USAID Advocates Judicious Use Of Health Care Financing Options

usaidThe United States Agency for International Development (USAID), has advised federal and states governments to ensure judicious use of available health financing options in the face of dwindling global funding for the health sector in Nigeria.

A representative of the American agency, Mrs Celeste Carr, gave the advice at a workshop on health care financing for state commissioners of health and their legislators in Abuja.

According to her, Nigeria’s health sector can be appropriately financed even in the face of dwindling global funding if local funding options are properly utilized.

In the last one decade, the Global Vaccine Alliance (GAVI), is said to have provided much funding for Nigeria’s health sector.

However, GAVI’s plans to stop the funding in the year 2017, has raised serious concerns about how the government will make up for the funding gaps that its exit and that of other donor partners would create.

Some participants in the forum have now advocated the need for a strong legal framework that will ensure universal health coverage and health care financing.

Meanwhile, a representative of the state’s Commissioner for Health, Balarabe Kakale, emphasized the need to implement the Abuja declaration of 2001 to improve financing for the health sector.

The nation’s annual appropriation for health has been fluctuating between 5.4 and 4.6 per cent of the total budget for the country since 2011.

However, in an attempt to improve the sector, the government is planning to scale the budget up to six per cent as it has earmarked 51 billion Naira for in the 2017 budget currently before the National Assembly.

NPHCDA Decries Poor Primary Healthcare Funding

NPHCDA Decries Poor Primary Healthcare FundingThe National Primary Health Care Development Agency (NPHCDA) has blamed inadequate funding of the health sector on the poor primary healthcare services in Nigeria.

The Acting Director of NPHCDA, Emmanuel Odu, made the criticism at the 2016 annual primary healthcare lecture in Abuja, organised to discuss sustainable financing options for the sector.

Mr Odu stressed the effects of poor funding for the health sector on primary healthcare services in Nigeria, revealing that over 70% of Nigeria’s health funding comes from donor partners, tax revenues and ‘out of pocket’ spending by the individuals.

Also, a representative of the Northern Traditional Rulers at the forum and Emir of Jiwa, Idris Musa, explained how the lack of funding for primary healthcare had affected their communities.

The Director of Public Health at the Federal Ministry of Health, Evelin Ngige, who spoke on behalf the Minister of Health, confirmed the poor monetary allocation to the health sector.

She, however, assured the people of the government’s determination to provide more funding going forward.

The Global Vaccine Alliance, otherwise known as Gavi, has provided much funding for primary healthcare service in Nigeria.

The decision of the organisation to stop the funding of vaccines in Nigeria by 2017 has raised serious concern about how the Federal Government would make up for the funding gap that the exit of Gavi and other donor partners would create.

Out of the 6.08 trillion Naira 2016 budget, 221.7 was earmarked to fund the health sector.

This is a far cry from the 15% of Nigeria’s budget agreed by African leaders at the Abuja Declaration in 2001 to be committed to the health sector.

WHO Says Pilot Phase Of Malaria Vaccine Due In 2018

Malaria DrugsThe world’s first malaria vaccine will be rolled out in sub-Saharan Africa in 2018, the World Health Organisation (WHO) has confirmed.

It says funding is now secured for the initial phase of the programme and vaccinations.

The vaccine, known as RTS,S, acts against P. falciparum, the most deadly malaria parasite globally and the most prevalent in Africa.

A statement by WHO said advanced clinical trials had shown RTS,S to provide partial protection against malaria in young children.

“The pilot deployment of this first-generation vaccine marks a milestone in the fight against malaria.

“These pilot projects will provide the evidence we need from real-life settings to make informed decisions on whether to deploy the vaccine on a wide scale,” the Director of the WHO Global Malaria Programme, Dr Pedro Alonso, said.

Vaccine Financing

The Global Fund to Fight AIDS, Tuberculosis and Malaria on Thursday approved $15 million for the malaria vaccine pilots, giving assurance of full funding for the first phase of the programme.

Earlier this year, Gavi, the Vaccine Alliance and UNITAID announced commitments of up to US$ 27.5 million and $9.6 million, respectively, for the first four years of the vaccine programme.

RTS,S was developed through a partnership between GlaxoSmithKline and the PATH Malaria Vaccine Initiative (MVI), with support from the Bill & Melinda Gates Foundation and from a network of African research centres.

“WHO recognises and commends the leadership and support of all funding agencies and partners who have made this achievement possible,” Director of the WHO Department of Immunization, Vaccines and Biologicals, Dr Jean-Marie Okwo-Bele, said.

