By Philip Jakpor
Nigeria’s 2021 national budget has not disappointed pessimists. Like previous years public health was relegated to the back seat in terms of priority and funding.
The breakdown of the approved budget shows that the health sector received only N547 billion (five hundred and forty-seven billion naira), representing about seven per cent of the budget’s total of N13.58 trillion.
This meagre allocation falls far short of the 15 per cent recommended by African governments in the Abuja Declaration in 2001 in which they agreed that such allocation on a yearly basis can go a long way in addressing deficiencies in their health systems.
Ironically, the approved budget will see a whopping N380.21 billion go to recurrent expenditure, and N132 billion for capital projects. N35.03 billion captured under the Basic Health Provision Fund, will go to managing emergencies and infectious diseases such as the COVID-19, salaries of health workers, and logistics involved in the day to day running of the health ministry and tertiary health facilities. It will also go into the purchase of personal protective equipment for health workers fighting COVID-19, interventions against diseases such as malaria, tuberculosis, meningitis, and HIV/AIDS. It will also address the construction and rehabilitation of primary health facilities, purchase and maintenance of cancer machines, and a pool of funds for health insurance packages.
Despite the clamor for sustainable funding for tobacco control by public health advocates since the passage of the National Tobacco Control (NTC) Act in 2015, there has been no budgetary allocation to support implementation of the Act. Part 3, Section 8 (1) of the Act provides for the creation of the Tobacco Control Fund which “shall consist of monies made available by the Federal Government from annual budgetary allocation approved by the National Assembly”.
Another source of funding recommended in the Act are subventions from any of the governments of the Federation to meet the stated Objectives of the Act.
Owing to dearth of funding for tobacco control, it is no longer in contention that a host of Ministries and Departments of Government now accept sponsorship of their activities from the tobacco industry and their front groups. In Lagos, the annual Food Fair held on October 18 is partly bankrolled by the tobacco industry. The Federal and State Ministries of Agriculture are also in an open partnership with the tobacco industry through their FADAMA and extension programmes. Such interactions are regularly displayed on the twitter, Instagram and facebook pages of the tobacco multinationals.
But these engagements are not restricted to agriculture. In the education sector, the Foundation for A Smoke-free World is cashing in on the Nigerian government’s poor funding for research and innovation and initiating appealing programmes that grab young minds. One of such initiatives is the Conrad Nigeria Challenge, described as “an annual, multi-phase innovation and entrepreneurial competition that encourages young adults to leave their mark on the world. The participating pupils usually between the ages 12-18 years are described by the promoters as “entrepreneurial problem-solvers”, addressing challenging social, scientific, and societal issues through creativity, and critical-thinking.
Some of the schools that have “benefited” from the Challenge are in Lagos and Akwa Ibom States. The 2018 winners were flown from Nigeria to the final summit which was held at the Kennedy Space Centre, Visitor Complex, Florida, USA.
The kinds of engagements above are among the many that informed the verdict in the Tobacco Interference Index 2020 Report supervised by the Global Centre for Good Governance in Tobacco Control (GGTC) at the School of Global Studies in Thammasat University, Thailand which established that the Nigerian government has fallen short of several critical standards of transparency and probity in engagements with the tobacco industry.
The report exposed how the tobacco industry in Nigeria has been interfering in tobacco control policies through their so-called corporate social responsibility activities or through front groups in contravention of the World Health Organisation’s Framework Convention on Tobacco Control (WHO-FCTC). The findings would seem to point to unseriousness in Nigeria’s fight against the tobacco epidemic.
It is therefore imperative that Nigeria helps itself by exploring options for funding tobacco control which must not rely solely on foreign donations. Nigeria must learn from countries that have identified and now explore indigenous options for adequate and sustainable local funding for tobacco control. Vietnam is one of them. Vietnam is one of the 15 leading countries with highest smoking prevalence (45.3% in male and 1.1% female). Owing to the strong political commitment, in 2012, the government passed a comprehensive tobacco control law. Its implementation draws funds from a 1.5% compulsory surcharge tax from the tobacco industry. This innovation in tobacco control funding is now viewed as a model of the fight against the tobacco epidemic. Singapore, Thailand, Malaysia, and Indonesia also have local funding mechanisms for tobacco control and health promotion. The Southeast Asia Tobacco Control Alliance (SEATCA) is currently working with these countries on tobacco taxation policy and mechanisms to earmark or surcharge tobacco taxes for tobacco control.
The lesson for Nigeria is that tobacco control is not sustainable through foreign grants alone. The sooner the Nigerian government understands this and starts exploring other reliable and sustainable options such as the national budget and innovative tobacco taxes, the better for the health and wellbeing of Nigerians.
- NB: Philip Jakpor works with Corporate Accountability and Public Participation Africa (CAPPA).