to dispensing low quality drugs to patients. At the end of the day, patients are forced to seek for alternative services, while the capitation, which is usually paid in advance, will not be used for the purpose for which it was released.
Adeyeye Arigbabuwo, General Secretary, Healthcare Providers Association of Nigeria (HCPAN), who spoke exclusively to BusinessDay disclosed that the 62 percent of the capitation meant per head for enrollees to receive healthcare services under the scheme has led to the low quality of services and drugs administered to Nigerians
who may not be commensurate to improve the health of the patient.
According to Arigbabuwo, capitation is used for providing primary healthcare services only hence it is also used to control use of health resources by putting the physician at financial risk for services provided to the patient. He hinted that providers are paid according to the number of enrollees attached to the family.
In his words “Don’t forget that the actual amount of money paid (capitation) is determined by the range of services provided, the number of patients involved, the period of time during which the services are provided. All these are developed using local cost and average utilisation of services. Aside this, the HMO makes the fee for service payment to non-capitation receiving healthcare providers who offer services on referral from other approved providers.
Arigbabuwo maintained that why hospitals make recourse to HMOs for authorization before embarking on higher/expensive treatment is that the level of care has gone beyond the primary care level and as such codes or pre-authorization are needed to be given by the HMO to the secondary care provider to treat the patient.
He added “though the authorization is to prevent abuses as well as ensure that appropriate healthcare provider provides the relevant healthcare services which is commensurate to the patient’s need, more often than not, providers take undue advantage of the low tariff to foot drag on issues of carrying out treatment which sometimes lead to the death of such patients.
You will recall that in the United States of America, about 90 percent of the health budget of 2010 was passed to the general practitioners to decide what the primary, secondary or tertiary healthcare provider receives for services rendered enrollees of the health insurance scheme, adding “such a feat can be replicated in Nigeria.”
For Victor Amadi, Lagos State Coordinator, NHIS, drugs that are administered to enrollees at the hospitals are the prescribed drugs, pharmaceutical care and diagnostic tests contained in the National Essential Drugs List and Diagnostic Test Lists. He noted that if the drugs are not covered with the scheme, the enrollees through its healthcare provider are given the drug list which he should purchase elsewhere.
Amadi disclosed that at the moment, a 48 hour range is given for response by HMO to carry on with the treatment as if such doesn’t happen, the other provider can carry on with the treatment pending when the HMO respond.
There is no gain saying that with life expectancy in Nigeria at approximately 47 percent as against World Health Organization’s (WHO) life expectancy average at 67.2 percent, providing quality healthcare services to Nigeria will not in any way portend danger for the economy.
Critical interventions recommended to revamp the healthcare system in the country include increasing government allocation to health at all levels, expanding the NHIS coverage and regulatory functions, implementation of the community-based health insurance schemes, as well as pooling funds using common basket approaches by all actors involved in financing health in Nigeria.
Alexander Chiejina
Given this lofty dream, the nation’s quest for rapid economic development could be a mirage unless federal government intervenes in the current operations of the National Health Insurance Scheme (NHIS), charged with the responsibility of providing easy access to health care to all Nigerians.
This is so because the 11 year old scheme which is to provide health care at affordable prices to Nigerians, who, will in turn contribute to the nation’s Gross Domestic Product (GDP) are being denied under the pretext that the current 15 percent deductions from workers salaries is not enough to avail them of the necessary health care services.
The Scheme, which was established under Act 35 of 1999 by the Federal Government of Nigeria, is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems.
Under the scheme, employers contribute 10 percent while employees make it up with the 5 percent monthly. Health insurance is a social security system that guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals.
GDP is the total market value of all final goods and services produced by labour in a country within a given year. It can be estimated, in theory, on expenditure basis, which is how much money was spent, output, how many goods and services were sold and Income basis, how much income (profit) was earned within that period.
Being as it may, economists use GDP indices to measure the overall growth or decline of a nation's economy among others.
