Tag: Ifeanyi Nsofor

Time to Ensure Equity in Global Research Vocabulary — Global Issues

Categorizing countries into “low- and middle-income countries” and “high income countries” is not appropriate for studying healthcare systems and population health. It is misleading to categorize countries for convenience of data analysis and interpretation. Credit: Charles Mpaka/IPS
  • Opinion by Ifeanyi Nsofor, Sowmya R Rao (abuja)
  • Inter Press Service

ABUJA, Aug 11 (IPS) – A recent publication in the journal PLOS Medicine reviewed the relationship between COVID-19 and mental health in eight low- and middle-income countries, collectively referred to as LMICs. As important as this publication is, we are appalled by the widespread use of the term “low- and middle-income countries” utilized in this article, and indeed in the majority of the global health literature and discourse.

This term vastly oversimplifies the relationship both between individual LMICs, and between LMICs and High-income countries (HICs). It isn’t an exaggeration to say that the term is colonial and racist. It divides rather than unites. It is time to change the narrative and use an equitable term to describe countries in the Global South.

We are both from the Global South and now work in the Global North. Sowmya is from India while Ifeanyi is from Nigeria. We both live in the U.S. Indeed, Sowmya has lived there for more than 30 years. In our global health careers, we have experienced inequities meted to us and people like us simply because of where we are from.

Terms such as “low- and middle-income countries” perpetuate these inequities and use the same brush to paint 85% of the world’s population as the same. The Global South has almost six times the population of the Global North, is incredibly diverse, and has pockets of high-, middle- and low-income communities. Even within a single LMIC there is incredible diversity.

Without a doubt, categorizing countries into “low- and middle-income countries” and “high income countries” is not appropriate for studying healthcare systems and population health. It is misleading to categorize countries for convenience of data analysis and interpretation.

According to Google Scholar, so far in 2023, over 12,100 publications have used “low-and-middle income countries ” in their titles or in the text. A couple of editorials calling for a change in the classification were published in 2022 and yet, the same journal has over 15,000 publications since 2022 (more than 6000 in 2023) using these terms. Is this classification appropriate for healthcare-related research? We also do not believe that World Bank classification of countries using the gross national income (GNI) is appropriate in this scenario.

Furthermore, funding agencies and peer-reviewed journals perpetuate this problem by requiring the investigators to generalize studies conducted in one country (even one city/town/village) to not only the entire country but beyond that to other “low- and middle-income countries”.

Countries vary in their population sizes, demography, cultures, type of governments, education systems, health care policies, health care access, diseases, and socio-economic problems. Summarizing data across these countries and studying them as a unit to find a one-size-fits-all solution undermines the problems.

For instance, Nigeria has an estimated population of more than 200 million, more than 250 ethnicities that speak over 500 languages. On the other hand, India is the most populous country in the world, with a population of over 1.4 billion. It has more than 2000 ethnic groups that speak over 19,000 languages or dialects.

First, begin to rectify this issue by ensuring that studies are customized to each country so appropriate policies can be implemented to improve healthcare in the country being studied. Most problems and solutions are local and must be studied in this context.

Second, funding institutions and peer-reviewed journals should not insist on generalizability of the results beyond the targeted populations but focus on the possibility of the solutions being adaptable to different populations and situations.

Studies that can positively impact these populations even if small are worth being conducted and published. It may then be further researched and adapted as necessary in different settings but that should not be a condition for funding or publishing.

Third, knowledge transfer should be bi-directional and not unidirectional as is currently done. Therefore, countries in the Global North should be open to learning from solutions found in the Global South (what are also termed as “resource-limited or resource-poor” countries).

There are many lessons in this regard: African Union’s coordination of country COVID-19 responses through the Africa Centre for Disease Control, and diverse experiences on managing epidemics in the Global South.

Finally, researchers must tap into the power of local knowledge. This means including Ministries of Health and local investigators to identify the main problems that need studying and finding solutions to mitigate them – another step towards creating equity.

