‘Health bill, necessary for MDG’s achievement’
Dr David Olayemi, is the senior programme adviser, of “Save the Children” Nigeria, in this interview by Ruby Leo and Judd Leonard Okafor, he speaks on the need to have a serviceable health bill to help improve the well being of Nigerians.Why is the health bill so important to Nigeria’s health?
We discovered that the environment for advocating on health issues generally in Nigeria is very difficult because of the policy of the environment. We know that without legal support, it is very difficult to advocate to Nigerian policymakers on health matters.
If the law in Nigeria has a robust platform for safeguarding people’s health, then it is much easier to appeal to policymakers to at least keep to the rules and ensure that the health of Nigerians is assured, because basic health as far as we are concerned is a right.
Having realized that the constitution is silent or has not made justice able provisions for health, we decided to support the development of such a legal requirement to ensure that the health of the Nigerian is assured. What that means is that it commits government to strengthening the system to make quality health available. It also ensures that some money is provided to take care of Nigerians’ health.
If you look at some of the clauses in the health bill, which is still a subject of controversy, you will discover that provisions are made to ensure that Nigeria’s health system is strong enough to have all the six pillars of the health system strengthened in order to be able to support health.
These six pillars include governance, financing, provision for drugs, infrastructure, human resource for health, health management information system. We believe that if this is strong enough, a Nigerian will be able to access health wherever he or she lives. It will be possible for the child to have quality health made available to him or her.
Has the health bill made any provision to strengthen these six pillars that you have spoken of, despite these controversies?
We are starting from a zero situation to a more positive situation. You can never have a document that is good enough to address all issues. You can also not have a document that does not have its own flaws. These are human documents. To that extent, it is not as strong as we the advocates would want it, but it is much stronger than when we had nothing to rely on. To that extent, the national health bill is actually leading us in the right direction.
Realizing that such a document will certainly need some correction in the future in terms of review, for god’s sake let us at least start from somewhere, let us at least be seen to be moving in the right direction—which is what the national health bill is doing. It is a document written by imperfect human beings. It is a document that has its own flaws. But as controversial as it may be it addresses fundamental problems. To that extent, it is the right way to go, and I believe that the President should be appealed to—to append his signature to that bill.
We have been talking about appealing to the president for assent, but indications are that the bill might not be with the president at the moment, that it might have left the National Assembly and gone back to the federal ministry of health. It is not categorically certain where it is now, but there is concern about the controversy that led to the uncertainty as to where it is now.
The President has not come out to tell Nigerians what he sees as the problems with the bill. Maybe he doesn’t have to tell Nigerians—I don’t know. But I am just hoping that if the President has some issues with the health bill, he will make them known to the National Assembly so it can reciprocate by correcting those things and getting it across to the president as soon as possible.
We are talking about the lives of Nigerians, mothers and children dying in their thousands. It gives me a lot of concern. I believe it gives the president a lot of concerns too. If it does, then I hope the president will clearly articulate his reservations and the National Assembly will correct those things and get it across to him. We have stayed seven or eight years without a law.
Remember 2015 is around the corner and the truth is that Nigeria is not moving in the right direction in terms of achieving MDGs 4 and 5. The whole world is waiting, and I believe this is a golden opportunity for the President to write his name in gold. We will never forget a president that signed that bill. That is the truth.
How is the international bodies handling or taking the president’s refusal to assent to the bill, would this affect their commitment to the countries?
Nigeria is presently at a stage where the world is expecting it to succeed in terms of achieving the MDGs, and this can only be done if the environment is made right. It is obvious the environment in Nigeria wherein the health Nigerians can be assured is not right, and the bill is just one way to get it done.
It is actually the first step. A situation where policymakers do things in health and make [them] look like a favour is not right. Basic health, basic education, shelter, water—all are rights. We have given the president our resources to be able to make certain rights available to us.
It is not a favour. These rights are fundamental, nonnegotiable. It is like my resources have been placed in the hands of those who govern us so that they can repackage it properly and get them back to us. If I am not getting it, then I am denied something that is fundamental. If the minimum that should be done for everybody is ten percent, if I am not getting that ten percent, then I am being denied a right. If I now need something beyond the ten percent, I have to source for it myself. If somebody needs a kidney transplant, for instance, that is what you have to source for. But the basic ones, which have to be clearly defined according to our resources, are what we are asking for—and they are what this law guarantees.
Nigeria is where majority of children and mothers in Africa are dying. That is unacceptable. Is it because we don’t have as much resources as Ghana and South Africa? Of course, your answer will be quite clear—no. We have more resources than those countries, so why are they getting those basic rights and we are not? These are questions Nigerians should be able to clearly understand and ask—and I hope our leaders will reciprocate by rising to the occasion to provide the services.