Our Planet, Our Health – Why Nigeria’s UHC Champion Must Care About Environmental Health

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By Dara Ajala-Damisa and Vivianne Ihekweazu (lead writers)

Today, April 7, is world health day, an important day from all points of view; one that draws attention to a specific health topic that concerns people around the world. The theme for World Health Day in 2021 was all about building a fairer and healthier world through stronger elements of universal health coverage (UHC); in 2022, the focus is on the urgent action needed to keep humans and the planet healthy through deliberate climate action. In this article, we demonstrate how interconnected these two themes are and how Nigeria cannot achieve one without the other.

Environmental health is a key component of preventive health and is often overlooked, but it is one of the fundamental pillars of UHC and one of the three components of A health approach. A focus on preventative health is also one of the main recommendations of the recent Lancet Nigeria Commission Report that calls for One Nation, One Health.

The phrase, One Nation, One Health, speaks to the imperative correlation between environmental action and universal health coverage. The critical dependence of human health on environmental health means that Nigeria is better placed to ensure equitable access to quality and affordable health care for all Nigerians. when health systems align human and environmental health and drive a movement to create societies focused on total well-being.

Why does Nigeria need a UHC champion?
In 2019, Nigeria spent only about 3% of its gross domestic product (GDP) on health, it goes without saying that for a population of over 200 million, these expenditures fall short of what would be sufficient for a well-resourced health system. Underinvestment in health care means that 70% of the health expenses of Nigerians are borne by them. If a country’s priorities are reflected in the amount of resources allocated to it, then Nigeria’s current spending on health suggests that this sector of the economy is not seen as a priority. The COVID-19 pandemic and the resulting economic impact should remind us that “health is wealth”. The health of a population and the strength of a health system contributes significantly progress in other sectors of the economy. Therefore, multisectoral policies for health for all aimed at strengthening health systems best bet.

Image credit: Nigeria Health Watch

To progress and improve the country’s health indices, Nigeria needs to invest a greater share of its GDP in the health sector and improve governance and the efficiency of the allocation of the funds used. Therefore, political commitment is needed to champion the achievement of UHC in Nigeria.

Why should Nigeria’s next UHC champion mainstream environmental health?
Low investment and political inaction regarding environmental degradation have a negative effect on health and contribute to increased poverty, with an impact on access to water and sanitation for base. Environmental degradation also contributes to conflict and instability in the country. This is seen in areas like the Lake Chad Basin which has reduced by 90%, impacting agricultural production and the food security and nutritional status of the most vulnerable populations.

Like extreme weather events become more common, the impact of an already weakened health system will be felt even more. The floods worsen spread of waterborne diseasesoverwhelming health systems increased incidence of diseases such as choleraa epidemic Nigeria is currently struggling. While the droughts jeopardize food security for already vulnerable populations. Climate change and the effects of inaction will undermine progress in health and achieving UHC will be a harder goal to achieve if critical action is not taken.

Image credit: Nigeria Health Watch

Increased investment in population health – of which environmental health is an important component – ​​will ensure that citizens, especially vulnerable population groups, are more resilient to health risks. The health and socio-economic consequences of climate degradation are more acutely felt among these vulnerable populations, further aggravating the inequalities they already face in terms of access to health care and other basic social services.

A champion of UHC, while striving to strengthen the health system, should prioritize the implementation of existing policies that are already in place, for example compulsory state health insurance that will enable the access to health care for Nigerians, especially the poor, and mainstreaming policies that address the challenges of Nigerians. currently face environmental risks and a deteriorating healthcare system.

Image credit: Nigeria Health Watch

The most inequitable aspect of climate deterioration is that the most vulnerable populations are often hardest hit by floods, droughts, land degradation and desertification. These vulnerable groups of people in low-income communities are also the least able to protect themselves and their families against it. These kinds of glaring inequalities run counter to everything that the concept of universal health coverage stands for. Thus, making progress towards UHC also means taking deliberate steps to close the gaps caused by the deteriorating climate.

How to integrate environmental health into universal health coverage
The Nigerian UHC Champion can mainstream environmental health into UHC by working with other key stakeholders to increase awareness of the impacts of climate change and ensuring that there is greater consideration for a climate transition towards a low carbon economy in Nigeria. Policymakers must strive to achieve evidence-based climate adaptation that protects health and prioritizes a climate-resilient health system.

In terms of prevention, environmental health must be addressed in the service-oriented nature of UHC. At the service delivery level, human resources for health can be strengthened to deploy counseling and behavior change models, where environmental health factors such as exposure to contaminated air and water can be avoided. Educating communities about these environmental exposures is paramount to successfully protecting their health.

The goals of climate action and UHC are similar: ensuring equity without exception, mitigating health risks, and enabling everyone to lead healthier lives free from financial hardship.

So, we ask, who will be the next UHC champion of Nigeria? Perhaps, as Professor Tanimola Akande aptly put it to our UHC Dialogue 2017We don’t necessarily need just one #UniversalHealthCoverage champion. We could have multiple local champions advocating for UHC.” As Nigeria rushes into an election year and today as we join countries all over the world to mark World Health Day, perhaps we can all be champions of UHC, advocating for stronger health systems and a healthier planet.

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