Having countries from the Global South involved with setting study priorities and also funding portions of studies will ensure that they are vested in the process and are equal partners in studies that impact their own populations. Indeed, no country has infinite resources as was seen during the recent COVID-19 pandemic and any solution that uses the available resources efficiently should be welcomed.

LMICs and HICs are vestiges of colonialism. They divide instead of unite by making the most populous parts of the global community inferior to the least populous. Most importantly, they perpetuate inequities which pose serious consequences for global solidarity.

Using ‘Global South’ versus ‘Global North’ to refer to LMICs and HICs respectively in global research vocabulary is the most equitable thing to do.

Dr. Ifeanyi M. Nsofor, MBBS, MCommH (Liverpool) is Senior New Voices Fellow at the Aspen Institute, Senior Atlantic Fellow for Health Equity at George Washington University, 2006 Ford Foundation International Fellow.

Dr. Sowmya R Rao is a Senior Research Scientist with the Department of Global Health at Boston University School of Public Health (BUSPH), a Fellow of the American Statistical Association and a biostatistician primarily interested in global health disparities.

© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service

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What Sub-Saharan African Nations Can Teach the U.S. About Black Maternal Health — Global Issues

While poor maternal outcomes among Black women in the U.S. is not new, improving it is imperative. U.S. policymakers can look to sub-Saharan Africa for guidance on reversing this trend. Credit: Ernest Ankomah/IPS
  • Opinion by Ifeanyi Nsofor (abuja)
  • Inter Press Service

ABUJA, Jun 02 (IPS) – New research shows that Black mothers in the United States disproportionately live in counties with higher maternal vulnerability and face greater risk of preterm death for the fetus, greater risk of low birth weight for a baby, and a higher number of maternal deaths.

While poor maternal outcomes among Black women in the U.S. is not new, improving it is imperative. U.S. policymakers can look to sub-Saharan Africa for guidance on reversing this trend.

The problem of poor maternal health for Black women in the U.S. is dire. Too many Black women die during pregnancy and childbirth due to preventable causes. For instance, the 2020 maternal mortality data rates released by the U.S. Centers for Disease Control showed overwhelming maternal deaths among Black women compared to other women over a 3-year period (2018 – 2020).

To put it in context, maternal deaths among Black women in the U.S. is worse than African countries like Namibia, Botswana, South Africa, Libya, Tunisia and Egypt.

Further, according to the Kaiser Family Foundation, maternal and infant health disparities are symptoms of broader underlying social and economic inequities that are rooted in racism and discrimination.

In a previous piece, I wrote about the way that institutionalized racism is keeping Black Americans sick. Therefore, healthcare providers and policymakers across the U.S. must ensure respectful maternity care for all women during pregnancy, childbirth and afterwards.

The United Nations Office of the High Commissioner for Human Rights says respectful maternity care“encompasses respect for women’s basic human rights, including recognition of and support for women’s autonomy, dignity, feelings, choices, and preferences, such as choice of companionship wherever possible”.

Unfortunately, there is overwhelming evidence that Black American women face disrespect and profound indignity during pregnancy and childbirth. Tennis player and businesswoman Serena Williams almost died due to blood clots after giving birth because her nurse refused to listen to her cry for help. That clot could have led to a stroke. Her doctor eventually listened to her, and this saved her. If one of the most influential and most powerful women can have such a near-death experience, what is the fate of other Black American women who are not as privileged? Respectful maternity care is a way to ensure equity irrespective of class and race.

These are three lessons American policymakers can learn from successful maternal health projects across countries in sub-Saharan Africa as they try to save Black American lives.

First, is the continuum of care – prevention of postpartum hemorrhage project, implemented by Pathfinder International in Nigeria. It was a novel project that deployed several evidence-based interventions to prevent excessive bleeding after childbirth across the country.

These included the use of misoprostol to ensure adequate uterine contraction after the delivery of the baby; use of a plastic sheet with a pouch for blood loss estimation and active management of the third stage of labor to ensure the placenta is properly separated after the baby is delivered. These interventions led to a reduction in women who bled excessively after childbirth and improved the overall survival of women in participating health facilities.

