Dissecting CBN’s strategic focus on medical tourism, research, CACOVID

Recent travel to London for medical checkup by President Muhammadu Buhari reminded Nigerians about the degenerating state of health care in the country. In this report, CHIMA NWOKOJI reviews the state of Nigeria’s health care system and the interventions of the Central Bank of Nigeria (cbn) to ensure that the sector is revitalised.

Public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak as an important element of national security.

The Nigerian health care had suffered several infectious disease outbreaks year after year. This gave rise to the need to tackle the problem.

Before the outbreak of COVID-19, the Central Bank of Nigeria (CBN) had decided to support the government by helping to build specialist hospitals across the country, focusing on diagnosis and surgery.

Driven by the belief that health is wealth, its intention had been to reduce the drain on the country›s foreign reserves caused by constant travelling of Nigerians abroad to seek medical assistance. It also took it up to support the pharmacy and pharmacology industry.

Pre-COVID-19 Healthcare Sector Intervention Facility

Nigeria’s health care system has gone from being comparable to the rest of the world in the 70s and early 80s, to one of the world’s most underfunded and least robust. Despite a 2001 declaration by African heads of state — known as the Abuja Declaration — to allocate at least 15per cent of their national budgets to health care, successive Nigerian governments since then have consistently allocated under 10 per cent of their budgets to health care

So, as part of proactive measures to reduce medical tourism which is estimated to be costing Nigeria about $1 billion annually, as well as support the growth of the Nigerian healthcare sector, the CBN introduced the Healthcare Sector Intervention Facility.

The facility, already running before the outbreak of COVID-19, was aimed at strengthening the sector’s capacity to meet the increasing demand for healthcare products and services, particularly pharmaceutical companies and other healthcare value chain players intending to build or expand capacity.

Emefiele stated that currently, 82 projects, valued at N85.89 billion had been financed through the scheme, stressing that the projects financed comprised 26 pharmaceutical and 56 medical ones across the country.

Grant for COVID-19 vaccine research

As at March 2021, the CBN had disbursed a total sum of N253.54 million grant to five health researchers under the Healthcare Sector Research and Development Intervention Scheme (HSRDIS). It was meant to aid the development of vaccines and drugs to combat communicable and non-communicable diseases, including COVID-19.

The scheme is part of the apex bank’s policy response to the COVID-19 pandemic to spur the development of vaccines and drugs. Emefiele, said in Abuja during the award of grants to successful applicants that so far, 68 proposals had been evaluated from the over 286 proposals received from the public, while five proposals with merits, valued at N253.54 million, were recommended by experts for financing.

The HSRDIS was introduced with the release of the implementation guidelines and subsequent inauguration of the Scheme’s Body of Experts (BoE) in July 2020.

Under the HSRDIS, grants are provided to researchers and healthcare institutions for the development of vaccines, drugs and herbal medicines, which could help curtail the spread of COVID-19 and any other communicable or non-communicable disease.

Already, some of the recommended proposals had the potential to enable the development of the Nigerian vaccine for COVID-19 as well as other solutions to some of the country’s healthcare challenges.

“We all witnessed how a number of countries and territories adopted stringent and immediate export restrictions on critical medical supplies and drugs that were specifically meant to help countries respond to the spread of the virus,” he stated, hoping that the grant scheme will facilitate Nigerians’ access to the much-needed vaccines and drugs not just for COVID-19, but other communicable or non-communicable diseases.

He added that the CBN remained committed to the successful implementation of the scheme and will ensure the review and evaluation of subsequent applications. Review of proposals is still ongoing and the Body of Experts is expected to provide recommendations for additional award of grants soon.

“Today’s grant awards are a testimony to the significant role research and development in healthcare could play in supporting economic growth, particularly as growth is highly dependent on a strong and healthy workforce.

“Meeting our need for a strong and healthy workforce with better safety profiles is a task that can only be addressed through a healthcare sector that provides for significant investments in research and development.

“We all witnessed how a public health emergency brought strong economies and developed nations to their knees. In Nigeria, it exposed the fragility of our healthcare system and the urgent need to look inward and build a more robust and sustainable healthcare system,” the CBN governor said.

Commending CBN, the Secretary to the Government of the Federation (SGF), Mr Boss Mustapha, who is also Chairman of the Presidential Task Force on COVID-19, said though COVID-19 had come with adverse impacts on the economy, it also provided opportunities which the country must take advantage of to transform the country’s healthcare system.

