Insights and Opportunities
Overview: Nigeria’s Health Minister, Professor Adenike Grang, is leading a new initiative to leverage public-private partnerships (PPP) to revamp the country’s healthcare delivery system. Nigeria continues to import most of its medical equipment and pharmaceutical products. Local production is limited to peripheral items such as hospital beds and gurneys. The country lacks the necessary infrastructure and know-how to produce, especially precision medical equipment. However, over the past twelve months, Nigeria has been reforming healthcare policies and rebuilding tertiary healthcare institutions, such as teaching hospitals and primary healthcare centers.
Telemedicine promises a lifeline for Nigeria’s rural and semi-urban communities, which do not have access to any form of functional healthcare facilities. Currently, Nigeria is pursuing an agenda of universal access to both telecommunications and primary healthcare services. The expectation is that by 2015, every Nigerian, no matter his social status, will have access to a form of healthcare service within 15 kilometers. Associated with this national goal is the necessity for technology infrastructure development, capacity building and continuous training for healthcare personnel.
Telemedicine is almost unknown in Nigeria. This is not surprising considering that until recently, Nigeria did not have the appropriate technology and infrastructure base to venture into this specialized class of healthcare services. However, the Society for Telemedicine and e-Health in Nigeria (SFTeHIN), is pro-actively pursuing its development and massive adoption by leading hospitals, public agencies, and private healthcare operators including social entrepreneurs who work in rural communities. Most members of the association are professionals who were trained in America or Europe, or have relationships with users of telemedicine outside Nigeria. The U.S. has a unique opportunity to leverage its bilateral relations to help Nigeria diffuse tele-medical technology, install equipment and develop systems to revamp its moribund primary healthcare services nationwide.
In May 2007, the Nigerian Communications Commission (NCC) issued third generation (3G) licenses to four telecommunications companies. The expectation is that the license beneficiaries will pioneer the laying of the foundation for the high speed voice, data and video transmission networks Nigeria needs to proactively lead the West African sub-region in telemedicine, tele-education and electronic business development.
The vision of Health for All by the Year 2015, will be advanced if Nigeria can leverage telemedicine to improve service delivery especially primary healthcare centers in rural and semi-urban communities. To improve performance standards, the country needs to train more personnel, reduce cost of services, and access expertise not readily available in the country. According to the President of Nigerian Medical Association (NMA), Doctor Dan Gana, primary healthcare system in Nigeria has since collapsed.
Currently, the country boasts of 25,000 practicing doctors from an estimated 50,000. The remaining 25,000 have emigrated to Europe, America, or Middle East. Medical experts have described the Nigerian healthcare system as a manmade disaster. The Government of Nigeria is currently reforming the industry sector starting with introduction of a National Health Insurance in 2005. According to industry sources, four teaching hospitals were transformed into centers of excellence for tertiary healthcare and four more will be completed in 2007. In 2006, 200 primary health centers were rehabilitated and equipped, while about 93 more have reached advanced stages of completion. In 2007, Nigeria established more HIV/AIDS testing and treatment centers.
The government insists it will not be solely responsible for primary healthcare services across the country. Instead, it will support the states in an effort to bring primary health care services to the people, especially in rural communities. The government also restated its commitment to the resuscitation of the healthcare delivery system through systematic funding and mobilization in line with the Bamako Initiative Program, a series of reforms in response to the deterioration of public health systems in developing countries. Despite these pronouncements, the government’s budget allocation to health continues to be less than 10 per cent of the total national budget, which puts it far below the World Health Organization’s minimum recommendation of 15% of the total annual allocation.
Nigeria says it is committed to the Millennium Development Goals but the health sector has remained almost stagnant and old facilities are collapsing. The vision of Health for All by the Year 2015, therefore, may not be realized as there has been very little visible improvement in this sector. Perhaps the only visible program in the sector is the vigorous. enforcement of regulation in food and drug administration by the leadership of the National Agency for Food and Drug Administration and Control (NAFDAC).
Nigeria continues to witness a massive import of food and drugs that have expired or are about to expire. Some of these imports come through the seaports, but large consignments reportedly are hauled overland through porous border routes. However, the leadership of NAFDAC has won praise for courage, thoroughness and integrity. National Health Insurance Scheme (NHIS), introduced in 2006, appears to be going well. The NHIS was first proposed about 30 years ago, but due to inconsistencies in policy implementation, the scheme was delayed for three decades. The NHIS is aimed at generating resources for healthcare delivery as well as providing access to quality healthcare delivery. Other categories of healthcare services that have been given high priority include the intensification of non-curative components of primary health care, such as sanitation health education, national preventive campaigns against childhood diseases and free compulsory immunization programs.
HIV/AIDS has been identified as a growing problem in Nigeria. The government has expressed concern about this looming menace as it could have a devastating impact on Nigeria’s growth and poverty-alleviation efforts if unchecked. Officially, the rate of HIV infection in Nigeria is about 5.8%. It is estimated that the government would need about $63 million to combat aids in Nigeria. This would include substantial purchases of drugs and HIV/AIDS-related test kits.
Nigeria remains a major destination for global export of healthcare products and services. Speaking at an official event to mark the World Cancer Day in Nigeria, the Health Minister, Professor Adenike Grange said that Nigeria may record 500,000 cancer cases annually up from current level of 100,000 cases from the. year 2010. To check this potential calamity, Nigeria needs to establish more centers to screen, treat and advise patients.
According to industry reports and market intelligence, malaria is on of the principal causes of illness and death in Nigeria. Current statistics indicate that nine out of ten deaths related to malaria that occur in Sub-Saharan Africa including Nigeria, is mostly among young children and pregnant women. In spite of its economic burden, about $12 billion in Nigeria and other African countries, this problem makes the country a growth market for U.S. equipment for preventing and treating malaria cases.
In addition to public sector demand, the private sector accounts for much of Nigeria’s imports and a significant percentage of informal exports to West Africa. As in previous years, refurbished and used medical equipment will remain in high demand, particularly in the private sector.
Opportunities exist in Nigeria for professional training and environmental services in the healthcare sector. There is a dearth of specialist expertise in many specialized fields and a near absence of cutting-edge technology application in most healthcare institutions in Nigeria.
Best Products/Services: Analytical and examination instruments; Ultrasound scans; Anesthesia equipment; and Mortuary and laboratory equipment.