For example, a new study on the efficacy of the plastic sheet carried out in 80 hospitals across 4 African countries, showed a reduction in the number of women experiencing severe bleeding by 60%.

A second example is the maternal nutrition program, implemented by Garden Health International in Rwanda. Adequate nutrition during pregnancy is imperative for the wellbeing of the unborn child.

The first 1000 days of life are even more crucial. Through the Maternal Nutrition curriculum, pregnant women are encouraged to attend antenatal classes at least four times in health facilities where they are educated on how to address the factors that can contribute to malnutrition. Women are taught how to prepare a balanced meal, the importance of hygiene and food safety in preventing malnutrition, the importance of the timely introduction of breastfeeding and complementary feeding, and postnatal care.

For instance, through the “one pot, one hour” cooking initiative, families are taught to use readily available foods to prepare nutritious meals is a core component of this program. Its success led to its adoption by the Rwandan Ministry of Health and it was implemented by 44,000 community health workers across the country.

A last example is the Kangaroo Mother Care for very low birth weight infants in South Africa. Very low birth weight infants are prone to hypothermia – a significant and potentially dangerous drop in body temperature.

According to the WHO, Kangaroo Mother Care involves infants being carried, usually by the mother, with skin-to-skin contact. If the mother is unable to fulfill the role, the father or other members of the family can take on the responsibility of skin-to-skin contact and provide warmth for the infant. A study of Kangaroo mother care of 981 very low birth weight infants admitted at Charlotte Maxeke Johannesburg Academic Hospital over a six-year period showed increased weight gain, lower rates of complications of prematurity and low overall mortality.

A multi-country study by the World Health Organization showed that in Ethiopia, government leadership; an understanding by health workers that kangaroo mother care is the standard of care; and acceptance of the practice from women and families helped improve the implementation of kangaroo mother care.

Institutionalized racism over many decades has put Black Americans in the most vulnerable counties in the U.S. Health policymakers, healthcare providers, donors, non-profit organisations and all stakeholders involved in maternal healthcare in the U.S. must implement interventions that are shown to save lives. The African continent is a great place to look.

Dr. Ifeanyi M. Nsofor, MBBS, MCommH (Liverpool) is Senior New Voices Fellow at the Aspen Institute, Senior Atlantic Fellow for Health Equity at George Washington University, 2006 Ford Foundation International Fellow

© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service

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Mental Health Must Be Addressed in Medical Facilities and in Communities — Global Issues

It is imperative to identify symptoms when they are present and provide timely care. Asking routine questions at primary care visits is an effective way to achieve this. Credit: Unsplash /Melanie Wasser.
  • Opinion by Ifeanyi Nsofor (abuja)
  • Inter Press Service

ABUJA, Feb 09 (IPS) – Patients who visit public clinics in Abu Dhabi, United Arab Emirates, are asked mental health questions to detect signs of stress and depression early. The process starts with a basic checklist, with patients referred to a nurse, doctor, or specialist. Asking these questions at primary care not only can identify issues early on, but it also helps decrease the stigma often associated with mental health while maintaining anonymity.

This initiative is praiseworthy and should be replicated in all health facilities – both public and private. To ensure continuum of care, mental health services should also be provided in communities.

Globally, there are millions of unmet needs for mental health care. Globally, more than 970 million people are living with a mental disorder, with anxiety and depressive disorders the most common. According to the U.S. Centers for Disease Control, more than 50% of Americans will be diagnosed with a mental disorder at some point in their lifetime.

Without a doubt mental health is important. However, just like physical health, it fluctuates. In an episode of my public health advocacy project, ‘Public Health for Everyone’, Victor Ugo – global mental health advocate and founder of Nigeria’s leading mental health not-for-profit, Mentally Aware Initiative said, “mental health is a continuum – sometimes we experience good mental health and other times, bad mental health”.

Therefore, it is imperative to identify symptoms when they are present and provide timely care. Asking routine questions at primary care visits is an effective way to achieve this.

