NIGERIA MEDICAL ASSOCIATION

COMMUNIQUE' of the Meeting of the National Executive Council (NEC) of the Nigerian Medical Association (NMA) which was held in Jos, Plateau State, November 30 - December 6, 2014 

THE JOS DECLARATION

The meeting of the National Executive Council (NEC) of the Nigeria Medical Association (NMA) took place at Exile Centre, Ray field, Jos, Plateau State, between November 30th and December 6th, 2014. The NEC examined several issues, including some  contemporary issues in the country and made the following declarations:

 

NMA and Current Services in the Nation's Public HealthCare Facilities

The NMA is deeply perturbed by the burden of health challenges bedeviling the nation. This is compounded by the rat-race power tussle among health care givers threatening the already ravaged health care system in the country. For the avoidance of doubt, the NMA wishes to inform Nigerians that doctors in Nigeria remain committed to providing qualitative health care services to the nation, even in the face of several challenges and difficulties.

We hereby bring to the public notice that the members of the NMA are NOT on strike, but rather have continued to render services and keep the nation's public health care facilities functional despite the current strike action being embarked upon by health workers. Members of the NMA will continue to keep health service running and shall not succumb to cheap blackmail.  

We, however, urge the government to honor all agreements so far reached with the Nigerian Medical Association, to boost the already based morale of the Nigeria doctor.

 

Good Governance and 2015 General Election 

As the events that will culminate in the 2015 general elections in Nigeria kick off in different parts of the country, apprehension appears to be building up among the citizenry for so many reasons, ranging from the insecurity the face-off  between the executive and legislative arms of government, the threat of impeachment being peddled by a sizeable section of the National Assembly on the economic crisis that has necessitated desperate measures from the government. The NMA wishes to join other Nigerians at home and abroad as well as the international community, to express the need for politicians in the country to tread with caution so as not to cause tension in a system that is already heated to a near-boiling point. In addition, INEC should ensure that all prospective political aspirants obtain mental certificate of fitness from relevant health professionals before their applications are ratified by INEC. Experience with some politicians demonstrated that they are suffering from dipsomania, delusion of grandiose/persecution, which rehabilitation or else they will institute a governance of deptocracy. They should be cleared by relevant health professionals. We also urge the Federal Government to  scale up security apparatus to checkmate the emerging security challenges in the country.

 

 

The Nigerian Medical Association urges Nigerians of voting age to participate fully in the coting process and elect their leaders come 2015. Nigeria cannot afford any form of failure either in the boiled or the elections proper. In this regard,  INEC, as an unbiased umpire, should do all within her statutory powers to ensure a credible, free and fair election in 2015.  

To this end, the Nigerian Medical Association accepts to partner with INEC and calls on her members to volunteer as electoral officers toward achieving a hitch-free election.

 

Ebola Virus Disease 

The NMA wishes to thank the Federal Government and the Nigeria people for their show of unity of purpose and commitment towards the fight that kicked Ebola Virus Disease (EVD) from our country. Despite the serious terror and security challenges in the country, our collective resolves and efforts that made us win the war against EVD in Nigeria were unparalleled. The story of how Nigeria ended what many believed to be potentially the most explosive Ebola outbreak imaginable is worth commending.

 

NIGERIA's freedom from the Ebola virus was officially confirmed by the World Health Organisation (WHO) on 20/10/2014. In the  words of Dr Margaret Chan, the Who Director-General, "If a country like Nigeria, hampered by serious security problems, can do this - that is, make significant progress towards interrupting polio transmission, eradicate guinea-worm disease and contain Ebola, all at the same time-any country in the world experiencing an imported case can hold onward transmission to just a handful of cases."

 

Nigeria's globally-acclaimed success against Ebola is a testimony to what we can achieve if we set aside our differences and work together. The NMA urges Nigerians to strive to replicate this unity of purpose and all-hands-on-deck approach adopted against Ebola in other areas of our national life. The victory over Ebola in Nigeria has sent a very Clear message to the global health arena that Nigeria has what it takes to lead the world in the health sector.

