Experts brainstorm on political economy of health for national dev’t

Stakeholders have said pushing health up the political agenda not only increases involvement of political leaders in health affairs but also leads to improvement in the country’s health system. They said prioritizing health, just like the economy, security, and others, will also improve the country’s poor health indices, and accelerate universal health coverage as well […]

Stakeholders have said pushing health up the political agenda not only increases involvement of political leaders in health affairs but also leads to improvement in the country’s health system.

They said prioritizing health, just like the economy, security, and others, will also improve the country’s poor health indices, and accelerate universal health coverage as well as economic growth and national development. 

Investing in the future of Nigeria through the political economy of health was the thrust of the recent Future of Health Conference (8th Edition) in Abuja organised by the Nigeria Health Watch, a non-governmental Organisation and other partners.

Critical stakeholders in healthcare, finance, politics, and other allied sectors discussed the factors that influence Nigeria’s health policies.

They also brainstormed on how political, social, and economic factors shape individual and population health outcomes, health service development within the economic and political context, as well as how to create a national health service that meets the needs of all Nigerians.

The experts said the approaching 2023 general elections present an opportunity to take advantage of the potential policy window to push healthcare up the political agenda.

Viviane Ihekweazu, Managing Director, Nigeria Health Watch, said, in spite of the health sector being a critical driver of the economy across the globe, it has not received optimum attention across different leaderships.

She said elections are not lost or won, based on a candidate’s health policy, adding “It is at this point of transition, we have the opportunity to redefine what the health agenda should be as political aspirants are vying for political office and when a new government is starting; this is also a time when they are most responsive.”

Ihekweazu said achieving universal health coverage (UHC) requires strong political will at different levels of governance, including the national and sub-national levels.

“For the candidates, this engagement will put into perspective, the challenges in the health sector and the required policy interventions that will change the narrative,” she added.

Also speaking Professor of Health Economics , Policy and Pharmacoeconomics, University of Nigeria, Nsukka, Obinna Onwujekwe,  said health actors’ focus should be investment cases that show links between health and development.

 In his presentation on the ‘Political economy of health in Nigeria’, he said all levels of government in the country, as well as traditional leadership structures, civil society, private sector, religious organisations and communities influence health and have valuable contributions to make to health.

According to him, directly linking estimates of the cost of action to the costs of inaction enable policy makers to clearly see the investment case for early action to improve health.

He said doing so has clear economic gains in the short, medium and long-term.

He said, “economic gains in future years from preventing child mortality results in around an 8-fold return on investment.

“From 2020 to 2030, for Diarrhoeal Diseases (DD), scaling up to 90% coverage, results in almost four times the percentage of Gross Domestic Product (GDP), gained than the percentage of GDP spent.

“For Lower Respiratory Tract Infections (LRTI), scaling up to national targets results in three times the percentage of GDP gained than the percentage of GDP spent.

“When these investments are implemented efficiently, over a million children’s lives will be saved and it will be feasible for Nigeria to achieve the Sustainable Development Goals (SDGs) target on reducing under-5 child mortality to below 25 per 1000 live births by 2030.”

According to him, investments required to obtain these large benefits are affordable at just 0.03% of GDP per year during 2022-2030 in Nigeria for DD and 0.05% for LRTI.

“There is generally low level of health spending, with less than 5% of the GDP spent on health and public health expenditure contributing less than 30% of total health expenditure.

“More than 50% of current health expenditure is allocated to curative care with respect to preventive/primary health care, indicating inefficiency of resource allocation,” he said.

Onwujekwe, who is also the Lancet Nigeria Commissioner, advised that governance and prioritisation of health are the first places to start.

He added that actions to improve the health of Nigerians must operate within an extremely complex governance system, with responsibilities for various aspects of the health system, and financing, split across federal, state and local governments as well as the private sector.

Also speaking, the Director General,  Budget Office of the Federation, Ben Akabueze, who was represented by Prof. Olumide Ayodele, said health investments will serve as a catalyst for higher labour force, high productive, innovation and income growth.

He said it is therefore important to make significant investment into health to ensure that we have the capacity to do more.

Also, Dr Habib Sadauki, national president, Society of Gynaecology and Obstetrics of Nigeria (SOGON), said health is key to any developing nation, and how much you put in health is how much health you have.

“Health financing is a major determinant of the health of the people. If we get financing right, we can reduce the maternal mortality rate and improve healthy human capital for improving the national socioeconomic and political development,” he added.

Speaking on the Economy of Health, Onoriode Ezire, Senior Health Specialist, World Bank Group, said Nigeria’s health sector is still largely under-funded and health indexes are still very poor.

He said investment in health contributes to achieving other developmental goals like reduction in equity and promoting shared prosperity.

“Government at all levels must prioritise health; lessons from COVID 19 are still fresh in our minds

 Speaking during the panel  session, Robert Yates, Executive Director, Centre for Universal Health, Chatham House, said Universal Health Care reforms bring huge political benefits, noting that political leaders who launch successful Universal Health Coverage reforms often get re-elected and become national heroes.

 Olumide Okunola, Senior Health Specialist at the World Bank in Nigeria said given the high population growth rate of 2.6 per cent per year, the level of real GDP per capita at end-2022 is expected to be below the 2011 level and is not expected to return to pre-COVID-19 levels before 2025.

“In brief, growth is still too low to create the kind of economic opportunities that Nigeria needs,” he added.

Obi Emmanuel Ikechukwu, commissioner of Health, Enugu State said health system governance means that  “strategic policy frameworks exist and are combined with effective oversight, coalition building, regulation, attention to system design, and accountability.”

He said strong governance in health systems must be guided by competent leaders with a clear vision and the ability to motivate and mobilize other health system stakeholders.