“Our Health Issue isn’t in the 2016 Budget”. This is what I hear either one on one or whenever Iam in the midst of health civil society organizations (CSOs) in Abuja. Everyone is talking and lamenting that their issue isn’t captured in the 2016 budget that was presented to the national assembly by President Buhari. Below are some of the messages I captured.
“Aminu – could you imagine that in 2016 budget there are no funds allocated for nutrition despite Nigeria being a signatory to many local and international agreements.” Another one that I got via email goes this way “Aminu you must write about the National Health Act where it’s says 1% of the Nigerian total consolidated revenue must be allocated to health budget yearly and it is not in the 2016 budget yet, what is wrong with our President that promised Nigerians change”. One CSO leader told me that he is disappointed that even though Nigeria commits to London Summit declaration for Family Planning which aimed at raising domestic funding to about 300% yet the 2016 budget is silent about financing family planning”.
I don’t know whether to laugh or to be sad about this development and of course someone asked me whether the issue I am advocating for happened to be in the 2016 health budget and my answer was YES, in the affirmative. Iam not happy indeed that all the issues that people talked to me about aren’t in the budget but the most important question to me is ‘Why aren’t they’? They aren’t allocated for because no one put them there and no one genuinely advocated for them both from within and without until they are allocated for.
A budget document is a product of what people worked on. Someone must submits a proposal, depends and ensures it is allocated. The President and his economic team aren’t medical doctors or health workers to appreciate the necessity of everything we are talking about. The Federal Ministry of Health and the national health CSOs must make a case, convince the economic team beyond reasonable doubt and ensure priority areas in health are costed and budgeted for. If we do not do our homework, the budget will be devoid of what we want to see in it. It is as simple as ABC.
At a CABRI Financing Healthcare in Africa Conference that took place in Tanzania from 30th November to 1st December 2015. I made a presentation to a team of senior budget officials from African countries titled “What can Budget Transparency and Participation do for Health?”
Some of the issues I raised in the meeting are some of the reasons why the Nigeria’s 2016 budget is devoid of allocation for many health issues. I made reference to RESYST study in Kenya, South Africa and Nigeria which revealed that;
- Ministry of Health can lack macro-economic know-how or political influence to make a convincing case to Ministry of Finance.
- Ministry of Finance may not trust the health sector to deliver results or value for money
- Process for developing the budget can erode the final health sector allocation
I also threw a rhetorical question in the meeting “how can budget transparency and participation remedy this situation?”
Transparency helps to build ministry of finance trust in health sector by linking public funds to results, empowering non-state actors to track whether value for money is delivered and if not, why and public participation in budget process helps ministry of health make its case to ministry of finance by bringing additional expertise and bringing more voices to the table in support of health services.
The foregoing is simply telling us that both the Federal Ministry of Health and the national health CSOs have to sit up and engage in series of high level and tough negotiations with the national planning commission and federal ministry of finance. President Buhari cannot just allocate money for family planning, immunization, nutrition, lifesaving drugs and primary health care without any credible push by the Federal Ministry of Health and the national health CSOs. Some of us may not be happy with this assertion but that is the way the cookies crumble, to borrow a leaf from James Hardly Chase.
The 2016 budget isn’t completely devoid of allocation to any health priority. I reliably gathered that finances to procure vaccines are allocated to the tune of N4 billion and I also gathered that a lot of advocacy was done within and without to make it happen. So the truth is that all the health issues that aren’t allocated for could equally be allocated for. It is a matter of meaningful engagement and sustained advocacy.
All comments to Dr Aminu Magashi Publisher Health Reporters (firstname.lastname@example.org)