 We always say that health is wealth and to be a country of wealth, we have to look to the health of our people. How much of this health are we having? What kind of path do we need to take to attend this universal health care coverage in Nigeria? A lot of people say that sector has been bastardized. A lot of people say that sector is dying. We just saw some headlines a few days ago that so many wards in the Lagos State University teaching hospital have been closed because there are no doctors, there are no medical personnel to man those wards in the hospital, a hospital as big as Luth in Lagos State. And so we are getting worried. So there is a conference coming up on Tuesday on the universal health care coverage in Nigeria and we are glad to have someone with an insight into that conference that is coming up who will be telling us what will happen then and then the kind of things that we need to do to attend this universal health care coverage in Nigeria. I am talking about Dr Adedayo Adedibigwe, a consultant. Dr Adedibigwe, good morning and welcome to the show. Good morning and thank you for having me on your show. Thank you. We understand like I said that there is going to be a conference on Tuesday. Tell us more about this conference and what we will be looking out for at this conference. All right. So good morning everyone. The conference is in Bayania Scientific Conference and that will be hosted by the Association of Public Health Physicians of Nigeria, the Lagos State Chapter. Once every two years, the Association of Physicians of Nigeria, Lagos Chapter, which is an umbrella body that comprises of all public officials in Lagos State. We come together and we look at issues that are bedeviling the health sector in Nigeria and Lagos State in particular. And we try to look for solutions. We brainstorm, we discuss, we profess solutions and then we engage appropriate government authorities and that are responsible for solving some of those challenges. And that is what we're going to be doing again on Tuesday, the 5th of December. And so the theme of this year's conference is universal health coverage and we are present, you know, the journey so far and with regards to the Lagos State experience. And so we'll come together on that day and discuss some of the issues. And we hope that at the end of the day our community will be able to profess some solutions to so many challenges that are facing the health sector. And just like you said, we have so, so, so many challenges in the health sector. Okay, so how does this universal health care work for an average person in Nigeria? What do they need to know about this? All right. Thank you. But the concept of universal health coverage is, you know, everybody having access to quality health care services, when they need it, wherever they need it. And at a cost that does not cost them to break the bank. That is just what universal health coverage means. You need to assess health care services. You don't need to travel from maybe a remote area in Ibejuleki down to Ikechia to assess health care services. You don't need to break the bank to do that. And whatever health care services you are assessing must be affordable. You don't need to go and sell off your property. You don't need to, you know, you don't need to use money meant for other purposes to do that. And that is what universal health coverage means. And so this is generally what every single country tries to achieve, right? Ensuring that their citizens have access to quality health care services, you know, without having to, you know, run into financial hardship. Okay, so what are the benefits? And I know that in Nigeria, most times some of these health care providers are usually like in the private sector. So does this also cover like government hospitals and stuff like that? What are the benefits that we can actually get from this universal health care coverage? Alright, so universal health care coverage is more like a policy. And that encompasses whether you are a public or private sector health player. It's just policies that ensure that if you are a patient or you are somebody that needs a particular health service, whether you're going to the public hospital or you're going to the private hospital, whichever one you choose, whichever one is closest to you, the same conditions apply. Yeah, the private sector is a major player in the health industry, but government is still the major player in the health care industry. And most of the affordable services as they provide have been covered. Some of the private hospital services are usually out of reach for the ordinary Nigerians. And that is what universal health care coverage tries to bridge. Such that how do we come to a consensus where people do not need to look into the depth of their pockets to determine whether to go for health care services or where exactly to assess those services. And so universal health care coverage is a policy. And at the conference, you know, we'll be engaging all senior government officials, top legal state government officials at the conference, and we'll sit down in a roundtable to look at those issues and provide solutions. I'm sure that every day we look at the news, we are always inundated with stories about medical workers living in the country, one of two services not being provided. Just as you said, a report came out a few days ago that a ward was being shut down in the Lagos University in hospital. And so many other stories across the country that were here every day. And these are what we're trying to look at. These are conversations that happen every single day in Nigeria. But universal health care coverage is a policy. It's not like looking at what are those factors that, you know, mitigate against some of these challenges we