Sadly, poor perception and stigma associated with mental health vary. For instance, the 2018 mental health in Nigeria survey, which I co-led, revealed shocking results. More than 5,300 respondents were interviewed in all 774 local councils across the country.

Seventy percent of Nigerians believe mental health disease is, “When someone starts running around naked”; and 54% said “possession by evil spirits as a cause of mental health disease”.

Furthermore, 18% said they will take someone with mental health disease to a prayer house for deliverance; traditional medicine healer (8%); locking up the person (4%) and beating the disease out of the person (2%). These shocking results underpin how difficult it can be to change behaviors to improve mental health.

As mental health is a continuum, so should mental health care. It is important to provide care not just at medical facilities but at community levels too. Community members may not be aware that primary care facilities provide mental health care but people they know in the community reach out to them.

Other reasons that community efforts are important include the reality that in many regions, health facilities may be far away from where people live or there may be unattainable costs associated with accessing care at health facilities. These are two examples of successful community-based mental health care services.

First is the Fellowship Bench, which began in Zimbabwe and was founded by Psychiatrist and Aspen Institute Senior New Voices Fellow Dixon Chibanda. Dixon lost a 26 year old patient to suicide because her family could not afford the $15 bus fare from her village to his clinic in Harare, Zimbabwe, for a follow-up visit.

It was a turning point for him, and this sad experience birthed The Friendship Bench. The Fellowship Bench deploys grandmothers, an ever-present human resource in communities, to provide mental healthcare. Grandmothers are trained on evidence-based talk therapy delivered on a park bench. In 2006, the first group of grandmothers went to work.

Chibanda believes that depression is treatable and suicide preventable. However, in low- and middle-income countries, there are not enough psychiatrists. Consequently, 90% of those needing mental health care do not get it, he said in his TED Talk. Therefore, innovative solutions such as The Friendship Bench are necessary to bridge the mental health care gap by providing care right in communities where people live.

Another effort is Mentally Aware Nigeria Initiative (MANI). It provides virtual mental health care to a large community by disseminating mental health information to its more than 180,000 followers on Facebook, Twitter, Instagram, TikTok and LinkedIn.

MANI reaches more than 3 million people (mostly young people) monthly through these social media platforms. MANI’s services are needed in a country of more than 200 million people with less than 250 psychiatrists. This translates to one psychiatrist servicing one million Nigerians. MANI provided mental health care during Nigeria’s 2020 EndSARS campaign against police brutality. Young people protested police brutality but were still brutalized and killed during the protest. Many people needed mental health care and MANI was there to provide it by offering calls.

One of the major challenges to providing mental health is the cost. More funding is required to support and scale more community-based mental health interventions. In 2022, the U.S. Department of Health and Human Services announced nearly $35 million in funding opportunities to strengthen and expand community mental health services and suicide prevention programs for America’s children and young adults.

In Europe, there is a €3,355,000 grant for large-scale implementation of community-based mental health care for people with severe and enduring mental ill health. In Nigeria, the TY Danjuma Foundation recently awarded a grant to Jela’s Development Initiatives to train 200 teachers about basic mental healthcare and create awareness for effective curriculum delivery.

Jela’s Development Initiatives also hosts ‘unburden’ – a group therapy session supervised by a mental health expert, which enables participants to speak about issues affecting their mental health within a safe and confidential space. These kinds of funds are important and need to continue regularly.

Providing mental health services at primary care and community levels can help millions of people. Supporting these efforts is the equitable thing to do.

Dr. Ifeanyi M. Nsofor, MBBS, MCommH (Liverpool) is Senior New Voices Fellow at the Aspen Institute, Senior Atlantic Fellow for Health Equity at George Washington University, 2006 Ford Foundation International Fellow

© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service



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100 million People with Long COVID is a Crisis We Must Address — Global Issues

With the rise in COVID-19 cases fueled by new variants, the number of long COVID cases will keep increasing. Credit: Unsplash/Ivan Diaz
  • Opinion by Ifeanyi Nsofor (abuja)
  • Inter Press Service

ABUJA, Sep 01 (IPS) – More than two-years in, the COVID-19 pandemic rages on with rising cases and deaths every day.  A silent and more long-term pandemic occurring simultaneously is long COVID. The impact of long COVID has serious consequences for the future of humanity and should worry us all.

