…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.”
Sunday, February 6, 2011
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
Tuesday, November 30, 2010
HIV/AIDS in Nigeria: re-evaluating the finances spent in combating the pandemic
Within the week, Nigeria joined the rest of the world to mark World AIDS Day with the theme “Universal access and Human Rights”. On that day (December 1st) health experts and stakeholders across the globe gathered in several fora to raise awareness about the pandemic even as it international solidarity is demonstrated.
While World AIDS day is one of the most visible opportunities for public and private partners to spread awareness about the status of the pandemic and encourage progress in HIV/AIDS prevention, treatment and care in high prevalence countries and around the world have continued to remain a major concern. This is as the 2008 figures released by the World Health Organisation (WHO) reveal that 33.4 million people are living with HIV and an estimated 2.7 million are newly infected with the virus.
Driving this matter home, when the HIV virus was first discovered in Nigeria in 1986, billions of Naira was pumped in through various fronts which were targeted at fighting the scourge. Latest reports suggest that the huge sums spent on the prevention and management of the pandemic may not be over yet in the country as Director General, National Agency for the Control of AIDS (NACA) John Idoko revealed that the country needs about N6 billion to effectively combat the Acquired Immune Deficiency Syndrome (AIDS). Idoko made this disclosure at Abuja while briefing the press on activities lined up to mark the 2010 World AIDS Day.
Been that as it may, Olusoji Adeyangu, a medical expert at Adeoyo Maternity Hospital, Ibadan, who spoke with BusinessDay recently, disclosed that recent statistics of HIV/AIDS, may continue to be scary for the African continent despite all sorts of campaigns and investment, unless something drastic is done.
According to Adeyangu, "There are serious emerging challenges for the continent in terms of treatment. This is the soul of the epidemic- it intersects with the weaknesses of the human condition: sex, drive to procreate, power imbalance between the genders, poverty etc. Don’t forget that gender issues and poverty as the unique drivers of the spread of the virus in sub-Saharan Africa.”
As the United Nations recent report of 4.6 percent as HIV prevalence rate in Nigeria, some school of thought are of the view that the reduction in prevalence rate may not really justify the huge funding that the HIV/AIDS project has gulped so far in the country.
At the moment, it is very difficult to make reference to any credible statistics for Nigeria given the fact that the treatment situation is such that about half a million people among those who are HIV positive in the country need to be on treatment.
From this figure, almost half access their treatment from sources other than that of government, yet, every year, it is believed that HIV/AIDS gulps so much from the federal budget and attracts heavy grants from donor agencies.
According to the Global Fund which is the largest donor agency in Nigeria on HIV/AIDS, Nigeria has attracted approximately $200m over five years to fight HIV/AIDS. This figure, the body said, is outside the yearly budgetary allocations to the agency from government and grants from other donor agencies. The principal recipient of most funding for HIV/AIDS remains the National Agency for the Control of AIDS (NACA).
In 2006, the Global Fund cancelled a grant to Nigeria for reasons that border on non-performance. If the grant for that year was approved, it could have got thousands of People Living with HIV/AIDS (PLWHA) who need treatment on the anti retroviral therapy. Inadequate capacity for efficient programme management of large-scale financial interventions for public health was one important reason the body cited for the cancellation.
Apart from claims that the agency presented questionable data, it also said that NACA favoured a manual accounting system, which was inefficient. To the Global Fund, "funds should not just be spent simply for its own sake, just as a process, or disappear into deep private pockets, but to achieve concrete outcomes in prevention, treatment and lives saved by the interventions funded".
For the United States President’s Emergency Plan for AIDS Relief (PEPFAR), another major funder of HIV/AIDS activities in Nigeria, the size of the population and the nation pose logistical and political challenges particularly due to the policy of the Nigerian Government to achieve health care equity across geopolitical zones.
However, the necessity to coordinate programmes simultaneously at the federal, state and local levels introduces complexity into planning, the body noted.
“The large private sector is largely unregulated and, more importantly, has no formal connection to the public health system where most HIV interventions are delivered. Training and human resource development is severely limited in all sectors and will hamper programme implementation at all levels. Care and support is limited due to the fact that existing staff are overstretched and most have insufficient training in key technical areas to provide complete HIV services,” it stated on its website.
Going further, between 2005 and 2006 alone, a total of N14.7 billion was budgeted to fight HIV/AIDS from the federal allocation.
While efforts are been intensified by NACA, development partners and other relevant stakeholders in the country towards curtailing the economic damage caused by the high level of morbidity resulting from AIDS, it is imminent to state that genuine efforts should be made at channeling the funds earmarked for treatment and management of AIDS should be judicious spent.
For a HIV/AIDS activist, “if the treatment of the virus is the main challenge a country like Nigeria is facing in tackling HIV, then major effort and funding should be directed at making treatment available for all living with HIV and other related infections. And if we are grappling with mobilisation and advocacy or behavioural change, it will be beneficial and better to channel our effort financially and otherwise in that direction.
“Our collective sincere effort and activities that are aimed at reducing the spread of the pandemic must be visible and evident for us to be encouraged and hopeful of a reversal in the spread of the virus. Our effort and the resultant impact must justify the funds that are being received, which would then justify demand for more funds from donors and the government.”
In addition, the plans by the Federal Government to halt and reverse the spread of HIV by 2015 may not be achieved if it doesn’t sincerely provide universal access to HIV prevention, treatment, care and support programmes in the country.
By Alexander Chiejina
While World AIDS day is one of the most visible opportunities for public and private partners to spread awareness about the status of the pandemic and encourage progress in HIV/AIDS prevention, treatment and care in high prevalence countries and around the world have continued to remain a major concern. This is as the 2008 figures released by the World Health Organisation (WHO) reveal that 33.4 million people are living with HIV and an estimated 2.7 million are newly infected with the virus.
Driving this matter home, when the HIV virus was first discovered in Nigeria in 1986, billions of Naira was pumped in through various fronts which were targeted at fighting the scourge. Latest reports suggest that the huge sums spent on the prevention and management of the pandemic may not be over yet in the country as Director General, National Agency for the Control of AIDS (NACA) John Idoko revealed that the country needs about N6 billion to effectively combat the Acquired Immune Deficiency Syndrome (AIDS). Idoko made this disclosure at Abuja while briefing the press on activities lined up to mark the 2010 World AIDS Day.
Been that as it may, Olusoji Adeyangu, a medical expert at Adeoyo Maternity Hospital, Ibadan, who spoke with BusinessDay recently, disclosed that recent statistics of HIV/AIDS, may continue to be scary for the African continent despite all sorts of campaigns and investment, unless something drastic is done.
According to Adeyangu, "There are serious emerging challenges for the continent in terms of treatment. This is the soul of the epidemic- it intersects with the weaknesses of the human condition: sex, drive to procreate, power imbalance between the genders, poverty etc. Don’t forget that gender issues and poverty as the unique drivers of the spread of the virus in sub-Saharan Africa.”
As the United Nations recent report of 4.6 percent as HIV prevalence rate in Nigeria, some school of thought are of the view that the reduction in prevalence rate may not really justify the huge funding that the HIV/AIDS project has gulped so far in the country.
At the moment, it is very difficult to make reference to any credible statistics for Nigeria given the fact that the treatment situation is such that about half a million people among those who are HIV positive in the country need to be on treatment.
