The poor state of healthcare in Nigeria can be attributed to a host of reasons, chief among these reasons is the lack of adequate funding in the sector. This issue brief looks at some funds that can be redirected towards funding healthcare in Nigeria.
Issue-Brief | Abiona Adekunle
Just recently, the National Association of Resident Doctors went on an indefinite strike to protest poor working conditions and pay - leaving hundreds of patients stranded. While resident doctors went on strike in Nigeria, President Muhammadu Buhari travelled to the United Kingdom to get the best medical care.
The state of healthcare in Africa’s most populous nation is nothing to write home about as the sector is plagued with multifarious issues. Chief amongst these problems is the fact that the health sector is underfunded. Against the backdrop of the pandemic year, one would have thought that the Nigerian Government learnt a thing or two but sadly the total allocation to the health ministry (including statutory allocations) for 2021 was just 4.4% of Nigeria's annual budget. This figure is 4% less than the 2020 allocation and also lower than the last 5-year average of 5%. This is contrary to the Abuja Declaration which called for the allocation of a minimum of 15% of the national budget to health.
For a country that was once the standard of the black race in the country, Nigeria’s fall from grace is mirrored perfectly by the health sector. A once-booming industry, so glorified that even it had Saudi Royalty reportedly visit for medical check-ups, the present situation of Nigeria’s health sector is rather pitiful. A 2018 study in the Lancet of global health care access and quality ranked Nigeria 142 out of 195 countries.
The health sector as with every other industry in every country needs adequate funding to survive and indeed thrive. What happens when such an important sector is not adequately funded is the obvious reality of present-day Nigeria. A reality that sees medical personnel leave the country in their droves and sees thousands of citizens (including the President) seek health solutions in other countries. Fortunately, this reality can be remedied by strategically distributing resources and funds into the sector. In a country like Nigeria where the misappropriation of funds is the order of the day, the ideal distribution of resources will go a long way in improving the health sector.
Some Revenue that can be channelled into healthcare
Healthcare can be appropriately funded in Nigeria if resources in the country are redistributed adequately. Some of the areas where funds need to be re-distributed to allow for adequacy will be discussed below.
The COVID 19 pandemic exposed the frailties of Nigeria’s healthcare system to the extent that there was a mass shortage of oxygen and bed at various hospitals at isolation centres.
Cutting unnecessary tax incentives
Nigeria is losing a lot of money from multiple poorly administered tax incentives system, which reduces our capacity to fund critical infrastructure like health care. Studies confirm that tax incentives have more negative than positive impact on sustainable development in developing countries. It is counterintuitive to expect an increase in revenue by granting tax waivers that hamper our revenue base. In 2016, a report revealed that $US3.3bn were given as incentives to IOC’s through generous tax breaks. Eliminating or streamlining a number of these incentives granted to corporations doing business in Nigeria could help reserve funds for investing in healthcare.
Reducing legislative Spending
In Nigeria, a legislator’s hazard allowance is pegged at a whopping 1.2 million naira while that of a medical practitioner at a paltry 5,000 naira. It has been reported that Nigerian federal legislators are the second-highest paid in the world with each senator earning around $597,000 per year. This results in a total of ₦20 billion ($65 million) per year and ₦79 billion ($260 million) at the end of each legislative tenure. For a country that is regarded as the poverty capital of the world, this is wasteful spending. It is therefore ironic that it still runs an extremely expensive legislative body.
The legislative arm of the country has been constantly accused of being insensitive, and for good reason, the body consistently receives way more resources than it should. Funds that otherwise could be utilised in improving the country, and particularly the health sector. The harrowing contrast of the legislature and the dying health system is seen in the remuneration between both. This and more are also many more areas where funds are misused. Thus, a redistribution of funds from the expensive legislative arm will also help in whatever way possible to improve healthcare, and healthcare funding in the country.
Since the turn of the century, and indeed, the 4th republic, different administrations have worked to recover funds carted away to foreign countries by past leaders. Nigeria has recovered a total of $3.6 billion stolen by the former Head of State, General Sani Abacha from 1998 to 2020. However, there is no public information on how the government utilised the recovered funds. That said, a proposal of pumping a fraction of these recovered funds into the health sector is advised
Blocking revenue leakages in our Ports
In March, it was reported that Nigeria loses about N800 billion monthly due to a lack of 24-hour seaport operation. Additional revenue is also lost to the bad roads leading to the seaports in Lagos. Despite efforts to fix this situation, it has continued to exist therefore leading to a loss of revenue which could be channelled into other areas of the sector for growth. For instance, if the government and the port operators could get this right, such funds could be channelled into purchasing necessary equipment into hospitals nationwide or even paying salaries for medical personnel.
Nigeria must take steps to prevent an already impending crisis in its health sector. The COVID 19 pandemic exposed the frailties of Nigeria’s healthcare system to the extent that there was a mass shortage of oxygen and bed at various hospitals at isolation centres. One would have expected that the government will take immediate steps to improve the sector but so far nothing appears to have been to fix this. The remuneration of healthcare workers must be addressed immediately to ensure the well being and welfare of our medical personnel.
Abiona Adekunle | Research Assistant, Governance and Institutions | firstname.lastname@example.org
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