Although most of the stakeholders who spoke with Business Day agreed that capitation, which is the monthly payment of between N500 and N550 per head by Health Management Organizations (HMOs) to primary health care providers (Hospitals) is too meager, they deplored activities of the two parties which embark on delay tactics, thereby frustrating the patients. The essence is to maximize gains from the contributions as 62 percent of the capitation is expected to be expended on the patients.
The hospitals make recourse to HMOs on complicated ailments or those that require attention of specialists for authorization before proceeding to treat the patients. In most cases, the HMOs would foot drag in sending the needed code that will enable the hospital access to funds on treating the patients. Hospitals, on the other hand, resort to dispensing low quality drugs to patients. At the end of the day, patients are forced to seek for alternative services, while the capitation, which is usually paid in advance, will not be used for the purpose for which it was released.
Adeyeye Arigbabuwo, General Secretary, Healthcare Providers Association of Nigeria (HCPAN), who spoke exclusively to BusinessDay disclosed that the 62 percent of the capitation meant per head for enrollees to receive healthcare services under the scheme has led to the low quality of services and drugs administered to Nigerians
who may not be commensurate to improve the health of the patient.
According to Arigbabuwo, capitation is used for providing primary healthcare services only hence it is also used to control use of health resources by putting the physician at financial risk for services provided to the patient. He hinted that providers are paid according to the number of enrollees attached to the family.
In his words “Don’t forget that the actual amount of money paid (capitation) is determined by the range of services provided, the number of patients involved, the period of time during which the services are provided. All these are developed using local cost and average utilisation of services. Aside this, the HMO makes the fee for service payment to non-capitation receiving healthcare providers who offer services on referral from other approved providers.
Arigbabuwo maintained that why hospitals make recourse to HMOs for authorization before embarking on higher/expensive treatment is that the level of care has gone beyond the primary care level and as such codes or pre-authorization are needed to be given by the HMO to the secondary care provider to treat the patient.
He added “though the authorization is to prevent abuses as well as ensure that appropriate healthcare provider provides the relevant healthcare services which is commensurate to the patient’s need, more often than not, providers take undue advantage of the low tariff to foot drag on issues of carrying out treatment which sometimes lead to the death of such patients.
You will recall that in the United States of America, about 90 percent of the health budget of 2010 was passed to the general practitioners to decide what the primary, secondary or tertiary healthcare provider receives for services rendered enrollees of the health insurance scheme, adding “such a feat can be replicated in Nigeria.”
For Victor Amadi, Lagos State Coordinator, NHIS, drugs that are administered to enrollees at the hospitals are the prescribed drugs, pharmaceutical care and diagnostic tests contained in the National Essential Drugs List and Diagnostic Test Lists. He noted that if the drugs are not covered with the scheme, the enrollees through its healthcare provider are given the drug list which he should purchase elsewhere.
Amadi disclosed that at the moment, a 48 hour range is given for response by HMO to carry on with the treatment as if such doesn’t happen, the other provider can carry on with the treatment pending when the HMO respond.
There is no gain saying that with life expectancy in Nigeria at approximately 47 percent as against World Health Organization’s (WHO) life expectancy average at 67.2 percent, providing quality healthcare services to Nigeria will not in any way portend danger for the economy.
Critical interventions recommended to revamp the healthcare system in the country include increasing government allocation to health at all levels, expanding the NHIS coverage and regulatory functions, implementation of the community-based health insurance schemes, as well as pooling funds using common basket approaches by all actors involved in financing health in Nigeria.
Alexander Chiejina
Placing health research in the Nation’s healthcare agenda
There is no gain saying that the improvement in healthcare delivery is closely associated with advances in medical research. However, strengthening medical research capacities at country levels have constituted the most powerful cost effective and sustainable means of advancing a nation’s health and development.
Taking a cursory look at healthcare delivery across the globe, there is no gain saying that health research plays a pivotal role in the development of any nation. This is in view of its contribution to the provision of solutions to health problems, providing evidence for addressing communicable and non-communicable diseases, reducing health disparities, strengthening national health systems as well as deliver healthcare services.
With Nigeria yet to assume the driving seat of health research within sub Saharan Africa let alone the African continent, medical experts in the country have called for on Government at all levels to provide the necessary leadership in the area of developing and sustaining health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in the country.
