So Much For A National Health Bill

On Thursday, May 19, 2011, the National Health Bill, which defines, streamlines, and provides a framework for standard and regulation of health services nationwide, defines rights and duties of healthcare providers, health workers, health agencies and users, and provides guidelines in the development, promotion and formulation of national health policy, among others, was passed by the Senate of the Federal Republic of Nigeria.

Chukwu: Nigeria's Health Minister

Prior to the passage of the Bill, angry Market Women Association members and several pressure groups had on Wednesday, May 18, besieged the National Assembly to protest against the delay in passing the Bill, threatening to go into the Chambers naked if security personnel prevented them from going in. It took the intervention of Senator Iyabo Obasanjo-Bello and Senator Gyan Dantong to pacify the protesting women.

But less than twenty four hours after the passage of the Bill, war of words broke out. Different factions emerged, with some speaking for and others against the Bill. Threats and ultimatums were issued, and the various factions challenged one another to public debates. The Assembly of Healthcare Professional Associations and Unions called on President Goodluck Jonathan not to give assent to the National Health Bill, saying “there will be no peace in the health sector if the bill becomes law”.

But the Nigerian Medical Association, NMA, had earlier in April called on President Jonathan to exercise his executive power and ensure that the National Health Bill is passed and assented to before the end of the last legislative and executive term. President of NMA, Dr Omede Idris, while addressing a press conference in Abuja, had said: “For the health bill to go through this current legislative assembly without passing it into law smacks of the government’s insensitivity to the plight of all Nigerians – adults, men, women, youths, children and newborns alike, health-wise. Over this period of six years, six million Nigerian children and 317,400 Nigerian mothers have died.” And so, the controversy went on and on.



Jonathan: President of Nigeria



Recently again, following the reassurance given to the Nigerian Health Sector Reform Coalition, NHSRC, by Nigeria’s Minister of Health, Prof Onyebuchi Chukwu, that President Goodluck Jonathan would soon assent to the National Health Bill, the Order of Knights of St. Mulumba, Nigeria, has joined in pleading with the President not to sign the Bill into law. In a full page advertorial in a national daily titled “Why The President Cannot Sign The National Health Bill” and signed by Bro Enoma A. Bazuaye-Ekwuyasi (Supreme Physician) and Bro Anthony C. Onuh (Supreme Knight), the exalted Order outlined numerous reasons why the President, in their considered view, cannot sign the Bill in question into law.

First on the list was that the Bill has exceeded the thirty-day period within which the Constitution allows the President to assent to it. According to them, the 1999 Constitution of the Federal Republic of Nigeria provides that a Bill passed by the National Assembly can only be assented to by the President within thirty days. Following, therefore, that President Jonathan has failed to assent to the National Health Bill since May 2011, he cannot possibly to assent it now.

The exalted Knights also pointed at the vehement opposition that has trailed the Bill, particularly from various health professional bodies in Nigeria, including the Pharmaceutical Society of Nigeria, PSN, Health Workers Association of Nigeria, Association of General and Private Medical Practitioners of Nigeria, AGPMPN, and the Association of Medical Laboratory Scientists of Nigeria, AMLSN. This, they said, signifies that these professional bodies probably had no input into the draft of the Bill or that the Bill failed to promote their respective interests, either of which would imply that the National Health Bill was not the people’s health bill because it lacked the people’s will and input. It was rather a contraption of a few senators who were hell-bent on making their authority felt and imposing a national health bill on the people of Nigeria.

But more worrisome to the Knights was Section 51 (1 and 2) of the said Bill, which provides that: “(1) A person shall not without the prior written approval of the Minister:- (a) manipulate any genetic material, including genetic material of human gametes, zygotes or embryos; or (b) engage in any activity, including nuclear transfer or embryo splitting, for the purpose of the reproductive cloning of a human being. (2) No person shall import or export human zygotes or embryos without the prior written approval of the Minister on the recommendation of National Ethics Research Committee.”

According to the Knights, the above provisions enable the Minister to play God, with unbridled powers to grant life and death to human embryos, harvest human egg and sperm, and even do business with them. In their words: “Simply, the section is aimed at legalising the manipulation, aggression and violence against Nigerian children, embryos and zygotes. A mere written permission from the Health Minister is all that is required for any person to have full legal backing to manipulate any genetic materials, including genetic material of human gametes, zygotes and embryos, import and export human embryos, as well as conduct any experimentation for human cloning and other purposes.

“Section 51 grants unquestioned and unaccountable powers to the Minister of Health. Through his written permission, he allows whomsoever he wishes to engage in any activity such as nuclear transfer, embryo splitting for the purposes of the reproductive cloning of a human being. These are activities that are morally and socially objectionable and a cause of serious concern, conflict and regulation in developed countries.

“The Health Bill empowers the Minister, through his written permission, (with or without the non-binding recommendation of National Ethics Research Committee), to grant a license to any person or group of persons to import or export Nigerian human zygotes or embryos to foreign countries for whatever purposes including cloning (therapeutic or otherwise), sale or as a gift to communities in countries with restrictive laws against such practices.

“Introducing Section 51 through the back door is treacherous and lacking in respect for the life of Nigerians and human society. This enigmatic clause is an affront on the dignity of man. The merchandising and trafficking on human gametes, zygotes, embryos or human cloning should be banned outright and not left to the whims and caprices of the Minister of Health.”

The exalted Order also condemned other activities of the Health Minister, whom they alleged has been hobnobbing with the United Nations Population Funds, UNPFA, and promoting various questionable projects and programmes that have nothing to do with the health needs of Nigerians, like aggressive free distribution of contraceptives, including injectable contraceptives, in all public health centres and institutions in Nigeria which he flagged off in April 2011.

In conclusion, the Knights of St. Mulumba restated the deplorable state of the health sector in Nigeria, arguing that as it is, attaining the health-related Millennium Development Goals (MDGs) is virtually elusive, given that health indicators in the country remain abysmal. While calling on the President not to succumb to the intense pressure from self-serving groups from within and outside Nigeria who are asking him to sign the Bill, but to withhold his assent until all the anti-life and other retrogressive clauses are expunged, they insisted that “the Health Bill in its present form is an invitation to more crises in the health sector. Nigerians deserve a Health Bill that will guarantee the health of all Nigerians.”

As it is now, that Nigeria needs a Health Bill is not in question. But with the controversies already generated by the Bill, and considering the issue of time lapse raised above by the Knights of St. Mulumba, the question is: will the President disregard these issues raised and go ahead to sign the Bill into a federal law, or will he subject it to further review before giving his assent? No doubt, the onus rests on President Goodluck Jonathan, and Nigerians are watching to see how it goes.