NMA To FG: 5% Budgetary Allocation For Healthcare Still Low

By Bukola Kayode

The Nigerian Medical Association (NMA) has called on the Federal Government to ensure transparency and accountability in the management of funds allocated for healthcare delivery.

The association in a communique issued at the end of its National Executive Council Meeting held in Abuja between 10-17 December, said with the evidently low five percent allocated to health in the national budget, it is has become even more important that all monies set aside for the sector is well used and not mismanaged.  

This year’s conference had as its theme: “Achieving Universal Health Coverage in a Depressed Economy”.

Also in the communique signed by the association’s National President, Dr. Uche R. Ojinmah and its Secretary General, Dr. Jide Onyekwelu, the association highlighted challenges slowing down the country’s push for Universal Health Coverage and other lingering problems in the health sector which have led to poor outcomes.

Among other solutions, NMA advised government to provide an enabling working environment for doctors and other health workers, reduce out-of- pocket expenditure for health services and invest in making life better for citizens. The doctors also called on the Federal Government to ensure that the 1% allocation for healthcare from the consolidated revenue fund is well managed.  

Beyond the health sector, the association decried the high cost of living and the increase the number of people descending into poverty, owing to the economic crisis. They called for action from government to ameliorate the suffering of the people and improve the country’s economic indices.

The doctors also commiserated with the people of Tudun Biri, Kaduna State government and the Federal Government over the accidental bombing of civilians by the Nigerian Army.  

“While praying for the peaceful repose of the dead and quick recovery of the injured. We commend the Nigerian military for accepting responsibility and call on the military to refine the sensitivity of its intelligence so as to avoid a recurrence. NEC calls on our dear Federal Government to quickly compensate the victims”, the communique read in part.

Read full communique bellow:  

COMMUNIQUE ISSUED AT THE END OF THE DECEMBER 2023 NATIONAL EXECUTIVE COUNCIL (NEC) MEETING OF THE NIGERIAN MEDICAL ASSOCIATION (NMA) HELD AT THE WACP CONFERENCE CENTRE AND SUITES, GADUWA, ABUJA, NIGERIA, FROM 10THTO 17 THDECEMBER, 2023.

PREAMBLE

The National Executive Council meeting of the Nigerian Medical Association (NMA) was held at the WACP Conference Centre and Suites, Abuja, Nigeria between 10^th and 17^th December, 2023. The theme of the conference was “Achieving Universal Health Coverage in a Depressed Economy”.

The National Executive Council meeting was preceded by several humanitarian, social and advocacy-oriented activities including the 5^th Dr Ameyo Stella Adadevoh Memorial Free Medical Outreach to Jahi Community which is a low-income residential area in Abuja. In all, three hundred and one (301) patients with various medical conditions were offered free medical consultations, surgical consultations, dental and ophthalmological services. There were Media engagements on the theme of the conference. Courtesy visits were paid to the Hon. Coordinating Minister of Health and Social Welfare; Prof. Muhammad Ali Pate CON, Hon. Minister for Education; Prof. Tahir Mamman OON SAN, Hon. Minister of State for Education; Rt. Hon. (Dr.) Yusuf Tanko Sununu, Permanent Secretary, Ministry of Defence; Dr. Ibrahim Abubakar Kana mni and Permanent Secretary Ministry of Niger Delta; Dr. Shuaibu M.L Belgore. The colourful opening ceremony under the distinguished chairmanship of the Permanent Secretary, Ministry of Defence; Dr. Ibrahim Abubakar Kana mni, the Coordinating Minister of Health and Social Welfare ably represented by Dr. Jimoh Salaudeen, mni, the Minister of State for Education; Dr. Yusuf Tanko Sununu ably represented Rt. Hon. Dr. Samuel Adejare, the Federal Capital Territory Mandate Secretary for Health and Social Services ably represented by Dr. Ahmed Dan Fulani and His Royal Majesty, Matthew Alaji Opaluwa Oguche Akpa II, Attah of Igala ably represented by Chief James Onoja PhD, SAN. The Immediate Past President of World Medical Association; Dr. Osahon Enabulele, Past Presidents of NMA, Past Secretaries-General of our Association and Chairmen of all the NMA State/FCT Branches also attended the Opening Ceremony. Present also was the Chief Medical Director of the Federal Medical Centre, Jabi, Abuja who delivered the Keynote Lecture; Prof. Saad A. Ahmed and other notable personalities within and outside the Federal Capital Territory.

The NEC meeting also featured a very successful NMA National leadership Retreat on Developing Effective Followership Skills: The Panacea for Actualizing our Collective Dreams.

The NMA President, Dr. Uche Ojinmah was appreciated by NEC members for his exemplary leadership.

OBSERVATIONS:

1. NEC noted with grief the unfortunate accidental bombing of innocent civilians at Tudun Biri in Igabi LGA of Kaduna State and acceptance of responsibility by the military.

