COVID-19: The Nigerian State, Elitism And Masses By Amirah Folashade Yusuf

Public health and safety are an integral part of national security. The dysfunctional health system in Nigeria, my dear country, has always been a concern for everyone – medical practitioners, middle and lower class citizens, and of course the downtrodden. COVID-19 pandemic has accentuated the transmogrification of this perturbing health concern as affecting not just the poor but also, members of the ruling class and the affluent in our society.

On March 29, 2020, the World Health Organisation declared COVID-19 outbreak a pandemic. COVID-19 is an abbreviation for “coronavirus disease 2019” caused by a novel coronavirus named ‘SARS-CoV-2 virus’. It causes mild to severe illnesses. Older adults, mostly age 65 and above, and individuals of all age groups with underlying chronic medical conditions like cancer, diabetes, heart and lung disease, are the most vulnerable to COVID-19.  

COVID-19 is a litmus test for the resilience of our fragile health system. As a toxicologist in training with a knowledge of the poor hygienic conditions in Nigeria, I postulate that we may be in for a long one. This is because our public health sector is under-resourced and underfunded. With less than 500 ventilators in the country, how best can we save lives if the COVID-19 prognosis of the identified and asymptomatic patients escalates? As a mother who once lost a preterm baby to the unavailability of a ventilator in one of the best hospitals in Lagos, I can relate to the imminent danger in the country. I wonder what the fatality rates would be if there were a huge demand for ventilators in the treatment of COVID-19 across the country.

It is vital that the health budget is tailored towards key financial necessities and committed to the implementation of strategic health policies. This is one of the things we always miss out in the country at all levels. For example, the N427bn budget for the year 2020 means that N46bn is available for capital spending in this sector and N2, 000 for each citizen. Let me break this down further. According to UNICEF, 750,000 children died in Nigeria in 2015 from vaccine preventable diseases. And it costs around $36 (N14,000) to vaccinate one child, putting it at N90 billion to vaccinate an estimated 7.4 million babies annually in the country. What is our strategic health policy that our budgets cannot finance that had to take COVID-19 outbreak before we start seeking and tapping into private sector intervention in the country? Could it be because the ruling class have never been in need of these facilities – so there wasn’t much to be concerned with then? 

Are we still so poor at handling our medical affairs despite receiving a wonderful tutelage from Microsoft billionaire, Bill Gate, telling us the need to invest in medical/nutritional needs of our new-born coupled with quality education. He even went further to show brain formation of well-nourished baby compared to their mal-nourished counterparts. Prof Esther Duflo of MIT, the author of ‘Poor Economics’ noted this point as well, when analyzing factors that make nations (and individuals) go poor. Why is our NTA – Nigeria Television Authority seeking to get USD 500M loan facility in a country where over 70 per cent of the populace is just two dialysis away from chronic poverty? Why would such money not come from private investors while we create a system that boost the health and thus wealth of the nation? Would the story have been the same if the ruling class were able to fly out to their usual destinations to receive world class health treatments they never provided back home to the citizens? Food for thought!

As a proud Nigerian who believes in the Nigerian project, my hope and indeed prayers is that our leaders find it conscientious enough to come out of their indifferent and nonchalant attitude to public health care and pursue a rigorous, deliberate policy to build robust health care system from primary to tertiary levels. This is important because, there is a global consensus that the wealth of a nation is integrated in its health. A healthy citizenry is far better along all frontiers. President Nelson Mandela would forever be remembered for insisting to be treated in his homeland till he passed away. While we seek no right to withdraw anybody’s freedom and liberty, we should be astonished that despite years of budgetary back and forth, our leaders are not comfortable enough to use our own hospitals back home.

Finally, I would like to applaud the effort of NCDC and the Lagos State Government so far. Despite the various awareness carried out daily, ignorance on the side of the populace as regards medical awareness may be a bigger evil we will have to contend with. This also brings to fore, the need to intensify on quality education, and move quickly to knowledge economy. Recent development in epidemiological studies of infectious diseases is more data driven – based on the county’s demographics. We must, as a nation be able to identify ourselves and gather the most basic data with historical trends centrally. This would have made contact tracing easier.

Amirah Yusuf is a veterinary doctor and a PhD candidate in the Department of Environmental Toxicology and Interdisciplinary Sciences, Texas Southern University, Houston, USA

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