 

Despite this feather NMA wishes to reiterate that Nigeria cannot afford to declare Ebola over. The first outbreak is over, but others may come, for as long as travelers continue to cross her boarders through the land, air and sea. Nigerian government and health officials, including staff in the WHO country office, should well be aware that the country will remain vulnerable to another imported case as long as intense transmission continues in other parts of West Africa. It is for this 

reason that the NMA is calling for the surveillance system to remain on guard, at a level of high alert.

Selective Ill-treatment of Doctors by Lagos and Ebo State GovernmentsThe Association condemns in totality the practice in Lagos State where doctors are being employed as casual workers, the so called "contract appointment". The NMA reiterates that this casualisation of workers (doctors) below the age of 50 years is illegal at variance with the public and civil service rules. The NMA also categorically condemns the selective application of the state's "no work no pay" policy and victimization of doctors in the employment of Lagos State government. We note with great displeasure that this policy was meted out to members of Medical Guild in Lagos in May 2012, August and September 2014.

 

We appeal to the governor, Mr. Babatunde Raji Fashola, to as a matter of urgency, stop and correct this anomaly of casualisation of doctors and recommence Residency Training of resident doctors in LASUTH, Ikeja. We demand that our members be paid their withheld wages since all other workers who embarked on strike in the state were paid.

 

The NMA equally appeals to the comrade governor of Edo state, Adms Aliu Oshiomhole mni, CON, to pay the July and August withheld salaries to doctors in Edo state who participated in the recent nationwide NMA-called out strike. A part from Lagos, Edo State is the only state in the federation that has not yet paid her doctors.

 

Safety of Commuters

NMA appraised as worrisome the incessant vehicular crashes on our highways with attendant huge losses of life and disability. 

 

This is specially so in these "ember" months, which no doubt, evoke anxiety in many commuters in Nigeria, especially with the supposed increased rate of road users, the impatience of drivers coupled with the rise in crime rates. Road accidents have been adjudged, in many cases, to be one of the most common causes of deaths for people aged 15 to 19 years old. Road traffic crashes also claim many young victims with more than 500 children killed each day as they travel to and from school, playgrounds and the homes of family and friends. This is in addition to millions of other people of all ages that are also seriously injured.

 

It only by understands the major risk factors for road crashes that effective counter measures can be instituted to address them. Many attitudes are responsible for the rise in road traffic crashes; from speed limit violation and recklessness among (especially desperate commercial) drivers, outright disregard for road traffic rules to the negligence of other road users regarding road safety and even the lackadaisical attitude of passers-by to road crash victims, which may result in the death of individuals from lack of prompt medical attention.

 

NMA views the recent partnership initiative with relevant stakeholders by the Federal Road Safety Commission (FRSC) as a welcome idea and calls for cooperation from the public for safer roads for all. The move by the FRSC to commence the installation of speed limiting device in commercial vehicles in the country from June, 2015 is a most welcome idea. This innovative technology has the potentials to curb over speeding and by extension, protect the lives of passengers by taming the tide of road traffic accidents on our highways.

 

The police should ensure that apart from installing gadgets to reduce speed, they (Policy) should be provided with equipment for measuring alcohol blood level and those above normal should be prosecuted. The slogan is "If you drive don't drink, if your drink don't drive". No driver should be allowed to be driving continuously for more than eight hours. A driver behind the steering should not be sleeping.

 

The NMA is glad to partner with FRSC to protect the lives of our commuters especially in areas of rescue, stabilising the scene of the accidents, and training the rescue team on the use of life-saving equipment and rapid response operation. The NMA urges FRSC to heighten the commission's "ember months" sensitisation campaign and sanction offenders. Government should provide political will and sufficient offenders. Government should provide political will and sufficient resources necessary to tackle the menace of crashes on our road. The deplorable states of many of our roads should be accorded the needed attention they deserve as a Mather of urgency. The relevant government agencies should develop sustainable road safety strategies and programmes, which rethink the relationship between roads and people, and encourage the use of public transport as much as possible.

 

Collaboration with International bodies

The NMA has continued to collaborate with Nigerian doctors in Diaspora in USA, UK and Canada under the auspices of AMPA, 

MANSAG, ANPA. This platform has enhanced exchange of ideas and skills as well as charity donation and medical outreaches.  

