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27/03/2020

Because Health is Wealth

PREAMBLE

The world is dealing with an invasive virus that has the potential to overwhelm public health structures with relative ease. Faced with the immediate task of developing measures to protect citizens, our governments are torn between managing two existential threats - confronting this pandemic and fighting endemic poverty in Nigeria.

Our view is that the maxim, 'health is wealth', should guide their actions. They must be bold to take tough decisions, think outside the box and develop measures that fit our peculiar situations. After consultations and reviews during the ARG meeting, the following proposals are recommended for consideration and possible implementation by relevant authorities.

MULTI-PRONGED PUBLIC HEALTH INTERVENTION

Easing into a new norm. This pandemic may cause radical shifts in the way we live, at least until a vaccine is developed. Even if a vaccine is developed for Covid-19, it is recommended that this lockdown should be seen as a precursor to a new 'normal', not a phase that will soon fade. This is in the light of possible pandemics in the future. We therefore urge our governors to focus on implementing policies that will ease us into this new norm.

Multi-level communication strategy. There appears to be few actors and many spectators in this fight against Covid-19 pandemic. Our governors should please consider involving respected community members and trusted community health workers who should be trained to disseminate the right messages using every kind of media space and formats.

Daily briefings led by the governors. It may be desirable for our governors, flanked by public health experts, cultural and religious influencers to address the citizens at a fixed time daily on live broadcast. Our people need information that inspire, empower, and motivate them to take collective actions. This may help to cast away fear mongering, restore confidence in the polity and prevent descent into lawlessness.

Prevent the spread of the virus to rural communities. From all indications, we have passed the exposure stage into the community transmission stage. Proactive measures must therefore be taken to prevent the spread into our rural communities. Whatever measure this will take must not be sacrificed, including reviewing payment and transportation means.

Wearing face masks. The use of cloth facemasks should be encouraged but we must desist from promoting it as a foolproof measure. Though, there is no clear scientific evidence, current belief is that wearing of face masks by the general population may help to slow down the transmission touch points and spread. This must be practiced with other regulations like avoiding non-essential movements, social distancing, washing of hands and environmental cleaning, especially of surfaces touched by hands.

Training of health workers and provision of personal protective equipments. Many hospitals are admitting Covid-19 cases before knowing it. It is therefore crucial to train all healthcare workers, as first responders to medical needs, about early detection, appropriate response to identified patients, and the lines of communication to relevant government agencies. Such trainings, we understand, are already available online. Our governments' responsibility therefore is to encourage all health workers to take the training and enforce strict compliance through carrot and stick methods.

Testing Centres. There should be increased testing capacity in all the states, as Lagos State has commendably done. This will help to identify cases faster and reduce the spread of the virus when such cases are taken into isolation

Practice of self-isolation should be replaced with government-controlled isolation. In addition to decentralising testing capacity, we recommend the establishment of isolation centres in each LGA also. Asking people to self-isolate in densely populated areas may be counter-productive.

LGA Covid-19 Task force team. Each local government area should establish its own task force team because state-wide strategies need to fit into peculiarities of each neighbourhood and this is where the LGA management team may come in useful.

Media Houses as strategic partners. The jury is out on the percentage of our people that still believe corona virus pandemic is a hoax. There however are hints that the number is substantial. Journalists, particularly the radio stations, can help fill this gap at this critical time and should be trained to report this pandemic and serve the people with accurate and inspiring information.

SOME ECONOMIC RECOMMEDATIONS

Democratise wealth through local production capacity. If, as it is being predicted, wearing of face masks and use of hand sanitizers will become normal public space etiquette, it is imperative that we turn this into economic stimulus. We encourage our governments to stimulate small scale industries to produce these in order to check opportunistic price inflation.  With proper guidance and incentives, our tailors can make face masks and public health centres can produce sanitisers.

Distribution of relief to the most vulnerable. One way to ensure this is to introduce biometric data collection and other processes like queue management that only those without alternatives could endure. More importantly, this situation offers an opportunity to institutionalise a Universal Basic Income from government to citizens.

