Déjà vu – Claims of HIV Cures and re-treading old Ground

A few days ago while in Abuja, I was surprised to hear the news presenter announce that a Federal High Court had “lifted the ban” on Dr Abalaka’s “vaccine” against HIV. The presenter went on to say that, although the vaccine had been approved by influential international bodies more than a decade ago, the then Federal Government had banned it and that last year the court had ruled that the ban was illegal.
On hearing this, I was struck by a number of things – an abiding discomfort at the quality of reporting on science and health matters in the Nigerian media; a sense of guilt that, in failing to tell our stories, younger Nigerians are at risk of repeating missteps of the past; and a fear that many, misled by the news item, may put their lives at risk.

Listening to that programme took me back nearly 15 years to when I was a young doctor in Abuja, struggling to manage patients in a Nigeria where anti-retroviral drugs were so costly that there were virtually unavailable. As we had little to offer patients that we diagnosed with HIV then, it was little surprise that many desperately turned to whatever non-orthodox options were being offered, and there were many willing to step into that breach. Dr Abalaka was one of these, and many turned to him, selling all that they had to partake of his “treatment”.

Hajia Fatima Muhammad – Working to improve the Lives of Women in Northern Nigeria

Nigeria has one of the highest maternal mortality rates in the world with 560 women dying for every 100,000 live births. Although there has been an improvement in the past decade, it still remains unacceptably high. The North East geopolitical zone has the highest maternal mortality rate of 1,549/100,000 live births, compared to 165/100,000 live births in the South West Zone — an almost 10-fold difference.
A study by researchers from Columbia University carried out in Northern Nigeria in 2012 found that most pregnant women had “little or no contact with the health care system for reasons of custom, lack of perceived need, distance, lack of transport, lack of permission, cost and/or unwillingness to see a male doctor.”
It is easy to shrug away this statistic and wonder what to do – but there are many innovative ways out there on how to confront this, and some of these are beginning to be deployed and show results. Tackling this monumental problem requires a knowledge and understanding of local contexts, and there are some individuals and organizations who are engaging passionately in this work. This week, we want to highlight the work of one of these individuals.
Last year, in December 2014 in London, we were privileged to hear from Hajia Fatima B Muhammad, a midwife and midwife educator with over 20 years working experience in Maternal and Child care in Northern Nigeria, as she gave a talk at TEDxEuston’s 2014 conference with the theme “Facing Forward”. In her talk, Fatima spoke on behalf of her sisters, her daughters, her nieces and her cousins in parts of Northern Nigeria, who don’t have access to healthcare. But, as she makes clear, it is not just access to healthcare that matters but the ability to negotiate their own destinies and fulfil their full potential as productive members of society.

Why is no one talking about these three big challenges the Nigerian health sector is facing?

The National Health Bill
For the second time since he became president, President Goodluck Ebele Jonathan has the chance to sign a new National Health Bill into law, which would help set the legal basis for urgently needed changes in the health sector around funding, access and delineation of responsibilities between the different tiers of government. This bill has been ten years in the making, in various forms and has been passed for the second time by both houses of the legislature in Nigeria, both controlled by the ruling party, the People’s Democratic Party. The first time the Bill came to his desk – he did nothing. He neither objected nor supported the bill … he just did nothing, until the time required for presidential assent passed and the Bill had to be sent back to the legislative arm to begin another lengthy process of deliberations.
This time, the members of the House of Representatives and the Senate have again done their bit, they have revised the bill, trying to resolve some of the concerns that have been raised by various interest groups – from health professional groups jostling for recognition to faith groups concerned about the transplantation section of the bill. Yet again, it is on the president’s desk, and, three days to the deadline for presidential assent, there is again a deafening silence from the Presidency and from opponents of the Bill.
Many people argue that there are some aspects of the bill that are imperfect, and yet they are not many coming out publicly to say what these concerns are, allowing us to have public debate around them. Many people have not even seen the revised version of the Bill and appear to be basing their opposition on earlier versions of the Bill. It is important to remember that few legislative bills are ever perfect. Most people, who have bothered to read the latest version of the Bill, agree that there is little of serious contention left.

Putting Health on the Agenda of the Nigerian Elections: a Call to Action

It’s election season in Nigeria, and the volume of the debates online and offline are reaching a deafening pitch. Interestingly the focus of most of the campaigns and debates are not on the issues that will affect the future of our country. In 2015 – this is not good enough for a country with Nigeria’s aspirations. Therefore, today with this blog, we are calling you to action to join us in putting health and healthcare on the agenda in this election. The quality, access and effectiveness of our health and healthcare affects every one of us.
Previous attempts to address challenges in the health sector have been dominated by the provision of infrastructure in tertiary care facilities. While medical infrastructure and equipment are part of the problem, they are a small part of it. The heart of the challenge in providing for the health of the Nigerian people lies not in buildings and equipment but in building systems that ensure effective management of the human and other resources required to prevent ill health and ensure good quality clinical care provided in health facilities.

How strikes are killing the Public Healthcare Sector and why it may be difficult to reclaim

An interesting scenario played out in 2014. After a strike that lasted about two months, all resident doctors in Nigeria were sacked; the strike was then called off and the doctors were re-instated. This strike by doctors, across public sector hospitals in Nigeria continued for over two months despite the ongoing Ebola outbreak at the time, probably the most important health emergency faced by Nigeria in recent times. Doctors’ unions insisted on continuing the strike despite calls from across the country -from market women to the president-to call it off. After the issues were resolved and the doctors went back to work, it did not take a soothsayer, given the pattern of preceding years, to predict that a strike by non-medical colleagues in the health sector would follow. JOHESU, the main body representing non-medical staff in the health sector has been on strike since November 2014, leaving most public hospitals barely functional. Again appeals by many Nigerians have fallen on deaf ears. Many patients have suffered the consequences, including the late Prof Akang of UCH, the late Veronica Ezugwu from Enugu State and the victims of a recent terrorist attack in Adamawa. Despite the discontinuation of their salaries by government, the strike has continued. This pattern reinforces a continuing cat and mouse game relating to relative status and pay between doctors and other health sector workers in Nigeria. The interest of the patient never features in these discussions.