The recent Household Pulse Survey by the U.S. Centres for Disease Control shows that an average of 14% of US adults report long COVID symptoms. This is staggering because 93 million cases have been reported in the U.S. This implies that 13 million people in the U.S. have long COVID. Long COVID is also a global phenomenon: 2 million people in the United Kingdom, half million in Australia, and more than 100 million people globally.

Long COVID is a group of symptoms which some have who, on the surface, recover from COVID-19 infection. Its occurrence is more frequent in those who had severe illnesses and in people who are not vaccinated. However, even those without COVID-19 symptoms when infected could have long COVID too.

Examples of long COVID include loss of smell, loss of taste, brain fog, difficulty in remembering past events, tiredness on exertion, chest pain, shortness of breath, headache, heart palpitations, muscle pain, change in skin and hair color and lots more.

Long COVID varies in duration. It could last for as short as 2 weeks and as long as many months after recovery from COVID-19 infection.

Research published in the British Medical Journal even documents a female patient with persistent loss in smell 27 months after the initial COVID-19 infection.  Therefore, it is unsurprising that some long COVID sufferers are unable to work. According to the Brookings Institution, long COVID could account for 15% of the  10.6 million unfilled jobs in the U.S.

With the rise in COVID-19 cases fueled by new variants, the number of long COVID cases will keep increasing. This is a wake-up call for global and country-level efforts to mitigate the impacts of long COVID. These are five ways to do so.

First, all global COVID-19 funds replenishment efforts must include plans to support long COVID interventions. These should go beyond COVID-19 prevention activities such as wearing of face masks, washing of hands with soap under running water and COVID vaccination.

Unfortunately, the 2022 “Break COVID Now Summit” co-hosted by Gavi only focused on replenishing funds to enable poorer countries to buy COVID-19 vaccines. Another way to ensure availability of funds for long COVID interventions before the next round of funds replenishment is ensuring that all COVID-19-related funding should include a component on long COVID. Such funding should cover local research on long COVID to determine the burden at country-levels, treatment and care for sufferers.

Second, some long COVID symptoms should be classified as disabilities. The U.S. Department of Health and Human Services recognises that long COVID can be a disability under the Americans with Disabilities Act if it substantially limits one or more major life activities. Other countries should do likewise.

Classifying long COVID symptoms as disabilities would enable sufferers to fully recover while being supported by the government or their employer. It would also protect the rights of sufferers from discriminations and stigmatization. For instance, a worker who has brain fog and difficulty in recalling past events requires time off work and mental health therapy to recover.

Third, update mental health care to include care of those living with long COVID. This should include updating standards of practice for mental health practitioners, mental health policies and laws. In addition, doctors should refer people with long COVID to mental health specialists.

This is relevant globally, especially in low and middle countries with poor awareness and services for mental health care. For example, in Nigeria, public perception of mental health is poor, qualified personnel are few, the law regulating mental health is from colonial times and care of those suffering from mental health disorders is mostly provided by unqualified personnel.

In 2019, I co-led the mental health in Nigeria surgery – the largest mental health survey in the country within the last 20 years. Our result showed that 70% of Nigerians say that mental health disorder is when the sufferer starts running around naked. Such wrong perception delays care and stigmatizes sufferers. One can imagine how long COVID sufferers with mental health disorders could be neglected in Nigeria.

Fourth, prioritise long COVID interventions in children because they are our future and long COVID could tamper with their abilities to be successful in life.

A systematic review of long COVID in children and adolescents shows a prevalence rate of 25.24%. The top five long COVID symptoms in children and adolescents are mood symptoms (16.50%), fatigue (9.66%), sleep disorders (8.42%), headache (7.84%), and respiratory symptoms (7.62%).

