1. Distinguished delegates, I am very delighted to welcome you to this 52nd National Council on Health (NCH) Meeting. You would recall that the last NCH 51st took place in November 19-23, 2007, in Lagos, during which we took the decision to hold the 52nd NCH Meeting in Kano, Kano State in May 2008. We regret that due to circumstances beyond our control, partly due to the very challenging and unsavoury developments at the leadership level of the Federal Ministry of Health, for most of the year 2008, we did not have the necessary and sufficient conditions to hold the 52nd NCH as earlier planned, until now. We thank God that we are here at last. We remain also very grateful to the Kano State Government, through the Kano State Ministry of Health for their steadfastness and understanding in (still) keeping fate with our collective decisions to host this meeting at this time period. On behalf of the Hon. Minister of State for Health and the rest of us, I say a BIG thank you to the Kano State Government. The status reports of our state of readiness for this meeting, which was given to me yesterday on my arrival, has played glowing tributes and commendations of the excellent and elaborate preparations made by the Kano State Government for this NCH meeting.
2. In February, during our maiden meeting as Ministers of Health with the Hon. Commissioners for Health, I highlighted the need to revitalize the nation’s Health System. At that meeting, we discussed various issues relating to the state of the health system which we all agreed is in dire need of fixing. I intimated you of the agenda and direction of the Federal Ministry of Health in the new dispensation to achieve a people-oriented and responsive health system that will achieve the Human Capital Development Program of Mr. President’s 7-Point Agenda. You would recall that we put before you as our major partner in health development in Nigeria, two very important issues for discussion and inputs: The Agenda for Health 2009; and the National Strategic Health Development Plan.
3. The Agenda for Health 2009 has the following strategic thrusts which were discussed in the group session during the meeting: Enhancing the Stewardship Role of the Ministry; Revitalizing the Health System with Emphasis on Delivery of quality health services through Primary Health Care and strengthening referrals with Secondary and Tertiary Institutions to reduce the disease burden and improve the health status of Nigerians; Enhancing Financial Resource Mobilization through the expansion of the NHIS and other Private Public Partnership (PPP) arrangements; Enhancing the Coordinating Role of the Ministry and its interface with States, Local Governments and Donors; Human Resources for Health; Strategic Information Management & Research; Communication and Public Relations Management. I believe the discussions were very rich and implementation of some of the recommendations will enhance the efforts we are all making to impact positively on our health system.
4. As we intimated you during our last meeting, the Minister of State for Health and I feel very strongly about interacting more closely with the States, hence the creation of the State Coordination Unit in my office. Also, because of the great potentials in working with the private sector, which are yet to be tapped, I have also created a Public-Private Partnership (PPP) Unit in my office. If we all, at federal, state and local government levels, unify our efforts with those of the private sector, I believe the health system will be strengthened.
5. We also intimated you about the National Strategic Health Development Plan (NSHDP) which would serve as the ONE Reference Plan for all - with an associated consolidated national health investment plan. I have since inaugurated the Technical Working Group (TWG) and they have been working tirelessly towards the mandate given. Presently, as we meet, the TGW is also meeting in Abuja to develop the Zero-Draft of the National Strategic Health Development Framework. At the end of the process work, a National Strategic Health Development Plan, consisting of three (3) parts would have been produced: indicating the Priority Areas; Goals; Strategic Objectives; Strategies; and Activities including various stakeholders’ roles and responsibilities; Monitoring Evaluation indicators; costing/health investment dimensions and timelines for deliverables between now and 2015. As we have agreed, I shall be holding our next meeting with the Hon Commissioners in Abuja on April 27/28, 2009 to look specifically the draft NSHDP framework. We shall endeavors to circulate copies of the framework ahead of time to ensure meaningful discussion. While I recognize the huge demand and commitment of your time, I believe it is important we set the framework right now in order to get on with producing the respective health plans for our collective accountability for health development in this country.
6. The theme of our deliberations at this National Council on Health meeting is on “Meeting the Challenges of Health-Related Millennium Development Goals”. This is unquestionably an appropriate for these times in our health development. Let me take this opportunity to remind ourselves once again of the eight Millennium Development Goals (MDGs) endorsed at the UN Millennium Summit in September 2000, by 147 countries (Nigeria inclusive) for poverty reduction and social progress to be attained by the year 2015. These are to: (1) Eradicate extreme poverty and hunger, (2) Achieve universal primary education, (3) Promote gender equality and empower women, (4) Reduce child mortality, (5) Improve maternal health, (6) Combat HIV/AIDS, malaria and other diseases, (7) Ensure environmental sustainability and (8) Develop a global partnership for development. As we can see, out of the eight goals, three of the goals (4, 5 and 6) are directly health-related while three others (1, 7 and 8) are health and nutrition dependent.
7. We are six years down the line to the year 2015 when we are supposed to have achieved the MDGs. How far have we gone to realizing these goals? How have we assessed ourselves? Progress in achieving the health millennium development goals has been quite minimal as shown below:
a. Infant mortality rate was 97 deaths/1,000 live births in 2000 and appears to have worsened to 113 deaths/1,000 live births, as against the MDG 4 targeted improvement to 30 deaths/1,000 live births by 2015.
b. Under 5 mortality rate was 230 per 1,000 in 1990; 191/1,000 in 2006 and would require a 60% reduction to bring to 77 per 1,000 in 2015 in order to achieve a 1/3rd reduction from the 1990 level and meet the MDGs goal.
c. Maternal mortality rate was 1,000 per 100,000 in 1990; and 800 per 100,000 in 2006 and would require about 70% reduction to bring it to 250 per 100,000 in order to achieve 704 per 100,000 live births, a 1/3rd reduction from 1990 in order to meet the MDG goal for maternal mortality.