face. And how do we solve them? Looking at particular ways are true. This is not English. This is just, these are our challenges. How do we face it? And what do we need to do? Yeah, but like she was asking what the advantages are in the first place. Why are we even talking about this policy? It seems as if it's not working. Because you've been talking about it. This is every two years you talk about it. Now people are still living what's being closed in hospitals and all that. The cost of medication and getting any kind of health care is rising up. Are you saying that discussions like these conferences, like these roundtable discussions like these, are not having the impact that you wanted to have? Or are you telling us that it has impacted so much on the health sector that you can beat your chest and say we're proud of this? What is missing? Well, my opinion is that, you know, it is still a political way. Which is more important. These conversations happen every day. Our session is a session of public health physicians. If you go to conferences organized by the Nigerian Medical Association, the Nigerian Association of Resident Doctors, and so many other medical associations in the country, these are conversations that happen on a year-to-year basis. And then, but the one thing that is missing is the political way from those responsible to actually act on some of these things. And that is the missing link. Government needs to prioritize the health sector. I was just yesterday, I was looking at the budget presentation by the end of the February public of Nigeria. And I was surprised to see that health was not taking so much part of the budget. There's a recommendation that 15% of the country's budget should go to the health sector. Nigeria has never achieved this for once. And if we take health serious, we will dedicate more of our resources to the health sector. And that is what we're not doing as a country. We are focusing so much on other things such that we neglect the health sector. And these are conversations that we want to continue to have. It's not getting any better, and that is the truth. These are not getting better as we expect them to be, especially in the health sector. So we want to bring it to the consciousness of every single person that matters. And we hope that the media will help us cover these events and look at these conversations, practical conversations that are going to be discussed so that you can bring it to the attention of all the stakeholders. We're meeting in a political way, and that is the missing link. Yeah, but you've said you're advocating privatization of the health sector. What do you mean by that? Because there are some people with a different school of thought. They don't feel that health should be something, health and education should be something that you privatize. So when you say privatization, what's the limit to which this has to be privatized? What do you really actually mean? Well, maybe you didn't get what I said. I'm not an advocate of the privatization per se of the health sector because once you privatize the health sector, it becomes out of reach of ordinary Nigerians. What I mean is we cannot ignore what the private sector contributes to the health sector. And this is why we encourage that government needs to bring the private sector together to have conversations. And I'll give you a practical example. Everybody knows what the cost of diesel today is in Nigeria. How would you feel if you walk into a private hospital and you don't have light? How would you feel if you need to have a surgery and there's no light in the hospital? The medical directors of these private hospitals are not getting a couple from government. Diesel is not being subsidized for them. They don't have any tax relief from government. They still pay their taxes. Yet they have to buy diesel to ensure that you have 24 hours in the hospital. These are costs of ever increasing that they have to deal with. And what we are asking is that government should come in, sit down with these people, look at ways by which they can mitigate some of these problems, they can help them, you know, offer these services to Nigerians. Okay. I'm just wondering. When the leaps collapsed and killed someone, a doctor, it was a government hospital. This means there to even, I don't have any funding. I don't know how they are going to give the funding. But like you said, maybe there could be policies that will make things really easy for the private sector to go on. I'd like to know what are your three main objectives, especially with this conference. So I know you said, you know, things are not the way you guys wanted to be your organization. However, what are the three main objectives that you want people to know about, even the government that you're asking to come and help out? What are the three main objectives right now? All right. So one objective is to first look at what are the drivers and the challenges of, you know, refusal to ensure that we achieve universal health coverage, especially in legal states. There are so many factors. Right. And those are some things, some of the, one of our objectives is to bring all these conversations to the fore. We're going to be having topical discussions. We're having seasoned people coming to speak to us. But beyond that, we're going to be having panel discussions. We're going to be bringing the patients on board to come and discuss what are the specific patient challenges. This is not just going to be a conversation where doctors sit down and speak to themselves. We're going to be bringing the patients and have a Nigerian patient come and tell you what are those challenges you face. When you go to the hospital, what do you face? What are those things you see? What are those