Yet, Lagos state is generally credited with the best ‘response’ to Covid-19 containment thus far

There is a medical emergency in Nigeria, but it is not Covid-19.  For many years now, the poor majority have been suffering a major health disaster. In 2018 the World Health Organisation (WHO) estimated that there were perhaps 20,000 deaths each week in Nigeria which could have been avoided if the necessary medical care had been provided.  These included the following estimated weekly deaths:

  • Lower respiratory infections – 5,500
  • Neonatal conditions – 4,000
  • Diarrhoeal diseases – 3,000
  • Tuberculosis – 2,000
  • Malaria – 2,000
  • Maternal conditions - 1,000[i].

The rich and powerful do not care as they can avoid these diseases.  They are frightened of Covid-19 as it has killed some of them.  We are suffering lockdowns to protect the rich.

In comparison, the latest estimates from the WHO are that, for the worst case scenario, not many more than 500 Nigerians may die from Covid-19 on average each week over the next year (this is over 7 times the reported level over the last week of 70).  Total reported Covid-19 deaths since mid-March is 549 compared to nearly 30,000 for malaria – and we know how to treat malaria.

Nigeria is the poverty capital of the world. But the result of the extremely low health spending by governments is that 80% of spending on health comes from peoples’ own pockets who are too poor to pay for proper health care for their families.  Is it any surprise that a quarter of global deaths from malaria occur in Nigeria, that maternal and under-five deaths are amongst the highest in the world or that this country was one of the last to eradicate polio?

The public health services are so bad in Nigeria that the resident doctors were forced to strike for a week earlier in June.  They were striking for proper protective equipment, against not being paid their full salaries, hazard pay and failure to implement previous agreements.  They were right to strike to protect our health services – let’s just hope that the government will keep to their agreement this time.  ASCAB stands in solidarity with all healthworkers.

The Government should immediately double the Federal budget for health (and education and water/sanitation) – with similar increases at state and local government  levels.  We need to double the recurrent health budget to employ more doctors and nurses (half may be unemployed or paid less in the private sector) and pay for tests and medicines. Building hospitals takes too long and still excludes the poor if charging for basic tests and medicines continues.  Doubling the health budget would still mean that Nigeria spends significantly less than the average for sub-Saharan African governments.

Since the end of military rule governments have accepted the Neoliberal (US) approach of health insurance rather than universal health care provision as, for example, in Britain.  The National Health Insurance Scheme (NHIS) was established in 1999, but still only covers around one in 10 of the population.  International experience shows that this is an inefficient approach that fails to provide cover for all citizens.  The US spends twice as much of its GDP on health care than Britain to achieve the same average results.  In the US this average hides great variations especially for the 15% that are not covered by health insurance[ii].

In the country where at least 40% of the population are poor, the economic hurdle of access to decent healthcare must be addressed. Ensuring that all primary healthcare, tests and medicines are provided free at the point of use would appear to be an obvious initiative. As well as the huge immediate health benefits, this would also reduce corruption and revenue leakages which are an inevitable effect of charging for public services.  It also provides an efficient way to provide direct economic support to the poor.

[i] World Health Organization, Department of Information, Evidence and Research

(April 2018) Estimated deaths by cause, sex and WHO Member State, 2016


[ii] https://www.healthcareadministration.com/brief-comparison-uk-healthcare-system-vs-u-s-healthcare-system/