The thought of children and adolescents dealing with such conditions is disheartening. Their development and productivity are stifled. Therefore, paediatricians, parents and child social workers should be trained on providing the best long COVID care for children and adolescents.

Lastly, invest in nonprofits providing long COVID interventions because governments alone cannot cater for the huge backlog of sufferers. COVIDAid – the first long COVID Charity in the United Kingdom — has brought long COVID to the front burners of national discuss in the UK. It has provided support to more than 125,000 people via a web hub, held live events on the mental health impacts of COVID-19, launched new free long COVID courses and encourages voluntarism for long COVID.

Nonprofits play important roles in bridging gaps in social development. Having more of these types of long COVID nonprofits would ensure these achievements are replicated in other countries.

Long COVID is an existential threat to humanity. Globally, the 100 million long COVID sufferers are more than the population of Germany. There is fire on the mountain. We must consolidate global efforts to quench the fire.

© Inter Press Service (2022) — All Rights ReservedOriginal source: Inter Press Service

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Polio Eradication Will Take Funds and Awareness — Global Issues

A polio vaccinator administers the oral polio vaccine to a child in Pakistan. Credit: Ashfaq Yusufzai/IPS
  • Opinion by Ifeanyi Nsofor (abuja)
  • Inter Press Service

ABUJA, Jun 22 (IPS) – For forty days, Kunle Adeyanju – a Nigerian, Rotarian, polio eradication advocate and biker – rode for more than 12,500km from London to Lagos to raise funds for polio eradication.

Adeyanju documented his journey on Twitter, where his handle is appropriately named @lionheart1759. Indeed, it takes one with a lion’s heart to embark on such a bold adventure. People like philanthropist Bill Gates, who works on polio eradication, and the CEO of Twitter, Parag Agrawal, tweeted out their support and admiration.

I also followed Adeyanju’s journey on Twitter, and I applaud him too, including because I love to see individuals pursue their dreams, no matter how terrifying it seems. Ellen Johnson Sirleaf, Africa’s first female President and former President of Liberia, aptly captures this sentiment, “The size of your dreams must always exceed your current capacity to achieve them. If your dreams do not scare you, they are not big enough.”

I also support his cause. Polio is a serious infectious disease – it causes paralysis of muscles and also kills if the respiratory muscles are affected. In the past, polio victims who were unable to breathe on their own were placed in iron lung machines to enable them to breathe. Thanks to the efficacy of the polio vaccine, this is now history.

I am a proud alumnus of polio eradication. It was my first experience in global health. As a young monitoring, evaluation and surveillance officer at Nigeria’s National Programme on Immunization, I was involved in the global polio reaction initiative supporting advocacy, training of health workers and supervising routine and polio vaccinations across Nigeria.

We’ve seen in recent years how the global community has come a long way in almost making polio the second infectious disease (after smallpox) to be eradicated. Without a doubt, Rotary International has been a major partner and funder on this journey. I am part of the Rotary International family and was the president of the Rotaract Club at the Nnamdi Azikiwe University College of Medicine, Nnewi, southeast Nigeria. Rotary International launched a global polio vaccination campaign in 1985.

Three years later, the Global Polio Eradication Initiative (GPEI) was established. At that time, polio paralysed more than 1000 children globally daily. Since then, more than 2.5 billion children have been immunized against polio. Consequently, global incidence of polio cases has decreased by 99%. Currently, wild poliovirus continues to circulate in Afghanistan and Pakistan. Nigeria interrupted polio transmission in 2019.

Even in the face of dwindling resources and competing demands, the push for the total eradication of polio must continue because as long as even a few people have polio, it could spread widely again. The final five-year push to eradicate polio would cost an estimated less than $1 billion per year.

Like Adeyanju, Gates, and others, I want to see polio completely eradicated. These are four areas where those $5 billion funds could make that possible.

First, polio vaccine is needed to vaccinate all eligible children. To be fully protected for life, children need four doses of polio vaccines. Polio vaccines come in two forms – oral and injectable. Based on UNICEF estimates, cost per fully vaccinated child is $0.42 for oral polio vaccine. In contrast, it is $2.78 for an injectable polio vaccine.

