By Drew Povey
THE Nigeria Centre for Disease Control (NCDC) reported on Thursday, November 12, 2020 that 76 people in three states had died from suspected yellow fever this month. Almost 20 cases, from the same three states (Bauchi, Delta and Enugu) were confirmed in a laboratory as being from this virus.
In the same period, the number of deaths from Covid-19 across the country was less than a third as many as from yellow fever. This shows, yet again, that the government needs to worry more about the illnesses that the poor majority suffer from, and provide proper budgets to ensure that they can be treated in public health facilities. The outbreaks of yellow fever in recent years demonstrate the government’s failure to fund immunisation for most of the population.
Unlike these deaths, coronavirus also attacks the rich and there is no treatment for them to buy or to receive, even in London, New York or New Delhi. The rich and powerful are, consequently, scared of coronavirus. At least four governors, including the governor of Kaduna State, for example, were infected and Abba Kyari, President Buhari’s Chief of Staff, died from the disease. So coronavirus is attacking the most powerful in the land and they are fighting back despite this impacting adversely on the poor majority.
There is a medical emergency in Nigeria, but it is not Covid-19. For many years now, the poor majority have been suffering a major health disaster. In 2018, the World Health Organisation estimated that there were perhaps 20,000 deaths each week in Nigeria which could have been avoided if the necessary medical care had been provided.
These included the following estimated weekly deaths: lower respiratory infections – 5,500; neonatal conditions – 4,000; diarrhoeal diseases – 3,000; tuberculosis – 2,000; malaria – 2,000; maternal conditions – 1,000; and nutritional deficiencies – 1,000.
These figures are almost certainly underestimates due to under recording and death reporting not being compulsory. In contrast, little more than 30 people a week died from the Covid-19 outbreak over the entire first eight months and the figures are less than half of this level now. In total, less than 1,200 people have died from Covid-19 compared to the above weekly poverty-related deaths.
Unlike these deaths, coronavirus also attacks the rich and there is no treatment for them to buy or to receive, even in London, New York or New Delhi. The rich and powerful are, consequently, scared of coronavirus. At least four governors, including the governor of Kaduna State, for example, were infected and Abba Kyari, President Buhari’s Chief of Staff, died from the disease. So coronavirus is attacking the most powerful in the land and they are fighting back despite this impacting adversely on the poor majority.
The biggest killer in Nigeria is clearly poverty. Coronavirus is making this worse, but the rich are trying to escape from Covid-19 by launching a massive attack on the poor.
The total numbers that have died as a result of the lock-downs and repression by the security forces is not known. But the World Food Programme estimates that 9 million people die of hunger each year – more than AIDS, malaria and tuberculosis combined and much more than the total global Covid-19 deaths of well less than 1.5 million.
The UN expects hunger deaths to increase by several millions this year as a result of restrictions imposed to try and reduce the impact of Covid-19. In April and May of this year, over 800 Nigerian civilians died in incidents related to insecurity, many of these were inflicted by the security forces (Humangle). In a couple of days around 20th October, 80-100 people were killed in Lagos alone by the army and police. This is why the independent Citizens Tribunals being organised by the Alliance on Surviving Covid-19 and Beyond (ASCAB) are so important.
Covid-19 is real and has inflicted horrors across the world, but the poor suffer worse every year. The difference between Covid-19 and the diseases of poverty is that we know how to solve poverty and its related diseases. We already have a vaccine for hunger – it is food.
Poor people in Nigeria account for about a quarter of all deaths from malaria globally. These deaths would be greatly reduced if more people slept under mosquito nets, took malaria tests when they thought they had malaria and were then treated promptly. Poor people cannot afford to do this, but the rich can, so they are hardly affected by malaria.
It is estimated that deaths from tuberculosis could be reduced by 90% by 2030 by increasing detection rates, strengthening primary health care provision and treating many more patients. This would cost the government around N80 billion a year or perhaps five per cent of its annual budget. So again tuberculosis is a disease of the poor that the rich are not bothered about.
The top three risk factors for death or disability in Nigeria are malnutrition, water/sanitation and air pollution. These factors only really impact on the poor. Nigeria leads Africa in air pollution deaths (most are included in the lower respiratory infections category above). This may cause 114,000 deaths a year including more than 64,000 deaths from the use of wood or charcoal-fuelled stoves for cooking which largely affects women.
