Wednesday, 19 August 2015

Medical institute groans under paucity of funds

…Setback to research, development of drugs 

Unless there is quick intervention by government to address the appalling issue of dearth of funds in many public institutions, especially the health sector, attainment of quality research and proper health indices may remain a mirage. Giving the indication recently was the management of the Nigerian Institute of Medical Research (NIMR) who lamented the dwindling state of the foremost research institution in the country. 

A look at the state of infrastructure within the Yaba (Lagos) premises of the institute showed several dilapidated structures, even abandoned projects. According to the management, the institute has not received a dime for capital expenditure from the Federal Government this year. And to raise capacity of researchers and avail some equipment, NIMR is currently on self-help – crying for public support. 

This was confirmed at a recent symposium to commemorate fifth year anniversary of Prof. Innocent Ujah as the Director General of the institute.   Through the support of local and international partners, the institute is today proud of a Biomedical Training and Cancer Research Centre, due for commissioning in September. But, where the support is not forthcoming, like the case of providing the institute a modern library, the projects are abandoned. The DG noted that the institute had in fact had perennial shortages in capital allocation over the years. A fact sheet revealed that out of the N90million budgeted for capital expenditure in 2010 only N29million was released. 

NIMR library abandoned since 2014
The budget was N298million in 2011, of which the institute got N95million. This year, it was N85million budget and midway into the year, none has been released.   Investigation by Newswatch Times showed that NIMR might not be the only government institutions in this pain. What holds for NIMR holds for other parastatals and agencies of the Federal Ministry of Health like the National Primary Health Care Development Agency (NPHCDA) and National AIDS Control Agency (NACA) among others. NIMR is the apex health research institute established by the Act of 1972 to conduct research into diseases of public health importance in Nigeria and develop structures for the dissemination of research findings, while providing the enabling environment and facilities for health research and training. 

Despite, the gradual crippling effect vis-a-vis poor funding, Ujah noted that NIMR had recently shown how critical it is in the case management and emergency response to the Ebola outbreak of 2014. But, a lot more, including a possible cure for the disease could have been achieved if government had been committed to research over the years.   He recalled that the epidemic, brought into Nigeria by US-born Liberian Patrick Sawyer, was an opportunity for Nigeria to upgrade her foremost research institute for contemporary relevance. It is today recounted as a missed opportunity.   “On our part,” Ujah said, “we wrote position papers and sent them to appropriate authorities but, up till today, nobody has asked of its content.” “This is what we mean by missed opportunity. 

We think that our laboratory, of Bio-safety Level 3, should have been upgraded to Level 4 to help us deal with live viruses, because we don’t want anyone to die in the process of doing research. We have missed that opportunity, and we don’t know if Ebola will come again, though we don’t pray for such but we have to prepare,” he said. The NIMR boss further said that the country lack sufficient capacity for research generally and not only in NIMR. For NIMR though, “our location is a major disadvantage.”   “We are supposed to be in Abuja by now and close to the seat of government. 

Anything that involves government is in Abuja. If you are in Lagos and think government (Federal) can hear you, then you are wasting your time.” Relaying the track record of institutional poor funding, Ujah said: “The funding was abysmally poor before I came in but from 2011, the budget has increased to about N298 million but the release was N95 million. So, when they say NIMR gets only N95 million, it is not only us, but also everywhere. We are saying that it should not be a cut-across reduction. If you have one billion naira budget and it is reduced by 40 per cent, then there is still a lot left. But, if it just N100 million that is reduced by 40 per cent, then almost nothing is left. 

The reduction is just too mathematical, I must say, he said adding: “We did well in 2013; it went to about N470 million out of which about N90 million was released. Nothing has changed. This year, nothing has been released and we are in July. I can tell you that the money for capital was N50 million. Whether it will come or not, I don’t know. “It is not for lack of trying. We tried in 2013 and we got something. This is the stark reality; if you want breakthrough, then you must invest in research. But, we are fond of wanting to reap where we didn’t sow.” Ujah further said that the researchers were, however, taking consolation in the new administration and the National Health Act, to give them a change in fortune. 

Besides the Health Act availing universal health coverage for all Nigerians, it also promises funding for all health institutions, which includes the research institutes. Expressing optimism, Ujah said: “We are hopeful that funding for health research that will inform policies, will improve, especially now that we are in the season of change. We hope for positive changes so that NIMR will be able to carry out more researches and also make breakthrough in medical researches.   “As we speak, the funding is shamefully small, but health research is very expensive. “You must deliberately invest in research if you want to make breakthrough. The National Institute of Health in the US and MRC of England are heavily invested in.   “We believe that the Federal Government and private sector will do the same. 

Research, whether it is health, engineering or agriculture, thrives development. Nigeria has the capacity and with political will, we can support researches to boost our development drive,” he said. Dr. Mohammed Lecky, guest speaker at the symposium, while making his presentation at the symposium, urged the researchers to exercise a cautious optimism, saying very little would be achieved without deliberate effort to implement the Act’s provisions. Lecky, who is the Executive Director, Health Reform Foundation of Nigeria (HERFON), said that the provisions were as vital to universal health coverage as they are to funding groundbreaking medical researches. 

The National Health Act represents the first statutory and comprehensive law in Nigeria that serves as a framework for the regulation, development and management of a national health system and also set standard for rendering health services in Nigeria. Against this background, the Executive Director, HERFON, called on the Federal Government to fully implement the National Health Act. Lecky made the call describing the act as a rallying framework toward achieving universal health coverage in the country. The Executive Director, HEFRON said: ‘’The act is inclusive and unifies health services for the regulation, development and the management of the nation’s health system. 

‘’If this act is well implemented without corruption, it will reshape the Nigerian health landscape to the extent that all Nigerians, without any exception, would be entitled to basic minimum package to health services,” he added. ‘’Healthcare will be accessible and affordable to all. Perfecting the strategies of implementing the health act is the only way to achieve universal health coverage in Nigeria,’’ he said. Lecky concluded: “Finally, as we transition to the post-2015 era, the inherent capacity of the National Health Act to re-shape tie Nigeria health landscape is as real as it is ambitious. 

It is a unifying legislation, coherent, clear and an unambiguously most powerful piece of legislation (some would say since independence) that is aimed at social equity and justice. “We should have good reasons to expect great things on account of the National Health Act in years ahead. But, can we rise to this collective challenge? Lecky asked rhetorically?

This story was published in Newswatch Times on July 25, 2015.

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