The National Public Health Agency Alternative

by Bolaji Aregbeshola

There is no gainsaying the fact that Nigeria is faced with a lot of public health challenges and there is a need to design programs to address these problems in order to improve the health of the citizens. Though there have been different emergency plans by governments; the entire country is still at risk of disease outbreak. The number of disease Nigerians are exposed to demands that we have an effective and efficient emergency response and preparedness system so that we can reduce the number of cases and deaths arising from disease outbreaks.

In order to achieve this, there must be an institution with a capacity to provide prompt and effective public health interventions to Nigerians. Surveillance of potential threats which is one of the means by which disease outbreaks are prevented needs to be given maximum attention.

National emergency response and preparedness team was constituted by the Federal Ministry of Health (FMOH) in recognition of the importance of disease prevention and control. But having the department of public health which is responsible for public health, emergency preparedness and response as well as disease prevention and control under the FMOH has not helped matters besides the mission of public health as defined by the Institute of Medicine (IOM) which is “fulfilling society’s interest in assuring the conditions in which people can be healthy” has not been achieved by the department of public health under FMOH. Every year, Nigeria records an outbreak of different diseases which kill innocent Nigerians in their thousands. Despite this yearly occurrence of outbreak, there has not been an effective and efficient emergency response and disease prevention system in Nigeria. This is why the department of public health under the FMOH needs to be upgraded into an agency with or as part of the FMOH that will focus on emergency planning and preparedness; disease prevention and control; and promotion of the health of Nigerian people while the FMOH focus on other issues.

The FMOH is a public health agency and service of government but its response system is slow. The role of the department of public health in disease prevention and control under the FMOH has not been felt over the years. Epidemic prone disease such as CSM, Cholera, Measles, Lassa Fever, Yellow fever as well as other disease of public health importance like diarrhoeal, malaria, plague, tuberculosis, pertussis, onchocerciasis, pneumonia, HIV/AIDS, STI, hepatitis B and so on, require a specialized agency to mitigate their effect on the population. The establishment of a National Public Health Agency will increase the capacity of FMOH to provide prompt and effective public health interventions to Nigerians. This is necessary if government must reduce the incidence of disease and disability. Surveillance, emergency preparedness, disease prevention and control will be the main responsibility of the NPHA thereby relieving the FMOH of the burden of having to ensure the health promotion of Nigerians along with other functions of the Ministry. The formulation of NPHA is imperative if the public health problems in Nigeria must be addressed besides the agency will be concerned with threats to the health of the Nigerian people. FMOH as the Nigerian public health service hardly serve the public due to budgetary constraint and its focus on running and maintaining the teaching hospitals in the country. The breakdown of the budget that goes into the Ministry of Health shows that the department of public health receive less funding compared with the department of hospital services. NPHA will replace the department of public health which is ineffective due to lack of paying attention to public health. The reorganization of the National Health System by creating a National Public Health Agency will ensure proper response to public health problems and emergencies as well as prevention of disease, prolonged life and promotion of health. FMOH focus more on hospital services and this has affected the public health aspect of the Ministry’s work. There is a need for legislation in support of the establishment of NPHA as a parastatal of the FMOH. Note that the purpose of the department of public health will still remain under the new agency. The president will appoint its head, and this appointment may or may not require senate approval. The Director General of the NPHA must have a master’s in public health or a public health degree as well as managerial and financial skills.

As earlier stated, Nigeria is faced with a lot of health threats and it is the duty of governments to protect the citizens from threats to their health as well as protect the health of every Nigerian. Unfortunately, the health of the Nigerian people is not a top priority of governments and this is the bane of poor health status and health indices in Nigeria; and until there is proper investment in the health of the Nigerian people channelled through preventive services and emergency preparedness, the national health system will not achieve the purpose for which it was established.

Cholera outbreak in Nigeria killed more than 1500 people in 2010. It was the worst outbreak in Nigeria in recent years. The number of cases was three times higher than that of 2009 and seven times higher than in 2008. According to UNICEF, UN & WHO, women and children account for four out of every five cases. This shows that we need a defence system against public health threats and issues. There is an urgent need to create a public health agency in order to curtail the outbreak of diseases. The fire brigade approach has led to unnecessary deaths of Nigerians. The weak health system in Nigeria is exemplified in the outbreaks that kill innocent Nigerians. There will always be heavy seasonal rains besides the scarcity of clean water and proper sanitation are public health problems that have been with us for many years, hence, the need for proper emergency planning, preparedness and response system to address public health emergencies.

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