Tuesday, 26 March 2013

LAZ UDE EZE : THE RETURN OF THE NATIONAL HEALTH BILL



The Return of the National Health Bill
When the National Health Bill 2008 was passed in May 2011, it appeared its seven year sojourn in the National Assembly had come to an end. That was not to be. The bill was not given assent by the president and it was returned to the National Assembly last year for further legislative action. My disappointment with the lack of urgency in the passage of the bill was exacerbated by the presidential inaction. I used my blog and the social media channel to lead advocacy for a presidential assent but that appeared to be an exercise in futility.  
It may be recalled the earlier passage was preceded by a massive protest by Nigerian women at the National Assembly. Why would they do so? About 55,000 women die annually from pregnancy-related causes in Nigeria every year. As if that is not enough, up to one million Nigerian children under the age of 5years are also victims of preventable death. This has made pregnancy and infancy that should be a period of joy to the family to become a nightmare. For me, it’s personal. In June last year, Mrs Ngozi Nwozor-Agbo, my former editor in Campus Life of The Nation newspaper died after child birth. She was one of the greatest supporters of my health advocacy activities before her regrettable demise.  More so, as a medical practitioner, I was always frustrated by situations where many of my patients could not afford payment for the treatment of minor health conditions. Why can’t they pay? The explanation is very simple; about 70% of the total health expenditure in Nigeria is out-of-pocket in a country where 72% live in poverty. So the system expects folks who can’t afford three-square meal to pay for their medical bills which is not plausible. Regrettably, our health system has lacked an integrated regulatory framework for years, thereby making it an all comers affair with rising prevalence of quackery.
The good news is that the National Health Bill has returned to the Senate. The public hearing conducted provided an opportunity for skeptics to be educated and grey areas hopefully addressed. At the moment, there is every indication that the bill will be passed to law within the next few weeks. The bill will provide a regulatory framework for the Nigerian health system which will result in standardization and improved quality of health services. It will revitalize primary health care, the cornerstone of our health system which has been in shambles for years due to lack of funding. This level of care serves majority of Nigerians at the grassroots and its chronic weakness has accounted for the unacceptably high maternal and child deaths in the country.  It will improve access to health care to millions of Nigerians and also make treatment more affordable.
Meanwhile, I’m not unaware of the controversial provision of the bill which provided for harvest and possible transfer of embryonic stem cell outside the shores of Nigeria with the approval of the health minister. I have concern about making such provisions in this bill. Embryonic research and organ donation are highly sensitive areas that in my opinion deserve a separate legislation and proper enlightenment. Medical anthropological ethnographers have documented unethical research practices by foreign companies in clinical trials involving human subjects particularly in low income countries. It will be catastrophic for unsuspecting Nigerians if any legislation inadvertently makes the country a safe haven for multinational pharmaceutical companies to carry out such unethical practices.   
With the impending passage of the National Health Bill 2012 and ongoing legislative action on the proposed amendment to the National Health Insurance Scheme Act, one would expect a significant improvement in the strength of the Nigeria’s health system. Our mothers and children deserve life. 
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Laz Ude Eze, MB,BS (Ibadan) CBHE (World Bank Institute)
MPH/CGH Candidate 2013
University of Kentucky, USA 

Director of Commuinications & Advocacy, HAPPYNigeria 



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