Looking back on 2013

The private sector started out making in-roads into what big-time, big-spending health care.

Private notches
A private consortium proposed a $650 million (N104.7bn) multi-hospital complex for 1,687 beds, in Abuja, but government hasn’t seemed keen, even though health minister Onyebuchi Chukwu said the project fit the concept of a new designed city to mark 100 years of Nigeria’s amalgamation.
Kanu Heart Foundation started a N5 billion fund to open a cardiac centre and save treatment costs. The centre, formed after football start pulled through a heart surgery himself, has 126 patients-young as four months, old as 52 years-on its surgery list. It has sponsored 425 surgeries for such patients in the past 13 years in hospitals in Britain, Israel and India.
Nigerian doctors have begun some chest beating about doing such surgeries at home. In July, Garki Hospital, Abuja-the country’s five-year-old experiment in public-private partnership-grabbed headlines when it operated on a two-year-old to close a hole above her heart.
It was a landmark surgery. Months later, surgeons  there did three more open-heart surgeries, using Nigerian and foreign hands.
One such foreign hand was Dr Nadey Hakim, transplant surgeon at London’s Hammersmith Hospital. With more than 2,000 successful kidney transplants under his belt, he oversaw Abuja’s first such transplant in January on a 20-year-old at ViewPoint Hospital. In November, he worked with GHA’s Dr Elijah Miner to complete three consecutive kidney transplants.
Dr Hakim was optimistic he would sit on the sidelines next time he’s invited for a kidney transplant.
“You have got a beautiful, rich country, with the most beautiful highways ever. You should be able to have the best hospitals in the world. Money is not an object. People come and work in Nigeria to earn money, so obviously you must have the money somewhere. But I think you should be selfish and use it for yourselves instead of sending all those hundreds of thousands of pounds to the States or England to spend on other people,” he said.
“We can expand [the services]. I see no reason why we cannot perform ten transplants a month. It is more difficult to get a visa to come to Nigeria than to do the transplant.”
Also this year, Bauchi State saw its first spinal surgery performed by a team led by Dr Kawu Ahidjo of University of Abuja Teaching Hospital.
Money and vaccines
Go back to the $650 million (N104.7bn) mentioned at the outset. Coincidentally, $650 million is roughly the cost of the National Routine Immunisation Strategic Plan to ensure that more than 90% of local government areas around the country attain 80% immunisation coverage by 2015 by cutting out blockages that stop vaccines reaching children.
The plan got strong backing from billionaires Bill Gates and Aliko Dangote  during the former’s visit in November.
Other than doling out the money, both believe at least four in 10 deaths among children can be stopped if immunisation systems work effectively.
National Primary Health Care Development Agency said it was bearing down on its target immunisation coverage for children.
“We are beginning to see a lot of progress in our immunisation system,” said the agency’s executive director, Dr Ado Muhammad.

By October, routine immunisation reached more than eight in 10 children-a figure the agency said was “unprecedented” and could be exceeded, once cold chain system for vaccine improves.
Polio immunisation took a hit after some 13 vaccinators were shot dead in two states while on duty.
However, half of all children not immunised were either in Kano (with security challenge) or Lagos (with access challenge)-two states that account for 50% of unimmunised children nationwide, the agency said
Mass vaccination for other diseases have also hit high numbers-10 million for yellow fever, 11 million for meningitis in 2013 alone.
It is difficult to gauge the number of deaths averted. But actual number of deaths that occur are a minefield. Health authorities continually disputed statistics quoted in the media. Nigeria’s own current demographic survey was conducted in 2008, and an expected 2013 edition is yet to be released.
The figures were grounds for claims the country could not meet targets on Millennium Development Goals by 2015. Not to worry. Nigeria shifted the goal post-flagging off instead Sustainable Development Goals post-2015.

Ambitions
It is also the sort of ambitious statement that greeted the African Heads of Government Summit, where President Goodluck Jonathan unveiled his “presidential response” that aims to test up to 80 million Nigerians for HIV.
The summit also considered tuberculosis and malaria-as well as possible widespread adoption of controversial insecticide DDT in malaria eradication programme on the continent.
Only one-third of 1.5 million HIV-positive Nigerians people eligible for treatment actually get treatment.
In December, some swore off therapy after a generic ARV manufactured by Lagos-based pharmaceutical firm Tyonex caused adverse reactions, blaming regulating agency NAFDAC and federal health ministry.
It’s a falling-out set to continue into 2014 in the same fashion as healthworkers and the government clashed at several points through 2013.
The biggest contention was the National Health Bill. Both Senate and House of Representatives have spoken of possibility of passing the bill in 2014-and leave entrenched camps to sort out their differences.

Strikes, more strikes, and then some
But the differences simply continue, and stole into doctors’ demands when Nigeria Medical Association issued an ultimatum in September. A recent assessment of health workforce concluded there was just one doctor for every 2,500 Nigerians, adding the country would need up to 80 years to reach adequate doctor-population ratio.
NMA cited the issue among reasons it could continue a suspended strike in January-noting that injustices against doctors had driven many of its members out of the country.
Despite the giddying heights that started off 2013, the year slumped to strikes at its close-with a promise that the low could linger into 2014.