HEALTH MINISTER MISFIRES ON FOREIGN HEALTH DONORS
By Farouk Martins Aresa
The Minister of Health Professor Ositimehin wants approval by his ministry before any fund is sorted from foreign donors for projects, trips by individuals and its agencies. Usually this is the case anyway since there has to be coordination for the overall health projects in the Country. The problem is that there are agencies under the loose supervision of the Ministry of Health that were very effective until they were completely taken over and reduced to this bureaucratic nightmare.
Indeed, the Minister may have good intention to protect the Country from unscrupulous markets that have penetrated Africa like empty capsules, unqualified foreign health professionals, and substandard health equipments but=2 0when it comes to request for programs, training and stipends, individual agencies only need to coordinate to avoid duplications and promote diversifications of funds. It must not override unique achievement that can and will be recognized internationally.
This is not about pet projects of state governors’ wives begging for foreign donations all over the world to stock their foreign bank accounts disguised as alleviating the suffering of the poor. If they are sincere about their missions, let their husband redirect looted funds to their causes. The Minister need to distinguish leeches from discouraged medical workers trying to refresh their training from any available source. Local donors neglect our professors for foreign universities.
Most of the reputable foreign health donors prefer to go through established agencies in Nigeria. It will be surprising if UNICEF will fund individual pet projects rather than community groups. Bill Gates Foundation will bank roll polio vaccine but he will not hand over the money because we are noted for throwing it down the drain. What Nigeria does with the vaccine is our business because other vaccines donated have been rendered impotent in the past due to poor storage. The point here=2 0is that international donors usually target a community not an individual.
In the case of workshops, short training and conferences in specialized professions, the Ministry can work with associations of physicians, pharmacists, nurses or dieticians etc. But the complete control from the Ministry is chilling. There are individual abuses, no doubt but those ones can be checked by the approval process that allows them to take time off from regular duties. We are all aware of flagrant favoritism displayed where cronies taken from unrelated unit get trained at the expense of dispirited scientists. The Minister must also point those out to be balanced and fair.
One of such agencies was Basic Health Services Implementation Scheme that was funded by Ford Foundation under Primary Health Care and headed by Professor Olukoye Kuti while still with Lagos University Teaching Hospital. This was one of the best health services in the Country up to the early 80s. As soon as the Federal ministry of Health took it over, Primary Health Care Unit budget was slashed and the good Professor had to retreat back into the University.
It was heart-wrenching to watch your baby die in the hands of neophytes. So was Primary Health Care in the Ministry of Health after Professor Kuti left. All the arduous work done to secure the grant, equipments and logistics could not be met by the Ministry but they wanted control. In short it became a personality conflict between a junior and less experience Director of Health Planning and Prof. Kuti. Something or somebody had to give and it was the Prof. that left.
Primary Health Care was left at the mercy of World Health Organization, UNICEF, UNFPA and other international organizations. They provided drugs, equipments and facilitated logistics for workshops in rural areas. Prof. Kuti could not let go completely as his expertise and experience were sought on a daily basis by those whose responsibility it was to make Primary Health Care work in the then 19 States of the Country. Moreover, he trained many of them before he left.
This is why this new directive from the Ministry of Health must be viewed with misgiving. Nobody can dictate to international health agencies how much to give and to whom because they usually conduct need assessment through the World Health Organization in cooperation with local, state governments and non-government agencies. By this process, the Federal Government is included as a partner in the provision of services since our preference is for local personnel.
The threat from Federal Ministry of Health can be dangerous because of what was witnessed during the reign of a head of state when Nigeria was completely isolated from international funds and donors, resulting in the loss of scholarships and training in and outside of the Country. Our children suffered the consequences of dry stipends. We have not recovered from the neglect of those days. This may be an extreme example but the fear cannot be too great to imagine.
Professor Kuti later became the Minister of Health and you can imagine what happened to the Director that had eased him back to the University. Primary Health Care Unit became his focus again as a Minister but a great deal of ground was lost while he was side-stepped. It is so easy to destroy but much harder to build. Our problem has always been lack of steady hands, progressive steps are usually taken but we also take many steps back in the hands of unpatriotic egomaniacs.
Moreover, some of the international health agencies would rather deal with non-government and non-profit groups for flexibility, and more important to make sure that the grassroots are the recipients of their support. We have seen free milk, food and drugs distributed in the open market for sale after getting them on the pledge that they will be distributed free to the people in rural areas. Government supervision is necessary especially in a field such as health. Total control can also be detrimental when a single ministry at the center dictates where and whom should receive international health support that are not based on groups’ need or individual effort to build on.
The bottom line is that most of the funds and training are for the benefit of the masses that need them in the Country not for those who have access to treatment in foreign hospitals. There is a great need for enterprising young health professionals to compete with government and private hospitals in the delivery of health services to the rural areas in our Country. If they can write and get grants to deliver such services we lack in the interior, the Ministry should encourage them.
If notable private innovative minds in Nigeria are competing with private individuals in other countries and they are successful where our Ministry of Health has failed in attracting extra funds that would not come into the Country anyway, encourage them. If these individuals are competing with the Ministry for its massive jurisdiction for individual gain, sanction them.