Diarrhoea is caused by dirty water. Poor sanitation and hygiene is the second largest killer of children under five in Nigeria. WaterAid estimates that one in three Nigerians do not drink clean water and a similar number do not have access to basic sanitation. As a result, 60,000 children under five die unnecessarily. Washing hands is one of the key measures to avoid exposure to coronavirus. How do the poor Nigerians do this if they do not have access to clean water?
The recently announced further fuel price increases demonstrate the futility of the trade union leaders of the NLC and TUC negotiating with the government. We need action rather than words for the NLC and TUC to regain their position as saviour of the working people. Twenty thousand Nigerians die every week from diseases related to poverty. We need action comparable to that introduced to protect the rich from Covid-19 to protect the rest of us from poverty.
In 2001 African governments pledged to spend at least 15% of their budgets on health in the Abuja Declaration. Some countries, like South Africa, have achieved this target. In contrast, in Nigeria, overall public spending on health in 2018 was only 4% of federal, state and local government budgets and less the following year. The Nigerian government’s highest-recent public budget share for health was 5% in 2012. The 4.2% per cent proposed for 2021 is a small improvement over the 2019 and 2020 figures, but still not much more than a quarter of the level agreed in the Abuja Declaration.
The current federal government may have increased spending on health, but hardly enough to keep pace with inflation and not as a proportion of the overall budget. This underfunding of public health is the main reason for the rash of strikes in the health sector this year. This demonstrates how poor conditions are in our public hospitals and health centres.
This under-funding of public health service means that even the poor have to pay nearly 80% of their health costs from their own pockets. As a result, they suffer chronic ill-health and many die from diseases that could be easily cured. “Every day, approximately 2,300 under-five-year-olds and 145 women of childbearing age die in Nigeria. These deaths are mostly preventable.” We need a massive increase in the health budgets, especially for primary healthcare, to meet up with international norms. One of the reasons that Buhari was originally elected was his promise to increase funding for public health services; he has not delivered on this promise.
The biggest killer in Nigeria is clearly poverty. Coronavirus is making this worse, but the rich are trying to escape from Covid-19 by launching a massive attack on the poor.
Isolation centres are being used to incarcerate the poor who have Covid-19. By early April 2020, the military had developed 21 such centres and state governments had established more of their own. But the rich and powerful, like the four governors who tested positive for coronavirus, have not suffered the indignity and dangers of being sent to such centres. At its peak, nearly 3,000 people may have been locked up in these concentration camps. Many of these poor people have protested that they are not receiving proper treatment or enough food.
Making facemasks compulsory in public is another excuse for harassment and extortion from the police. Lagos State promised to arrange for one million face masks to be made by local tailors. What are the other 19 million Lagosians to wear?
Coronavirus is a risk for the poor and rich alike, but the poor already face huge poverty related risks – coronavirus only increases this risk by perhaps 2.5%. The recent National Bureau of Statistics report found that 40% of Nigerians have to survive below the national poverty line of N11,500 a month. This was set at a level that only just allows individuals to be fed, clothed and housed at the most basic levels. During the lockdowns, the poor and informal workers faced the choice of going out to try and work or their families going hungry. For many of them, the logical choice was to go out and face the harassment of the security forces.
The easiest way to relieve poverty and its associate deaths would be to increase the minimum wage. We need the minimum wage to be fully implemented in all states and increased again next year which will be 10 years since the previous increase in 2011. It is embarrassing that the minimum wage of N30,000 has yet to be implemented in the nation’s capital over 20 months after the figure was agreed.
Recent events have demonstrated the extent to which palliatives intended for the poor had been looted by the rich and powerful. School feeding programs and social protection are notorious for their levels of corruption. It would be far more efficient to support the poor by eliminating all charges for health and education, at least at primary levels. Much of the revenue collected at this level already leaks before reaching any government bank account.
The recently announced further fuel price increases demonstrate the futility of the trade union leaders of the NLC and TUC negotiating with the government. We need action rather than words for the NLC and TUC to regain their position as saviour of the working people. Twenty thousand Nigerians die every week from diseases related to poverty. We need action comparable to that introduced to protect the rich from Covid-19 to protect the rest of us from poverty.
Povey is a member of Socialist Labour and Alliance on Surviving Covid-19 and Beyond (ASCAB).
