Adewole @ 65: Leaving an indelible mark in the health sector By Kazeem Akintunde

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Two days ago, the Federal Ministry of Health under the leadership of Professor Isaac Folorunso Adewole rolled out the Basic Health Care Provision Fund, BHCPF, with the formal launch in Osogbo Osun State.

With the launch, an estimated 100 million Nigerians will now have access to basic health care at the Primary Health Centre closer to their homes, as one PHC in each political ward across the country will deliver the BHCPF. Nigerians seeking care and medical attention on issues such as Malaria treatment, ante-natal care, delivery including Caesarean sections, under 5 childhood illnesses, immunisation and screening and referral of hypertensive and diabetic cases will all be offered at the PHC level and paid for by the Federal Government.

The launch in Osogbo will be replicated in Niger State on May 10, Katsina- May 14 and Abia State- May 16, with phased roll out planned in other parts of the country.
For almost four years, this educationist in charge of the Nation’s health sector has contributed immensely to the overall development of the country in general and the health sector in particular.

Since his assumption of office, Professor Adewole has gradually changed the narrative in the health sector as he anchored his programme on the revitalisation of the Primary Health Care system in the country, which he described as the bedrock for our health care development.

Primary Health Care Revitalization project under his watch has received top priority. To date, over 4,000 PHCs have been upgraded. The World Bank through the Nigerian State Health Investment Project (NSHIP) has upgraded 1400 PHCs, UNICEF supported with 774 while the DFID led Maternal, New-born and Child Health (MNCH2) programme has refurbished 954 PHCs. State Governments are not left out, with Governors taking the initiative to improve delivery of care at the PHC level. His desire is to ensure that 10,000 PHCs are renovated and put to use across the country.

Under his watch, Professor Adewole has transformed health care system in the country. He oversaw the development of the 3rdNational Health Policy and the second National Strategic Health Development Plan (NSHDP II). Both documents provide the underpinnings for Nigeria to achieve Universal Health Coverage and provide an opportunity to shape the direction of the health sector.

On a programmatic level, Prof Adewole has moved systematically to address the drivers of underperformance. The following are examples of achievements so far:
The Fight Against HIV/AIDS, TB and Malaria –The health sector focus has shifted from passive to active case-finding in key affected populations, including people living with HIV/AIDS, children, urban slum dwellers, prisoners, migrants, internally displaced persons and facility-based health care workers, to target those most at risk for TB.

There has been an increase in GeneXpert sites from seven health facilities in 2011 to 390 facilities as at the end of 2017 to enable us detect accurately and respond to TB cases. The Minister has expanded screening for TB, with over 2m people screened and 204,000 treated in 2017 and 2018. We have conducted with funding support from US Government and Global Fund the National HIV and AIDS Indicator and Impact Survey to address the lingering challenge facing HIV and AIDS data in Nigeria. The results of the survey indicate that the prevalence of HIV/AIDS has dropped from 3% in 2014 to 1.4%. We have expanded HIV/AIDS treatment to additional 78,000 Nigerians since 2017. We are intensifying the war against malaria with the distribution of 33.1m nets between 2017 and 2018. We will distribute an additional 12.3m nets this year. This has led to a modest reduction of the burden from 42% to 27% in the last 2 years.

Fight against Polio Eradication Initiative (PEI) – To ensure effective and efficient coordination of immunization activities, the Minister approved the establishment of, Emergency Routine Immunization Coordination Centres at the National, States, and Local Government Area levels known as NERICC, SERICC and LERICC respectively to coordinate routine immunization activities and quickly improve immunization coverage at these levels in the low performing states. In less than a year, the States’ Emergency Routine Immunization Coordination Centres (SERICC) have been established and functional in 18 low performing states (Kano, Kaduna, Katsina, Kebbi, Sokoto, Zamfara, Jigawa, Yobe, Borno, Bauchi, Adamawa, Taraba, Gombe, Kogi, Niger, Nasarawa, Plateau, and Bayelsa). This effort is already yielding fruit. Our immunization coverage has gone up from 48% to 57% between 2016 and 2018. We look forward to our certification as polio free during Mr President’s second term.