Speaking recently in Lagos on the theme “Nigeria: Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja disclosed that till date, medical research has provided the strongest support for preventive and curative medicine.
While recounting that medical research began to develop in Nigeria in 1920 when the Rockfeller Foundation established the Yellow Fever Commission and seminar initiatives like the International Conference on Health Research priorities for Nigeria in the 1990s, National seminar on Essential National Health Research (ENHR) etc. to name but a few, he regretted that till date, certain policy directives to champion health research in the country are yet to be implemented thus stalling the advancement of medical research in the country.
According to Lecky “The National Health Research Policy and the National Health Research Priorities, which were drafted in 2001 and revised in 2006, is still awaiting implementation into the mainstream of the nation’s health system. Although the National Ethical Research Committee is on place, there is poor adherence to ethical guidelines in medical research resulting probably from absence of ethical review boards in most states and higher institutions. Also, monitoring, and evaluation of research is limited and researchers are not adequately motivated.”
He further added that factors responsible for the inadequacies in health research in Nigeria includes lack of co-ordination, lack of regular forum to discuss health research, poor linkage between research and policy, inadequate research priority setting, dearth of research infrastructures, sub-optimal capacity building strategies, and ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (for research institutes in the country like Nigerian Institute of Medical Research (NIMR)and National Institute for Pharmaceutical Research Development NIPRD), human resources challenges, shortage of specialised expertise, inadequate prioritization by development partners and other funding bodies have negatively compounded the relegation of medical research in the country.
Nwanyanwu stated that currently, health research is not a priority of governments as it is considered not attractive due to time constraints, bearing in mind the high technical expertise and a diversion of intervention resources.
He added that “there is the need to promote public-private partnerships, advocate improved funding for public health research, encourage philanthropy to invest in health research like Ford Foundation, Bill & Melinda Gates Foundation, partners to include research into all interventions and encourage the use of research findings in services”
It is worthy to state that the increased longevity of humans over the past century can be significantly attributed to advances resulting from medical research. Among the major benefits have been vaccines development for measles and polio, insulin treatment for diabetes, classes of antibiotics for treating a host of maladies, medication for high blood pressure, improved treatments for AIDS and increasingly successful treatments for cancer and other emerging diseases.
Aside this, research funding in many countries emanates from research bodies which distribute money for equipment and salaries. For instance, in the United Kingdom, funding bodies such as the Medical Research Council derive their assets from UK tax payers, and distribute this to institutions in a competitive manner.
In 2003, The National Institutes of Health and pharmaceutical companies in the United States collectively contributed 26.4 billion dollars and 27.0 billion dollars, respectively which constitute 28 percent and 29 percent of the total as at 2003 to medical research. Other significant contributors included biotechnology companies, medical device companies, other federal, state and local governments as well as foundations and charities, led by the Bill and Melinda Gates Foundation.
With developed nations setting the pace globally, Nigeria can’t afford to lag behind bearing in mind its quest of becoming one of the twenty leading economies in the year 2020 as well as meeting with the Millennium Development Goals deadline of improved healthcare by 2015.
For Innocent Ujah, Director General, NIMR, “Key requirements for health research success include strategic research planning, sustainable funding of research, strengthening identifiable health research institutions at all levels such as NIMR, NIPRD, teaching hospitals, Federal Medical Centres, linking research to global and national initiatives and objectives, develop transparent approach for using research findings to aid evidence based policy at all levels and undertake research at critical areas already identified in different forums.”
More importantly, at the institutional level, there is the need to generate innovative development plan based on the National Strategic Health Development Plan (NSHDP - a heath component of Vision 20; 2020), which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP.
At the national level, it is imperative to progressively increase investment in health research, pursue the passage of the Health bill and approve Health Research Policy and priorities, and establish a robust database of health research for better co-ordination.
Alexander Chiejina
Taking a cursory look at healthcare delivery across the globe, there is no gain saying that health research plays a pivotal role in the development of any nation. This is in view of its contribution to the provision of solutions to health problems, providing evidence for addressing communicable and non-communicable diseases, reducing health disparities, strengthening national health systems as well as deliver healthcare services.