Attraction of Health investments is also health encouraged, which is aimed at making Nigeria a foremost destination for 

 

health tourism.

 

Immunization and complete eradication of poliomyelitis

The NMA hereby calls on the federal government to scale up the immunisation coverage and activities throughout the federation to ensure a complete eradication of poliomyelitis come 2015. The NMA is ever ready to partner with the relevant agencies in this regard.

 

Budgeting and financing of the healthcare 

We wish to remind the three tiers of government on the need to ensure the setting aside of a minimum of 15% of the African  

Union's 2000 treaty in Abuja Nigeria, knowing fully well that this is the recommended minimal percentage for health.  

Universal Health Care coverage cannot be actualised without a reliable and realistic budgeting into the nation's healthcare services.

 

NHIS & Universal Health Coverage

The NMA appreciated the FG's recent initiative tagged "The 2014 Declaration" which aimed to ensure that the 30 per cent Coverage (UHC) target by 2015 set by the president is achievable. The declaration sought to develop a blueprint on how to ensure UHC in the country, and charged all levels of government in the country to increase budgetary allocation to health with a portion earmarked for UHC priority interventions; define a standard benefits package of essential health services that address priority health care needs of Nigerians, and inaugurate appropriate committees that will initiate actions towards the realisation of the recommendations of the Presidential Summit. The NMA views this action as a right step in the right direction. The NMA commends the organisers of this summit and charge the Federal, State and Local Government authorities to faithfully implement the recommendations in the UHC 2014 Declaration to achieve the desired objectives.

 

There is no gain doubting the critical role of a healthy population in promoting sustainable economic growth and national development. To achieve this, we must not only institutionalize UHC, we need to develop our healthcare delivery systems.  

Adequately staffed and equipped hospitals need to be made available throughout the country, including the rural areas, where most Nigerians live. The UHC Declaration has rightly identified unequal quality of health care services, and shortage and mal-distribution of human resources for health as key challenges. These manifest in the shortage and quality of health care services and human resources in our rural areas. The relevant authorities must resources to redress this. 

 

The NMA supports the Federal Government's position on the importance of health to national development, and its identification of insurance as the best vehicle to achieve universal health coverage. The socio-economic realities in the country at this time dictate that there is a dire need for the expansion of access to healthcare in the present-day Nigeria, requiring all levels of government and even non-governmental organisations to do everything possible to make health care available to all, especially those on the lower rungs of the social ladder. In this regard, the plan by the NHIS to enroll pregnant women and children under the age of five in the scheme by 2015 is also a step in the right direction. It will help to increase the base of participants, reduce infant and maternal mortality, and move the nation closer towards the attainment of the objectives of the scheme.

 

Health insurance is one sure way to provide health care for the poor. It is, indeed, the best way to ensure that both the rich and the poor can access healthcare wherever they live in the county. It is the panacea for sustainable growth and development. NMA strongly believes that UHC will help to reduce Nigerians' penchant for medical tourism, as it will provide a pool of funds to improve health care services in the country.

 

It is out view that the presidential mandate of 30 percent coverage of Nigerians in the NHIS by 2015 is conservative enough.  

The relevant agencies of government should be able to achieve and even exceed this, if they demonstrate the necessary commitment to achieving the objective. The Federal Government has rightly set the ball rolling towards the achievement of this objective with the 2014 Declaration on UHC. The challenge now is in the courts of the three tiers of government to work towards the institutionalization of the scheme. Sadly, only very few states have embraced the NHIS at the moment. It is also necessary to increase the need for greater commitment of the formal sector, which has not been impressive so far, while strategies are designed to bring in the largely untapped informal sector.

 

To achieve UHC and increase enrollment in the NHIS, all hands must be on deck to promote public enlightenment on the benefits of health insurance.

The NHIS must, however, intensify improvement (e.g. digitalisation) of its operations on its ongoing) biometric data capturing of participants, which has already reportedly thrown up 100,000 fake enrollees. Fraudsters must not be allowed to hijack and make nonsense of this very noble scheme.

 

Long Live Nigerian Medical Association NMA

Long Live Federal Republic of Nigeria

 

Signed

Dr. Adewunmi ALAYAKI

Secretary General 

Nigeria Medical Association