Second, polio surveillance is a continuous process necessary for prevention and detection of the virus. The polio virus is passed out in stool. That’s why polio transmission is faeco-oral.

This makes polio transmission common in communities with poor sanitation and widespread public stooling. Surveillance activities involve collecting and screening stools of children who have quick onset paralysis after episodes of fever. Further, environmental surveillance of polio involves collecting and testing sewage water for the polio virus.

Third, vaccine storage via modern cold chain equipment. Maintaining the right cold chain for vaccines requires constant electricity, which is lacking across communities in sub-Saharan Africa. For example, only 48% of sub-Saharan Africa has access to electricity, according to the World Bank.

Therefore, clean renewable energy such as solar is a sustainable way to provide the right cold chain for vaccines. Across African countries, some primary health centers already use solar freezers for vaccine storage. Solar freezers don’t come cheap. A Solar Direct Drive Freezer sold on the African Union’s “Africa Medical Supplies Platform” costs $5,797.56.

Lastly, public health education is imperative to achieve equity in complete polio eradication and to continue to see successful vaccination campaigns in countries without polio. Indeed, the University of Global Health Equity, Rwanda captures this succinctly, “to achieve equity in healthcare, depends on equity in health education”.

Polio education is delivered in communities using community health workers, community leaders and community based organisations. Other means include use of radio, TV, print media and electronic media. More polio education should be delivered via social media. Adeyanju has made polio topical among youths on social media by following his heart and pursuing his dream

Adeyanju’s bold ride from London to Lagos has put polio on the front burners of international discourse, especially in these times of covidization of everything.

Through his action, he has answered in the affirmative Rotary International’s four-way test of what people say, think or do:

Is it the truth? – Yes

Is it fair to all concerned? – Yes

Will it build good will and better friendships? – Yes

Will it be beneficial to all concerned? – Yes

Thank you, Kunle Adeyanju. Your boldness will save lives and stop children from being paralysed. You are a hero.

Dr. Ifeanyi McWilliams Nsofor is a graduate of the Liverpool School of Tropical Medicine. He is a Senior New Voices Fellow at the Aspen Institute and a Senior Atlantic Fellow for Health Equity at George Washington University.

© Inter Press Service (2022) — All Rights ReservedOriginal source: Inter Press Service



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Corruption Kills — Global Issues

Nigerians should not be pushing against global COVID-19 vaccine inequity amid widespread looting of the national treasury. Credit: UNICEF/Nahom Tesfaye
  • Opinion by Ifeanyi Nsofor (abuja)
  • Inter Press Service

ABUJA, May 24 (IPS) – Nigeria’s accountant-general, the administrative head of the country’s treasury, has been arrested by the Economic and Financial Crimes Commission for allegedly stealing 80 billion naira ($134 million). This is a staggering theft in a country that has an estimated poverty rate of 95 million (48% of the population) and some of the worst health indices in the world.

As a universal health coverage and global health equity advocate, I know that Nigeria’s health system would be stronger and work better by blocking these leakages and channeling the funds to provide universal health coverage for every Nigerian.

Indeed, the stealing of public funds denies millions of people healthcare, which comes with severe health consequences. These include citizens living with chronic debilitating illnesses, loss of productivity, worsening poverty and even death. In our country, about 58,000 women die during pregnancy and childbirth yearly; and 1 in 8 children do not live to witness their 5th birthday. Simply put, corruption is a matter of life and death.

These are five examples of how the missing 80 billion naira could improve the health of Nigerians if rechanneled.

First, 80 billion naira would fund President Muhammadu Buhari’s plan to provide health insurance for 83 million poor Nigerians, as part of his implementation of the new National Health Insurance Authority Act that he recently signed into law.

Further, the missing 80 billion naira is 114 times the 701 million naira budgeted for the defunct National Health Insurance Scheme in 2022. It is unsurprising that the Scheme did not achieve a national health insurance coverage of up to 5% for the past 18 years.

