Health advocacy and international perspectives

He put it succinctly that “the world is moving and passing us by, but we are hardly aware of it. Fundamental earth-shaking events and decisions are being made at the global level, but we are not bothered because we do not even know. We are locked in our local corner under a spell of dormancy […]

He put it succinctly that “the world is moving and passing us by, but we are hardly aware of it. Fundamental earth-shaking events and decisions are being made at the global level, but we are not bothered because we do not even know. We are locked in our local corner under a spell of dormancy and ignorance that was cast upon us by our local conditions.”
While I wish Auwal Anwar all the best and welcome him to the club of “taking hot tea and coffee and less social life” to survive a weekly writing of this nature, I want to agree with his assertion which is applicable in the Nigeria’s health sector as most of our decisions, policies and health financing are being influence by what happens globally. We can’t but to know what is going on and how best we can maximise benefit to our country and equally prioritise what works best in line with the local context.
Some examples are worth mentioning here. It was at the London Summit on Family Planning in 2012 that Nigeria was applauded for committing to in addition to our current annual funding of US$3 million for the procurement of reproductive health commodities to add US$8,350,000 annually over the next four years from 2012 making a total of about US$45 Million. This was an increase of 300%. Regrettably as we enters this New Year, the 2013 allocation wasn’t release. We are also aware that as a follow up to the Addis meeting on domestic health spending in Africa, our Minister of Finance Dr Ngozi Okonjo-Iweala was excited at a Washington meeting of Global Fund’s Fourth Replenishment in December 2013 to announce US$150 million in new investments in HIV prevention and treatment in Nigeria and also announced a US$30 million contribution to the Global Fund. It is important to note the effects of global event in our health sector.
Another significant action in Nigeria is the campaign to pass in to law the long awaited national health bill which serves as a veritable tool to address funding gap in the health sector and ensures improved quality of care. This moves is also in line with Nigeria’s commitment to the United Nation Secretary General’s Strategy on women’s and children’s health. When it becomes a law, its implementation will improve financial resources from the proposed 2% of the Consolidated Federal Revenue Capital that would be channelled to primary health care and national health insurance. Regrettably the bill previously was passed twice by the federal legislatures but not assented by the executive arm of government.  
Are we aware that in 2012, the United Nation’s Commodities Commission was formed to call attention to the need for increasing access to and use of critical medicines and health supplies in the countries where the most women, newborns, and children under five die each year ? Specifically, the Commodities Commission, led by Co-Chairs President Goodluck Jonathan of Nigeria and Prime Minister Jens Stoltenberg of Norway, released a report which outlined a priority list of 13 reproductive, maternal, newborn, and child health (RMNCH) commodities that can prevent and treat many of the leading causes of death in these countries. In spite of the strong evidence showing their impact in saving lives, too often the 13 commodities are out of the reach of those individuals who need them. These medicines and health supplies cost just dollars, with the majority costing less than US$1 per dose. However, multiple barriers prevent people from accessing these commodities.
“There is no doubt that lives can be saved by increasing access to affordable and effective medicine and health supplies. We must all make a difference and the timer is now”. The above statement was made by our President Goodluck Jonathan as the co- chair of the live saving commodities commission in 2012 during its launch. How many of us are aware of this bold statement by our president? Can we populate our media including facebook and twitter accounts with these messages and hold our president to account?
We should also be aware that as part of the support for the implementation of the commission’s 10 recommendations an initial group of 8 ‘Pathfinder’ Countries* were selected and prepared plans to scale-up access to life-saving commodities and services. These efforts are facilitated by a Trust Fund, housed by UNFPA and supported by a small ‘secretariat’ called the RMNCH Strategy and Coordination Team, housed by UNICEF. The 8 countries are DRC, Ethiopia, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, and Uganda and each country had submitted dedicated plans/proposals to carry forward the recommendations within their country and had received support from the RMNCH Fund to implement their plan.
Nigeria resource request was $9,986,589 (Child health 58%, Newborn health 16%, Reproductive health 16%, and maternal health 7%, and RMNCH mix 2%). It is expected that advocates should contribute to the successful implementation of the plan/proposal by doing some of following activities;
1.      Identify specific advocacy activities highlighted in the plans and explore opportunities for partnership with the Ministry of Health.
2.    Identify additional individuals or audiences that need to be engaged to move forward the plan.
3.    Provide information and highlight commitments to relevant stakeholders, such as parliamentarians, Ministry of Finance, state governors, media and civil society organisations, promote accountability for the plan and track progress.
All comments to Dr Aminu Magashi at [email protected]