How we plan to stop Nigerians from foreign medical tripsThe nation’s Health Minister, Prof Onyebuchi Chukwu, has many worries. One of the tasks before him is how to stop the outflow of foreign exchange in the name of medical trips abroad. He says in this interview with EMMA UJAH that some Nigerians, including public officers, travel abroad for treatments for which Nigeria has expertise and technology to effectively handle and that such waste must stop. Excerpts:
What was your first challenge upon assuming office as Minister of Health?
From time to time, I have been looking at issues regarding the Nigerian health sector. The first thing that I understood about the Nigerian health sector is that certainly, the minister, the minister of state and indeed the Federal Ministry of Health cannot do it alone because health is supposed to be on the concurrent list. I said it is supposed to be because under the current constitution, it’s not mentioned there at all.
It’s neither on the concurrent list nor the exclusive list. So, that tells you how we appreciate health matters in this country. But going by the 1979 constitution, it was clearly on the concurrent list. So what it means is that the Honourable Minister of Health alone cannot pretend to be responsible for the healthcare of Nigerians. He has to be sure that various local governments and commissioners of health, work with him. This means that he has to work very hard to get the cooperation of all stakeholders.
There is a body called the National Council on Health, which meets once or twice in a year. But it is a consensus, advocacy and collaborative body and not just one where only the minister forces his instructions on the members.
What is the issue at the federal level? In the health sector, it is the responsibility of the federal government to ensure that epidemics are prevented, managed and taken care of. That is the only area that is the exclusive responsibility of the government when it comes to public health and epidemics.
How then are you collaborating with the two tiers of government to provide for efficient health services for Nigerians?
We operate from three levels: primary, secondary and tertiary. The federal government concerns itself only on the tertiary. What it does in the primary health care is to show the way for other tiers of government to follow. So, it is an instigator, a catalyst and promoter of primary health to ensure that it remains the bedrock of healthcare in the country.
We operate from three levels: primary, secondary and tertiary. The federal government concerns itself only on the tertiary. What it does in the primary health care is to show the way for other tiers of government to follow. So, it is an instigator, a catalyst and promoter of primary health to ensure that it remains the bedrock of healthcare in the country.
We have five priority areas in the health sector. The first is leadership, followed by governance and stewardship.
The second priority has to do with meeting the Millennium Development Goals, MDGs. The third priority is disease prevention, surveillance and control, by the federal government. The fourth one, given the background of what we met on ground where people were not working together in the health sector, especially the heads, professionals and groups working differently without harmony. It was clear that team work was the major mandate which Mr. President has given to the Minister of Health.
Finally, why do Nigerians still have to go outside the country to access health care and sometimes even what you may regard as ordinary healthcare? So, those are the five priorities which the government wants to tackle in the health sector.
One major health challenge in Nigeria is malaria. What are you doing in this regard?
Malaria remains an endemic in Nigeria. Malaria is being fought with what we called integrated vector management, which is what we all agreed under the World Health Organisation, WHO. We are integrating this by ensuring that all pregnant women must take preventive drugs to assist them maintain malaria free period. We are saying that they need to sleep under the net just like the children and other people who are vulnerable to malaria. These nets must not be ordinary ones.
Malaria remains an endemic in Nigeria. Malaria is being fought with what we called integrated vector management, which is what we all agreed under the World Health Organisation, WHO. We are integrating this by ensuring that all pregnant women must take preventive drugs to assist them maintain malaria free period. We are saying that they need to sleep under the net just like the children and other people who are vulnerable to malaria. These nets must not be ordinary ones.
Then Nigeria did what no country has ever done in the world by distributing almost 15 million nets from 2009 to date. Our target as at the end of 2010 was to distribute 63 million nets and we will get to that figure this year, but the population has increased and we need to do more than that. Everybody acknowledged that we have improved even though we can still do better.
Those nets are treated ones being distributed free, but people can buy them from shops. We distribute free to people who are vulnerable to malaria and can protect them for up to two years. We also do the indoor residual spraying, which we have been doing and it is still going on, but we have only been able to cover about 80 per cent of households. The spraying protects for about three months after which one needs to repeat it.
Is there the possibility of mankind having a vaccine for malaria?
It is difficult but not impossible. A few months ago I was specially invited by think-thank groups in the UK to lead a discussion at a forum. It was a two-day meeting where the strategies for fighting malaria were to be discussed. And also the vaccine candidate that has the greatest promise. We call them vaccine candidates because they have not been proved to have universal protection against malaria.
The best of all of them is the RTSS which is being produced by GSK. Preliminary trial shows that it can reduce the number of episodes of malaria when someone has been vaccinated with that particular one by 50 per cent.
So if you used to suffer about six episodes of malaria a year, it reduces it to three. It still has not been zero. We came to discuss the development. It is most promising. It is not easy to produce vaccines because of the nature of the genetic make-up of the parasite.
There is hope now and the target is that by 2020 more work would be done by GSK. Now it can help us to reduce child mortality. We discussed the modalities for introducing the vaccine to tell people that it cannot protect for ever but it can reduce malaria.
Another one is tuberculosis, TB. It also remains a problem in Nigeria, but what has made it worrisome is the fact that we have more drugs resistance in the country.
Unfortunately, the facilities for treating them are just being developed. During the TB Day on March 24, this year, we went to Lagos to open a new facility, which is a joint effort of the federal government, Lagos State government, WHO and the United States which has been committing a lot of funds to TB control by establishing the facility in addition to what we already have. Presently we have centres in Ibadan, Calabar and before the end of this year; the one in Zaria will be opened. And hopefully, that of Kano will also come on stream as we have started developing them.
This year, the federal government will buy the second line drugs to treat the multi-resistance TB. What we have been doing is team work; we have set up a Presidential Committee on Harmonious Relationship among professionals in the health sector.
It took the committee almost a year to submit its report, but we have reviewed it at the ministry and would soon be taken to the Federal Executive Council, but most of their recommendations have been accepted by the ministry.
Again, the present administration has cleared all the arrears of salaries of health workers in the federal government service. This is a major achievement in the area of staff welfare in the country, though there was a problem when the administration came on board, we have been able to pay all the arrears, so we do not owe workers. For sometime now, the federal health workers have not been on strike, but at a time, it was like an everyday show. We are into months now without having any strike by the health workers at the federal level. We hold meetings with them regularly where we interact and discovered that team work is better for all.
Then still on the issue of disease control and surveillance, we are doing well. WHO says Nigeria is one of the best countries that are doing well in terms of integrated disease surveillance. But we want to do it better; we have a system that is working though not up to our standard as Nigerians. This present administration of President Goodluck Jonathan, for the first time in the country established the Nigerian Centre for Diseases Control with a director, Professor Ola Sidi in charge.
We are also working with the United States which has the original centre for disease control to further develop it.
Also, we have been able to introduce new vaccines for meningitis that can last for 10 years instead of the usual two years, but the introduction to cover the whole country is in phases.