• The NEC observed that Nigeria was already in serious cataclysmic economic crisis, as evidenced by the surge in consumer price indices, increase in number of multidimensionally poor Nigerians which now exceeds 100 million according to the World Bank data, the heightened hunger and suffering in the country. 

• The NEC noted that despite considerable efforts, progress towards Universal Health Coverage (UHC) targets in Nigeria has been slow. This delayed progress towards UHC is further threatened by a set of four interlinked health transitions: shifts in demography, transitioning of disease burden, reduction in development assistance for health and poor domestic health finance.

• The NEC noted as unacceptable, the current situation where 75-80% of Nigerians pay out-of-pocket for their medical expenses and insurance. The NEC further clearly stated that Health Insurance holds the capacity to provide solution to accessible, affordable and sustainable healthcare delivery for Nigerians.

• The NEC noted that the present Federal Government led by President Ahmed Bola Tinubu GCFR has proposed 5% of the total budget for 2024 to health; this is an improvement on previous budgets but this is still far from the benchmark of 15% proposed by the Abuja declaration of 2001. 

• The NEC observed that Nigeria is heading for a catastrophic Human Resource for Health (HRH) crises, if the current rate of migration of Medical and Dental Practitioners to overseas “Jappa syndrome” is not reversed immediately.

• The NEC expressed great worry at the fact that despite the tremendous efforts being made by healthcare workers to deliver health care services to Nigerians, they were still violently assaulted and kidnapped in their workplaces and other places. The NEC also seriously frowned at the inability of Governments at all level to effectively check security lapses and the ravaging incidence of kidnapping, armed robbery, banditry and extra judicial killing of Nigerians.

• The NEC reviewed the level of progress in clearing the backlog of salary arrears, implementation of the new hazard allowance and other salary packages for doctors and other health workers in Abia, Ekiti, Ondo and Imo states. The NEC was extremely impressed with the various interventions of the Executive Governor of Ekiti State; Abiodun Abayomi Oyebanji in improving the holistic salaries and allowances for all doctors and other health workers in Ekiti State. The NEC noted the level of progress made in Abia, Ondo and Imo States in clearing the unpaid salaries and improving the wages of doctors and other Health workers in their States.

• The NEC unequivocally condemned the non-implementation of the Revised CONMESS circular and Accoutrement allowance as circularized since July 2023 by the Federal Government despite several reminders and entreaties.

1. The NEC expressed dismay at the unmitigated slide of the value of the Naira and exit of giant pharmaceutical companies from Nigeria with consequent effects of drugs shortage, geometric increase in the prices of drugs, increasing unemployment and galloping inflation. The NEC noted that these companies as a prelude to their closing shop in Nigeria lamented about our challenging business environment due to the impact of Naira depreciation, forex scarcity and high cost of doing business in Nigeria. The NEC further noted that the exodus raises serious concerns about access to essential medicines for millions of Nigerians.

1. The NEC noted as unacceptable the recent obnoxious directive by the Management of Ambrose Alli University, Ekpoma, Edo State asking the medical students to sign an undertaking that their statutory six-year medical undergraduate program could be extended to over 12 years.  The NEC further regarded the above action as unfair, very irritable and highly provocative to the tenets of the international human rights law, constitution of Federal Republic of Nigeria and civil liberty. NEC also condemned the authorities of Alex Ekwueme Federal University, Ebonyi State for charging astronomically high school fees from the medical students and condemning the students to paying school fees without progression in academic level.

1. The NEC noted the successful and historic completion of his tenure office by Dr. Osahon Enabulele   as the President of World Medical Association at the last General Assembly on 7^th October, 2023 in Kigali, Rwanda. The NEC observed that Dr. Osahon Enabulele is the first Nigerian that occupied this office and gave a stellar performance. 

1. The NEC deliberated in line with the established tradition and constitutional provisions on which geopolitical zone in Nigeria should host the next NMA Secretariat (2024-2026) in the spirit of fairness, unity and equality.

1. The NEC expressed satisfaction with the preparation for the hosting of the NMA Games 2024 and the 2024 Annual General Conference/Annual Delegates Meeting (AGC/ADM) by the Lagos State and Cross River State NMA Branches respectively.

RESOLUTIONS:

1. NEC commiserates with the good people of Tudun Biri, Kaduna State government and the Federal Government of Nigeria while praying for the peaceful repose of the dead and quick recovery of the injured. We commend the Nigerian military for accepting responsibility and call on the military to refine the sensitivity of its intelligence so as to avoid a recurrence. NEC calls on our dear Federal Government to quickly compensate the victims.

• The NEC urges Governments at all levels to prioritize the health and well-being of all Nigerians by rolling out robust palliative measures, and other social intervention strategies aimed at cushioning the present hunger and harsh economic condition in the country with the aim of lifting millions of Nigerians out of multidimensional poverty.

