‘We Must Address Primary Healthcare’—Osotimehin

Q: Health professionals in Nigeria, especially doctors and nurses, are fond of embarking on industrial actions. For example, the medical doctors in Lagos State just called off their strike. How do you hope to curtail the incessant industrial actions?
A: I think that most of that would be by dialogue. My colleagues in the profession are angry. They are angry with society and about the things we’ve been talking about- the environment they work in, the right sets of equipment, maintenance of those equipment, commodities flow, getting drugs when you need it. Plus the fact that they feel that they are under-remunerated, they should be given money and all that. And I think that by dialogue, a clear understanding of the workings of government would come to them. And I think that we would be able to make a difference in the way that we do things. I believe that every health professional in Nigeria wants to contribute, but we need to create the space for them to do that. And we need to continually work with them to improve the conditions of service, both in terms of material and non-material needs.

Q: Recently you said there was no swine flu in Nigeria. Are you still holding that point of view?
A: Yes, there is none as I speak because we have a surveillance system that tells us what is going on. The World Health Organisation,WHO, and us work in tandem. And we get updates on a daily basis. And we also have our own surveillance system in control. And we have laboratories where we can confirm it. So we are comfortable. We don’t have Swine Flu. We have mounted a very good response. There is good public education. We have also gone out to sensitise commissioners for Health and health workers in all states and local governments. We have drugs, if we have an outbreak. And we are ahead of the cause.

Q: The rate of prevalence of tuberculosis HIV/AIDS is very high in Nigeria. What are you doing to reduce it?
A: We’ve sent in our TB programme. And I believe that what we have done will actually reposition our response to TB. Something else that I have done since I have been here is to now look at the synergy between TB and HIV and how we can use resources that come from TB, HIV and malaria in a synergistic way so that we can actually do better. So we can leverage the resources, we can make them work better for us and we can do things easily.

Q: Maternal mortality rate is very high in Nigeria. In fact, Nigeria has the third highest maternal mortality rate in the world. How are you going to change that?
A: Some of the things are what my colleague (the Minister of State for Health) has been talking about.We are arranging a response and we are collaborating now–the ministry of health, the ministry of women affairs and an agency in the ministry of health–to work out a system of ensuring that we can address the issues of maternal mortality. Now when we look at maternal mortality, what are the things that cause mortality? It is bleeding, infection, blood pressure in pregnancy. Those are the three major things. Now if we can get blood to patients quickly we can reduce mortality. If we can treat infections quickly, we can reduce mortality. If you then ask patients to attend ante-natal clinic regularly, then you can detect blood pressure and at the same time you can manage it well. So that is what we are trying to do. And we have a midwifery scheme that we are trying to develop to get midwives to various parts of Nigeria where in fact there is no skilled person; to get midwives who work in communities. They would be able to mobilise the pregnant women, they would be able to ensure that these things don’t happen. Overriding for me is public education. People must know, they must know that all these are so easily preventable. And I believe that if we work with communities and the state and local government, we would make a difference.

Q: What fond memories do you have of your days in NACA?
A: My fond memories are in those days I would sit like this and it would be 11:00pm. We were just at work. We were doing our work. It was just fun for me. Also when you do things and it appears as if it is working, you get a response from the public. Several places I go and people stop me and say NACA, that tells me we are getting through. It took us a while, but I think the fact that we were able to do something for the Nigerian public, which was appreciated, gives me so much joy.

Q: Was there anything you should have done that you now feel you didn’t do?
A: Yes, we couldn’t have done it all. Maybe seeing through the legislation that protects those who are living with the virus against discrimination. I would have loved to see that. But that I didn’t do.

Q: Propping up every successful man, they say, is a woman. Now talking about your wife, how did you meet her?
A: I met my wife in the university.

Q: How does she feel when you tend to overwork?
A: My wife is a jewel in that sense. She understands that what makes a man is his work. There was never a time we quarrelled about my work. She supports me when it comes to my work. So I have that confidence that if it is about work, then I don’t have any issues.

Q: How do you relax?
A: I take long walks and I read. I was to take up golf  but I think I would start in June.

Q: Why did you study medicine?
A: I can’t remember ever in my life thinking of anything else from when I was young. Even when I was in school, I was not doing well and it was clear to everybody that I might not become a doctor. Everybody used to make fun of me. But I said I would get there. And I did. But my father was my major backbone who just stood and ensured that I didn’t veer off and I was able to deliver.

Q: Traditional medicine practitioners always lay claims to their ability to cure supposedly incurable diseases like HIV/AIDs and Diabetes. What is your take on that?
A: My take is that since that claim has been made we should allow people to vet. I believe that in our roots and herbs there are many active ingredients which we might not even know in orthodox medicine. What we encourage them to do, though, is to ensure that they make available these herbs and allow stringent logical testing to take place so that we can identify what is the active ingredient. We can then tell how much of what you need to take. And we can also discard the part of it which might be injurious to patients. What we use now in malaria, artemisinin, is derived from a herb. So a good number of drugs that we use in medicine are derived from herbs.