2020 Nigerian Budget: Dropping the Ball on the Health Sector, Again -By Judith Ann-Walker

For the fifth year in succession, the health sector is a low performer, a junior partner and bench-sitter on a losing B team as Nigeria sets national priorities in the annual budget. Both the 2014 “Budget for Jobs and Inclusive Growth” and the 2015 “Budget of Transition” allocated only 5.78 per cent to the health sector. The 2016 “Budget of Change” was no better, with only a 4 per cent allocation. This was also the case for the 2017 “Budget of Economic Recovery and Growth”, the 2018 “Budget of Consolidation”, and the 2019 “Budget of Continuity”, with 4 per cent, 4.4 per cent and 4.75 per cent allocated to the sector, respectively.

With a gloomy 2020 global economic forecast and an annual population growth rate of 2.6 per cent, it is easy to be persuaded by the government’s disproportionate prioritisation of THE ECONOMY. Not surprisingly, the 2020 budget, dubbed the “Budget of Sustaining Growth and Job Creation”, similar to the 2014 budget, focuses squarely on economic development. However, to balance the disproportionate focus on infrastructure, transportation and the economy, the government of the day has paid some limited attention to the social sector by allocating billions of naira to social investment programmes, to education and the Sustainable Development Goal (SDG) 5 – Achieving gender equality and empower all women and girls – which received more than half of the N40 billion allocated to the SDGs.

Budgeting is a difficult task and no government can satisfy all sectoral interests. However, in budgeting for the people, the government must be consistent with its own policy pronouncements on the centrality of health in its human development programme. Indeed, it is on page 3 of the Call Circular for the Budget of 2020 that health came in at the first place for honourable mention, as the government guided its ministries, departments and agencies (MDAs) on budgeting principles: “Prominence should also be accorded to human capital development, specifically Health, Education and Social Inclusion”.

The 2020 budget has done justice to government guidelines on education and social inclusion. But where is health? The proposed 2020 budget of the Federal Ministry of Health is N427.30 billion, which amounts to just 4.14 per cent of the budget, as against the 4.75 per cent of the 2019 approved budget. This means that instead of moving forward, we have moved backwards, losing the match before the whistle is blown.

But perhaps more worrying is tthe fact hat the statutory transfer of the 1 per cent Consolidated Revenue Fund (CRF) has been cut by half. The federal government has proposed N44.50 billion for the Basic Health Care Fund (BHCF) in the 2020 budget. This does not appear to be in accordance with the National Health Act (2014). In the Act, the federal government ought to allocate at least 1 per cent of the Consolidated Revenue Fund (CRF) for the BHCF, which should be about N81.55 billion.

In the face of this deprioritisation and disinvestment in the health sector, professional health associations and Nigerian citizens are calling upon the national legislature to reposition health as a catalytic sector for national development. Civil society organisations under the Partnership for Advocacy in Child and Family Health at Scale coalition are calling on legislatures not to be confused by the argument that funds released to the health sector are returned to the treasury on an annual basis. This is not an indication that the health sector is adequately funded. Rather, this is evidence that late releases and poor fiscal discipline lead to costs overruns on a host of incomplete health sector capital projects. Happily, the 2020 budget lays emphasis on completing ongoing projects “rather than commencing new ones”.

So as the ninth National Assembly studies, reviews and analyses the 2020 budget, citizens and stakeholders, including health associations, of Nigeria call upon legislators to score a goal for health. A goal for health is the goal for every other sector – education, infrastructure, transport. A healthy population is a productive population.

Judith Ann-Walker is the executive director, Development Research and Projects Centre. She can be reached through drpc20022002@yahoo.com