In October 2015, two independent WHO advisory groups comprised of the world’s foremost experts on vaccines and malaria – the Strategic Advisory Group of Experts (SAGE) on Immunization and the Malaria Policy Advisory Committee (MPAC) – recommended pilot implementation of the RTS,S vaccine in three to five settings in sub-Saharan Africa.

Required Four Doses

These recommendations followed a July 2015 announcement that the European Medicines Agency (EMA) had issued a positive scientific opinion of the RTS,S vaccine.

WHO officially adopted the SAGE-MPAC recommendations in January 2016 and has since worked to mobilise financial support for the pilots and to finalise the programme design.

The pilot programme will evaluate the feasibility of delivering the required four doses of RTS,S; the impact of RTS,S on lives saved; and the safety of the vaccine in the context of routine use.

It will also assess the extent to which the vaccine’s protective effect demonstrated in children aged 5–17 months old in the Phase Three trial can be replicated in real-life settings.

RTS,S is the first malaria vaccine to successfully complete pivotal Phase Three testing.

The Phase Three trial enrolled more than 15,000 infants and young children in seven countries in sub-Saharan Africa. Countries that participated in the Phase three clinical trials will be prioritised for inclusion in the WHO pilot programme, who said.

Consultations are ongoing and the names of the three selected countries will be announced in the coming weeks.

Who explained that there were two target age groups in the Phase Three RTS,S trials – infants who received the malaria vaccine together with other routine childhood vaccines at six, 10 and 14 weeks of age and older children who received their first dose of the malaria vaccine between five and 17 months of age.

The RTS,S vaccine is proposed as a tool to complement the existing package of WHO-recommended malaria preventive, diagnostic and treatment measures and will be used in combination with the current interventions. Other tools include: long-lasting insecticidal bed-nets, spraying inside walls of dwellings with insecticides, preventive treatment for infants and during pregnancy, prompt diagnostic testing, and treatment of confirmed cases with effective anti-malarial medicines.

Deployment of these tools has already dramatically lowered malaria disease burden in many African settings. Between 2,000 and 2015, the rate of new malaria cases in sub-Saharan Africa fell by 42% and malaria mortality rates fell by 66%.

However, this region continues to account for approximately 90% of global malaria cases and deaths.

As RTS,S is only partially effective, it will be essential that any vaccinated patients with a fever be tested for malaria, and that all those with a confirmed malaria diagnosis are treated with high quality, effective anti-malarial medicines.

Primary Health Care: Senate To Probe Usage Of Donor Funds

Senate-NigeriaThe Senate Committee on Primary Health Care and Communicable Diseases is set to probe funds meant for polio eradication in Nigeria.

The committee has alleged irregularities in the handling of over 420 million dollars global funds.

The Chairman of the Committee, Senator Mao Ohuabunwa, spoke with journalists on Monday as part of events marking the World Polio Day.

He said the committee would also check to see how the $1.5 million recently disbursed to 36 states in the country was utilized, to guard against the resurgence of polio.

The Senator said that it is important that donor funds are well spent and that funds meant for citizens reach those that need them.

The Geneva-based Global Alliance for Vaccines and Immunization (GAVI) had indicted Nigeria for alleged misapplication of funds donated for immunization of children against polio in the country.

Also, the Ministry of Health and the National Primary Health Care Development Agency were implicated in a fraud audit conducted by GAVI, in which over $400 million disbursed for procurement of vaccines was alleged to have been grossly abused by Nigerian officials.

Meanwhile, the United Nations Children’s Fund (UNICEF) has also urged Nigeria to strengthen its primary healthcare system in other to curb the spread of wild polio virus in the northeast to other parts of the country.

The Chief of Health for UNICEF in Nigeria, Mr John Agbor made the appeal at another news conference in Abuja to mark the 2016 World Polio Day.

He explained that this has become important to enable Nigeria consolidate on the little gains already made in its effort to eradicate the virus.

Nigeria’s polio–free certification suffered a major setback in August 2016, when four new cases of wild polio virus were reported in the north east.

We’re Making Genuine Efforts To Correct Our Lapses – Buhari

BuhariPresident Muhammadu Buhari has given the assurance that lapses that have characterized Nigeria as a nation would be corrected.

Receiving a team led by Dr. Seth Berkley, Chief Executive Officer of Gavi and The Global Fund in State House, Abuja, Thursday, President Buhari said he was impressed with the patience and steadfastness of leading supporters of health care in Nigeria, “despite our shortcomings as a nation.”

“We are making genuine efforts to correct the lapses. We are very serious about people behaving themselves, and being accountable,” the President said.