From this figure, almost half access their treatment from sources other than that of government, yet, every year, it is believed that HIV/AIDS gulps so much from the federal budget and attracts heavy grants from donor agencies.
According to the Global Fund which is the largest donor agency in Nigeria on HIV/AIDS, Nigeria has attracted approximately $200m over five years to fight HIV/AIDS. This figure, the body said, is outside the yearly budgetary allocations to the agency from government and grants from other donor agencies. The principal recipient of most funding for HIV/AIDS remains the National Agency for the Control of AIDS (NACA).
In 2006, the Global Fund cancelled a grant to Nigeria for reasons that border on non-performance. If the grant for that year was approved, it could have got thousands of People Living with HIV/AIDS (PLWHA) who need treatment on the anti retroviral therapy. Inadequate capacity for efficient programme management of large-scale financial interventions for public health was one important reason the body cited for the cancellation.
Apart from claims that the agency presented questionable data, it also said that NACA favoured a manual accounting system, which was inefficient. To the Global Fund, "funds should not just be spent simply for its own sake, just as a process, or disappear into deep private pockets, but to achieve concrete outcomes in prevention, treatment and lives saved by the interventions funded".
For the United States President’s Emergency Plan for AIDS Relief (PEPFAR), another major funder of HIV/AIDS activities in Nigeria, the size of the population and the nation pose logistical and political challenges particularly due to the policy of the Nigerian Government to achieve health care equity across geopolitical zones.
However, the necessity to coordinate programmes simultaneously at the federal, state and local levels introduces complexity into planning, the body noted.
“The large private sector is largely unregulated and, more importantly, has no formal connection to the public health system where most HIV interventions are delivered. Training and human resource development is severely limited in all sectors and will hamper programme implementation at all levels. Care and support is limited due to the fact that existing staff are overstretched and most have insufficient training in key technical areas to provide complete HIV services,” it stated on its website.
Going further, between 2005 and 2006 alone, a total of N14.7 billion was budgeted to fight HIV/AIDS from the federal allocation.
While efforts are been intensified by NACA, development partners and other relevant stakeholders in the country towards curtailing the economic damage caused by the high level of morbidity resulting from AIDS, it is imminent to state that genuine efforts should be made at channeling the funds earmarked for treatment and management of AIDS should be judicious spent.
For a HIV/AIDS activist, “if the treatment of the virus is the main challenge a country like Nigeria is facing in tackling HIV, then major effort and funding should be directed at making treatment available for all living with HIV and other related infections. And if we are grappling with mobilisation and advocacy or behavioural change, it will be beneficial and better to channel our effort financially and otherwise in that direction.
“Our collective sincere effort and activities that are aimed at reducing the spread of the pandemic must be visible and evident for us to be encouraged and hopeful of a reversal in the spread of the virus. Our effort and the resultant impact must justify the funds that are being received, which would then justify demand for more funds from donors and the government.”
In addition, the plans by the Federal Government to halt and reverse the spread of HIV by 2015 may not be achieved if it doesn’t sincerely provide universal access to HIV prevention, treatment, care and support programmes in the country.
By Alexander Chiejina
CSR: FIDSON donates N1 million to children with special needs at CDC, Lagos
In what can be described as a conscious effort towards living out its motto “We value life”, Fidson Healthcare Plc yesterday extended her life-valuing gesture to people suffering from disabilities as it donated N1 million as part of its Corporate Social Responsibility (CSR) to Children Development Center, Lagos.
Making the donation on behalf of Fidson Healthcare, Oladimeji Oduyebo, Corporate Services Manger, Fidson Healthcare Plc said that the core of the company’s CSR is centered on children’s health, the company deemed it fit to contribute its quota towards improving the quality of life of the children.
Oduyebo noted that it was for this reason that it made the donation towards supporting Children Developmental Center, a non-governmental organisation totally dedicated to the provision of quality support services to children and young adults with disabilities.
In his words “children with various forms of disabilities are like any other children out there. So as a corporate organsation that focus on children’s health, there is the need to support those who take care of these children both financially and otherwise especially during their developmental stages so that they can have a feel of belonging in the larger society.
“However, over the years, we have also extended scholarship schemes to children in Nigeria as part of our CSR. Fidson Healthcare will always be committed towards formulating products and services which is geared towards improving the life and health of children.”
Responding to the donation, Yinka Akindayomi, service director, CDC, thanked the management and staff of Fidson Healthcare for providing financial support to the center. Akindayomi revealed that the primary aim of setting up the center was to add value to the lives of people with disabilities in order to make them stakeholders in nation building.
The service director disclosed that the challenge with running the center has been the negative perception of the community with regards to children with special needs as this has often times made parents with such children not seeing the need to invest in their lives to become leaders of tomorrow.
In her words “the perception of people with disabilities still remains a challenge in our society. We won’t be dissuaded by this singular fact. In CDC, we have in place the following quality service which are focused on improving such children; early intervention unit, pre-school unit, adolescent and young adults educational and vocational unit, physiotherapy and disability advocacy units to mention but a few. We have about 300 children in our care.
“We however solicit to the general public for more funds as it complete its Living and Learning center at Ibeju Lekki (an 8. 35acres of land) estimate to cost N500 million. The Phase One of the project is on-going and when completed will be relevant in meeting the ever changing needs of people with disabilities in Lagos and beyond,” Akindayomi concluded.
It is believed that with support from other corporate organisation in the country, children with disabilities will have a belonging in the outer society following acquisition of skills it must have acquired in centers of this sort.
by Alexander Chiejina
Making the donation on behalf of Fidson Healthcare, Oladimeji Oduyebo, Corporate Services Manger, Fidson Healthcare Plc said that the core of the company’s CSR is centered on children’s health, the company deemed it fit to contribute its quota towards improving the quality of life of the children.
Oduyebo noted that it was for this reason that it made the donation towards supporting Children Developmental Center, a non-governmental organisation totally dedicated to the provision of quality support services to children and young adults with disabilities.
In his words “children with various forms of disabilities are like any other children out there. So as a corporate organsation that focus on children’s health, there is the need to support those who take care of these children both financially and otherwise especially during their developmental stages so that they can have a feel of belonging in the larger society.
“However, over the years, we have also extended scholarship schemes to children in Nigeria as part of our CSR. Fidson Healthcare will always be committed towards formulating products and services which is geared towards improving the life and health of children.”
Responding to the donation, Yinka Akindayomi, service director, CDC, thanked the management and staff of Fidson Healthcare for providing financial support to the center. Akindayomi revealed that the primary aim of setting up the center was to add value to the lives of people with disabilities in order to make them stakeholders in nation building.
The service director disclosed that the challenge with running the center has been the negative perception of the community with regards to children with special needs as this has often times made parents with such children not seeing the need to invest in their lives to become leaders of tomorrow.
In her words “the perception of people with disabilities still remains a challenge in our society. We won’t be dissuaded by this singular fact. In CDC, we have in place the following quality service which are focused on improving such children; early intervention unit, pre-school unit, adolescent and young adults educational and vocational unit, physiotherapy and disability advocacy units to mention but a few. We have about 300 children in our care.
“We however solicit to the general public for more funds as it complete its Living and Learning center at Ibeju Lekki (an 8. 35acres of land) estimate to cost N500 million. The Phase One of the project is on-going and when completed will be relevant in meeting the ever changing needs of people with disabilities in Lagos and beyond,” Akindayomi concluded.
