*Capital Market To Use Its Platform To Source Fund For Healthcare—Obudegwu
*Nigeria Should Fund Healthcare Through A Universal Health Insurance System— Bode Agusto MFR
*Paying Out Of Pocket For Medical Expenses Cannot Deliver A Good Healthcare System—MD AXA Mansard Health, Adeniyi
*Nigeria Can Contribute To Global Health Through Its Work With Traditional Medicine— Ohuabunwa, President PSN
*Veritable Tool For Revamping The Health Care Sector Is Through Private-Public-Partnerships (PPP)— Helen Mtshali

With COVID 19, the decrepit state of our healthcare sector and the inability of people to resort to medical tourism has brought to the front burner, the need to revamp the Country’s healthcare sector.

Experts in the Capital Markets disclosed this during the annual business luncheon of the Capital Market Solicitors Association (CMSA) virtually held yesterday, with over a thousand registrants poised to listen to the theme “Financial opportunities in the Capital Market- an aid to improving the Nigerian Healthcare Sector”

In his welcome address, the Chairman of CMSA, Mr Benjamin Obidegwu, in encapsulating the purpose of the luncheon and the theme said, “COVID-19 pandemic has exposed, to a very large extent, the huge infrastructure deficit that we have in our health sector primarily because of lack of funds, the greater part of which comes from the government. As capital market operators, we resolved that we should use the platform of our business luncheon to draw the attention of the public to an alternative source of funding for our health sector and that is the capital market. This year’s conference therefore is aimed at broadening the perspectives of the Nigerian healthcare sector through discussions on access to the financial opportunities in the capital market”.

In his opening remark, Dr. Lamido Yuguda, the DG of SEC, affirmed that health is wealth and he expressed the willingness and optimism of SEC to see stakeholders in the health care sector approach the capital market for funds and investments. These funds would be useful in supporting indigenous medical and pharmaceutical institution in Nigeria. He is optimistic that the capital market is capable of raising the necessary funds required to revamp the healthcare sector in the country.

Mr. Bode Agusto MFR, in his Keynote address, set the tone for the conference by proffering six questions. His questions sought to establish who the stakeholders in the healthcare sector are and their value, how much it would cost the country to have a good healthcare system, who would pay for the health care, the role of lawyers and the role of the capital markets in achieving this.

Mr. Agusto confirmed that health care is expensive and the Government alone cannot fund it. Quoting Ezekiel J Emmanuel’s book, “Which Country Has the World’s Best HealthCare?” He said “Emmanuel set out the cost of healthcare in 11 countries namely USA, Canada, UK, France, Germany, Netherlands, Switzerland, Norway, Australia, China and Taiwan. According to him, the USA spends about US$11,000 per person per year, the most by any of these countries whilst China spends the least at US$960 per person per year. China’s average income per person is five times that of Nigeria. Were Nigeria to spend at China’s level after adjusting for income levels, she should be spending about US$200 per person per year. This means US$40billion per year or about 9% of nominal GDP. It also means spending N16 trillion per year, at current exchange rates, or almost two times the total amount shared by the Federation Account in 2019”.

Since the Nigerian Government alone cannot fund this, “Nigeria should fund healthcare through a universal health insurance system. Under this system, health insurance should be made obligatory for all Nigerians. Workers will pay their premiums largely through employer sponsored programs; self-employed people will buy their own insurance while Government will then assist the poor and weak in society to buy insurance. The premiums paid to health insurance companies thus create a large pool of savings to pay for healthcare”.

If Nigeria, he affirmed, starts with coverage of only 10% of the population and at an average annual premium of US$200 per person, “we create an industry that has annual spending power of at least US$4 billion, the equivalent of the annual GDP of Sierra Leone. If well managed and over time it is able to raise coverage to 80% of the population, the annual spending power of the industry would be US$16 billion per annum, roughly the size of the economy of the oil-producing nation of Gabon”.

Due to current and rising inflation rates in Nigeria, the savings made by health insurance companies from premiums, may lose their purchasing power. To remedy this, Mr. Augusto suggested that the “Capital market regulators would need to help set rules that will help ensure that those who borrow money from these pools of savings pay back as and when due”. This is usually done by setting risk tolerance limits and monitoring compliance with these limits. Importantly, premiums must also be adjusted at least annually to reflect the purchasing power of the Naira.

The conference had in attendance stakeholders in the healthcare sector: Doctors, Lawyers and Pharmacists and pharmaceutical companies, investment bankers, Medical insurance providers etc.

In his intervention, MD of AXA Mansard Health, Tope Adeniyi, corroborated the importance of medical insurance as stated by the keynote speaker. He spoke on the need for individuals and employers to embrace health insurance, as paying out of pocket for medical expenses as it is commonly done in Nigeria is not sustainable and it cannot deliver a good healthcare system. While admitting there already exists a culture of acquiring a healthcare plan, there needs to be more market penetration and inclusivity.

Mazi Sam Ohuabunwa, President of the Pharmaceutical Society of Nigeria and Former MD of Pfizer Nigeria, highlighted the need for Nigeria to reconsider the importance and contribution of traditional medicine, train the practitioners, fund research in order to promote safe and quality herbal drugs, and ultimately to regulate the Industry. According to him, Ghana has already adopted this model. Rather than be only a consumer nation, Mazi believes Nigeria can contribute to global health through its work with traditional medicine, with this there would not be an identity competition between Contemporary doctors and Herbal practitioners, each would be respected as being colleagues in delivering the desired health care.

Mr. Bola Onadele.Koko, CEO, FMDQ Group, highlighted the seeming paradox in relation to medical practitioners whose education are largely subsided in Nigeria but migrate to other countries to render their services. While affirming that the country has to pay these practitioners well and provide an enabling environment for them to work in order to retain them, he thinks it is unfair to the country and the country may have to rethink the education of these professionals and how they are financed.

Other panellists at the luncheon include Professor Wale Sulaiman, Professor of Neurosurgery and Chairman RNZ Global Ltd, Ike Chioke, Group Managing Director of Afrinvest West Africa Limited, Helen Mtshali, Managing Director, Healthcare Financial Services, GE Healthcare Africa and Olubunmi Fayokun, Senior Partner, Aluko & Oyebode.

In her contribution, Helen Mtshali opined that a veritable tool for revamping the health care sector is through Private-Public-Partnerships (PPP). She insisted that PPPs have worked in various industries; roads, airports and real estate. Healthcare is surely another sector it would be useful in achieving the desired results.

Ike Chioke, Group Managing Director of Afrinvest West Africa Limited, spoke on social impact bond (SIB) and he charged the CMSA to work on an arrangement whereby social impact bonds can be issued and people get a percent return without getting a full market return, since the bond will be targeted towards a social impact project, like health care. This he thinks is possible because several individuals and corporate bodies over the past months have donated billions of Naira to the government in it’s fight against Covid-19, without expecting anything in return.

It was generally agreed that good health care is important, it is a business and it should be treated as such to ensure efficiency and effectiveness. With good healthcare, life expectancy in the country would be higher, medical tourism would be stopped thereby saving the country’s forex, brain drain would be stopped/reduced and ultimately there will be more job opportunities, for example, the UK NHS employs 1.4million people and is one of the largest employers in the World.

Indeed, a healthy nation is a more productive nation.