Posted on: Mon 18-05-2020

The President and Commander in Chief 

Your Excellency, 

NIGERIA CANNOT AFFORD A POLICY SOMERSAULT ON HEALTHCARE DELIVERY. POLICY STABILIZATION & IMPLEMENTATION IS IMPERATIVE FOR COMMON GOOD 

We, Greater Health Initiatives (GI-II), are an agglomeration of human rights groups in the healthcare sector of our country. Our intervention and advocacy have been brought about by years of failed and anti people healthcare policies of government over the years. 

In this coalition are: 

(a) Justice Development and Peace Centre (J.D.P.C) 

(b) Community women initiatives (C.W.I) 

(c) Child Health Organization (C.H.0) 

(d) Concerned Mothers Association (C.M.A) 

We have been monitoring healthcare policies and implementations for many years before now. 

Your Excellency, we must start this important open letter with GRATITUDE to you for the Presidential directive issued on the 5th of May, 2020 to the effect that all medical Consumables imported into this country should be duty free. That was a Patriotic directive and we commend you for it. However, we remain worried about those entrusted to see to the implementation of your directive. We all know that most times good policies of Government are sometimes subverted either directly, through sabotage, or indirectly through wrongful implementation mechanisms. Most unfortunately, such deviations do not attract the requisite sanctions.

In 1988 World Trade Organization (WTO) recommended to member states importing medicaments not to charge more than 5% as import duty. This was to ensure Accessibility, Availability and Affordability of medicines to everyone. Nigeria did not implement it. 

(1) About six years thereafter, ECOWAS Committee on Health met, took cognizance of the inadequacy of the Pharmaceutical manufacturing companies in the sub-region vis-a-vis the growing population and recommended 0% (zero) duty on imported medicaments. A second meeting was held at Abuja in late 2012. On that score, the Federal Government decided in 2013 to abide by the ECOWAS recommendation of 0% (zero percent) for imported medicaments. Prior to that time Importers paid 20% duty. 

(2) On the 10th of January, 2017, your Excellency was present at Kuchisoro in FCT for the Revitalization of Primary Healthcare Centre where the then Minister for Health said Your Administration's goal was to establish or revitalize 10,000 Primary Health Centres across the country. On that day, Mr. President, you said "Our goal for revitalizing the Primary Healthcare Centres is to ensure that quality basic healthcare services are delivered to majority of Nigerians irrespective of their location in the country".

Your Excellency said further, "We shall focus more on people living in the rural areas and vulnerable population in our society such as women, children under five years of age, and the elderly in collaboration with National and International partners." In that wonderful speech, Your Excellency also said "Out of pocket payment for healthcare constitutes over 70% of the total healthcare expenditure. This is more than the globally recommended 3040%. However, only less than 5% of the total population are covered by any kind of Health Insurance or risk protection mechanism which is against the recommended 70% coverage by World Health Organization". Your Excellency concluded that speech with "OUR VISION IS TO REVERSE THIS UNSATISFACTORY SITUATION AND PROVIDE BETTER CARE FOR THE POOR AND NEEDY". 

Your Excellency, after this beautiful speech of yours, Your then Minister of Finance decided to put a stop to the 0% duty that has lasted for four years 2013-2017 and imposed a 20% Import duty with a new name called "IMPORT ADJUSTMENT TAX". With the devaluation of the Naira plus this 20% Import Adjustment Tax cost of drugs spiked high. Your laudable goal was totally disregarded. Your Excellency, it is good that you know that over 80% of the National drug needs are imported. This is due to the total lack of Infrastructure and requisite raw materials to aid local production. Despite this obvious fact, some profit driven and inconsiderate Nigerians who have always shown capacity to undermine positive national efforts by lobbying highly placed politicians and top government functionaries for the purpose of achieving narrow-minded personal agendas. To this end, we strongly fear that the result of the fake local capacity survey conducted within the pharmaceutical industry with intention to make government to ban the importation of critical drugs essential for the health of Nigerians. Their plan is to create serious scarcity and absolute monopoly for the merchants of death. 

But for the intervention of the Pandemic and the consequential confusion, Nigeria would have been facing a drug crisis of unimaginable proportion now. We believe you can never be part of such unpatriotic and horrible plan to kill Nigerians because you know that the wellness of a country is measured by the wellness of her people. This is how those you trust sabotage your edifying goals for Nigeria. Your Excellency has again ordered that Nigeria should return to 0% duty for hospital consumables which clearly includes Pharmaceuticals, and which constitute 90% of Hospital consumables. However, the customs' circular published on 29th April, 2020 has given a different interpretation to what hospital consumables are. To them, drugs are not consumables. Is it not funny that Syringes, Hospital Beds, Bandages, Thermometer, Paper Bed Sheet etc are seen by Customs as consumables but the drugs to be administered for curing an ailment is not.

We hope that your Presidential directive of 50, May, 2020 must supersede the Custom circular of 29th April, 2020

Our Prayers 

We plead with your Excellency to: 

(1) Keep a close watch on the officials involved in the implementation of your healthcare policies to ensure that your directives and health goals are strictly complied with. 

(2) Prevent any medical crisis that would arise from Non-Availability, and Affordability of drugs. (3) Monitor the Customs to ensure that they do not sabotage your directives. 

(4) Create a complaint desk for healthcare matters so that people can reach you directly. 

Your Excellency, if petrol can be subsidized because of common good why can't Healthcare be given a bigger attention for the common good. Healthcare is beyond politics and Health is Wealth. 

Your Excellency, if we go by your speech on the 10th of January 2017 and your directive of 5th May, 2020, you can make Healthcare delivery your number one legacy to Nigeria. It will wipe away any other negative legacy anyone may wish to associate with your tenure. Your Excellency, be determined to shame W.H.O who rated Nigeria as one of the worst places on earth to be an infant, a child or mother. You can stop the flight of our health workers to other countries. Nigeria can also host medical tourism like other countries.

We also urge you to stabilize your healthcare policies and make them pro-people, then monitor the healthcare operatives and pay them better. Fund Healthcare, save life and let history remember you for giving attention to what Nigeria had ignored for over 40 years. Your palliative as contained in your r May, 2020 directive should remain permanent till the end of your tenure. 0% duty was the policy from 2013 to 2017, whereas subsidy on Petrol has been on for over 17 years and Nigeria did not go under. Mr. President, this is your promise, keep it and score for humanity. God bless you. 

God bless Federal Republic of Nigeria.

Signed:

Achike Chude 

Convener

Funmi Folayemi 

Mobilization

Vicky Uremma 

Programme Officer 

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