It is believed that with support from other corporate organisation in the country, children with disabilities will have a belonging in the outer society following acquisition of skills it must have acquired in centers of this sort.
by Alexander Chiejina
Friday, November 26, 2010
Experts calls for strengthening of antimalarial efficacy
…as national monitoring key in preventing malaria drug resistance
For health experts across the globe, there has been increased worry over the incidence of some malaria medications which is believed not to have been efficacious in delivering the desired cure to people who take such antimalarial drugs.
With complaints on the inability of some drugs regimens to effectively cure malaria, the World Health Organization (WHO) has called on countries to be increasingly vigilant in monitoring antimalarial drug efficacy in order to allow for early detection of artemisinin resistance. This is one among several conclusions of the “Global report on antimalarial drug efficacy and drug resistance: 2000–2010”, which was released recently.
The report is based on 1100 studies conducted by national malaria control programs and research institutes over the ten-year period. The report estimates that only 34 percent of malaria-endemic countries are complying with WHO recommendations to routinely monitor the efficacy of first- and second-line antimalarial medicines.
In February 2009, the WHO confirmed that resistance to artemisinin had emerged on the Cambodia-Thailand border. Although patients infected were cured following treatment with an artemisinin-based combination therapy (ACT), the recovery took more time. In artemisinin-resistant areas, the high cure rates observed depends heavily on the efficacy of the non-artemisinin component of the combination.
Nonetheless, the report found that ACTs currently recommended by national malaria control programmes remain efficacious in treating malaria, with cure rates generally greater than 90 percent. In countries where the currently recommended ACT has a cure rate of less than 90 percent, policy change is ongoing to implement an efficacious replacement treatment for malaria.
In an interview with BusinessDay, Wellington Oyibo, consultant medical Parasitologist, college of medicine, University of Lagos, Idi-araba, Lagos, said that the emergence of artemisinin resistance on the Cambodia-Thailand border has been a wake-up call to the world to prevent its spread, increase monitoring, and preserve ACTs as the only effective treatment we have for falciparum malaria. Oyibo disclosed that it is imminent to state that prompt action will be critical to sustain progress in malaria control and achieve the health-related Millennium Development Goals.
According to him, “Recently, The Federal Ministry of Health (FMOH) carried out a Drug therapeutic efficacy testing (DTET) in seven centres to ascertain assertions of ACT resistance. The last testing was done in 2003 to ascertain chloroquine resistance. However, globally, a WMNET network is trying to track ACT resistance gene as is the case with prophylactic drugs like chloroquine and Fansidar.”
For Shilaj Chakravorty, Consultant Pathologist, BT Health & Diagnostic Complex, LASUTH, Ikeja, Lagos, antimalarial drug resistance is like a cancer which must be fought at every level. Chakravorty stated that affected countries need to be in the frontline in combating the emergence of drug resistance through proper surveillance by states which should ensure that all health institutions submit data of malaria cases with special reference on resistance to anti malaria drug.
According to him “Anytime issues of anti-malaria drug resistance is reported, such should be reported to the state health authorities. Also, there should be the discouragement of Nigerians engaging on across the counter purchase of anti malarial drugs as well as the need to educate the public on the importance of diagnosis before any administration of drugs to the ailing patient.
Importantly, there is need for tertiary malaria research centers have facilities to diagnose and confirm drug resistance as per the WHO guidelines. WHO should be empowered and supported to take a strong lead. It is crucial to protect ACTs as they are the best treatments for millions of people against malaria”
Even as scientists continue to investigate how and why artemisinin resistance specifically emerges, it is noteworthy to state that antimalarial drug resistance first emerges through a rare spontaneous change in the malaria parasite.
The subsequent ability of the drug resistant strain to survive and spread is influenced by many factors, including the use of substandard medicines and artemisinin-based monotherapies. However, it is clear that if the efficacy of artemisinin component continues to decline, there is an increased risk that resistance to non-artemisinin medicines used in the combination will emerge.
Currently, research efforts are ongoing to discover and develop new medicines for the treatment of malaria.
No doubt, efforts to contain the spread of artemisinin resistance on the Cambodia-Thailand border have been ongoing since November 2008. However, there is some early evidence that resistance to artemisinins may also be emerging on the Myanmar-Thailand border. There is also concern that resistance could spread from the Cambodia-Thailand border to Africa, as it did with anti malaria drugs such as chloroquine and sulfadoxine-pyrimethamine in the 1960s and 1970s.
With the Federal Government’s introduction of the use of Small Messaging Service (SMS) for collection of data for malaria control last week, health workers will be able to monitor implementation of health interventions more effectively. In the long run, routine data management as well as antimalarial resistance can be trapped and be effectively nipped in the bud.
By Alexander Chiejina
For health experts across the globe, there has been increased worry over the incidence of some malaria medications which is believed not to have been efficacious in delivering the desired cure to people who take such antimalarial drugs.
With complaints on the inability of some drugs regimens to effectively cure malaria, the World Health Organization (WHO) has called on countries to be increasingly vigilant in monitoring antimalarial drug efficacy in order to allow for early detection of artemisinin resistance. This is one among several conclusions of the “Global report on antimalarial drug efficacy and drug resistance: 2000–2010”, which was released recently.
The report is based on 1100 studies conducted by national malaria control programs and research institutes over the ten-year period. The report estimates that only 34 percent of malaria-endemic countries are complying with WHO recommendations to routinely monitor the efficacy of first- and second-line antimalarial medicines.
In February 2009, the WHO confirmed that resistance to artemisinin had emerged on the Cambodia-Thailand border. Although patients infected were cured following treatment with an artemisinin-based combination therapy (ACT), the recovery took more time. In artemisinin-resistant areas, the high cure rates observed depends heavily on the efficacy of the non-artemisinin component of the combination.
Nonetheless, the report found that ACTs currently recommended by national malaria control programmes remain efficacious in treating malaria, with cure rates generally greater than 90 percent. In countries where the currently recommended ACT has a cure rate of less than 90 percent, policy change is ongoing to implement an efficacious replacement treatment for malaria.
In an interview with BusinessDay, Wellington Oyibo, consultant medical Parasitologist, college of medicine, University of Lagos, Idi-araba, Lagos, said that the emergence of artemisinin resistance on the Cambodia-Thailand border has been a wake-up call to the world to prevent its spread, increase monitoring, and preserve ACTs as the only effective treatment we have for falciparum malaria. Oyibo disclosed that it is imminent to state that prompt action will be critical to sustain progress in malaria control and achieve the health-related Millennium Development Goals.
According to him, “Recently, The Federal Ministry of Health (FMOH) carried out a Drug therapeutic efficacy testing (DTET) in seven centres to ascertain assertions of ACT resistance. The last testing was done in 2003 to ascertain chloroquine resistance. However, globally, a WMNET network is trying to track ACT resistance gene as is the case with prophylactic drugs like chloroquine and Fansidar.”
For Shilaj Chakravorty, Consultant Pathologist, BT Health & Diagnostic Complex, LASUTH, Ikeja, Lagos, antimalarial drug resistance is like a cancer which must be fought at every level. Chakravorty stated that affected countries need to be in the frontline in combating the emergence of drug resistance through proper surveillance by states which should ensure that all health institutions submit data of malaria cases with special reference on resistance to anti malaria drug.
