Could the coronavirus catalyse healthcare funding in Nigeria?
The world is no stranger to negative shocks. The last financial crisis and the Ebola outbreak - two separate low points- are still in memory. Today's coronavirus situation is different. Countries face a double whammy: first, the immediate health implications and second, a steep drop in consumption together with a halt in production as lockdown measures come into place.
Policymakers have tried to salvage this situation either by converting ships into hospitals or sending money and other basic provisions to those in need. But there is no denying that the combined health and economic risk that the coronavirus poses sets it apart from recent crises the world has seen. The efforts are commendable, but why does it always take a crisis before governments pay better attention to crucial sectors like healthcare?
With neglect comes regret
Save for a few exceptions, healthcare systems around the world are characterised with underfunding and lack of prioritisation by governments. In the United Kingdom, the NHS, one of the world's best, has been a victim of austerity. And despite Obama's efforts, the United States failed to develop a system that provided affordable healthcare to its people.
Nigeria is no different. For years, our government has been criticised for the dearth of investment directed at the healthcare industry. We have seen heads of states fly out to receive medical treatment because they had more trust in doctors abroad. Now, everyone is dealing with the same task of stopping Covid-19 from overwhelming healthcare systems.
It's going to be a challenge for Nigeria who has consistently spent less than 5% of its budget on healthcare - equivalent to ₦2,000 per person annually. Estimates show that Nigeria has around 0.5 hospital beds for every 1000 people. South Africa has six times more, and Rwanda, which is close to achieving universal healthcare, has three times Nigeria's figure.
The most expendable foregone
So why did Nigerian governments behave this way?
Funding has always been the issue. Which, to an extent, is not a terrible excuse. Basic economics involves making a choice with limited resources and governments tend to have a lot of choices to make. They still have to fund other important sectors such as education, housing, and security.
What Nigeria hasn't done well is to spend its money wisely - we spent ₦2.4 trillion on petrol and electricity subsidies between 2015 and 2018. Further, the government itself is not prudent in the way it functions. Fancy cars, chunky salaries, and annual expenses such as ₦400 million for newspapers is a high price to pay for a government that doesn't provide adequate social services.
Meanwhile, the same healthcare professionals on the frontline of this crisis have experienced seven months without pay. Despite tumbling revenues, the government has found ways to pump money into healthcare.
The government recently announced a ₦500 billion coronavirus fund, which will come from some multilateral organisation borrowing and "special accounts." Funding programmes to contribute towards setting up labs testing centres have also been announced, and cash transfer schemes have kicked off. The government has also engaged with the private sector to set up intensive care units and other tools required by the healthcare industry.
Unfortunately, people were already dying and in desperate need before Covid-19 hit our shores but the required response was missing in action.
Because we didn't build the appropriate systems for dealing with a crisis, we find ourselves in a situation where we have inadequate medical equipment and are desperately attempting to feed people with bags of wheat. Whereas, citizens in other countries can call on already established systems like unemployment benefits in South Africa, for example.
Vision 20/20
They say hindsight is 2020, so we should hope this serves as a good lesson on the vital relationship between health and the economy. No one knows for sure when the virus will start to loosen its grip on the world, but that shouldn't stop us from looking forward. And as we do so, two questions come to mind: will these cash transfers and healthcare funding efforts be a flash in the pan aimed only at curbing the coronavirus epidemic? Or will this serve as a catalyst to the government to build a reliable welfare system that caters to its large and growing population? I hope it is the latter.
This way, the next time an outbreak happens, we will have more to show our support for our healthcare professionals. Further, policymakers will be less overwhelmed with the precarious task of saving lives while minimising economic damage in a country where people have always lived on less than a dollar a day.
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