• The NEC insisted that despite the present economic challenges in the country, implementing UHC in depressed economies is possible by instituting innovative funding models such as the so called “Sin tax”, focus on improved primary healthcare access, integration of technology to healthcare delivery and strengthening clinical governance at all levels. These measures shall stem the tide of out-of-pocket expenditure for healthcare which is currently stifling Nigerians.

• The NEC implored our Government to take practical steps to reduce out-of-pocket expenses for individuals seeking healthcare by introducing or expanding social health insurance schemes, providing subsidies or cash transfers for vulnerable populations, and exploring mechanisms to negotiate fair and affordable drug prices while strengthening our local pharmaceutical production sector.

• The NEC called on the Federal Government to ensure transparency and accountability in the management of the 1% Consolidated Revenue Fund, increase budgetary allocation to the health sector to at least 15% in line with Abuja Declaration of 2001 and exploring other innovative funding options for our health sector.

• The NEC reiterated the need for Governments at all levels to as a matter of          urgency provide better working environment for the practice of Medicine/Dentistry, pay better and competitive remuneration, show better political commitment to health and prioritize healthcare provision in their scales of preference, provide robust access to social amenities and upgrade decaying utilities, rejig our national security architecture for the safety of all citizens, and provide increased gainful employment opportunities for doctors. The NEC identified these          as critical factors that could halt the devastating medical brain drain.

• The NEC called on Governments and all the security agencies to effectively check security lapses and the ravaging incidence of kidnapping and banditry in Nigeria.  The NEC further urged them to quickly do the needful in addressing this menace to save Nigerians from further torment. 

• The NEC strongly commended the Government of Ekiti State and directed all the doctors working in Ekiti State to reciprocate the good gesture of the government.  The NEC implored the governments of Ondo, Abia and Imo States, to hasten the process of clearing the unpaid arrears of salaries and implement recent upwardly reviewed salary packages for doctors and other health workers in their States.

• The NEC resolved to give the Federal Government till 31^st of January, 2024 to implement the Revised CONMESS and accoutrement allowance with arrears from June 2023, or NMA will not be responsible for the breakdown of industrial harmony in the health sector.

1. The NEC appealed to the Nigerian government to take urgent action to mitigate the impact of   exodus of some pharmaceutical companies by creating a friendly business environment and investing in the domestic pharmaceutical industry.

1. The NEC called on the Management of Ambrose Alli University, Ekpoma, Edo State to immediately cease and desist from coercing her medical students into an unapproved intercalated program but rather legally and holistically address the root cause of her problem which is over admission into her medical school. The NEC also directed NMA Edo, to do everything possible under the law to ensure the rights and privileges of the medical students were not trampled upon. NMA also calls on the management of Alex Ekwueme Federal University, Ebonyi State to quickly stop the overinflated school fees and paying of fees without appropriate progression. The Nigerian Medical Association shall bare its fangs at these institutions if they do not quickly embrace change.

1. The NEC thanked the Immediate Past President of World Medical Association (WMA), Dr. Osahon Enabulele, for being a good ambassador of the Nigerian Medical Association and Nigeria, during his WMA Presidency.

1.  The NEC unanimously resolved that the Northeast geopolitical zone of Nigeria should host the NMA National Secretariat for 2024- 2026 executive tenure.

1. The NEC reaffirmed the hosting rights of the NMA Games 2024 and the 2024 AGC/ADM of the Association by the Lagos State and Cross River State NMA Branches respectively and enjoined all stakeholders to work towards the success of these events.

APPRECIATION:

The Nigerian Medical Association is immensely grateful to the following personalities who offered various forms of supports before, during and after the meeting:

Hon. Coordinating Minister of Health and Social Welfare; Prof. Muhammad Ali Pate CON, Hon. Minister of Education; Prof. Tahir Mamman OON SAN, Hon. Minister of State for Education; Rt. Hon.(Dr.) Yusuf Tanko Sununu, the Chairman of the Opening Ceremony and Permanent Secretary Ministry of Defence; Dr. Ibrahim Abubakar Kana mni , Permanent Secretary Ministry of Niger Delta ; Dr. Shuaibu Belgore, Federal Capital Territory Mandate Secretary for Health and Human Services; Dr. Adedolapo A. Fasawe,  Keynote Speaker and Chief Medical Director of FMC Jabi, Abuja ; Prof. Saad A. Ahmed, other Speakers,  the Registrar of National Postgraduate Medical College of Nigeria; Prof. Fatiu Arogundade, and the Attah of Igala; HRM Matthew Alaji Opaluwa Oguche Akpa II.

Special appreciation goes to the Local Organizing Committee and the State Officers’ Committee of NMA FCT led by Dr. Charles Ugwuanyi, sponsors, volunteers and every other individual and corporate organizations that partnered to make the meeting a huge success.

NEC congratulates the NMA FCT   Branch for an excellent hosting.

FELICITATIONS

The Association wishes all Nigerians Merry Christmas, a prosperous and healthier 2024 in advance.

Dr. Uche R. Ojinmah                                                                 Dr. Jide Onyekwelu President