While commending the CBN for the healthcare financing initiative, he said the country needed to boost its healthcare system to withstand further pandemics and any other related health issues.

“Once again, I congratulate the CBN governor and your wonderful team for the great job you have done to save our healthcare system and provide us with an opportunity for our researchers, ventilating their wealth of experience and creating a platform for us to further the course of research in the health sector.

“You’re doing a great job. We have battles with the ability to balance lives and livelihoods and I must say Emefiele, you have been at the forefront of that from day one either through the institution of the CBN interventions in several areas of our economy or in your leadership through the CACOVID.

“Never in the history of Nigeria have we had a national response that broadened the corporate work that we did with the COVID-19 response.”

The Minister of State for Health, Senator Olorunnimbe Mamora, appreciated the efforts of Emefiele in providing critical interventions at the point in time, adding that Emefiele was not just promoting the primary healthcare system but the impact of the interventions, when well implemented, would strengthen the system.

The CACOVID

Due to the sudden global health challenge (COVID-19), which wreaked havoc on most economies of the world, coupled with declining oil prices and declined government revenue; the Bankers Committee, comprising the Central Bank of Nigeria and the Deposit Money Banks, as well as key stakeholders in the private sector came together to set up an alliance in March 2020, known as the Coalition Alliance Against COVID-19 (CACOVID).

Notwithstanding existing support schemes, the Coalition Alliance Against COVID-19 (CACOVID), led by CBN has so far incurred an expenditure of N43.27 billion on the acquisition of, not only medical equipment and supplies but also food palliatives for vulnerable Nigerians. In order to ensure that these funds were judiciously utilised, a transparent and accountable framework was put in place by highly rated firms of chartered accountants like KPMG Professional Services as book keepers and Messrs Enrst and Young as Auditors.

The funds raised by CACOVID were used to support three key priorities – Medical facilities and equipment, food relief programs and communications plans.

In collaboration with other stakeholders, CACOVID developed 39 fully equipped isolation centers across the 36 States of the Country including the Federal Capital Territory (FCT). The sum of N4.19 billion was spent in building isolation centers. In addition, medical equipment such as PCR test kits for suspected cases of COVID-19 were procured along with other required medical items at a cost of N9.02 billion.

As a way of cushioning the impact of the lockdown on vulnerable citizens, CACOVID provided palliatives in the form of essential food items to 1.7 million households, which is equivalent to supporting eight million Nigerians. A total of N28.76 billion was spent procuring these food supplies, even do the distribution of these items was over delayed by state governments until people started breaking into the warehouses.

CACOVID also worked to improve awareness in rural communities on the COVID-19 virus, and the measures community health workers and other members of society should take when someone in the community is suspected of having symptoms similar to that of COVID-19. In lieu of this, expenses were incurred on Print, TV, radio, and social media as part of CACOVID communication plans.

The recent disclosure is in line with the principle of accountability and transparency, as the organisation seeks to lay bare facts regarding expenditure incurred so far; thereby, nipping in the bud, suspicions and unfounded rumor.

CACOVID has committed to fully rehabilitate all 44 damaged and destroyed police stations nationwide during the ENDSARS protest in a bid to restore provision of security in affected locations. Also, to further strengthen the security apparatus in the country, CACOVID has committed to provide over N100 billion to procure equipment and gadgets for the Nigerian Police Force over the next two years; as its contribution to fully modernise the Nigerian Police.

Other measures

On March16, the Central Bank of Nigeria announced new measures. They include: A 1 year extension of a moratorium on principal repayments for CBN intervention facilities; the reduction of the interest rate on intervention loans from nine per cent to five per cent; Strengthening of the Loan to Deposit ratio policy (i.e. stepped up enforcement of directive to extend more credit to the private sector); Creation of N50 billion target credit facility for affected households and small and medium enterprises; Granting regulatory forbearance to banks to restructure terms of facilities in affected sectors; Improving Foreign Exchange (FX) supply to the CBN by directing oil companies and oil servicing companies to sell FX to the CBN rather than the Nigerian National Petroleum Corporation; Additional N100 billion intervention fund in healthcare loans to pharmaceutical companies and healthcare practitioners intending to expand/build capacity; Identification of few key local pharmaceutical companies that will be granted funding facilities to support the procurement of raw materials and equipment required to boost local drug production.

Others are: N1 trillion in loans to boost local manufacturing and production across critical sectors; Adoption of a unified exchange rate system for Inter-Bank and parallel market rates to ease pressure on FOREX earnings as oil prices continues to plummet among others.

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