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By Henry Uche
There is no better time than now to discuss strategies for the country’s effective healthcare delivery as health experts converged recently at the 8th edition of the future of health conference in Abuja.
Long before Millennium Development Goals, (MDGs) and later Sustainable Development Goals, (SDGs), among the parameters used in determining the performance of a political economy are the quality of its public sector education system, life expectancy and Gross Domestic Product (GDP).
These three parameters are not independent of each other, as the quality of health of citizens will significantly influence their productive capacities.
Going by these, experts at the 8th edition of future of health conference in Abuja deliberated on the theme: “Political Economy of Health: Investing in the future of Nigeria,” with the aim of pushing healthcare up the political agenda and ensure that it takes its rightful place of prominence alongside the economy, security and other priority issues in the political discourse.
The organiser of the conference, the Nigeria Health Watch in a hybrid, affirmed that politics, economics and public policy are important determinants of population health. Moreover, countries, which practice social democracy, exercise higher public spending, and have lower income inequalities should have populations with better health status.
According to them, a core approach to the political economy of health involves the interrelationship between governance, politics, power, macroeconomic, public policy and population health, adding that the politicisation of health has seen the increased involvement of political leaders in health affairs and has revealed the need for greater political support to drive a nation’s health agenda.
They, however, noted that this has undermined efforts to prioritise health policies as self-interest and individual agendas of political leaders have often determined how a health policy is interpreted or how well it is implemented.
“An evidence of regardless of health was seen during the COVID-19 pandemic, where the politicisation of the response impacted the public space and compliance with public health advice globally.
“There is no arguing the role a healthy population plays in the prosperity of any nation. A country that has achieved universal access to healthcare for its citizens is more likely to succeed than one where healthcare access is inequitably distributed.
“Political leaders must understand that Universal Health Care (UHC) cannot be achieved if the political atmosphere is not pro-health. They must also understand that investing in health is important for economic development as it also bolsters productivity,” the group maintained.
The managing director, Nigeria Health Watch, Vivianne Ihekweazu, stressed that the World Health Organisation (WHO) has acknowledged that progress towards Universal Health Care (UHC) is in part political, and if countries possess the political will the necessary economic reforms can be carried out to make UHC possible.
She said: “Ultimately, we need to push health up the political agenda if we are to make any meaningful progress towards achieving UHC and if we want to see an improvement in Nigeria’s health indices. There’s a need for more innovative, scalable, and sustainable healthcare strategies.
“The importance of collaboration between the public and private sector to initiate and implement strategies to improve healthcare service delivery remains paramount.”
Ihekweazu added that the role of local, state, and federal government and other political office holders in creating a more favourable environment for better healthcare access to achieve better health outcomes for individuals and communities could not be alienated.
“Community leaders and groups, even civil society organisations (CSOs) must drive improvement in healthcare access and delivery in Nigeria. There’s need for development and implementation of health policies that affect positive and holistic change, growth and development for Nigeria’s healthcare system.”
She noted that if any significant progress is to be made toward achieving UHC and raising Nigeria’s health indices, then the 2023 general election gives a unique opportunity to advance healthcare up the political agenda, which must be maximised.
Panelists at the hybrid sessions proffered actionable ways to rev up Nigeria’s health sector and also came up with how political, social and economic factors could shape individual and population health outcomes; health service development within the economic and political context, and how to create a national health service that meets the needs of all Nigerians.
In his keynote address, director general, Budget Office of the Federation, Prof Ben Akabueze, emphasised the importance of healthcare investment as a driver of the economy. Akabueze, who was represented by his technical assistant, Prof. Olumide Ayodele, affirmed that there was no better time to discuss strategies for nationwide effective healthcare delivery.
Speaking on, ‘Political leadership in health-the impact of leadership on healthcare at sub-national level,’ the commissioner for health, Enugu State, Obi Ikechukwu Emmanuel, said that given that Nigeria has a federal system, there is a clear need for political will to drive implementation and domestication of federal health laws at the sub-national level.
The commissioner also emphasised the need to domesticate laws and policies like the National Health Act, National Strategic Health Development Plan and the National Health Policy at sub-national level.
“We should institute the rule to always plan, and then when we implement, always look at evaluating what we have implemented and then try again, because this is how others must have gotten it right,” he reiterated.
Comparing health allocations in Nigeria with other countries, a senior health specialist at World Bank, Onoriode Ezire, bemoaned that Nigeria’s health sector is largely unfunded and health indexes remain very poor. “Investment in health is directly related to the growth of the economy. The productivity of the country is a function of the state and status of the health of the people of the country.”
For Professor of Health Economics & Policy Pharmacoeconomics, Obinna Onwujekwe, “although, health is an investment with an often-overlooked connection to development, it is habitually perceived as consumer expenditure and not a contributor to social and economic development.”
Onwujekwe, who is also the Lancet Nigeria commissioner, advocated for multi-stakeholder synergy for increased investment and political participation in health.
In a panel discussion titled, “The economy of health,” Special Adviser to Nigerian President on Finance & Economy, Sarah Alade, placed emphasis on the need to inspire investors to discover opportunities and reasons why they should invest in the country.
The pandemic, according to her, has exacerbated the relationship between the economy and healthcare more than ever before. She also pointed out that the National Development Plan (NDP) relies on human capital development to be sustainable and ultimately successful.
