INVESTMENT OPPORTUNITIES IN THE NIGERIAN HEALTH SECTOR A PAPER PRESENTED BY

1. INVESTMENT OPPORTUNITIES IN THE NIGERIAN HEALTH SECTOR A PAPER PRESENTED BY THE HONOURABLE MINISTER OF HEALTH OF NIGERIA PROF. C.O. ONYEBUCHI CHUKWU AT THE BREAKFAST SEMINAR OF THE INSTITUTE OF DIRECTORS, NIGERIA IKOYI, LAGOS 28TH JUNE, 2012

2. PREAMBLE

3. IMPORTANCE OF HEALTH ‘More than anything else, health is important’ -President GoodluckEbele Jonathan, GCFR May 29, 2012 Health is wealth and there is no meaning human development without health. Health contributes to a nation Gross Domestic Product (GDP), its contribution is determine by the opportunity cost of its absence. It has been estimated that for instance that eradicating malaria will lead to a 10% rise in GDP.

4. UNDERSTANDING THE NIGERIAN HEALTH SECTOR The WHO defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity Nigerian Health Care Services: Public Sector - Federal- provision of tertiary healthcare State – provision of secondary healthcare L/Govt – provision of primary healthcare Private Sector - Partakes in all the three tier services

5. National Strategic Health Development Plan (2010- 2015) – prepared through an elaborate collaborative process, involving all stakeholders. It was developed based on the principle of one plan, one budget and one result matrix. It is also costed. -Total estimated cost of the NSHDP for the six year period is #4.1Tr (about USD26.6billion) -Annual cost per capita of #4,745 (about USD31.63) Who is to bear this burden of investment? Government, Private Sector, Development Partners, Individual Citizens. NB Household out of pocket expenditure remains by far the largest source of health expenditure in Nigeria (about 70%)

6. 2003 – 2005

7. 2003 -2005

8. Nigeria has developed a medium term strategy with a four year timeline tagged Transformation Agenda. • The health component of the agenda is derived from the NSHDP which has eight strategic priority areas; • Leadership and Governance for Health; • Health Service Delivery • Human Resources for Health; • Financing for Health; • National Health Management Information System; • Partnerships for Health; • Community participation and Ownership; and • Research for Health

9. The NHSDP supports private sector investments in all these areas. • Specific activities articulated in the NSHDP for effective and enhanced private sector engagement include • Support for the public private partnership policies and plans in States in line with the national policy on PPP. • The public sector collaboration with the private sector to improve health sector through professional development, supportive supervision, generation of public health information and intelligence. • Exploration of public private partnership in maintenance of medical equipment and office furniture. Active participation of private sector is therefore required in partnership with Government towards facilitating quick achievement of government ‘s health Care targets through; • Corporate social responsibility, • Partnership for profit, amongst others

10. FACTORS MILITATING AGAINST PRIVATE SECTOR PARTICIPATION IN THE HEALTH SECTOR A number of factors tend to discourage private sector investment in Nigeria health sector. Some of these include; 1. High cost of borrowing funds 2. Current security challenges. 3. Poor infrastructure based (high cost of doing business) 4. Absence of reliable health financing mechanizing for more than 96% of the populace (who pays for the services.)

11. However, I am happy to inform you that, Federal Government is leading efforts at addressing these challenges through the following. • Facilitating access to funds held by development banks (IFC, ADB, EBID, BOI. etc.) • ? ? Establishment of intervention funds • - Restructuring, retraining, and retooling of security personnel. - Addressing issues relating to extreme poverty. - Employementgeneration (YOUWI N, SURE-P.etc.) • Provision of power, water and roads are given high priority. The railway system is being revamped and the inland waterways areactively being developed.

12. Introduction of the community based social health insurance, and the voluntary contributor social health insurance scheme. These are in addition to the Federal public sector scheme. • The National Heath Bill. • The government is exploring innovative funding mechanism to achieve universal emergency medical coverage through the introduction of special levies/taxes. • Necessary regulatory framework has been put in place to protect private investment; -Creation of Infrastructure Concession Regulatory Commission (ICRC) - Policy on Public Private Partnership (PPP), which is currently in the process of being reviewed

13. MEDICAL TOURISM • There has been a phenomenal increase in Medical Tourism by Nigerians which is hinged on a number of factors:- • Lack of appropriate and modern facilities in our tertiary health care facilities. • Inadequate human capacity development that matches the modern technological advancement. • Incessant work disruption occasioned by workers’ strikes • Lack of information on facilities and services available in the country. • The propensity to patronize foreign goods and services • Unethical commercialization of referral system.

14. The Federal Government has embarked on a rescue mission of upgrading Tertiary Health Care Services to meet international standards through: • Upgrading of tertiary health centres to world class standard, presently there are ten of these centres that have been upgraded. Two more are nearing completion. • Skills and facilities mapping of the health system: this exercise has been successfully conducted and the data obtained was found to be useful in decision making in terms of personnel recruitment, deployment of equipments and patient referrals. • Through private public partnership arrangement, government intends to transformsome centres into Centres of Excellence. • Investors will be encouraged to invest in part or in full in our tertiary health care services.

15. Health care professionals will be assisted through soft loans to establish private specialty hospitals that will bridge the gap left by public health facility shortfalls. • There is an ongoing curriculum review to update training needs for all cadres of health care personnel. • Regulatory bodies have also been urged to ensure strict compliance with rules and ethics of various professions by all health workers. • A directory or compendium of facilities and services available in the country is being produced to serve as a general reference document for referrals within the country. • Government is about to introduce a policy that would address the issue of unnecessary government-sponsored overseas medical trips.

16. SPECIFIC INVESTMENT OPPORTUNITIES IN NIGERIAN HEALTH SECTOR • State-of-the- Art Specialist Hospitals • Trauma Centres • National Diagnostic Centre • Mobile Clinics • Small holder specialist clinics in different specialties of medicine and surgery • Pharmaceutical Products Factories in the area of production of condoms, HIV/AIDS drugs, test for HIV/AIDS and Malaria, Artemesinin based combination drugs, dental prosthesis • A Website-Based Directory and information database of Nigeria Health Sector Stakeholders • Central Medical Library • Reference Laboratory for quality assurance of medicines and medical products

17. Central Medical Library • Reference Laboratory for quality assurance of medicines and medical products • Healthcare Waste Management System • Vaccine Production Plants • Private suites in Federal Tertiary Hospitals for patients and relations • Emergency Ambulance Scheme • Drug distribution - Establishment of Mega Distribution Centres - Establishment of State Distribution Centres • Local production of Anti-snake Venom • Local manufacture of pharmaceutical grade starch • Manufacture of selected pharmaceutical active ingredients from imported intermediates until our privatized petro-chemical industry shall be in position to manufacture the intermediates

18. CONCLUSION

19. CONCLUSION • There is abundance of opportunities for private sector investment in Nigerias’ Health Sector • The foreigners are coming to seize these opportunities there is no reason why our business men and women should not be equally or even more interested. • It is the duty of government to guarantee the enabling environment, which this administration under the leadership of president Good luck Jonathan is currently doing. • Therefore I welcome you on board.

20. Thank you for listening