“We thank you for deciding to re-engage with us, despite our inefficiencies. You decided to be here, not minding our shortcomings. There are other countries that would bring less problems. We appreciate your commitment, and we will do our best to put ourselves in the best shape to help us,” President Buhari said.

Buhari-Global-fund-gavi

Dr Berkley, who noted that the three focal points of the Buhari administration; security, economic development, and anti-corruption were critical to the future of Nigeria, had raised issues over the way donor funds for health care were utilized in the past.

He said Gavi and the Global Fund were disappointed when forensic audit revealed systemic weaknesses and corruption in the utilization of funds given in the past, adding that there is now a “breath of fresh air” under President Buhari’s leadership and fight against corruption and they were willing to “close the books of the past, and look into future support.”Buhari-Adewole-Gavi-Global-fund

Minister of Health, Prof Isaac Adewole, who was also at the event, disclosed that those indicted in the audit of the donor funds in the past, which was done between 2010 and 2015, had already been questioned by the Economic and Financial Crimes Commission (EFCC), and would be arraigned in court soon.

Op-Ed: SERAP? Shut up!

serap

I am often amazed at the proclivity of some idle persons for claims that are not only exaggerated but also completely baseless. These ambitious individuals are usually used by paymasters to spin all sorts of specious tales whilst hiding behind the mask of non-governmental organisation, civil society or pressure group of various nomenclatures. Their ostensible motivation is public interest, but their real goal is to get back at perceived enemies of their sponsors and, perhaps, gain some popularity for themselves in the process. One group that appears to have mastered this art is so-called Socio-Economic Rights and Accountability Project (SERAP).

An examination of the group’s activities, compared to its stated objectives, shows that SERAP is little more than a terribly misguided set of noisemakers. While the group is touted as a non-profit organisation established “to promote transparency and accountability in the public and private sectors through human rights”, recent developments have shown that the organisation is nothing but a bunch of attention-seeking opportunists.

In fact, one doubts if it is really an organisation and not a “one-man battalion” with the unseemly prominence of one Adetokunbo Mumuni who is believed to be the body’s Executive Director.

Anyone who has been following this SERAP’s press releases and “media noise” would easily understand what I am talking about. The latest in the series of uncouth debates generated by the group is its false alarm about the recovered Abacha loot. In a statement made available to the public on November 29, 2015, SERAP alleged mismanagement of the recovered funds and called on President Muhammadu Buhari to probe ex-minister of finance, Dr Ngozi Okonjo-Iweala. How do you call for the probe of someone who facilitated the recovery of the loot and ensured its judicious disbursement?

Alluding to records purportedly obtained from the World Bank, Mumuni in SERAP says it is “closely studying and scrutinising with a view Dr-Ngozi-Okonjo-Iweala-2to discovering whether the documents contain details that Nigerians would like to see and whether the information correspond to the facts on the ground.” In the same breath, however, he calls for the probe of the former minister of finance. Isn’t it instructive that the ramshackle of a group has proceeded to pass judgement while acknowledging that it had not done due diligence to conclude its scrutiny and investigations?

Contrary to SERAP’s claims that the disbursement of the fund was not monitored, the World Bank indeed monitored how the money was spent, together with a group of Nigerian and Swiss NGOs. Beyond monitoring, they issued a report which is well documented at the World Bank. The gist of the entire process has been in the public domain for about a decade. Apparently, the bank has furnished SERAP with the relevant documents in this regard, and the latter is attempting to twist the information to defame Dr Okonjo-Iweala and sully her reputation.

The World Bank specifically stated in one of its reports that the monitoring and analysis of repatriated fund utilisation was undertaken both at the macro level and at the micro level. While the macro level involved analysis of general budget expenditure trends, the micro level deployed a field survey of randomly selected projects funded under the program. In its December 2006 report, a 58-page document [http://siteresources.worldbank.org/INTNIGERIA/Resources/Abacha_Funds_Monitoring_1221.pdf], the World Bank clearly affirms that in spite of expected difficulties recorded in the joint monitoring exercise – being the first of its kind – the process was largely successful. It earned a seal of approval from the government and civil society, both of whom acknowledged that they have found the exercise valuable.

Now, where was SERAP when these reports were published and jointly attested to by international observers, government representatives, and reputable Civil Society Organisations? The monitoring exercise involved bodies like the Nigeria Society of Engineers, Institute of Chartered Accountants of Nigeria, Action Aid International, Civil Society Legislative Advocacy Centre, among others. It is laughable that an organisation which claimed to have been in existence since 2004 has only just woken up in 2015 to raise issues where none exists. How daft and desperate can people be? Well, the good news is that SERAP and its sponsors are about to be revealed for who they really are. So Nigerians will not be deceived anymore by their antics.