challenges when you want to buy your drugs? If you have potential for diabetic, for instance, are you having challenges for chasing your drugs as the cost of medication gone off? We're bringing private sector players into the conversations. We're bringing government officials into the conversations. We'll be talking about health insurance, the popular Ileira echo in legal states. How can people go in and enroll? How can they benefit from these services that are offered? We're going to be talking about health insurance. We're going to be talking about access to global medications in Nigeria. Recently, we see pharmaceutical companies existing in the country because of our favorable policies. And that has, of course, driven up the cost of medications in the country. So we're going to be bringing them to come and speak to us. What are those challenges? What are those factors that are causing their drugs to go off? What can we do? Because we need to do something. We can't just keep on saying that people are going to be fine. No, we need to have these conversations. And when we're having these conversations, the government officials will be seated. And we're all going to be seeing and offering solutions. And at the end of the day, we're going to be drafting a communique which we're going to send to the very best agencies of government. Itemized line by line to say, OK, these are the problems the young doctors are facing. How do you follow up on this communique that you sent to the various agencies of government that need to see these communiques? Over the years, when you have this conference and you discuss these things and you profile the solutions, what do you do as a follow-up? Thank you. So periodically, we pay advocacy visits to relevant government agencies. This year, we've tried to be in this state-of-the-art assembly. Frequently, when there's a change of comment or when there's a change in appointment of somebody holding a seat, we go there, we register our presence. And since there's a working document that has come together, we represent these things to them to say, these are things that we have agreed on a year ago, two years ago. Conversations that you need to remember, that we have actually done those discussions for you, have done the hard work. We are just saying, please, when you guys sit down at those places that matter, let these conversations keep on becoming. Because the only thing we can do as a body is to advocate. We don't have the political power. We don't have the executive power to make some of these decisions. If you talk to another Nigerian, to another young doctor, they'll say they want to leave the country. I do not have the power to stop it. But the government, on the other hand, know what the problems are. And we're going to be treating some of these challenges. And we're going to be presenting at their table. So we do frequent and periodic advocacy visits to relevant agents of government, and the executive or legislative hand so that they can always remember these conversations. And that is what we're going to continue to be doing. All right. I want to talk about digitalization. Because you had said, I think you mentioned health insurance sometime. And are you looking for ways to ensure that even people who are at home can also get healthcare, this universal healthcare coverage you're talking about? Well, the truth about the matter is digitalization of healthcare, which is from what we call telemetry, where you have access to consultation with a healthcare provider via the use of digital tools. It's something that is happening in so many places in Nigeria, especially in legal states as well. You know, telemetry is something that is a service that has come to stay and so many people are adopting it. But also, we need to also look at the fact that telemetry on its own has so many challenges on its own. You have the challenges of internet coverage. You have the internet challenge of so many ailments that cannot be discussed via digital tools. The medicine is a profession whereby you marry what the patient tells you with what you physically can see and examine on the patient. So there are some ailments that, yes, you can make a consultation over the phone and you can ask the person to get this done or get this particular medication and you offer those services via digital tools. But there are also some that cannot be done through telemetry. But yes, telemetry is something that has come to stay. It's still something that is evolving. And as anybody is trying to work around the challenges, it's something that will continue to adopt to ensure that people have access to medical care or using the digital tools that we have all over the country. Because for me, when we talk about universal healthcare coverage, I think everything should be in it. It's all encompassing. So that's the reason why I even asked about digitalisation. I know that obviously we need more data on this and even for people who are living in rural areas, they need to have the access to internet and for them to be able to do this telemedicine we're talking about. But if we're talking about universal healthcare, I believe that it should be everything, all encompassing. Anyways, thank you so much for joining us today. We've been speaking to Dr. Adey Daio, Adey Ribibi, he's a co-chairman in a public healthcare physician at Las Suiz Ikeja and the Secretary Association of Public Health Physicians, Lagos Chapter. Thank you so much for coming and just giving us insights on what the conference is about and how we can access this universal healthcare. Thank you so much. Thank you so much for having me. Thank you. All right. So we'll go on a quick break and when we return, we'll be looking at our second hot topic. You want to speak around for that.