Building for the future
The past two weeks have been quite busy at the Ministry of Health. Today again, I share my top 3 reflections:
1. You cannot solve a problem by wishing it away
Driven largely by shocks caused by COVID-19, Nigeria in 2020, experienced its worst recession in the last 40 years. High monthly deductions (averaging N150bn) for subsidies by the NNPC meant less resources accrued into the federation account and therefore limited the fiscal room Federal and State governments had to ease the burden on households. Relatedly, food inflation rates of over 22.9% in April 2021 meant households felt the pinch even more.
So when the Association of Resident Doctors in Ekiti came to express their concerns to the temporary cut measures put in place by the Ekiti State Government and the implications on their finances, I totally understood where they were coming from. As a health economist, I’m quick to appreciate the implications of macro-economic challenges on the sectoral spending and this was no different.
As His Excellency empathised with the association during the meeting and explained that it was indeed a temporary measure, he was quick to point out that problems cannot be solved by wishing them away or pretending they don’t exist. A point, which I wholeheartedly agree with and took note of. As leaders, sometimes we take tough decisions, for the larger good, which are often not understood by those immediately affected. He ended the meeting by suggesting the association discuss with me to consider potential solutions. In my follow up discussions with them, I assured them we would look into it. Subsequently, I met with my colleague in finance, and we were able to “pull our teeth” to find a way.
Tough times don’t last, only tough people do. I do hope the members of the association appreciate the efforts taken by His Excellency Dr John Kayode Fayemi and the Commissioner for Finance Akin Oyebode in finding a temporary solution within a temporary challenge and redouble their commitment to delivering good quality care. As a government, we would continue to work on a month-by-month basis (during this challenging period) to manage our cash flow, whilst being mindful that our commitment to the State requires that we deliver on our promise.
2. The practical importance of the Social determinants of health
2 weeks ago, I received a directive to serve as a member of a committee to review waste management in the State.
You see, in Ekiti State and specifically in Ado-Ekiti where I currently live, waste management collection and disposal could be better optimised. So, when the letter came in, I looked forward to the committee meetings and was buzzing with the opportunity to contribute. Given my background in health systems, I recognise that environmental conditions are a key social determinant of health and health outcomes. Our interventions in the health space can only go so far, if the environment within which people live is not conducive for living and thriving. Clean air, clean water, and proper sanitation enhance household quality of life through reduced morbidity, and improved living standards.
In our meetings thus far, a couple of issues have stood out and I look forward to the recommendations we make and the subsequent implementation.
3. Giant strides towards transforming Ekiti State’s drug and medical supply system
I am thrilled that Ekiti State’s Drug Management Agency Bill will be presented to the State’s Executive Committee this week. A lot of meticulous work has gone into bringing the bill to this stage and I can’t be prouder of the team that has so far driven this achievement.
This bill and its subsequent passage is critical to our goal of achieving Universal Health Coverage. By providing the regulatory framework, we envision an agency that would have the authorising environment to thrive and achieve the aims I have for the agency, namely: (i) providing affordable and quality drugs and supplies to all health facilities in the State (ii) ensuring zero stock-out of essential drugs (iii) contributing to the State internally generated revenue (IGR).
Based on our estimates, there’s no reason the agency should not have a turnover of N300million in its first year.