According to him “Anytime issues of anti-malaria drug resistance is reported, such should be reported to the state health authorities. Also, there should be the discouragement of Nigerians engaging on across the counter purchase of anti malarial drugs as well as the need to educate the public on the importance of diagnosis before any administration of drugs to the ailing patient.
Importantly, there is need for tertiary malaria research centers have facilities to diagnose and confirm drug resistance as per the WHO guidelines. WHO should be empowered and supported to take a strong lead. It is crucial to protect ACTs as they are the best treatments for millions of people against malaria”
Even as scientists continue to investigate how and why artemisinin resistance specifically emerges, it is noteworthy to state that antimalarial drug resistance first emerges through a rare spontaneous change in the malaria parasite.
The subsequent ability of the drug resistant strain to survive and spread is influenced by many factors, including the use of substandard medicines and artemisinin-based monotherapies. However, it is clear that if the efficacy of artemisinin component continues to decline, there is an increased risk that resistance to non-artemisinin medicines used in the combination will emerge.
Currently, research efforts are ongoing to discover and develop new medicines for the treatment of malaria.
No doubt, efforts to contain the spread of artemisinin resistance on the Cambodia-Thailand border have been ongoing since November 2008. However, there is some early evidence that resistance to artemisinins may also be emerging on the Myanmar-Thailand border. There is also concern that resistance could spread from the Cambodia-Thailand border to Africa, as it did with anti malaria drugs such as chloroquine and sulfadoxine-pyrimethamine in the 1960s and 1970s.
With the Federal Government’s introduction of the use of Small Messaging Service (SMS) for collection of data for malaria control last week, health workers will be able to monitor implementation of health interventions more effectively. In the long run, routine data management as well as antimalarial resistance can be trapped and be effectively nipped in the bud.
By Alexander Chiejina
Funding slows pharmaceutical research institute’s efforts
… Promising therapies now in limbo
Research has been the bedrock of several scientific discoveries and breakthroughs across the globe. With researchers having to contend with the challenge of developing drugs to combat certain ailments, efforts at developing a potential therapy for sickle cell diseases and other ailments by the National Institute for Pharmaceutical Research and Development (NIPRD), Abuja seems to have hit the rock.
This is following recent reports which suggest that the institute, which develops traditional herbal remedies into drug candidates failed to secure the funding it expected this year and this has grounded research at the institute. Following this development, scientists are urging the Nigerian government to provide the financial support needed to save research programmes at the institute.
The institute has already developed a potential therapy for sickle-cell disease (SCD) and has encouraging results for compounds to treat malaria and tuberculosis. Sadly, a key grant from the United States National Institute of Allergy and Infectious Diseases (NIAID) has run out and the Federal Ministry of Health has failed to deliver an expected increase to its contribution. As a result of this, research on all three drugs has come to a standstill.
According to Karniyus Gamaniel, director general, NIPRD, the N49 million (US$325,000) NIPRD institute received this year from the Ministry of Health is not enough to cover the institute’s annual running costs of 265 million naira.
Gamaniel noted that the institute also received N70 million from the ministry in 2010 for capital projects, but lamented that this falls short of the more than US$2 million needed to buy equipment and for other infrastructural projects.
“There are lots of things we don’t do because we have no money. For instance, the institute needs N50 million in addition to its running costs to mount an 800-patient phase III clinical trial on its anti-malaria drug. In addition, one of the institute’s flagship laboratories, set up in 2005 with a grant of US$25 million from the National Institute of Allergy and Infectious Diseases (NIAID), is lying idle. NIPRD needs about N23million a year to cover maintenance costs and ensure a constant supply of electricity,” Gamaniel disclosed.
Joseph Okogun, a consultant phytochemist for NIPRD, said: “Without funding for this lab, it cannot carry out essential analyses of the structures of chemical compounds in their tuberculosis drug candidate, which is a mix of herbal extracts that have been shown to slow the growth of the tuberculosis bacterium. If funded, maybe, in six to 10 years time, we might get something developed into a drug.”
No doubt, the effects of the funding problems on efforts to test Nicosan (Niprisan) might jeopardise the institute’s potential treatment for sickle-cell anaemia — a genetic disease said to be associated with complications and a reduced life expectancy in people affected with the disease.
Patients with the disease have ‘sickle’-shaped red blood cells, which can clump together to block blood vessels, thereby causing strokes or pain. Based on West African plant extracts, Nicosan appeared to slow the clumping of blood cells in lab tests and early trials of the drug in patients suggested that it relieved some of the painful symptoms of the disease.
The Phase IIB (pivotal) trial suggests that Niprisan was effective in reducing episodes of severe painful SCD crisis over a six-month period. It did not affect the risk of severe complications or the level of anaemia. No serious adverse effects were reported. The single trial of Cajanus cajan (Ciklavit) reported a possible benefit to individuals with painful crises, and a possible adverse effect (non-significant) on the level of anaemia.
Furthermore, Nicosan was being produced in the country by the Nigerian subsidiary of US chemical company Xechem International. Just last year, Xechem International closed its factory and despite promises by the Nigerian government that it would restart production, the drug is currently unavailable.
Although the results of phase III clinical trials with Nicosan, funded by NIPRD, are yet to be published, Gamaniel admitted that they were “inconclusive.” In addition, financial constraints have hindered NIPRD from doing more phase III trials of the drug.
Taking a cursory look at the treatment of sickle cell disease, the sickle-cell drug hydroxyurea was marketed nearly two decades ago. However, the list of drugs able to treat the symptoms of the disease has been “abysmally short to nonexistent.”
Though no conclusions can be made regarding the efficacy of Ciklavit currently, based on the published results for Niprisan and in view of the limitations in data collection and analysis of both trials, phytomedicines (medicine derived from plants in their original state) may have a potential beneficial effect in reducing painful crises in SCD. This needs to be further validated in future trials to ascertain the safety and efficacy of phytomedicines in managing SCD.
No doubt, the NIPRD and other research institutes in the country are in a position to develop products or processes which can compete with imported technologies that are saturating the economy if well funded. Furthermore, efforts should be made by the institute, including other research institutes in the country, to draft a proposal for funding to the World Bank, the Global Fund to fight AIDS, tuberculosis and malaria, and other philanthropic organisations for grants. In this way, much of the funding can be used to upgrade the institute’s laboratories so that they can push forward the work on their drug candidates.
By alexander Chiejina
Research has been the bedrock of several scientific discoveries and breakthroughs across the globe. With researchers having to contend with the challenge of developing drugs to combat certain ailments, efforts at developing a potential therapy for sickle cell diseases and other ailments by the National Institute for Pharmaceutical Research and Development (NIPRD), Abuja seems to have hit the rock.
This is following recent reports which suggest that the institute, which develops traditional herbal remedies into drug candidates failed to secure the funding it expected this year and this has grounded research at the institute. Following this development, scientists are urging the Nigerian government to provide the financial support needed to save research programmes at the institute.
The institute has already developed a potential therapy for sickle-cell disease (SCD) and has encouraging results for compounds to treat malaria and tuberculosis. Sadly, a key grant from the United States National Institute of Allergy and Infectious Diseases (NIAID) has run out and the Federal Ministry of Health has failed to deliver an expected increase to its contribution. As a result of this, research on all three drugs has come to a standstill.
