15% Budget to Health; Nigeria’s Dilemma

Nigeria is playing chief host  to over 50  African heads of States in a Special Summit of the African Union on HIV/AIDS, Tuberculosis and Malaria tagged ‘The Abuja + 12 Meeting’ holding in Abuja on Monday 15th and Tuesday 16th July 2013 in Abuja .  The meeting reviewed progress made 12 years ago to increase […]

Nigeria is playing chief host  to over 50  African heads of States in a Special Summit of the African Union on HIV/AIDS, Tuberculosis and Malaria tagged ‘The Abuja + 12 Meeting’ holding in Abuja on Monday 15th and Tuesday 16th July 2013 in Abuja .  The meeting reviewed progress made 12 years ago to increase the proportion of health spending to 15% as well  in reversing the trend of infectious diseases.
In 2001, Nigeria had promised to spend 15% of Nigeria’s total annual budget on health. In 2013, only 5.6% of the budget is being spent on health, and that number has been decreasing every year since 2011. This is a moral dilemma for our country. We are hosting a meeting to review progress and we are among the countries that are far from meeting their commitment. On July 8th in a presidential statement about the upcoming Abuja +12 summit, President Goodluck Jonathan had this to say “AU Member States with the support of our development partners have through the years sought to implement these commitments with significant results to demonstrate.” It is imperative for Nigeria in line with the above statement to explain to its citizens what significant result we have recorded in line with the Abuja declaration.
If Ghana in 2013 could allocate 12.5% of its budget to health, then what stops Nigeria in doing same?
The summit of African Union on HIV and AIDS, Tuberculosis and Malaria (ATM) in  May, 2006 had observed that one of the 12 priorities for the  Abuja Plan of Action on HIV and AIDS, Tuberculosis and Other Related Infectious Diseases included Resource Mobilization and funding  also  observed that with respect to the proportion of national budgets allocated to health  33% of countries have allocated at least 10% of their national budget to health while one country has attained the target of 15% which is Tanzania.
  Another report by World Health Organisation (WHO) in 2010 titled ‘The Abuja Declaration: 10 years on’, observed that only three countries are on track with respect to the health MDGs whereas 27 countries have no or insufficient progress. Twenty six countries have increased the proportion of total government expenditures allocated to health since 2001. Eleven countries including Nigeria have reduced their relative contributions of government expenditures to health during the period.
 The Global AIDS Response Country Progress Report Nigeria GARPR 2012 has also observed that donor investment in the HIV response has however, continued to outstrip the government’s investment even though spending on HIV by Government increased from 7.6% in 2008 to 25% in 2010.
Some of the challenges observed with respect to funding of HIV/AIDS which will impact on the Abuja declaration was observed in the 2009 National HIV/AIDS Policy Review Report that “the national response faces significant funding gaps, funding at all levels is predominantly donor driven and donor dependent.
States’ political and resource commitment to HIV/AIDS remain extremely weak and in many cases have deteriorated as budget funds are seldom released and there is little or no allocation by LACAs. Governments at all levels have displayed reluctance to implement the one percent budget allocation to HIV/AIDS approved by the federal executive council.”
The report has also observed that there was monumental wastage of resources and capacity building at all levels of HIV/AIDS programme implementation due to staff attrition and bureaucracy. Private sector potential remains untapped. There is also the challenge of poor programme implementation, lack of transparency and accountability by stakeholders across the board which undermine the drive for diversified resources. The aforementioned is a rider for Nigeria to begin to factor why we are far from achieving 15% budget allocations to health.
Another significant action when taken that will help Nigeria jerk its budgetary allocation to health is for the national health bill to be passed in to an act. Its serves as a veritable tool  to address funding gap in the health sector and ensures improved quality of care which is in line with Nigeria’s commitment to the United Nation Secretary General’s Strategy on women’s and children’s health. And it will also catalyse improved financial resources from the proposed 2% of the Consolidated Federal Revenue Capital that will be channelled to primary health care and national health insurance.
The bill was passed by both the 2 chambers of the national assembly sometime back but suffered a hitch when it was the turn of President Jonathan to assent it into a law. The experience was the same during former President Obasanjo and late President Yaradua, in the sense that it received commitment from the legislative arms but lacklustre attitudes from the executive.
The past experience has prompted the question whether the bill is an executive bill or a private bill sponsored by some concerned individuals.
If the bill is an executive bill, why will the President refused to assent it? It is pertinent to answer the above question as we need to critically examine why the executive arm never assented the bill so that we know where our advocacy efforts will be concentrated.
It is important to examine the barriers and channel our energy and resources to redress the situation.  Does the bill have champions such as Ministers of Finances and that of health that could publically and behind the scene rally for its support, passage and assent by Mr. President?
The world is watching for Nigeria to take the right step in allocating 15% of its budget to health sector and the time to act is now.
 All comments to Dr Aminu Magashi at [email protected]