A mandatory health insurance program is a way to achieve universal health coverage for Nigerians because out-of-pocket spending at the point of healthcare pushes people into poverty. Isn’t it ironic that millions of Nigerians are pushed into poverty when they access healthcare and the accountant-general is alleged to have stolen 80 billion naira? This is a classic case of suffering in the midst of plenty.

Second, the stolen 80 billion naira can fund tertiary healthcare for millions of Nigerians who access care at teaching hospitals. Lagos University Teaching Hospital, University of Nigeria Teaching Hospital, University of Ibadan Teaching Hospital, Aminu Kano Teaching Hospital and Jos University teaching Hospital collectively have a budget of 78 billion naira for 2022.

Teaching hospitals do not just provide tertiary healthcare. They also provide primary and secondary healthcare services. In addition, they train medical students and other health professionals. They are also training institutions for doctors specialising to become consultants.

Third, the stolen 80 billion naira is 13 times the 6 billion naira collectively budgeted for National Obstetric Fistula Centres at Abakaliki, Bauchi and Katsina states in 2022. The World Health Organization describes obstetric fistula as an abnormal opening between a woman’s genital tract and her urinary tract or rectum.

It is caused by long obstructed labor and affects more than 2 million young women globally. The abnormal opening leads to leakage of urine and/or faeces from the vagina. Obstetric fistulas destroy the dignity of women. Victims are ostracized, stigmatized and lose economic power. It said that you smell victims before you see them.

That is the huge burden that victims carry. In Nigeria, prevalence of obstetric fistula is 3.2 per 1000 births. There are 13,000 new cases yearly. A review of obstetric fistula in Nigeria showed that the backlog of cases could take 83 years to clear.

In contrast, the stolen 80 billion naira would shorten the time it takes to clear this backlog. I know from my experience as a grantmaker. In 2012, I led the community health initiatives at the TY Danjuma Foundation. A one-year grant of 11 million naira awarded to a grantee in Kano state, northwest Nigeria provided surgical repairs of obstetric fistulas; training of health workers on repair and care of patients; economic empowerment of patients; and advocacy to communities to discourage early marriage and encourage health-facility-based deliveries.

Fourth, the missing 80 billion naira if allocated to the National Primary health Care Development Agency would improve COVID-19 vaccines procurement, distribution and administration in Nigeria. Indeed, that amount is more than 3 times the 24 billion naira budgeted for the NPHCDA in 2022.

So far, Nigeria is mostly depending on the generosity of vaccines donated by rich countries such as the U.S. through the COVAX facility. This is not sustainable. Recent news out of South Africa reveals that Aspen Pharmacare could shut down production of Johnson & Johnson COVID-19 vaccine because African countries are not placing orders as expected.

At a cost of $7.50 per dose of Johnson & Johnson COVID-19 vaccine, $134 million would buy 18 million doses to vaccinate Nigerians and help the country achieve herd immunity as quickly as possible. Nigerians should not be pushing against global COVID-19 vaccine inequity amid widespread looting of the national treasury.

Lastly, the stolen 80 billion naira is 1.5 times the amount budgeted for the 54-billion-naira Basic Health Care Provision Fund. According to the National Primary Health Care Development Agency, the fund is to improve access to primary health care by making provision for routine costs of running primary health centres, and ensure access to health care for all, particularly the poor, by contributing to national productivity. Eighty billion naira increases the number of poor and vulnerable Nigerians who could access healthcare through the Basic Health Care Provision Fund.

Sadly, while still trying to come to terms with the allegation against the accountant-general, there is more news of fraud in Nigeria. A former Managing Director of the Niger Delta Development Commission was arrested for allegedly stealing 47 billion naira. Also, the only female to have served as the speaker of Nigeria’s federal House of Representatives was also arrested for 130 million naira fraud.

These thefts must stop, and the funds should be put where they are most needed: funding healthcare. Without health, we have nothing.

© Inter Press Service (2022) — All Rights ReservedOriginal source: Inter Press Service

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