According to Karniyus Gamaniel, director general, NIPRD, the N49 million (US$325,000) NIPRD institute received this year from the Ministry of Health is not enough to cover the institute’s annual running costs of 265 million naira.
Gamaniel noted that the institute also received N70 million from the ministry in 2010 for capital projects, but lamented that this falls short of the more than US$2 million needed to buy equipment and for other infrastructural projects.
“There are lots of things we don’t do because we have no money. For instance, the institute needs N50 million in addition to its running costs to mount an 800-patient phase III clinical trial on its anti-malaria drug. In addition, one of the institute’s flagship laboratories, set up in 2005 with a grant of US$25 million from the National Institute of Allergy and Infectious Diseases (NIAID), is lying idle. NIPRD needs about N23million a year to cover maintenance costs and ensure a constant supply of electricity,” Gamaniel disclosed.
Joseph Okogun, a consultant phytochemist for NIPRD, said: “Without funding for this lab, it cannot carry out essential analyses of the structures of chemical compounds in their tuberculosis drug candidate, which is a mix of herbal extracts that have been shown to slow the growth of the tuberculosis bacterium. If funded, maybe, in six to 10 years time, we might get something developed into a drug.”
No doubt, the effects of the funding problems on efforts to test Nicosan (Niprisan) might jeopardise the institute’s potential treatment for sickle-cell anaemia — a genetic disease said to be associated with complications and a reduced life expectancy in people affected with the disease.
Patients with the disease have ‘sickle’-shaped red blood cells, which can clump together to block blood vessels, thereby causing strokes or pain. Based on West African plant extracts, Nicosan appeared to slow the clumping of blood cells in lab tests and early trials of the drug in patients suggested that it relieved some of the painful symptoms of the disease.
The Phase IIB (pivotal) trial suggests that Niprisan was effective in reducing episodes of severe painful SCD crisis over a six-month period. It did not affect the risk of severe complications or the level of anaemia. No serious adverse effects were reported. The single trial of Cajanus cajan (Ciklavit) reported a possible benefit to individuals with painful crises, and a possible adverse effect (non-significant) on the level of anaemia.
Furthermore, Nicosan was being produced in the country by the Nigerian subsidiary of US chemical company Xechem International. Just last year, Xechem International closed its factory and despite promises by the Nigerian government that it would restart production, the drug is currently unavailable.
Although the results of phase III clinical trials with Nicosan, funded by NIPRD, are yet to be published, Gamaniel admitted that they were “inconclusive.” In addition, financial constraints have hindered NIPRD from doing more phase III trials of the drug.
Taking a cursory look at the treatment of sickle cell disease, the sickle-cell drug hydroxyurea was marketed nearly two decades ago. However, the list of drugs able to treat the symptoms of the disease has been “abysmally short to nonexistent.”
Though no conclusions can be made regarding the efficacy of Ciklavit currently, based on the published results for Niprisan and in view of the limitations in data collection and analysis of both trials, phytomedicines (medicine derived from plants in their original state) may have a potential beneficial effect in reducing painful crises in SCD. This needs to be further validated in future trials to ascertain the safety and efficacy of phytomedicines in managing SCD.
No doubt, the NIPRD and other research institutes in the country are in a position to develop products or processes which can compete with imported technologies that are saturating the economy if well funded. Furthermore, efforts should be made by the institute, including other research institutes in the country, to draft a proposal for funding to the World Bank, the Global Fund to fight AIDS, tuberculosis and malaria, and other philanthropic organisations for grants. In this way, much of the funding can be used to upgrade the institute’s laboratories so that they can push forward the work on their drug candidates.
By alexander Chiejina
Wednesday, November 24, 2010
Reddington hospital records landmark achievement in medicine
…performs Nigeria’s first device closure of a hole in the heart by non surgical intervention
Another landmark achievement in the field of medicine has been recorded by Reddington Hospital as it has recorded successfully pioneered Nigeria’s First devised closure of the hole in the heart (Patent Ductus Arteriousis) by non surgical invention on Victoria Onuoha, a three year old child.
Making this known to journalists at its Victoria Island office yesterday, Olu Lawani, acting Medical Director, Reddington Hospital said that the achievement was made possible following an intense collaboration by a team of doctors at the Reddington hospital and Lagos State College of Medicine (LASUCOM) and Lagos State University Teaching Hospital (LASUTH), who were supported by cardiac physiologists, cardiac technicians, nurses and biomedical engineers in the spirit of public private partnership.
Olu Lawani revealed that PDA, a congential heart disease (CHD) commonly seen in early childhood, is a condition where the hole in the heart fails to close at birth for various reasons. He noted that while the diagnosis of the three year old child was made in LASUTH 2 years ago, there equipment for conducting such non surgical procedure wasn’t available in Nigeria as the family wasn’t able to muster the financial resources to go abroad.
In his words “the deviced closure of PDA is a common procedure carried out Europe, America, and some developing nations like India and South Africa. We are aware that one of the major challenges in treating CHD us the overall cost of carrying out the procedure, availability of high tech equipment, lot of consumables and devices that were procured from abroad at a huge cost. That is why Edensfield Health Foundation, a non-governmental organisation paid for the procurement of the device that was sourced from abroad.
Depending on the complexity of the disease, it costs between $500 to $5000 to purchase the device for the surgery. As a contribution to this landmark event, the management of the hospital took a decision to wave our charges regarding this patient in our facility. We hope the new low price regime would be effective from January 2011.”
Lending her view, Adeola Animashaun, consultant paediatrician cardiologist, LASUTH, who was part of the team that conducted the surgery, disclosed that this landmark achievement by Reddington Hospital has been used all over the world. Animashaun noted that the advantage of this process is that it has shorter procedure time, shorter hospital stay and no scar for the patient.
According to her “up till now, the only way this cardiac abnormality has been treated in Nigeria is through very complex surgery that involves cutting up the chest cage (ribs and sternum) to be able to have access to the heart before the procedure for the closure of the hole can be carried out. This is usually followed up with long post operative intensive care and hospital stay with its attendant moderate mortality.”
With the feat achieved by this hospital, the healthcare delivery system should be revamped to ensure that tertiary institutions are equipped with adequate facilities for various medical issues as well as capacity development. This is the long run will see endear the country to in medical tourism which countries like India, United States of America, and other countries in Europe enjoy.
By Alexander Chiejina
Another landmark achievement in the field of medicine has been recorded by Reddington Hospital as it has recorded successfully pioneered Nigeria’s First devised closure of the hole in the heart (Patent Ductus Arteriousis) by non surgical invention on Victoria Onuoha, a three year old child.
Making this known to journalists at its Victoria Island office yesterday, Olu Lawani, acting Medical Director, Reddington Hospital said that the achievement was made possible following an intense collaboration by a team of doctors at the Reddington hospital and Lagos State College of Medicine (LASUCOM) and Lagos State University Teaching Hospital (LASUTH), who were supported by cardiac physiologists, cardiac technicians, nurses and biomedical engineers in the spirit of public private partnership.
Olu Lawani revealed that PDA, a congential heart disease (CHD) commonly seen in early childhood, is a condition where the hole in the heart fails to close at birth for various reasons. He noted that while the diagnosis of the three year old child was made in LASUTH 2 years ago, there equipment for conducting such non surgical procedure wasn’t available in Nigeria as the family wasn’t able to muster the financial resources to go abroad.
