Panellists and other eminent Nigerians at the Lagos premiere of a documentary on the management of the COVID-19 pandemic in Nigeria have called for an effective national health insurance scheme, strengthened primary health care system, and sustainable public-private partnerships, PPP, and a holistically restructured health sector, among others.

The documentary titled: “Unmasked: Leadership, Trust, and COVID-19 in Nigeria”, was an eye-opener to what transpired during the response to the outbreak of the COVID-19 pandemic in Nigeria in 2020. The 95-minute documentary showcases the failures and challenges of the response and essentially serves as catalyst for a conversation on the shortcomings in the nation’s public health sector that were unmasked by the pandemic. A collaborative effort between Daria Media and Zuri24 Media, filmed with the support of MacArthur Foundation and PLAC, the film aims to bring about solutions to healthcare challenges in Nigeria. The documentary was a rare opportunity to look at what the COVID-19 pandemic exposed about the Nigerian response and to ensure that the nation learned lessons and got things right in the future.

The conversation focused on the issues thrown up by the documentary, specifically on public and private sector collaboration for the development of a robust and effective public health care system, and identification of strategies to bridge the lapses and gaps to response efforts during future health emergencies. Among the salient issues identified by the documentary were a lack of political will, poor leadership, collapsed or collapsing healthcare system, lack of adequate emergency preparedness, a weak health infrastructure, persistent brain drain, and lack of functional hospital equipment.

The Lagos State Governor, Mr Babajide Sanwo-Olu, who spoke at the forum, called for a change in the structure of governance to stem the unwanted tide even as he avowed that the COVID-19 pandemic had kickstarted the process of change. “We have to take the lessons from COVID-19 to galvanise tomorrow. Change in govt structure “The lessons are certainly not lost on me personally and my government. I know that indeed what COVID brought forward to us, these are things that if indeed we take the positive side of it, we can use to galvanise and create tomorrow,” he asserted. “The structure of our governance system is among the things we should look into and change, and the change has to be about all of us.” Sanwo-Olu who stressed that tough decisions have to be taken in the process of change, urged Nigerians to be prepared because other pandemics were on the horizon. “It is not about medical pandemic alone; it could be hunger pandemic, security pandemic, governance pandemic. Whatever it is, how prepared are we? What is the level of our resilience? “People have to come out and vote so that they can elect credible leaders. You cannot sit back and not be part of the process to elect your leaders. We have to be part of that change that we desire. Indeed, COVID-19 has started it for us,” he noted.

On his own part, the Governor of the Central Bank of Nigeria, CBN, Mr. Godwin Emefiele, urged the public and private sectors to collaborate to build more healthy and robust healthcare infrastructure in Nigeria. Emefiele, who was represented by the CBN’s acting Director, Corporate Communications, Mr. Osita Nwanisobi, argued that addressing the public health crisis along with the downturn in the economy required strong coordination. “In this regard, we disbursed over N83.9 billion in loans to pharmaceutical companies and healthcare practitioners which is supporting 26 pharmaceutical and 56 medical projects across the country. “We were also able to mobilise key stakeholders in the Nigerian economy through the CACOVID alliance, which led to the provision of over N25 billion in relief materials to affected households, and the set-up of 39 isolation centres across the country.” Emefiele said that besides food, healthcare expenses were a significant component of average Nigeria’s personal expenditure. According to him, out-of-pocket expenses on healthcare amounted to close to 76 per cent of total healthcare expenditure. “A key factor that has impeded access to healthcare for Nigerians is the prevailing cost of healthcare services. “Given the challenges our nation faced as a result of the pandemic, it is indeed vital that all stakeholders work towards building the capacity of our researchers and institutions to address domestic healthcare challenges. Strengthened partnerships “Strengthening collaboration and partnerships between researchers, public as well as private sector stakeholders across the country is crucial to enabling Nigeria to build a more robust and proactive healthcare infrastructure system,” he noted.

The Director-General, of the Nigeria Centre for Disease Control, NCDC, Dr. Chikwe Ihekweazu, remarked that the NCDC is now better prepared for future epidemics and pandemics. “It was when I went to China in 2020 that I realised how big a challenge we faced. However, we were proactive enough in our response.” According to Ihekweazu: “Nigeria is very diverse. Given the diversity of the country, one model of healthcare solution required in one state may not be applicable in another.

The resurrection of Primary Health Care A consultant medical doctor and former Ogun State commissioner for health, Dr. Olaokun Soyinka, called for the resurrection of the primary health care system. “It is the crux of healthcare delivery. It is the orphan child because it is not owned by anybody. There are three tiers of government contributing to it, that is the Federal, state, and Local Government Area (LGA),” he said. Also speaking, the Chairman, Evercare Hospital Lekki Limited, Mr. Tosin Runsewe, recommended mandatory health insurance to address the challenges and ensure Universal Health Coverage. Runsewe, who called for the training of more medical personnel, argued that if the NHIS were mandatory, it would take care of half of the Nigerian population, while the social health insurance programme that would cater care of the indigent people and those in informal employment will now take care of the remaining 50 per cent of the population. The Coordinator of the PTF, Dr Sani Aliyu had remarked: “Covid will decide the extent of leadership. The storm has only just started in terms of the socioeconomic impact.”