It will be recalled that this same Mumuni in SERAP was used to call for the revocation of Okonjo-Iweala’s appointment on the board of GAVI, owned by Bill and Melinda Gates, for spurious claims that the former minister favoured GAVI while in office. The silliness of SERAP is made glaring when one considers that the money in question was not Nigeria’s money in the first place. It was GAVI’s donation to Nigeria for the immunisation of Nigerian children, for which GAVI later discovered inappropriate use of $2.2million of the funds and therefore called for a refund of that amount. An official release of GAVI’s finding was published on its site several months ago to set the record straight on this transaction [http://www.gavi.org/Library/News/Statements/2015/Reimbursement-of-misused-amounts-identified-in-Gavi-Cash-Programme-Audit-in-Nigeria/].

Little wonder that despite the sponsored hullabaloo made by SERAP and its media cronies, GAVI did not even accord their noise a glancing attention.

I think it’s high time Mumuni, his hurting sponsors and SERAP shut up or go get another prey. That Okonjo-Iweala woman is too smart and too formidable a target for their puerile and uncoordinated stratagem. And the Nigerian people are a better informed audience than Mumu gives them credit for.

 

Issachar Odion is a Political Scientist writing from Port Harcourt.

Okonjo-Iweala Gets Two Key International Positions

Dr-Ngozi-Okonjo-Iweala-2Former Minister of Finance and Coordinating Minister for the Economy, Dr Ngozi Okonjo-Iweala has accepted two key international positions.

The first is to serve as Chair of the 28-member Board of the Global Alliance for Vaccines and Immunisation (GAVI), an international public-private partnership committed to saving the lives of children and protecting people’s health by improving access to immunization in developing countries, including Nigeria.

Dr Okonjo-Iweala was elected to the position after a competitive international search process.

In the second appointment, the former Managing Director of the World Bank has also joined the highly respected 167-year-old global investment firm, Lazard as Senior Advisor.

Her focus will be sovereign advisory.

“We are proud to welcome Dr. Okonjo-Iweala as a Senior Advisor to our world-leading sovereign advisory group,” said Matthieu Pigasse, Global Head of M&A and Sovereign Advisory of Lazard.

“She will bring a unique international expertise and experience that will benefit both our sovereign and corporate clients.”

At Lazard, Dr Okonjo-Iweala will work alongside colleagues including former Prime Minister of Australia, Paul Keating; former Special adviser to President Bill Clinton, Vernon Jordan; former Spanish Economy Minister and current Snr. Managing Director at Lazard, Rodrigo de Rato; former chair of NASDAQ, Frank Zarb; former Finance Minister of Chile, Andres Velasco; and former British Minister of Parliament/Secretary of State for International Development, Andrew Mitchell.

In her reaction to the two appointments, Dr Okonjo-Iweala, who would be working out of Paris, Geneva and London said,”I am excited to be embarking on this fresh journey. The two appointments will enable me to continue doing what I know best; rendering public service and using my financial and economist skills.

“I thank the international community for the recognition and continued support. I am also grateful for the prayers and support of many Nigerians.”

GAVI is a $12 billion multilateral partnership which disburses grants of upwards of $1.8 billion annually to developing countries for immunization programmes.

GAVI brings together developing countries and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialized and developing countries, research and technical agencies, civil society, the Bill & Melinda Gates Foundation and other private philanthropists.

GAVI is funded by governments of Australia, Brazil, Canada, Denmark, France, Germany, India, Ireland, Italy, Japan, the Kingdom of Saudi Arabia, Luxembourg, the Netherlands, Norway, the People’s Republic of China, Republic of Korea, Russia, South Africa, Spain, the State of Qatar, the Sultanate of Oman, Sweden, United Kingdom, and the United States as well as the European Commission, the OPEC Fund for International Development (OFID) and other institutional and corporate partners.

It would be recalled that, from 2000-2015, GAVI disbursed $425m in grants to Nigeria, an average of about $30m per annum for vaccination and immunization of children, including polio vaccines.

Dr Okonjo-Iweala succeeds Dagfinn Høybråten, a former Norwegian Minister of Health and current Secretary General of the Nordic Council of Ministers as Chair of GAVI.

Previous Chairs include Mary Robinson, former President of Ireland and respected education activist and former First Lady of South Africa, Graca Machel.