The recent upsurge in #Save'X' or #Save'Y' appeals on social media should be of great concern to any well meaning Nigerian. I was excited that Sylva Ifedigbo’s column of September 9, 2012 in Daily Times Nigeria dwelt on this subject. I wasted no time in reading the piece; had wanted to know if it addressed some concerns raised by other folks. Sylva and I have made donations towards some of these campaigns but there are concerns on whether it's really the way to go. This piece is a response to the opinion shared by my good friend, Sylva Ifedigbo and published in same newspaper on September 16, 2012.
In my understanding, Mr Ifedigbo agreed that it is fine to
provide funding assistance to people with ill-health but expressed fears that
such appeals on social media could give limitless opportunities for
manipulation by some bad eggs among us. He absolved government of blame but
rather lampooned non-governmental organizations (NGOs) whom he also accused of
applying donor funds for personal uses. He felt the solution was the
development and promotion of ‘sincere’ health advocacy and philanthropy.
There is no doubt that there are some compatriots who have
made it a duty to manipulate excellent initiatives for personal gains. Mass appeal for funding support for people
with health challenges did not begin with social media; I can remember the
‘Save Steve Kadiri’ appeal on African Independent television in late 90s.
People also do same with scary pictures on the streets and parks. Like Ifedigbo
rightly noted, the success of #SaveOke campaign on social media must have
triggered the upsurge in such appeals. The credibility of the appeals was
brought into question when someone was found to have included his personal
account number alongside with those of the beneficiary. But apart from the
proclivity to being abused, donor fatigue makes the #SaveSomebody appeals
unsustainable.
Although Mr Ifedigbo made a correct diagnosis of the
problem, I think the scathing remarks and blanket indictment of NGOs is
ill-informed, undeserved and most unfair. NGOs like other institutions in
Nigeria are not free from corruption, but that does not make them culpable for
the inability of many Nigerians to afford health care. Donor agencies have targets
for NGOs which they work assiduously to meet. Most donor funds support
provision of free HIV/AIDS, TB, Malaria, maternal and child health services in
designated facilities across the country. On the other hand, the #SaveSomebody
appeals are required for the management of non-communicable diseases. I’m not
aware of any donor fund meant for free treatment of cancer, chronic kidney
diseases, diabetes and hypertension in Nigeria. As a health professional that
have worked with both government and non-governmental institutions, I can
confidently say that successive governments in Nigeria have not demonstrated
satisfactory political will to addressing the nation’s health challenges.
Succinctly, the problem highlighted by this article borders
on health care financing. Though it isn’t peculiar to Nigeria but is our
government doing enough to solve it, the answer is NO. The report of National
Health Accounts (2008) found that 69 per cent of our national health
expenditure is out-of-pocket. The National Bureau of statistics report also
showed that more than two-third of Nigerians live below poverty line. The
official national unemployment rate (which I feel is underestimated) is about
24%. Yet, there is no functional health insurance programme for the unemployed,
the poor or even children neither does the existing health insurance program cover
catastrophic health expenditure as required by organ transplant and other major
surgeries.
A recent study, CarapinhaJL, et al. Health insurance systems in five Sub-Saharan African countries:Medicine benefits and data for decision making. Health Policy (2010), noted
that households use savings, sell assets, procure loans or borrow from family
and friends to cope with high out-of-pocket payments. Out- of-pocket payments lead to impoverishment
when payment is required to access health care services and when households do
not have the ability to pay.
Undoubtedly, well implemented social health insurance policies
prevent impoverishment from catastrophic health events. Well-designed medicine
benefit packages are therefore urgently needed to protect households from
economic burden and facilitate affordable, equitable access to quality use of
essential medicines.
I’ve discussed this topic with lots of Nigerian youths in
the last couple of weeks and all agreed that we need a sustainable solution. In
my opinion, a sustainable solution for this problem will be for government to
go beyond the formal sector and implement the other five social health
insurance programmes (urban self-employed, rural community, children
under-five, permanently disabled & prison inmates) contained in the NHIS
Act and also create insurance policy to cover catastrophic health events, the
unemployed and the poor.
Additionally, the National Health Bill should also be
re-presented to the national assembly for legislative action without further
delay. Government cannot do it alone but she must take the lead. It is then
that trusts/foundations by the billionaires, celebrities, religious/corporate
organizations would become more useful and less prone to abuse. It would be
awesomely good if all Nigerian youths and promoters of #SaveSomebody appeals
join efforts and demand that government makes this happen.
God bless Nigeria.
