Tuesday, 24 December 2013

Analysis of Nigeria's budget for health in 2014

N262B (1.7Billion USD) has been allocated to #health in Nigeria's 2014 budget; of which 82% is going to recurrent expenditure. All the detailed allocations to the Ministry of Health can be found here. We urge you to go to the website, download a copy (who knows how long it will be up) and use it to hold our health sector organisations accountable. Remember that we do have a Freedom of Information Act in Nigeria and we cannot blame government if we don't use it. 

Health Allocation in 2014 Nigerian Budget
The N262B allocated to #health is about 6% of the total budget and second only to defense, education and finance (finance includes debt servicing). It is slightly less than the N279 allocated to Health in 2013. 

Some interesting aspects of the budget includes the N4B budgeted for the National Health Insurance Scheme, this is before  premiums are collected! Yet, it still covers less than 4% of the population, mostly employees of the Federal Government and its parastatals. 

The National Arbovirus and Vector research Institute (heard of it?…..not surprised you haven’t....we have not either). Its gets a budget of N175M. We marveled at the existence of such an important research institute in Nigeria and desperately searched online for its outputs. We found a grand total of two articles published in 2008 and 2009. We will be looking for this institute in Nigeria next year - if you have any clues where they are, kindly share! 

Our regulator; the National Agency for Food and Drug Administration and Control (NAFDAC), gets a cool N4Billion – maybe 2014 will be the year fake medicines and fake "pure" water disappears from our shelves and the 'medicine line' in Ogbete main market is finally closed down! 

For our tertiary hospitals, which in combination consume a huge part of our health expenditure; the University of Nigeria Teaching Hospital gets more than any other teaching hospital in Nigeria in 2014 – a cool N10Billion! The Chief Medical Director; Dr Christopher Ama must be smiling in his office this morning (as on their website). In 2014, we will be visiting Dr Mba to experience what his "transformation agenda" is bringing to UNTH!  UCH Ibadan gets N9B, ABU Zaria  N6B, and LUTH gets N6B. 

The Nigeria Centre for Disease Control, said to be located in Abuja is finally on the map with N701M. We could neither find a physical address nor a website. If you can find any of these, please do let us know. How can we hold them accountable if it exists virtually? 

Then, there are all the health related items that for some reason or the other are not under the health budget, but under “The Presidency”. The Nigerian State House has budgeted N34M for an XRay machine, N41M for a mammography machine, and N1.6M for an embalming machine. We will not comment further on this...find out why here

Also not on the the health budget is the N2.1B allocated to the National Agency for the Control of AIDS  (NACA). The most worrying aspect of this is that  none of this is will go to providing the 2.5 million Nigerians living with HIV/AIDS with life-saving antiretrovirals. N50M will be spent on one line item; supervision, monitoring and evaluation. This will be enough to provide an extra 3500 Nigerians with ARVs at a conservative estimate of $100 per patient, per year in 2014. 

To do all your personal research, download the health sector's budget here. To find a lot more analysis on the budget (not health sector specific) go to the the excellent  website of "Budgit"  http://www.yourbudgit.com/ and follow them on twitter @BudgITng. They have an excellent spread sheet comparing the 2014 to 2013 budgets here.  

We have a lot more information to hold the institutions in the health sector accountable for how they spend our money! We will be doing a lot more of that in 2014! 


Uju Okereke said...

Very useful post Chikwe. I am now on a mission to find these ghost organisations. I mean even the NAtional CDC doesn't exist!!!!! What?????
I'll feedback if I discover anything.

ogo egbuna said...

What about NIMR- the national institute of medical research? They need all the help they can get. I work with them so I know they exist. They do a lot of important work and have outposts all over the country.

Oyewale Tomori said...

No, Uju
NAVRI and NCDC are not ghost institutions
NAVRI has been in existence since the 70s and NCDC since 2010.

See comments below

The National Arbovirus and Vector Research Institute is based in Enugu. It was originally the WHO Arbovirus Vector Research Unit, P.O. Box 104, Enugu, Nigeria.

The man to remember there is Mr. Ezike, a renowned entomologist of the highest caliber. We had worked with them in those gone by days testing their mosquito collections for viruses in Ibadan lab. They were always with us on all those YF field investigations serving as the main entomology arm of such investigations. Dr. Adeniji of the Ibadan lab also participated in the studies. It was the Enugu outfit that first described the presence of Aedes albopictus mosquitoes in Nigeria, and they later on went on to map the entire distribution.

In 2008, the Enugu NAVRI group worked with a WHO team to conduct an entomological risk assessment of yellow fever vectors in Nigeria. The team included the following Mr. Ezike, (currently with Novena University) Mr. Nwankwo, Mr. Umosu, (all of NAVRI), Dr. Mawlouth of Institut Pasteur Dakar, Senegal, Mrs. Agwu of UNN Nsukka, Mr. Uwagae and Miss Akerele both of Ambrose Alli University. The team was led by Dr. Okogun an entomologist also of Ambrose Alli. The report formed the basis of Nigeria's submission and request for over 100 million YF vaccine doses to GAVI-WHO support to conduct mass YF campaign in Nigeria. The first part of the mass campaign was carried out in Nasarawa, Akwa Ibom and Cross River States from Nov-Dec 2013. The entire country will be covered over the next 4 -5 years.