Increased access to immunization – In line with Prof Adewole’s commitment to the health of our people particularly children under 5, he engaged the Global Alliance for Vaccines Initiatives (GAVI) to continue their support for Nigeria. This has enabled the country unlock additional resources to the tune of $1.03bn grant for vaccines procurement and Health System Strengthening over the next decade.

Upgrade of Tertiary Health Institutions and War Against Cancer – We are gradually rebuilding the Nigerian Health System to handle cancer and other major cases in Nigeria. We have upgraded tertiary health institutions to enable them treat cancer cases. The National Hospital in Abuja now has 2 high-end Linear Accelerator (LINAC) with capacity to treat up to 200 patients per day. The official commissioning of the LUTH-NSIA Cancer Centre is a major achievement of this administration. Bunkers for radiotherapy machines, brachytherapy machines and other relevant equipment have been procured for the following teaching hospitals. (i) UCH (ii) UNIBEN (iii) UDUTH Sokoto (iv) ABUTH ZARIA (v) UITH Ilorin (vi) UNTH Enugu (vii) UNIMAID Borno
With the implementation of the Saving One Million Lives Programme for Results (SOML P4R), the FG is funding States based on results achieved and changing the narrative on health care to a focus on outcomes. The Federal Government has disbursed over $259m to States in the last four years and seen improvements in governance and accountability mechanisms and also improvements in health outcomes.

The provision of free surgical and laboratory services to all fistula patients in all Federal Teaching Hospitals and Federal Medical Centres (FMCs) in the country came under Professor Adewole’s watch while the supply of medical equipment to medical centres e.g. provision of 26 dental chairs to Federal Medical Centres and their outstations across the six geopolitical zones of the country, to strengthen oral health service delivery is ongoing.

The ministry has also supplied and upgraded six orthopantomogram machines in six dental schools across the six geopolitical zones to facilitate the development of human resource for oral health while at the same time improving oral health of Nigerians.

Of recent, the Ministry of health under him provided 8000 free surgeries and free cancer and Hepatitis B screening for indigent Nigerians under the Rapid Result initiative (RRI) while Health, Nutrition Emergency Response in the North East is been pursued with vigour.

In October 2017, the federal government took delivery of two multipurpose truck for Tuberculosis treatment tagged ‘Wellness on wheels’ WOW, for the eradication of TB in Nigeria
Also recently, President MuhammaduBuhari gave approval to the ministry to add 50,000 HIV patients on treatment which has greatly expand access to treatment, test and management of the disease in the country.

The good news today is that this amiable professor of Gynecology turns 65.
Adewole was born on May 5 1954 at ilesa, Osun State. His parents were traders. He attended Ogudu Methodist Primary School, Ilesa, where he spent one year, and Methodist School, Oke Ado in Ibadan, where he also spent another one year before completing his primary education at St Mathias Demonstration School Akure. He later attended Ilesa Grammar School where he obtained a Grade 1 certificate with distinction in 1970 and Higher Certificate, HSC, in 1972.

In October 1973, he enrolled at the College of Medicine, University of Ibadan where he obtained an MBBS degree and in 1978 won the GlaxoAllenbury prize for outstanding performance in Paediatrics.

In 1978, the same year he graduated from the University of Ibadan, he joined the University College Hospital, Ibadan. In 1979, he left the hospital for Sokoto for the compulsory one year of service in the National Youth Service Corps. On completion of his service, he worked for a year as a medical officer at Adeoyo Maternity Hospital, Ibadan, before returning to the college hospital as a senior house officer of the department of Obstetrics and Gynaecology. He held the position for one year before he was appointed registrar in 1982. In 1985, he left Nigeria for a research fellowship in the department of medical oncology at Charing Cross Hospital, London.

With the launch of BHCPF in Osun and the anticipated launch in three other states before the end of the current dispensation, Nigerians desirous of adequate health care will now have access without having to spend the whole day in the facility. Out of pocket expenses would also be greatly reduced and the match towards the slogan health for all would have been greatly realised.

Akintunde is the Special Assistant Communication and Strategy to the Minister of Health

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