•Charges political elite to learn from India’s healthcare success

By Sola Ogundipe

Renowned Professor of Pediatrics, and former Minister of Health, Professor Adenike Grange, has lamented the gradual erosion of access to quality and affordable healthcare in the country.

She has charged Nigerian political leaders who often seek medical treatment abroad while restricting the emigration of highly-skilled medical professionals, to learn from low/middle income countries like India that have successfully reversed the outward migration of their professionals.

Grange, who was one time President of the World Pediatric Association, and is currently Chairman of the Board of Trustees of  the Nigeria Universal Healthcare Advocacy Network (NUHCAN), stressed the importance of creating an enabling environment for healthcare professionals in Nigeria, including improvements in infrastructure, security, and the overall economic landscape.

Speaking during the NUC Day Webinar organized by NUHCAN, themed “Health as the Responsibility of Government”, she argued that the development of a robust healthcare system requires a multi-pronged approach, encompassing factors such as stable power supply, reliable internet connectivity, safe transportation, and a conducive legal and security framework.

Stressing that indeed the health of all Nigerian citizens is the responsibility of government, Grange said the right to healthcare is articulated in The Nigerian Constitution, Chapter II, Section 17.

The Nigerian Health Act, 2014, and one of its components the Basic Health Care Provision Fund Act (BHCPF) are two important specific legislative derivations of these provisions.

“The lack of justiciability of these constitutional provisions impacts the ability of citizens to assert and protect their rights, thus affecting the effectiveness of the legal framework in promoting justice and equity.

“Unfortunately, over the past five decades of my practice in Nigeria, I have witnessed the gradual erosion of the process to make possible the right of access to quality and affordable health care to the point where it is guaranteed only to political leaders who no longer patronise the healthcare system in Nigeria but they waste no time in jetting abroad to patronise the system that is partially serviced by highly qualified Nigerian doctors and nurses.

“Nigeria’s political leaders’ response to this ‘Japa’ syndrome is to deny these well-trained professionals from leaving Nigeria in search of merit-based positions abroad. How about providing the enabling environment here in Nigeria?

“Our leaders must learn from low/middle income countries that have successfully reversed the outward migration of their professionals. India is a case in point. They should consider other options that will create a win-win situation for all Nigerians.

“How about providing a sustainable enabling environment for the trained health human resource in Nigeria? Our political leaders and public officers must learn how to do this from the experiences of other low-middle income countries that have successfully reversed the outward migration of their health professionals.

Using India as a case point, she said over the past three decades India had developed its healthcare system from a grossly underperforming one to one that has now earned its recognition globally as a reliable destination for Medical Tourism.

“As essential components of health care development are the development of the basic infrastructures including sustained power supply, internet connectivity, safe transportation, legal frameworks for ensuring safety and peaceful resolution of conflicts, security and freedom of movement, food security, stability in the prices and quality of drugs and other commodities, Grange asserted.

According to Grange, the erstwhile Vice President, Professor Yemi Osibajo deserved commendation for entrusting his care to the Nigerian healthcare system during an alleged health problem which required a major surgical intervention.

“Unfortunately, his acclamation of the excellent care he received from a private hospital in Nigeria went unnoticed by the political elites. In recognition of the potential enhancement of the development of public-private partnerships especially for tertiary health care, Government should introduce attractive incentives for qualified practitioners, usually from the Diaspora, who would like to invest in setting up this type of resource-intensive health care delivery system.

“As one of the many surviving elderly Nigerian healthcare professionals, I would like to bring forward one glaring fact. That is, many of today’s Nigerian politicians were saved from perishing in their mothers’ wombs and during childhood through the hard work and expert interventions of several generations of dedicated Nigerian doctors, nurses and other healthcare professionals.

“How did they do it? Being one of them I can testify to the better character of politicians and senior administrators of those days. There was equity in remuneration for work done. Both the professionals and the political leaders rode in the same type of vehicle- for example, the Peugeot 404. There was mutual understanding and respect among healthcare professionals, administrators and politicians.

“Nowadays, the total remuneration of a legislator is at least five times that of a Professor of Medicine and Chief Consultant who is responsible for the expert medical care of patients. This makes legislators feel superior and they are constantly striving to attain the highest level of wealth accumulation effortlessly to the diminution of the remunerative power of other hardworking citizens whom they are supposed to represent in Congress.”

Recalling that In the 70’s and 80’s, there was empathy for the patients, Grance said the Heads of State attended conferences to listen to and act on recommendations for improving the healthcare delivery services.

“It was because of our collective advocacy effort that General Ibrahim Babangida head hunted in 1985 my mentor, late Professor Olikoye Ransome-Kuti, a doyen of Paediatrics for the post of the Minister of Health; he has since been recognised as the most impactful Minister of Health in Nigeria. Subsequently, I was also humbly privileged to have been head hunted by President Umaru Yar’Adua in 2007 to serve as his Minister of Health.

“During his tenure, he was unfortunately unable to control his administration to drive the process of transformation effectively due to his ill health which tragically had a fatal ending. As a result of this, my effort to continue with the transformative process begun by my predecessors was brought to an untimely and unfulfilled end. The Heads of States of those days who are still alive today can testify to this narrative.

“We, the survivors of that period have been kept alive by the Grace of God for a purpose and that purpose must be fulfilled to His Glory. Nigeria was great then. We know what to do if we really want Nigeria to become great again and to retain its meritorious human capital within its shores. There are documents, policies and programmes galore in every government and academic institution to guide us and now we have digital support which has facilitated the retrieval and sharing of knowledge.

“ What is required is the humility to recognise, collaborate and coordinate all valuable contributions of the past as well as the present to build the platform on which to remodel the prospects for enhanced and sustainable improvement in the future. Let us not waste any more time and money in retracing our steps from this precipice that would most likely lead us to total disintegration and destruction. The time to have begun our transformation back to our lost glory was yesterday but it is never too late to start.”

“My passion to witness during my lifetime a healthcare delivery system that can guarantee Universal Health Care (UHC) for the entire population remains unshaken. I know that this passion is shared by the active members of NUHCAN.

“This is the reason why we are at this Webinar- to take stock of our progress so far with a view to consolidating on notable areas of improvement and BRIDGING THE GAPS WHEREVER NEEDED. It is only in this way that we can remain motivated and keep hope alive for the future of our generations yet unborn!”