Tuesday, September 29, 2020 / 09:46 AM / OpEd
by Abiodun Awosusi / Header Image Credit: Abiodun Awosusi
Nigeria
launched an Economic
Sustainability Plan (ESP) in June 2020 as a one-year bridge plan beyond the
Economic Growth and Recovery Plan (ERGP 2017 - 2020). With funding
mainly from domestic sources, the plan aims to limit the health and
socio-economic impacts of the coronavirus pandemic. It precedes a new national
development policy which could be launched within the few months. Although
there is limited evidence of the impact of the EGRP across sectors particularly
health sector, it is important to analyze the implications of the new plan for
health stakeholders in the public, private and social sectors. This analysis
also allows citizens to understand how government's plans can influence
progress in the pharma market.
The
plan aims to sustain businesses throughout the COVID-19 crisis and create new
jobs. Its interventions cut across agriculture, trade and services - which
contribute significantly to Nigeria's Gross Domestic Product. The plan includes
targeted support to micro, small and medium-sized enterprises (MSMEs),
investment in digital infrastructure and expansion of the social protection programme
for the poor and vulnerable. The interventions are ambitious. It is unclear if
all of them will be fully operational within the 12-month implementation
timeframe. However, they provide guidance during this transit period and a
glimpse into key principles that will guide the successor
plan.
The
health
component of the plan includes immediate investment in response to
COVID-19, epidemic preparedness, funding for research and development (R&D)
as well as increase in health access. The specific interventions include
adequate financing of the preparedness and response plan with health insurance
coverage for health workers. Ongoing investments in healthcare infrastructure
at national and subnational levels is expected to shape additional health
financing in the post-COVID era through statutory health allocations and the
Basic Healthcare Provision Fund.
Investments in R & D
A
prominent objective for the health sector in the ESP is to galvanize
investments from domestic and external sources to make Nigeria a hub for
production of health products. The plan includes a special intervention fund to
promote R&D as well as local production of medical supplies and
pharmaceutical products. It encourages public and private agencies to patronize
local manufacturers and provides a special tariff regime for imported
manufacturing inputs. The National Agency for Food and Drug Administration and
Control is mandated to reduce product registration fees and waive product
license fees. The Central Bank of Nigeria launched the Healthcare
Intervention Fund to provide credit to functional health enterprises at low
interest rate. The plan also highlights a programme to commercialize research
outputs from federal research institutes.
The
implementation of the health plan requires a multisectoral approach and review
of existing policies. One entry route is the ongoing strategy development
effort by the National Institute for
Pharmaceutical Research and Development. The proposed 5-year strategic plan is
expected to cover 2020 - 2025, and align pharmaceutical transformation objectives
in the National Strategic Health Development Plan II with continental and global realities.
This process offers timely opportunity for researchers, policy makers, business
leaders and civil society to shape the future of pharmaceutical R&D in a
coherent way. Even with a transition in federal government, the strategic plan
can be a flexible roadmap for pharma sector transformation with focus on areas
of comparative advantage for Nigeria in continental and global value chains. A
related route is to sustain broad support for private sector players like 54Gene - an innovative R&D enterprise
working on genomic technologies for Africans.
A Growing Pharma Market
According to McKinsey, Nigeria's pharma market
is expected to be worth $3.6 billion by 2026 - with most of the value concentrated in urban
areas. Africa's pharma market is currently worth about $50billion with potential for significant increase within the next
decade as plans for an integrated continental market evolves. With endemic infectious diseases
like malaria, and the rise in the incidence of non-communicable diseases, access
to high-quality, affordable drugs is important for the populace. As health
insurance coverage expands through social and private health insurance schemes,
it becomes inevitable to have safe and effective drugs especially generic
medicines.
The ESP thus aligns with the growing movement to
increase local production of health products at regional and continental
levels. The Global Strategy and Plan of Action on Public Health, Innovation
and Intellectual Property provides a framework for investments in
pharmaceutical innovations and intellectual property protection. The African
Union Pharmaceutical Manufacturing Plan for Africa actively encourages production of
pharmaceutical products hinged on ample investments, strategic partnerships and
human capital development. The coronavirus pandemic underscores the urgent need
for implementation of these plans especially production of generic medicines
and medical supplies. The NIPRD plan helps to bring relevant evidence and
lessons from other countries to bear on Nigeria’s long journey toward
sustainable production of health and pharmaceutical products.
Sustaining Momentum for Progress
There is an opportunity to match increased
R&D investments and local production with improvement in the supply chain.
Although the main distributors of medicines in Nigeria sell through formal
channels, the retail and distribution network is largely informal and
fragmented. This leaves room for distribution and sale of fake and substandard
products which endanger lives. The good news is that integrated retail
platforms like HealthPlus, and digital pharma enterprises such as DrugStoc,
RxAll and MedSaf are working with regulators in deploying useful tools to
ensure access to safe drugs for health facilities and patients. In addition,
the African Resource Centre for Supply Chain in Nigeria uses evidence from sector diagnostics to
advocate for better supply chain systems and investments. At the continental
level, the African Union-backed African Medical Supplies Platform is an innovative platform that
facilitates pooling for purchasers, manufacturers and suppliers of health
products.
Despite the promise of local production, pharmaceutical
manufacturing is a long-term venture that requires large financial and
technical investments within a conducive business environment. Government
agencies, private sector players such as the Pharmaceutical Manufacturing Group
of the Manufacturers Association of Nigeria, the Association of Industrial
Pharmacists of Nigeria; the Pharmaceutical Society of Nigeria, Digital Pharma
Enterprises and similar groups have important roles to play to ensure
government's interest translate into sustainable pharmaceutical manufacturing
and deployment of adequate resources and digital tools across the pharma value
chain. Nigeria's socioeconomic realities are daunting but recent business, tax
and regulatory reforms could help to make the business climate better for health enterprises.
While a one-year ESP is insufficient to sustain the momentum for progress in
the pharma sector, the longer health sector and NIPRD strategic plans can fast
track sectoral transformation that contributes to improved health and wellbeing
for Nigerians. And more than developing plans, implementation is vital.
About the Author
'Biodun Awosusi is a health economist at Health Systems and Development
Enterprise. He is a TEDMED2020 Research Scholar and MIT Technology
Review Global Panel Member. Previously, he was health financing advisor at
Clinton Health Access Initiative; research consultant on the Bill and Melinda
Gates Foundation-funded Learning for Action across Health Systems at Oxford
Policy Management; advocacy manager at ACF International; and technical officer
on the USAID-funded Program to Build Leadership and Accountability in Nigeria's
Health System. He was the Nigeria Coordinator of the multi-country Rockefeller
Foundation-funded Health for All Campaign for Universal Health Coverage in
2014. 'Biodun holds master's degrees in International Health (University of
Oxford) and International Management (University of Liverpool) with a
bachelor's degree in medicine and surgery from Obafemi Awolowo
University.
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