Ugwanyi Charles warns that withheld funds and failing primary health centres threaten disease prevention and national health security.
Chief Consultant Neurosurgeon and former Chairman of the Nigerian Medical Association (FCT chapter), Ugwanyi Charles, has called for an immediate state of emergency in Nigeria’s health sector, warning that current funding shortfalls threaten the achievement of the 2030 Sustainable Development Goals.
Charles highlighted the alarming decline in the release of both the health capital budget and the 1% consolidated basic healthcare provision funds, which he said are crucial for strengthening primary health care, particularly in rural communities.
“A situation whereby both the capital budget on health and the 1% consolidated basic healthcare provision funds is made unavailable. The problem is not that the funds are not there. No, the funds have been budgeted. You don’t budget what you don’t have,” Charles said.
He explained that supplementary budgets exist, but the reduction and withholding of allocated funds remain the critical issue. “We need to focus attention on the governmental agency, which is at the level of the Accountant General, and begin to ask questions there.
“Why are these funds being withheld? Because it is just a joke. Is it that you don’t understand what health service delivery means, or that you’re using some strategies which you call a bottom-to-top approach, which really should not apply in the health industry? If it doesn’t apply in the ministry, in the military, on issues related to defence budget, it does not apply,” he added.
Charles warned that without proper funding, Nigeria’s efforts to strengthen rural health infrastructure will fail.
“The point is that achieving the four thematic areas, a brainchild of this current Ministry of Health, is going to be a pipe dream. And I’ll tell you why. Number one is that we need funds to penetrate the rural areas. Seventy percent of Nigerians reside in those rural areas,” he said.
He highlighted that only 10 to 15% of the country’s 34,000 primary health care centres are still in existence. “Now, that informs the current ministry to do something very smart, which is the aim to achieve reactivation of up to 17,000 of them out of those by 2027.
“They are hoping to rely on these funds, the consolidated funds, 1% consolidated, and also the capital expenditures. They must have this fund, the ministry must have this fund in order to attract counterpart funding from donor agencies.”
Charles also expressed concern that withheld funds block international support, noting that donor agencies condition assistance on counterpart funding.
He revealed a worrying downward trend in fund releases: “It has dropped from 45% release to 30% release to currently 15% release. Which means every year from 2022 till now, it keeps dropping by 15%. Now, if you extrapolate, if you project, it means that this coming 2026, there will be nothing to be released. But that does not mean that these funds have not been allocated.”
When asked who is responsible, Charles said: “I think that question should be directed to the relevant government agencies, because we know that funds are appropriated; we don’t appropriate funds that are not there.
“And then it is the responsibility of the AG, Accountant General’s Office, to release those funds. To be honest, those questions go beyond my scope. I am here as a clinician, and my primary responsibility is to look out for the Nigerian populace who deserve better than we are getting right now.”
Charles warned of the severe consequences for rural health and national safety. “Sir, the impact is huge. You need to travel to the rural areas and see what’s going on there.
“Part of the primary responsibility of the primary health agencies is to prevent diseases, reduce maternal and child health. And you heard the minister say that they are struggling, bending over backwards, to provide immunisation.
“Let me remind you that until that one person in the most rural area in Nigeria is immunised and protected from infectious diseases, none of us here in the city is safe. Don’t forget that COVID started from Wuhan, a tiny village somewhere in remote areas of China.
“But it caused an international pandemic that locked down the whole world. So such funds should not be toyed with. They should be made available.”
He also highlighted the economic and systemic benefits of adequately funded rural health programmes.
“Additionally, when these activities are ongoing in rural areas, it will even unlock the value chain in the health industry. Because it will create room for distribution of drugs, pharmaceuticals, vaccines, and there will be a lot of jobs created,” he said.
On what should be done to address the crisis, Charles urged the government to fully release allocated funds and increase overall health spending.
“What we should do is that the Part III ones that are located should be released 100%. No discussions. In fact, what we should be talking about is that those Part III funds that are located are not enough. We are looking for 15% according to AU declaration, and we’re hovering around 5%.
“Can we push it to 10%, 12.5%, and 15% and surpass and get to 20%? It is doable. That is what I mean by saying we must declare emergency in the health industry. The health of any nation, the wealth of any nation depends on the health of the nation,”he concluded.