With Nigeria yet to assume the driving seat of health research within sub Saharan Africa let alone the African continent, medical experts in the country have called for on Government at all levels to provide the necessary leadership in the area of developing and sustaining health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in the country.
Speaking recently in Lagos on the theme “Nigeria: Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja disclosed that till date, medical research has provided the strongest support for preventive and curative medicine.
While recounting that medical research began to develop in Nigeria in 1920 when the Rockfeller Foundation established the Yellow Fever Commission and seminar initiatives like the International Conference on Health Research priorities for Nigeria in the 1990s, National seminar on Essential National Health Research (ENHR) etc. to name but a few, he regretted that till date, certain policy directives to champion health research in the country are yet to be implemented thus stalling the advancement of medical research in the country.
According to Lecky “The National Health Research Policy and the National Health Research Priorities, which were drafted in 2001 and revised in 2006, is still awaiting implementation into the mainstream of the nation’s health system. Although the National Ethical Research Committee is on place, there is poor adherence to ethical guidelines in medical research resulting probably from absence of ethical review boards in most states and higher institutions. Also, monitoring, and evaluation of research is limited and researchers are not adequately motivated.”
He further added that factors responsible for the inadequacies in health research in Nigeria includes lack of co-ordination, lack of regular forum to discuss health research, poor linkage between research and policy, inadequate research priority setting, dearth of research infrastructures, sub-optimal capacity building strategies, and ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (for research institutes in the country like Nigerian Institute of Medical Research (NIMR)and National Institute for Pharmaceutical Research Development NIPRD), human resources challenges, shortage of specialised expertise, inadequate prioritization by development partners and other funding bodies have negatively compounded the relegation of medical research in the country.
Nwanyanwu stated that currently, health research is not a priority of governments as it is considered not attractive due to time constraints, bearing in mind the high technical expertise and a diversion of intervention resources.
He added that “there is the need to promote public-private partnerships, advocate improved funding for public health research, encourage philanthropy to invest in health research like Ford Foundation, Bill & Melinda Gates Foundation, partners to include research into all interventions and encourage the use of research findings in services”
It is worthy to state that the increased longevity of humans over the past century can be significantly attributed to advances resulting from medical research. Among the major benefits have been vaccines development for measles and polio, insulin treatment for diabetes, classes of antibiotics for treating a host of maladies, medication for high blood pressure, improved treatments for AIDS and increasingly successful treatments for cancer and other emerging diseases.
Aside this, research funding in many countries emanates from research bodies which distribute money for equipment and salaries. For instance, in the United Kingdom, funding bodies such as the Medical Research Council derive their assets from UK tax payers, and distribute this to institutions in a competitive manner.
In 2003, The National Institutes of Health and pharmaceutical companies in the United States collectively contributed 26.4 billion dollars and 27.0 billion dollars, respectively which constitute 28 percent and 29 percent of the total as at 2003 to medical research. Other significant contributors included biotechnology companies, medical device companies, other federal, state and local governments as well as foundations and charities, led by the Bill and Melinda Gates Foundation.
With developed nations setting the pace globally, Nigeria can’t afford to lag behind bearing in mind its quest of becoming one of the twenty leading economies in the year 2020 as well as meeting with the Millennium Development Goals deadline of improved healthcare by 2015.
For Innocent Ujah, Director General, NIMR, “Key requirements for health research success include strategic research planning, sustainable funding of research, strengthening identifiable health research institutions at all levels such as NIMR, NIPRD, teaching hospitals, Federal Medical Centres, linking research to global and national initiatives and objectives, develop transparent approach for using research findings to aid evidence based policy at all levels and undertake research at critical areas already identified in different forums.”
More importantly, at the institutional level, there is the need to generate innovative development plan based on the National Strategic Health Development Plan (NSHDP - a heath component of Vision 20; 2020), which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP.
At the national level, it is imperative to progressively increase investment in health research, pursue the passage of the Health bill and approve Health Research Policy and priorities, and establish a robust database of health research for better co-ordination.
Alexander Chiejina
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