In his words “the deviced closure of PDA is a common procedure carried out Europe, America, and some developing nations like India and South Africa. We are aware that one of the major challenges in treating CHD us the overall cost of carrying out the procedure, availability of high tech equipment, lot of consumables and devices that were procured from abroad at a huge cost. That is why Edensfield Health Foundation, a non-governmental organisation paid for the procurement of the device that was sourced from abroad.
Depending on the complexity of the disease, it costs between $500 to $5000 to purchase the device for the surgery. As a contribution to this landmark event, the management of the hospital took a decision to wave our charges regarding this patient in our facility. We hope the new low price regime would be effective from January 2011.”
Lending her view, Adeola Animashaun, consultant paediatrician cardiologist, LASUTH, who was part of the team that conducted the surgery, disclosed that this landmark achievement by Reddington Hospital has been used all over the world. Animashaun noted that the advantage of this process is that it has shorter procedure time, shorter hospital stay and no scar for the patient.
According to her “up till now, the only way this cardiac abnormality has been treated in Nigeria is through very complex surgery that involves cutting up the chest cage (ribs and sternum) to be able to have access to the heart before the procedure for the closure of the hole can be carried out. This is usually followed up with long post operative intensive care and hospital stay with its attendant moderate mortality.”
With the feat achieved by this hospital, the healthcare delivery system should be revamped to ensure that tertiary institutions are equipped with adequate facilities for various medical issues as well as capacity development. This is the long run will see endear the country to in medical tourism which countries like India, United States of America, and other countries in Europe enjoy.
By Alexander Chiejina
Monday, November 22, 2010
Stimulating SMEs development in Nigeria
In Europe and other developed nations across the globe, the small and medium enterprises (SMEs) have been responsible for stimulating industrial growth through innovation and competition. Alexander Chiejina writes on what the Bank of Industry in facilitating SME development and its challenges
In developed nations like the United States of America, Britain, Japan, the micro small and medium enterprises (MSMEs) sector play a critical role in the development and growth of its industrial sector and the economy at large. This is in view of the vast potentials the sector offers in creating jobs for the teeming population within the informal sector.
For instance, in Europe, Small and medium Enterprises (SMEs) comprise approximately 99 percent of all firms and employ about 65 million people. In many sectors, SMEs have been responsible for driving innovation and competition. Globally, SMEs account for 99 percent of business numbers and 40 percent to 50 percent of Gross Domestic Product (GDP).
With Nigeria been one of Africa’s most influential countries given its population size, levels of trade and size of markets within the continent and the West African sub-region, the country has the potential to play a more substantial role in regional trade if its MSMEs are well developed viz-a-viz financing and capacity building programmes. This in turn will diversify and promote sustainable growth of the country’s economy.
Sadly, with Nigeria’s dependence in oil, the non-oil producing sectors have been saddled with enormous challenges ranging from harsh operating environment to infrastructural problems, and varying government’s economic policies. This move has led to the suffocation of Small and Medium Enterprises (SMEs) as well as Micro Small and Medium Scale Enterprises (MSMEs) in Nigeria.
Given this glaring reality, the Bank of Industry (BOI), established in October, 2001 following the reconstruction of the Nigerian Industrial Development Bank (NIDB), was charged with the responsibility of diversification of the Nigerian economy from a monolithic oil dependent type to an industrial nation viz-a-viz funding and provision of advisory services
According to reports from the BOI, the bank presently extends at least 85 percent of its loanable resources to the SMEs sub-sector of the manufacturing sector. At present, the Bank’s lending policy is positively favorable towards SMEs, as well as stands ready to be involved in programs targeted towards trade finance and efficiency improvement of the sector.
The Bank is also actively involved in lending to large /corporate enterprises in various sectors of the economy. One of such enhanced financing is ‘Cooperative Cluster Financing’, which is designed to reach the relatively small operators without access to collateral properties.
Though seen as a major paradigm shift, the Bank has as at date approved over N1.360 billion under its Cooperative Financing window to more than 220 Associations involving about 25,000 employment opportunities. This entails the creation of new products/ businesses/cum expansion of existing businesses that are driven through group guarantees as major security option.
Going further, the bank is engaging in continuous advocacy with the state and Federal governments towards improving the operational environment of the MSMEs. This programme ensures matching the funds provided by state governments for onward lending to projects from the partner-states.
Amongst the Bank’s Entrepreneurial Development Programme include organising Boot- Camp workshop primarily to sensitise indigenous existing and potential entrepreneurs to business opportunities, financing, and inculcating successful management skills in local business owners to forestall large scale business failure; Empowerment of the Nigerian entrepreneurs through exposure to international best practices and establishment of global partnership in support of the MSMEs; and collaborating with various Multilateral Development Agencies in the training of local entrepreneurs.
Interestingly, the Bank has over time developed specialised skill and expertise in the Management of special funds which include: The National Automotive Development Council (NAC) Fund, Business Development Fund for Women Entrepreneurs (BUDFOW), Cotton, Textile and Garmenting Development (CTRG) and Rice Processing Fund.
As a further testimony to BOI’s efforts in development of a virile and competitive Industrial Sector, the Bank was considered a collaborator in the implementation of the CBN N500 billion direct intervention fund in the real sector made up of N300 billion for power and aviation sectors and N200 billion for refinancing/ restructuring of banks loans to the manufacturing sector.
Inspite of the intensive and extensive work with the SMEs over the period, BOI found out that finance is not the only major constraint for their development. Other major impediments include infrastructural inadequacies, poor packaged proposals by prospective borrowers, inability of project promoters to contribute equity, policies instability, and lack of entrepreneurial skill/ human capital.
In the agricultural sub-sector, the efficiency in converting the geo-locational comparative advantages of most states into competitive ones had hampered the financing of SMEs due to the inadequacy of post harvest supports as well as legal documentation in terms of delay and cost involved in processing C of O, and poor attitude to loan repayment by borrowers.
Based on BOI’s experience in real sector financing, availability of first class infrastructure in all its ramifications especially power and security, development of modern entrepreneurial skills through human capacity and empowerment, the provision of well articulated incentives that would encourage all the stakeholders particularly concessions to investors by way of reduced cost of land documentation will would induce industrialization in Nigeria.
Following successes achieved in other countries across the globe, the SMEs sector can be seen as a training ground for local skills to be developed. This will lead to a slump in entrepreneurs’ migration from rural areas to urban areas for manpower. Also, its development objectives will serve as a resource base for skill acquisition for multinationals thereby replacing existing foreign sources.
By Alexander Chiejina
In developed nations like the United States of America, Britain, Japan, the micro small and medium enterprises (MSMEs) sector play a critical role in the development and growth of its industrial sector and the economy at large. This is in view of the vast potentials the sector offers in creating jobs for the teeming population within the informal sector.
For instance, in Europe, Small and medium Enterprises (SMEs) comprise approximately 99 percent of all firms and employ about 65 million people. In many sectors, SMEs have been responsible for driving innovation and competition. Globally, SMEs account for 99 percent of business numbers and 40 percent to 50 percent of Gross Domestic Product (GDP).