The group has made several important publications on their area of study, and collaborated with many other units and departments, especially of the UNTH Enugu

This is an institute that has made significant contributions to the health of Nigeria and must be rescued. What we find is that more of what is allocated, for example in 2012 was not for developing the Institute but for contractors to construct drainage, access road and an auditorium. The rest of whatever was allocated to the Institute was for emoluments, nothing for research

Again, we hear that The Nigeria Centre for Disease Control, said to be located in Abuja is finally on the map with N701M. This is not the first time money has been allocated to the NCDC, but allocation does not always mean the money is disbursed, if disbursed, does not mean it is used for the INTENDED purpose of allocation and disbursement. Since established in 2010, it has been a war of destruction between the staff of the Ministry from the highest to the lowest

, Go to this website http://www.cdc.gov/globalhealth/countries/nigeria/what/hss.htm
and you will find some info about our NCDC
Nigeria’s Centre for Disease Control
In 2010, CDC helped establish the Nigeria Centre for Disease Control (NCDC) to support and sustain public health activities in Nigeria. The NCDC is housed under the Nigeria Federal Ministry of Health (FMOH). Like U.S. CDC, NCDC coordinates health responses and intervention activities to prevent and control emergencies and outbreaks. Professor Abdulsalami Nasidi , MD, PhD, OON, is the Director of NCDC.



Oyewale No





Oyewale Tomori said...

Attaching some info about the Enugu Arbovirus place

9. Onyido, A.E., Ezike, V.I., Nwankwo, E.A., and Ozumba, N.A. (2006a). Public health implications of giant trees in the proximity of human dwellings: tree-hole breeding mosquitoes of the Government Reservation Area (GRA) of Enugu metropolis in Southeastern Nigeria. In proceedings of 3rd National Conference of the Society for Occupational Safety and Environmental Health (SOSEH), 8-11th November 2006, Main auditorium, Nnamdi Azikiwe University Awka, page 140-143.
10. Onyido, A.E., Ezike, V.I., Nwankwo, E.A., and Ozumba, N.A. (2006b). Water-borne disease vectors of public health importance. Mosquitoes of Onu Anyi Agbaja-Izzi in Abakaliki Local Government Area of Ebonyi State. In proceedings of 3rd National Conference of the Society for Occupational Safety and Environmental Health (SOSEH), 8-11th November 2006, Main auditorium, Nnamdi Azikiwe University Awka, 144-147.
11. Onyido, A.E., Ozumba, N.A., Ezike, O.C., Nwosu, E.O. Nwaorgu, O.C. and Ikpeze, O.O. (2008). Mosquito fauna of a tropical museum and zoological garden complex. Animal Research International 5(2): 852-858.
12. Nwoke, B.E.B. and Nwoke, E.A. (2006). Contributions of occupational hazards and environmental degradation on emergence and re-emergence of diseases. Book of proceedings, 3rd Annual National Conferenceof Occupational Safety and Environmental Health Management in Nigeria, November 8-11th , 2006, Nnamdi Azikiwe University Awka, Anambra State Nigeria. Pp 7-16.
19. Bang, Y.H., Bown, D.N. and Arata (1980). Ecological Studies of Aedes africanus (Diptera Culicidae) and associated species in Southeastern Nigeria. Journal of Medical Entomology 17: 411-416.
20. Bang, Y.H., Bown, D.N., Onwubiko, A.O. (1981). Prevalence of larvae of potential yellow fever vectors in domestic water containers in Southeastern Nigeria. Bulletin World Health Organization 59: 107-114.
• {full_citation}
Willingness to pay for the retreatment of mosquito nets with insecticide in four communities of south-eastern Nigeria
1. Obinna Onwujekwe1,
2. Elvis Shu1,
3. Reginald Chima2,
4. Angus Onyido3,
5. Paul Okonkwo1
Article first published online: 25 DEC 2001
DOI: 10.1046/j.1365-3156.2000.00558.x
Blackwell Science Ltd

Tropical Medicine & International Health
Volume 5, Issue 5, pages 370–376, May 2000
WHO Arbovirus Vector Research Unit, P.O. Box 104, Enugu, Nigeria.


Idris Muhammad said...

Highly informative comments from professor Tomori. He knows both the NAVRI and NCDC well enough and was authoritative enough on the former. The comment on the NCDC suggests we still have outstanding doubts about this very important outfit that should promote disease control and prevention in Nigeria - rather like its US namesake (minus the N). It is sad if politics is standing in its way!

Idris Mohammed.

Anonymous said...

Thank you Tomori. Very grateful for this important information. I hope the writer of this column takes correction and does proper research before 'inciting the public against the government' by giving false information about these institutions as he/she kept saying they were inactive and not on the map. Also Chikwe, if the budget on health is less than defence, education and finance, then it makes it 4th and not second. Nice sarcasm tho, I enjoyed the article.

Amaka said...

How can we say a research centre is presently active/functional with research dating 1980 and the most recent in 2008 - 6yrs ago. It just supports the question the author asked - are they still functioning??

The info about the Nigerian CDC is as vague as what the author intimated....and this is a dept about to gulp 701m