Prioritise social protection policies. In this situation as the world has found itself, only countries that excel in human capacity development through education, health and social protection policies will cope better. Specifically, a strategic decision to upgrade the capacity of the local healthcare centres and General hospitals should be paramount to the extent that each of them should have an isolation centre that serves as temporary bay for any suspected Covid-19 case. This strategic decision should include quality and safety of drugs supply chain, a functional health insurance, and investment in medical research and technologies.

Undertake civil service reform and strengthen public accountability. We urge our governors to adopt a three-year plan that transforms public service to full scale e-service. This would mean retraining civil servants and retaining those that merit it. This reform should be guided by meritocracy, excellence and technology. Those disengaged will, through a loan secured for public service reform, continue to draw salaries for three years while they are retrained for another industry, especially agriculture. 

Local security: circumstances during this lockdown have brought to the fore the need to have policing decentralised in Nigeria. We urge our governments to expedite actions on the Amotekun initiative, for a start, and equally consider other proposals to strengthen local security. 

Restructuring of Nigeria's governance architecture. ARG believes that Nigeria's fate and future is inextricably linked to the campaign to restructure. We are convinced that efforts to diversify Nigeria's economy will remain unproductive until restructuring becomes a prerequisite. This is because in any ethno-religiously diverse country as Nigeria, such initiatives are never successful when dictated in a top-bottom manner as we are doing. For clarity, the restructuring campaign has four main components listed below:

Redefining federating units: The concept of what a federating unit is and how to define it for a sustainable Nigeria must be bravely put on the front burner. There is no economic, scientific or political analysis that supports the imperative of 36 states. Creation of states has contributed to Nigeria's worsening political instability because the demand has become insatiable. It may lead to the ultimate dismember of Nigeria because the more atomised federating units become, the less capable they are to respond to the socio-economic needs of the people. Our submission is that we consider a regional architecture that embraces states and embodies consensus, collaboration, self-determination and self-sufficiency.

Devolution of power and reducing corruption: The Second Schedule to the 1999 Constitution containing legislative powers needs to be urgently reviewed. It is our submission that Nigeria needs one legislative list that defines only the role that the Federal Government should take up on behalf of the federating units. Every other matter should be residual. The distribution of Federal Government's relief by the ministry of Humanitarian Affairs, Disaster Management and Social Development has again revealed the need for Federal Government to hands-off certain responsibilities, for the sake of efficacy. How does it sound that an agency based in Abuja is able to identify the vulnerable people in the deep recesses of Zamfara or Osun States? As Senator Ali Ndume has claimed, it is impossible to kick out corruption with such governance structure as Nigeria's.

Reducing governance cost: A number of federal ministries should at best operate as policy and research centres of the Federal Government and leave implementation to the federating units. Nigeria's recurrent expenditure is outrageous, relatively unproductive and eventually unsustainable.

Reviewing resource management: The undergirding concept of Nigeria's resource management which is equality of states should be jettisoned for an equitable philosophy. Covid-19 is a clear example that states are not the same and cannot be treated equally, no matter how hard we try. Nigeria is attempting to achieve nationhood through an awkward means of taking over the resources of its constituents and then feeding them 'equally'. Our submission is that each federating unit, as may be eventually defined, should manage its own resources while paying an agreed percentage as first line charge into federal purse.

CONCLUSION

There may never be life as it used to be. We should therefore focus on embracing a new way of life. For instance, it may be convenient to postpone NECO and WASSCE examinations but should this pandemic stretch longer, how convenient will it be to postpone elections without a constitutional crisis, say in Edo and Ondo States?

Embracing this new normalcy calls for individual and corporate realignment but more importantly, it calls for a gradual and holistic overhaul of Nigeria's governance structure by embracing sound arguments of restructuring, planning for a future without crude oil and adopting innovations that improve public accountability and efficiency.

Signed:

Hon. Olawale Oshun                                                            

Chairman

Mr. Ayo Afolabi

Secretary

This Advertorial was published in The Nation newspaper.

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