8. Health, we all know, is central to the achievement of the MDGs and requires major improvements in health systems and health outcomes across the country. It is said that “health is wealth” and “a healthy country is a wealthy country”. It is therefore very important that we all work towards improving our health status in this country. Indeed, achieving the health MDGs is a complex and challenging task but it is a task that must be done. Some countries have made impressive gains and are "on track," but many more are falling behind. The situation is not encouraging for goals related to lowering infant and maternal mortality as well as infectious diseases, especially in sub-Saharan Africa (which, of course includes Nigeria). This is 2009, where can we say we are in realizing these health specific MDG goals? We need to know where we are and where we are going.
9. Just recently we all witnessed the March 2009 National Immunization Plus Days (NIPDs) which took place between 27th and 30th March in all the States of the Federation. Mr. President flagged off the Polio Vaccination campaign in Abuja and all the State Governors also flagged it off in their various States. These NIPDs are dedicated days when every child aged 0-5 years is expected to receive two (2) drops of Oral Polio Vaccines (OPV) irrespective of previous vaccination status, as well as the administration of other high impact child survival interventions. The flag-off by His Excellency, Mr. President came at a time when the commitment given by the administration to the global polio eradication initiative activities in Nigeria is being transformed to improved program performance; and obviously the highest moral and political boost to the polio campaign in the country. The campaign will save thousands of Nigerian children from avoidable deformities and deaths; a campaign for the survival and development of our children who are the future of this nation.
10. The number of polio endemic countries has reduced from over 125 to only 4 countries by 2008: Nigeria, Pakistan, Afghanistan and India. Nigeria is the only country in the world with all the three types of wild polio viruses in circulation. Although Nigeria has made considerable progress towards achieving the interruption of wild polio virus transmission, there are challenges that remain. In 2008 the country experienced an upsurge in cases linked to sporadic cases reported in some of our neighboring countries (Niger, Benin, Togo, Ghana, Burkina-Faso and Mali). So, the world community has become more worried that we are now serving as exporters of the polio virus to our neighbors. Beside the global concern, Nigerian children continue to be paralyzed due to the virus. In 2008, 806 Nigerian children were paralyzed or deformed by Polio disease. That is nearly three times as many as the year before! Just two drops of Oral Polio Vaccine administered at least four times to each of these children would have prevented these overwhelming deformities and, sometimes deaths, among the children so affected and spared their families the hardship. Already, in 2009, at least 68 children have been affected and 18 of them paralyzed as of February 11, 2009. In previous years, the cases were mostly concentrated in the north. Now they are occurring as far south as Ogun, Lagos and other states.
11. Nigeria joined a synchronized, cross-border immunization campaign in February 2009 in which 40 million children were vaccinated; 25 million of those children were Nigerians. This round targets over 47 million children below the age of five (5) years. This campaign demonstrates the organization and commitment of thousands of healthcare workers, volunteers, community organizers and parents. Eradicating Polio is also an act of international citizenship. It is the duty of all to eradicate polio. If we all - governments, community leaders, the media, teachers, parents and other partners - do our part, we could stop polio in its tracks, NOW! You may recall the thrust of the collective commitment to polio eradication, routine immunization and primary health care at the Governors’ Forum during the February 2009 visit of Mr. Bill Gates in order to further translate our desire and determination to interrupt wild polio virus in Nigeria and bequeath a legacy of optimal health to our children. I believe that the momentum generated from such a consideration will drive the campaign to unprecedented levels of coverage in terms of numbers and quality.
12. I believe that the challenges of meeting the health-related MDGs include: (i) Getting national governments to increase health spending significantly (ii) Developing better policies toward households as producers and demanders of care (iii) Improving health service delivery (iv) Strengthening core public health functions (v) Getting additional financial resources in a sustainable way, and (vi) Coordination of donor actions. All these fall within the purview of key thematic areas such as Healthcare Financing, Service Delivery, Communications/Health Promotion, Knowledge Management, Donor coordination, Monitoring & Evaluation/Health Management Information System, Logistics, Research, Public-Private Partnerships, Governance/Stewardship, Social Development and the very critical issue of Human Resources for Health.
13. As we all know, accessible, affordable, acceptable and accountable qualitative healthcare delivery depends on various components (i.e. infrastructure, equipment, etc.) but most importantly on human resources. The human resources for health play a key role in our prospects of achieving the health-related millennium development goals. It is in recognition of importance of this component that I take a pause at this juncture, to propose that we convene an Extraordinary National Council on Health primarily to deal with HUMAN RESOURCES FOR HEALTH with all the complex issues involved with a view to finding lasting and sustainable solutions to the challenges we face year in year out.
14. During the course of this Council meeting, there will be group discussions on the theme of the meeting which was given by the Senior Special Assistant to the President on MDG, Mrs. Amina Ibrahim. We need to brainstorm and find solutions to which we all shall commit ourselves to implementing in order to ensure their realization. At the end of the discussions, we should be able to come up with concrete decisions, resolutions and time-bound action plans for accelerating the achievement of the health MDGs by 2015. It is my hope that at the end of this Council meeting, we shall definitely move the improvement of our health system and the health status of our people forward thereby realizing our national health goal and the objectives of our reforms.
15. Distinguished Ladies and Gentlemen, I am hopeful that this Council meeting will pay attention to the current situations of all the issues to be discussed and make general recommendations on the best way forward.
16. I wish you all fruitful deliberations and God bless. Thank you.
Professor Babatunde Osotimehin, OON
Honourable Minister of Health
April 6, 2009.
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