With Nigeria been one of Africa’s most influential countries given its population size, levels of trade and size of markets within the continent and the West African sub-region, the country has the potential to play a more substantial role in regional trade if its MSMEs are well developed viz-a-viz financing and capacity building programmes. This in turn will diversify and promote sustainable growth of the country’s economy.
Sadly, with Nigeria’s dependence in oil, the non-oil producing sectors have been saddled with enormous challenges ranging from harsh operating environment to infrastructural problems, and varying government’s economic policies. This move has led to the suffocation of Small and Medium Enterprises (SMEs) as well as Micro Small and Medium Scale Enterprises (MSMEs) in Nigeria.
Given this glaring reality, the Bank of Industry (BOI), established in October, 2001 following the reconstruction of the Nigerian Industrial Development Bank (NIDB), was charged with the responsibility of diversification of the Nigerian economy from a monolithic oil dependent type to an industrial nation viz-a-viz funding and provision of advisory services
According to reports from the BOI, the bank presently extends at least 85 percent of its loanable resources to the SMEs sub-sector of the manufacturing sector. At present, the Bank’s lending policy is positively favorable towards SMEs, as well as stands ready to be involved in programs targeted towards trade finance and efficiency improvement of the sector.
The Bank is also actively involved in lending to large /corporate enterprises in various sectors of the economy. One of such enhanced financing is ‘Cooperative Cluster Financing’, which is designed to reach the relatively small operators without access to collateral properties.
Though seen as a major paradigm shift, the Bank has as at date approved over N1.360 billion under its Cooperative Financing window to more than 220 Associations involving about 25,000 employment opportunities. This entails the creation of new products/ businesses/cum expansion of existing businesses that are driven through group guarantees as major security option.
Going further, the bank is engaging in continuous advocacy with the state and Federal governments towards improving the operational environment of the MSMEs. This programme ensures matching the funds provided by state governments for onward lending to projects from the partner-states.
Amongst the Bank’s Entrepreneurial Development Programme include organising Boot- Camp workshop primarily to sensitise indigenous existing and potential entrepreneurs to business opportunities, financing, and inculcating successful management skills in local business owners to forestall large scale business failure; Empowerment of the Nigerian entrepreneurs through exposure to international best practices and establishment of global partnership in support of the MSMEs; and collaborating with various Multilateral Development Agencies in the training of local entrepreneurs.
Interestingly, the Bank has over time developed specialised skill and expertise in the Management of special funds which include: The National Automotive Development Council (NAC) Fund, Business Development Fund for Women Entrepreneurs (BUDFOW), Cotton, Textile and Garmenting Development (CTRG) and Rice Processing Fund.
As a further testimony to BOI’s efforts in development of a virile and competitive Industrial Sector, the Bank was considered a collaborator in the implementation of the CBN N500 billion direct intervention fund in the real sector made up of N300 billion for power and aviation sectors and N200 billion for refinancing/ restructuring of banks loans to the manufacturing sector.
Inspite of the intensive and extensive work with the SMEs over the period, BOI found out that finance is not the only major constraint for their development. Other major impediments include infrastructural inadequacies, poor packaged proposals by prospective borrowers, inability of project promoters to contribute equity, policies instability, and lack of entrepreneurial skill/ human capital.
In the agricultural sub-sector, the efficiency in converting the geo-locational comparative advantages of most states into competitive ones had hampered the financing of SMEs due to the inadequacy of post harvest supports as well as legal documentation in terms of delay and cost involved in processing C of O, and poor attitude to loan repayment by borrowers.
Based on BOI’s experience in real sector financing, availability of first class infrastructure in all its ramifications especially power and security, development of modern entrepreneurial skills through human capacity and empowerment, the provision of well articulated incentives that would encourage all the stakeholders particularly concessions to investors by way of reduced cost of land documentation will would induce industrialization in Nigeria.
Following successes achieved in other countries across the globe, the SMEs sector can be seen as a training ground for local skills to be developed. This will lead to a slump in entrepreneurs’ migration from rural areas to urban areas for manpower. Also, its development objectives will serve as a resource base for skill acquisition for multinationals thereby replacing existing foreign sources.
By Alexander Chiejina
Thursday, November 18, 2010
Students Vs ASUU
When two elephants fight…
With the paralysis of academic activities in universities by ASUU over issues relating to proper funding and infrastructural facilities in the nation’s ivory towers, Alexander Chiejina writes that only an adequately funded public education sector can guarantee improved working conditions for education workers.
For Damian Okonkwo, a two-hundred level student in the Department of Industrial Physics, Imo State University, (IMSU), his plans on completing his academic pursuit next year seem to have suffered a big blow, following the paralysis of academic activities in universities as a result of the strike action embarked upon by the Academic Staff Union of Universities (ASUU).
Since finishing his first semester exams in August this year, he had no option than to come back to Lagos, where his parents stay in a bid to see what menial jobs he could do pending when the strike by ASUU is called off.
The same experience can be said of Merit Harrison, a third year law student at Anambra State University, who disclosed to BusinessDay that she has resulted to staying at home since she didn’t have any qualification which would earn her a job at the moment. Harrison revealed that her parents are worried because her younger brother who gained admission to study Medicine at Abia State University, ABSU was affected.
No doubt, the strike embarked upon by ASUU across Universities owned by the State governments since July 2, 2010, generated headlines in print and electronic media across the country. At the last count, more than 10 Universities were on strike action. They are Abia State University (ABSU), Anambra State University, Ebonyi State University, Enugu State University of Technology (ESUT), Imo State University (IMSU), Rivers State University, Rivers State University of Education, Lagos State University (LASU), Cross River University of Technology (CRUTECH), Olabisi Onabanjo University (OOU) and the Tai Solarin University of Education (TASUED).
In Lagos, even education workers' unions of State-owned institutions like the Lagos State Polytechnic (LASPOTECH), Michael Otedola College of Education (MOCPED) and Adeniran Ogunsanya College of Education (AOCOED) have joined the strike action. Meanwhile, all Universities in the five states (Anambra, Abia, Ebonyi, Enugu and Imo States) of the South east have been on strike since August 2010.
Their grouse has been attributed to the refusal of the state governments to fully implement agreement signed between the Federal government and the Staff Unions last year after a 4-month nationwide strike action that paralysed activities in the nation’s ivory towers.
The Federal government had signed agreement covering improved condition of service, education funding, University autonomy and academic freedom. This agreement also prescribed a gradual increase in education funding and the establishment, by all Universities governing council, a budget monitoring committee involving elected representatives of students and staff unions to monitor how the University authorities spend government allocations.
However, a recent communiqué of the meeting of the National Executive Council (NEC) of the Academic Staff Union of Nigerian Universities (ASUU), published in one of the national dallies last month reveal that neither the Federal government nor any state government has fully implemented the agreement. Actually, the Federal government and some state governments only implemented the salary component of the agreement which includes a 53.37 percent pay rise. In reality, none has implemented other components of the agreement like improved funding, university autonomy and academic freedom.
Speaking recently to newsmen, Ukachukwu Awuzie, President ASUU, decried the crisis that has enveloped the nation’s university system which has often led to countless industrial action by the body. Citing a case of Anambra State University, Awuzie noted that there were only five professors, four of which belong to the faculty of science, 20 senior lecturers and 29 lecturers for a student population of about 21,000.
