The availability of adequate and quality medicines in West Africa has, for so long, depended on what foreign manufacturers ship into the sub-region. This development has not portrayed us as a serious-minded people who can fix the very many challenges facing our health care systems. It is even sadder to come to terms with the fact that most West African countries have failed to build structures that can foster a sound healthcare system. They prefer to travel to the developed countries of Europe and America for medical tourism, while their own healthcare systems are in shambles. This problem has continued to fester like an untreated sore, even though politicians in these countries have not stopped using promises of a perfect healthcare system to seek electoral votes.
The deliberate and blatant refusal of successive governments to build on the few gains recorded by their predecessors in the health sector has led to the abandonment of laudable projects that could have impacted positively on the populace. In such instances, party politics, ethnicity, religious sentiments and a passion for mediocrity come into play, at the expense of collective progress. This does not portend any good for in Africa which is still struggling to meet up with the sophistications of the developed nations of the world.
Burden of pharma manufacturing
In many West African countries, pharmaceutical manufacturing is a very terrible venture, due to the many infrastructural problems the manufacturer grapples with. It is no longer news that raw materials, such as ordinary water, are no longer readily available to pharmaceutical manufacturers in countries like Nigeria, where the water has to be treated before being used for production.
It is even more worrisome to know that the treatment of the water costs money. This is one of the reasons most pharmaceutical manufacturers are heavily dependent on China and India for their raw materials. Sadly, this does not end with Nigeria; it is also the same case with many West African countries. The big question is, why must these West African countries continue to depend on Asia for their raw materials?
The answer is not far-fetched. Most African leaders only pay lip service to the issue of quality healthcare, which they have turned into a campaign tool. All flowery promises they make during elections about how they will transform their respective health systems usually die with the conclusion of the elections. As pointed out earlier, they prefer to have their health systems in coma, while they travel abroad for medical tourism, at the expense of their nation’s hard-earned resources. This perhaps explains the reason diseases like malaria are still ravaging the continent, in spite of the massive resources that some of the countries are blessed with.
Ravages of corruption
In some West African countries, unimaginable corruption has been the greatest bane of quality healthcare delivery. In such countries, politicians embezzle even monies donated by foreign agencies for the provision of healthcare, leaving the vulnerable populations to suffer untold health challenges.
In some cases, things that are supposed to be free medical provisions, such as mosquito nets, face masks and common drugs – such as analgesics donated by donor agencies – are sold to patients at outrageous prices. Some are also stolen by the healthcare workers themselves only to sell them to unsuspecting members of the public.
In other instances, truancy and absenteeism by some health workers constitute another form of corruption. In many of Nigeria’s primary healthcare centres, this is the order of the day. Health workers who are supposed to attend to the urgent, daily needs of patients either report late to their duty posts or do not report at all. Their reasoning is that as long as their remuneration is not affected, they can do whatever they like with government work.
This mindset, which, unfortunately, has developed into a mentality, is one of the reasons public service in Nigeria is almost like an exercise in futility. Government invests huge resources and reaps nothing in return. Ironically, such malpractices have continued unabated, even when brought to the attention of government. This is usually because of the shared corruptibility among those who populate government circles. A thief does not indict a thief. If this happens, all hell will be let loose. And if all hell is let loose, there wouldn’t be an enabling environment for the enjoyment of the loot.
In the abstract to the scholarly article, “Corruption in Anglophone West Africa health systems: a systematic review of its different variants and the factors that sustain them”, published in Health Policy and Planning (Volume 34, Issue 7, September 2019), Obinna Onwujekwe, et al stated that: “West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern, given the role of corruption in hampering access to, and utilisation of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sustainable Development Goals”.
In a related indictment, Pius Agbenorku of the Reconstructive Plastic Surgery and Burns Unit, Komfo Anokye Teaching Hospital, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, stated in his research paper, “Corruption in Ghanaian healthcare system: the consequences”, published in the Journal of Medicine and Medical Sciences (Vol. 3, 2012), that: “Ghana’s public healthcare system has been faced with some issues of corruption. In its 2006 Global Corruption report, Transparency International ‘has identified the health sector of Ghana as a corruption prone area with evidence of bribery and fraud across the breadth of medical services. This is said to have emanated from petty thievery and extortion, to massive distortions of health policy and funding, fed by payoffs to officials in the sector’”.
These references show that the issue of corruption in the West African healthcare system is becoming endemic, bearing in mind the fact the Nigeria and Ghana are major stakeholders in the sub-region, in terms of investments and regional cooperation.
Stemming the tide
To salvage the already precarious situation of the healthcare delivery systems in the West African sub-region, the respective governments of countries that make up the region must imbibe the global best practice principle and abhor all forms of mediocrity. Putting the most qualified people in sensitive positions will go a long way in curbing the problem because anyone who is worth his qualification would not want to cut corners or support any process that short-changes the masses.
Before corruption can thrive in a system, it has to first receive the support of a group of people. In Nigeria for instance, ethnicity, religious sentiments and political orientation are factors that have been allowed to fragment the smooth running of the healthcare system. Appointments are made, not based on merit, but on the aforementioned factors. Moreover, expertise and competence are made subservient to nepotism and favouritism. Yet, the best healthcare systems in the world are not built on such retrogressive sentiments.
West African leaders must, as a matter of utmost importance, prioritise the entrenchment of an enviable healthcare system and discourage the laughable medical tourism to Europe, Asia and America.