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Preventing epidemics: Need to mainstream National Action Plan for Health Security from 2022 MDA budgets

Against the backdrop of emerging and re-emerging diseases in Nigeria, experts have called for the inclusion of the National Action Plan for Health Security activities in the annual budgets of Ministries, Departments and Agencies (MDAs) from 2022.

In addition to the COVID-19 pandemic, the country has continued to witness disease outbreaks. This year alone, the country has recorded persistent outbreaks of cholera and Lassa fever among others. This diseases outbreak have impacts on the country’s health sector and the economy.

However, sources of health financing in Nigeria are a major challenge in achieving epidemic preparedness response in the country.

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The National Action Plan for Health Security (NAPHS) was developed in 2018 to address identified gaps in epidemic preparedness and health security in the country. This includes challenges on policy, legal and institutional frameworks.

The NAPHS (2018 – 2022) provides a roadmap to improve health security in Nigeria; to be achieved through a multi-sectoral approach hinged on the principles of ‘One Health’ with significant participation from stakeholders from relevant government ministries, departments and agencies and partners.

Speaking during a high-level meeting with Heads of MDAs organised by the Nigeria Health Watch and other partners, the experts called for the inclusion of NAPHS activities in the 2022 budget.

They also advocated for multi-sectoral collaboration for the successful implementation of the NAPHS with the Federal Ministry of Finance, Budget and National Planning (FMFBNP) leading the coordination process for Advocacy on Financing Health Security in Nigeria. 

Kemi Agbaoye, Senior Programme Manager Nigeria Health Watch said one of the major obstacles to implementing the NAPHS has been the paucity of funds.

She said the NAPHS should be funded because it is essential to provide funds for the NCDC, Ministry of Health, security agencies and all other MDAs to support their efforts to protect the public and the economic health of the nation.

Dr Vivien Idogho, Technical Lead NAPHS, said 2022 is key to correcting delays and deficits in implementation across all 19 technical areas for a holistic One Health Plan.

She said priority activities identified from some technical areas that need funding are radiation emergency, point of entry, bio-safety and biosecurity, chemical events finance and legislation among others.

On radiation emergency and Point of entry, she said, “In Nigeria, there are six hospitals, across the six geo-political zones dedicated to radiation emergencies. 

These require the right equipment such as PPEs and radiation detection equipment to treat radiation emergencies.

“These equipment should be available, not sourced at point of crisis, and training of radiation health care workers for effective response to radiation emergencies.

“Point of entry- Funding to develop a national contingency plan for land boarders across Nigeria.”

Dr Idogho said a review of NAPHS implementation showed that while prevention groups have made some commendable progress in the broad area of prevention of epidemiology, funding this group will provide for higher scores from its current lowest score among the other groups.

She said ways to address these funding gaps include advocacy, sustainable funding, staff, communications and collaboration across and among MDAs and sensitization of the Nigerian public on the importance of demands from their legislators’ health financing

The Director General, Budget Office of the Federation, Ben Akabueze, in his presentation on ‘Financing Health Security: An Effective Budgeting Tool for Epidemic Preparedness’, said with increased allocations to health in emergency provisions from budget amendments in 2020 and 2021 including the 2022 proposal, it is important government at all levels improve allocative efficiency for health sector expenditures while improving transparency and accountability frameworks for allocated health sector funds.

Represented by his technical advisor, Alfred Okoh, he said recent trends show improved federal government allocation to the health sector.

However, he said greater attention also needed to be paid to targeting public health expenditure to ensure appropriate revenues are raised where possible, while maintaining adequate services.

He added that overall, greater emphasis needs to be placed on transparency and accountability as citizens need to be involved and consulted beyond formal oversight mechanisms.

The meeting also discussed the priority areas and core needs for MDAs with relation to the NAPHS and how these needs can be funded with a focus on the domestication of NAPHS in the annual budget.

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