In Nigeria, high blood pressure IS a terminal disease for the poor – Tola Adenle
It’s time African governments take the health of the masses more seriously, and this short essay is a short non-medical look at the Nigerian public health provision scene and how Nigeria can lead the way to solving medical problems without creating such burden on the poor that they neglect the purchase of medications for their ailments.
I’m not versed in how the government’s National Health Scheme (NHS) works but as things always go in Nigeria, it was not long before a service meant to alleviate the plight of the masses towards health care, became a gravy train for non-medical outfits that have muscled in on what is a truly lucrative pie. I believe a re-orientation of this supposed health subsidy calls for immediate attention.
Here are a few reasons why the NHS as constituted cannot succeed – if it’s still on at this writing as – believe it or not – I’ve been on this essay for months despite its brevity – and depth:
In the course of my little research, I found that there have been cases of people dying from untreated high blood pressure in a country where top government officials, politicians and their families and even those at the bottom of government hierarchy – those in charge of local governments – routinely fly overseas to receive medical treatment for ailments big and small.
As this is strictly an essay about possible solutions, there is no need to go into the usual area of maladministration and corruption as most write-ups in Nigeria on social issues tend to move but how the government can re-direct the massive resources being spent on the NHS at the moment into a program that would benefit those most deserving of government’s assistance.
Here are my suggestions:
If a government agency decides to go this route after a thorough research into quality AND pricing, it should not be difficult to have Nigerian hypertensive patients pay considerably-reduced prices for high blood pressure, diabetes and other commonly-sought medications.
Now, if government would choose the eventually-advisable manufacture of generics of lapsed-brand patents’ route, then Nigerians would truly be able to benefit from purchasing cheap world-standard medications, and everybody would also benefit: government would inch its way up to one that cares; employment would be created; manufacturers can sell to the sub-region where citizens would also benefit from reduced drug prices, and quacks – ever ready to cash in on loopholes which to them are “new opportunities” – would be driven out of the business of practicing Medicine without certificates OR dispensing drugs without Pharmacy degrees.
The short-term solution of importation of generics by government after a thorough research by a medical-cum pharmaceutical professional to be followed by a well-laid out plan of going the route of obtaining lapsed patents with the aim of assisting big pharmaceutical companies to locally manufacture generics is, in my opinion, a goal worth pursuing.
Of course, none of my suggestions is offered with professional knowledge; they are based on my experiences of coming across an amazingly large number of poor Nigerians in my Southwestern Nigeria, weighing the possibility of importation and local manufacturing of generics versus the present chaotic, expensive and ineffective NHS.
High blood pressure should not carry the fear factor that cancer and other really deadly disease because it can be controlled so that a person afflicted can still lead a very normal life.
I’m not versed in how the government’s National Health Scheme (NHS) works but as things always go in Nigeria, it was not long before a service meant to alleviate the plight of the masses towards health care, became a gravy train for non-medical outfits that have muscled in on what is a truly lucrative pie. I believe a re-orientation of this supposed health subsidy calls for immediate attention.
Here are a few reasons why the NHS as constituted cannot succeed – if it’s still on at this writing as – believe it or not – I’ve been on this essay for months despite its brevity – and depth:
- Even if the medical outfits that the “federal” government’s Ministry of Health supposedly reimburses for providing medical treatment to deserving Nigerians perform the responsibility for the cash payments received, it would not be right because patients need to pay something, no matter how small; I understand the program is “free”.
- The present method supposedly sees non-hospital outfits springing up to jump on the gravy train of such an open system. From information gathered, there are already “big” Nigerian men and women behind obscure – hopefully, real – hospitals and are collecting big cheques. This essay does not imply that government is [officially] aware of the shenanigans.
- The patients that the subsidized scheme is supposed to assist do not get the “free” or even partially-free medical supplies despite the huge amounts government must be disbursing. Whatever is being budgeted for the scheme is probably being creamed off at the Ministry level from the medical outfits – genuine or otherwise.
- Most patients who reside in towns where medical outfits do give out the “free” medical supplies are not even aware such exists and so still go the expensive route – or skip buying drugs once confronted, for example, with the cost of a 30-day high blood pressure medication that can run from N2500 – over N4000 monthly ($15 – $26) in a country where millions live for less than a dollar a day.
In the course of my little research, I found that there have been cases of people dying from untreated high blood pressure in a country where top government officials, politicians and their families and even those at the bottom of government hierarchy – those in charge of local governments – routinely fly overseas to receive medical treatment for ailments big and small.
As this is strictly an essay about possible solutions, there is no need to go into the usual area of maladministration and corruption as most write-ups in Nigeria on social issues tend to move but how the government can re-direct the massive resources being spent on the NHS at the moment into a program that would benefit those most deserving of government’s assistance.
Here are my suggestions:
- The government must consider as a matter of national emergency the importation of generic drugs from India as a first step so that a high blood pressure diagnosis would stop being a diagnosis of imminent deaths to the poor.
- Secondly, how to be able to manufacture these drugs locally should be a second step. To accelerate production of generic medications, a route that has seen India become a major player in the manufacture of generic drugs, government should look outside the Civil Service to work with knowledgeable and respected – even retired medical professors here and in the Diaspora – to source respected generic drug manufacturers in India, New Zealand, Israel or anywhere with supplies that meet WHO/international standards.
- The Nigerian government knows the reputable and very big players in the pharmaceutical manufacturing sector, and there are quite a bunch of them: Beecham, etcetera. India has become a big player and a respected one even in the highly-controlled U.S. pharmaceutical sector.
If a government agency decides to go this route after a thorough research into quality AND pricing, it should not be difficult to have Nigerian hypertensive patients pay considerably-reduced prices for high blood pressure, diabetes and other commonly-sought medications.
Now, if government would choose the eventually-advisable manufacture of generics of lapsed-brand patents’ route, then Nigerians would truly be able to benefit from purchasing cheap world-standard medications, and everybody would also benefit: government would inch its way up to one that cares; employment would be created; manufacturers can sell to the sub-region where citizens would also benefit from reduced drug prices, and quacks – ever ready to cash in on loopholes which to them are “new opportunities” – would be driven out of the business of practicing Medicine without certificates OR dispensing drugs without Pharmacy degrees.
The short-term solution of importation of generics by government after a thorough research by a medical-cum pharmaceutical professional to be followed by a well-laid out plan of going the route of obtaining lapsed patents with the aim of assisting big pharmaceutical companies to locally manufacture generics is, in my opinion, a goal worth pursuing.
Of course, none of my suggestions is offered with professional knowledge; they are based on my experiences of coming across an amazingly large number of poor Nigerians in my Southwestern Nigeria, weighing the possibility of importation and local manufacturing of generics versus the present chaotic, expensive and ineffective NHS.
High blood pressure should not carry the fear factor that cancer and other really deadly disease because it can be controlled so that a person afflicted can still lead a very normal life.
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