World Bank, WHO ask Nigeria to curb graft
From Okumephuna Chukwunwike,
Abuja
AFTER a thorough diagnosis of Nigeria's health problems, some senior officials of the World Bank and the World Health Organisation (WHO), at the weekend offered only one prescription: Tackle corruption.
The advice was the summary of a three-day conference organised by both global bodies, hosted by Nigeria last week in Abuja. It was tagged: "High level forum on the Health Related Aspects of the Millennium Development Goals".
At the conference were world leaders in health and development, ministers of health and finance, and donors as well as senior officials of the global development community and charity organisations, such as the Bill and Melinda Gates Foundation.
The participants were unanimous: Nigeria is set to miss its millennium health target if it fails to frontally tackle corruption.
The Senior Vice President of the World Bank, Dr. Jean-Louis Sarbib, identified corruption as the major impediment to the development of health care in Nigeria.
"Let us call it by its name. Corruption is the reason Nigerian health care has remained dormant despite all efforts being made to put it in good shape." He added: "I know what am talking about and I have facts to buttress my point having worked as an expert for the World Bank on Africa before my present position".
Sarbib regretted that for too long, Nigeria had been denied access to foreign benefits as a result of corruption. He however expressed happiness that facts on the ground reveal "that the present Minister of Health is committed to giving a new face to health care in Nigeria."
Dr. Kirsten Leitner, an Assistant Director-General in charge of Sustainable Development and Health Environment at the WHO while commending the nation's present efforts called for transparency in all aspects of health care and "especially transparency in financial management of the resources."
She added: "Transparency, transparency, and I say it again transparency, is the word. It will definitely change the look of health care in Nigeria if it is taken seriously."
Briefing the media at the weekend after the meeting, the Health Minister, Prof. Eyitayo Lambo said that Nigeria had the potential to meet most of the goals before 2015.
He added, however: "If one puts also in consideration the level of corruption in the nation, especially at the local council level, one will obviously be in doubt if we are really going to meet the goals."
Lambo decried a situation where local councils employ more staff than required simply on political considerations and ethno-tribal affiliations "most of such employees," he noted, "are incompetent" and consume the limited resources meant for the Primary Health Care Development for salaries.
Lambo said: "This is not supposed to be. What the WHO said is that at least 60 per cent of health expenses should be for the provision of the health care and about 40 per cent or even less for the payment of manpower. But here in Nigeria the reverse is the case and this is very dangerous for a nation like ours."
He said that his administration is committed to giving Nigerians good health as a democracy dividend, adding that primary education would soon cease to be the responsibility of the local councils.
"This is to enable them concentrate more on the provision of Primary Health Care at the grassroots level as a step in ensuring that we meet at least a good percentage of the Health Related Aspects of the Millennium Development Goals," he said.
Lambo lamented the level of decay of Primary Health Care facilities at the local council level and attributed it to lack of commitment on the part of those at that level and also to the fact that health care in Nigeria has not been ascribed legally to any tier of the government in the federation.
"People used to think that health is in the concurrent list of the federation, but it is not true. In fact, the constitution is not specific on which work each level of government will play in the provision of health care. The work each of them is doing now is derived from the dictates of the National Health Policy but the good news is that very soon the National Health Act will wear a new look," he said.
He said that Nigeria, with about one-fifth of the population of sub-Saharan Africa, has unacceptable human development indicators in Africa.
"The 2003 Nigerian Demographic and Health Survey (NDHS), which provides data to track progress towards the country's attainment of health Millennium Development Goals, shows the following: Very low immunisation coverage, high infant/child and maternal mortality rates, high prevalence of malaria and about 10 per cent reduction in Human Immunodeficiency Virus (HIV) prevalence rate but with over three million people infected. These poor health indicators have been due largely to the weak national health system, which the current comprehensive health sector reform, is trying to address," he said.
"In addition to the need for increased additional funding, if we must accelerate the achievement of targets, some governance and management issues are also important variables in our success factors. For example, just moving the purchase of vaccines and other essential commodities and supplies from capital to recurrent expenditure alone will improve accessibility and availability of immunisation and hence, coverage by as much as 10 per cent. This is just with current level of funding alone," Lambo said.
In September 2000, 189 world leaders made a commitment to achieve the Millennium Development Goals by 2015. Three of the eight goals relate directly to health: To reduce maternal mortality by three-quarters, child morality by two-thirds and combat HIV/AIDS, malaria and other diseases.
Health is also an essential component of three further targets: to halve the proportion of people who suffer from hunger, improve access to safe drinking water and sanitation and ensure affordable, safe access to essential drugs.
The high level forum comes in advance of 2005, the "report card year,' when heads of state will meet to review progress at the forth-coming Millennium +5 Summit in September 2005.`
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