"The above scenario should be situated within the context of the loud cry by all and sundry for improved quality in our universities to make them competitive in the world intellectual market and to raise their ranking. With the above picture, is it not deceitful and wishful thinking to expect the lecturers in these universities to produce world-class graduates? From the above, we have universities with over 21,000 students having fewer than 700 academic staff whereas Harvard University in Boston, that is rated the best in the world, has 11,000 professors for a student population of about 18,000. It is obvious that the political class in the South East has collectively failed their people,” Awuzie stated.
While regretting this anormaly, the ASUU boss hinted that the state of underfunding of the university, has led to the university receiving a mere sum of N50million, barely 50 per cent of the current outdated monthly salary bill while it needs about N180million to pay salaries monthly.
According to the United Nations Development Programme (UNDPP), in its Human Development Index reports of 2005, “Due to poor funding of education, education at all levels suffers from low academic standards; lacks requisite teachers; both in sufficient quantity and quality. Even the few qualified teachers available are no sufficiently motivated in terms of remuneration/ conducive operating environment to maximise their output into the education system. Schools are over-populated and classrooms are over-crowded, facilities are inadequate and over-stressed, library shelves are empty and covered with cobwebs, while laboratories lack up-to-date equipment.”
Current statistics suggest that no Nigerian University can be found among the first 500 in the world and the first 50 in Africa. While the Committee of Directors of Academic Planning of Nigerian Universities (CODAPNU) in a communiqué issued at the end of their 2010 CODAPNU workshop and annual general meeting held at the University of Ilorin, October 24 and 28, 2010, called for the state governors to address this issue as soon as possible so that the affected undergraduates can return to school, they recommended that academic programme curricula review should be broad-based, incorporating inputs from industries and other major stake holders. There are of the view that the review should also be regular, need-based and responsive to development aspirations of the society.
“The academic planning units of our universities should rise up to the challenge of providing direction in the implementation strategy of multi-institutional approach to curricula development, research administration and management of quality instructional service delivery,” it advised. Above all, only an adequately funded public education sector that is placed under public democratic control and management can guarantee improved working conditions and wage for education workers.
BY Alexander Chiejina
With the paralysis of academic activities in universities by ASUU over issues relating to proper funding and infrastructural facilities in the nation’s ivory towers, Alexander Chiejina writes that only an adequately funded public education sector can guarantee improved working conditions for education workers.
For Damian Okonkwo, a two-hundred level student in the Department of Industrial Physics, Imo State University, (IMSU), his plans on completing his academic pursuit next year seem to have suffered a big blow, following the paralysis of academic activities in universities as a result of the strike action embarked upon by the Academic Staff Union of Universities (ASUU).
Since finishing his first semester exams in August this year, he had no option than to come back to Lagos, where his parents stay in a bid to see what menial jobs he could do pending when the strike by ASUU is called off.
The same experience can be said of Merit Harrison, a third year law student at Anambra State University, who disclosed to BusinessDay that she has resulted to staying at home since she didn’t have any qualification which would earn her a job at the moment. Harrison revealed that her parents are worried because her younger brother who gained admission to study Medicine at Abia State University, ABSU was affected.
No doubt, the strike embarked upon by ASUU across Universities owned by the State governments since July 2, 2010, generated headlines in print and electronic media across the country. At the last count, more than 10 Universities were on strike action. They are Abia State University (ABSU), Anambra State University, Ebonyi State University, Enugu State University of Technology (ESUT), Imo State University (IMSU), Rivers State University, Rivers State University of Education, Lagos State University (LASU), Cross River University of Technology (CRUTECH), Olabisi Onabanjo University (OOU) and the Tai Solarin University of Education (TASUED).
In Lagos, even education workers' unions of State-owned institutions like the Lagos State Polytechnic (LASPOTECH), Michael Otedola College of Education (MOCPED) and Adeniran Ogunsanya College of Education (AOCOED) have joined the strike action. Meanwhile, all Universities in the five states (Anambra, Abia, Ebonyi, Enugu and Imo States) of the South east have been on strike since August 2010.
Their grouse has been attributed to the refusal of the state governments to fully implement agreement signed between the Federal government and the Staff Unions last year after a 4-month nationwide strike action that paralysed activities in the nation’s ivory towers.
The Federal government had signed agreement covering improved condition of service, education funding, University autonomy and academic freedom. This agreement also prescribed a gradual increase in education funding and the establishment, by all Universities governing council, a budget monitoring committee involving elected representatives of students and staff unions to monitor how the University authorities spend government allocations.
However, a recent communiqué of the meeting of the National Executive Council (NEC) of the Academic Staff Union of Nigerian Universities (ASUU), published in one of the national dallies last month reveal that neither the Federal government nor any state government has fully implemented the agreement. Actually, the Federal government and some state governments only implemented the salary component of the agreement which includes a 53.37 percent pay rise. In reality, none has implemented other components of the agreement like improved funding, university autonomy and academic freedom.
Speaking recently to newsmen, Ukachukwu Awuzie, President ASUU, decried the crisis that has enveloped the nation’s university system which has often led to countless industrial action by the body. Citing a case of Anambra State University, Awuzie noted that there were only five professors, four of which belong to the faculty of science, 20 senior lecturers and 29 lecturers for a student population of about 21,000.
"The above scenario should be situated within the context of the loud cry by all and sundry for improved quality in our universities to make them competitive in the world intellectual market and to raise their ranking. With the above picture, is it not deceitful and wishful thinking to expect the lecturers in these universities to produce world-class graduates? From the above, we have universities with over 21,000 students having fewer than 700 academic staff whereas Harvard University in Boston, that is rated the best in the world, has 11,000 professors for a student population of about 18,000. It is obvious that the political class in the South East has collectively failed their people,” Awuzie stated.
While regretting this anormaly, the ASUU boss hinted that the state of underfunding of the university, has led to the university receiving a mere sum of N50million, barely 50 per cent of the current outdated monthly salary bill while it needs about N180million to pay salaries monthly.
According to the United Nations Development Programme (UNDPP), in its Human Development Index reports of 2005, “Due to poor funding of education, education at all levels suffers from low academic standards; lacks requisite teachers; both in sufficient quantity and quality. Even the few qualified teachers available are no sufficiently motivated in terms of remuneration/ conducive operating environment to maximise their output into the education system. Schools are over-populated and classrooms are over-crowded, facilities are inadequate and over-stressed, library shelves are empty and covered with cobwebs, while laboratories lack up-to-date equipment.”
Current statistics suggest that no Nigerian University can be found among the first 500 in the world and the first 50 in Africa. While the Committee of Directors of Academic Planning of Nigerian Universities (CODAPNU) in a communiqué issued at the end of their 2010 CODAPNU workshop and annual general meeting held at the University of Ilorin, October 24 and 28, 2010, called for the state governors to address this issue as soon as possible so that the affected undergraduates can return to school, they recommended that academic programme curricula review should be broad-based, incorporating inputs from industries and other major stake holders. There are of the view that the review should also be regular, need-based and responsive to development aspirations of the society.
“The academic planning units of our universities should rise up to the challenge of providing direction in the implementation strategy of multi-institutional approach to curricula development, research administration and management of quality instructional service delivery,” it advised. Above all, only an adequately funded public education sector that is placed under public democratic control and management can guarantee improved working conditions and wage for education workers.
BY Alexander Chiejina
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