Wednesday, 12 June 2013

INDIA-NIGERIA: REKINDLING AN OPPORTUNITY FOR SHARED GROWTH THROUGH PARTNERSHIP IN HEALTHCARE DELIVERY

Columnist: Daniel Chimezie

INTRODUCTION
As diverse as human cultures and beliefs are, it is justifiable to say that all humanity derives from one source of life. Most religions believe that man emanated from a creator, so it could be argued that all human beings and cultures came out of an original family. Thus, despite the seemingly differences among countries and cultures, there are still broad areas of similarities.
THE INDIA-AFRICA CONNECTION
A lot of similarities also exist between India and Africa. According to a publication in the Trinidad and Tobago Guardian Newspaper (April 15, 2011), the African continent is separated from the sub-continent of India only by the Indian Ocean. The publication argues that before the invention of modern navigational ships and equipment, there has been exchange of people and ideas between Africa and India. These shared experiences between India and Africa form enough justification for co-operation between them to overcome the challenges of development in both parts of the World.
THE INDIA-NIGERIA CONNECTION
The Nigerian-Indian experience is an extension of the Indian-African experience. There are many things that are common between India and Nigeria. Apart from the shared diverse cultural heritage, India represents the biggest democracy in the World while Nigeria is the biggest democracy in Africa. The Fact sheet on bilateral cooperation provided by the High Commission of India in Nigeria indicates that similarities in colonial struggle against the British, large multi-ethnic, multi-religious and developing societies have created bilateral affinity. The factsheet also indicates that both Nigeria and India share common perspectives on international political, social and development issues. India-Nigeria’s relation cuts across the political, economic and cultural divide. The Fact sheet also shows that in recent years, Nigeria has been one of the main sources of crude for India providing 8% to 12% of India’s crude requirements thereby playing an important role in Indian energy security. Nigeria remains the largest trading partner of India in Africa while providing the largest market in Africa for Indian exports. In 2011-2012, bilateral annual trade turnover was over US $17.3 billion registering an impressive growth of over 34%.  
The factsheet also indicates that India has huge investments in Nigeria’s upstream sector with multiple investments in telecommunications, pharmaceuticals, steel and power transmission sectors and other strategic sectors.
BEYOND THE FIGURES
Figures aside, evidence abound of a long-term healthy relationship between India and Nigeria. I have a first-hand experience. When I became the Editor-in-Chief of the Nigerian Economics Students Association (NESA), University of Benin Chapter, I was saddled with the responsibility of producing the ‘Economist’ magazine, an annual publication of the Association. As I was going through past editions of the magazine, I found in the oldest edition I could trace (published in 1983), that about half of the Lecturers in the department as at that time were Indians. This at least means that Indians have contributed to the Nigerian educational system and serves as an evidence of a relationship that has endured.   
ROOM FOR EXPANSION: EXPLORING OPPORTUNITIES IN HEALTHCARE DELIVERY.
However, there is room for expansion on existing partnership between India and Nigeria. One area of partnership that India and Nigeria need to exploit further is the area of healthcare. This is because of the critical importance of health in driving productivity and national development. Issues concerning health have always captured global attention with health issues including the reduction of child mortality, improving maternal health and combating HIV/AIDS, malaria and other diseases forming the core agenda in the Millennium Development Goals (MDGs). Although, Nigeria and India share similar historical experiences in the challenges of healthcare, it is worthy to note that India has made more appreciable progress in this regard.
INDIA’S EXPLOITS IN HEALTHCARE DELIVERY.
India has developed a healthcare system that is self-sustaining and which presents a lesson to other countries of the World. According to the Economist (April 16, 2009), Indian entrepreneurs are channeling the country’s rich technological and medical talent towards frugal approaches that have much to teach the rich World’s bloated healthcare system. The Indian healthcare system remains a major revenue earner to India through high-end tourism. India’s spectacular performance in the area of healthcare could be attributed to an efficient private sector healthcare system existing side by side with a public healthcare system with private providers which include qualified and alternative private practitioners accounting for about 80% of all healthcare delivered in India(Lath, n.d).
THE NIGERIAN UGLY EXPERIENCE IN HEALTHCARE DELIVERY
The Nigerian experience is quite a contrast to the Indian healthcare system. Healthcare delivery in Nigeria is still faced with problems of quality of healthcare and the problems of accessibility to healthcare. According to Professor Peter Nwangwu(n.d), the problems of quality of healthcare in Nigeria include the thorny issue of adequacy of healthcare facilities and systems, including healthcare policies at medical centers, adequacy of standard operating procedures at these centres, adequacy of the level and scope of care provided by physicians and nurses in light of current knowledge and accepted standards of medical practice in current world medical literature. He also identified the problem of accessibility to include the evaluation of the adequacy of the numbers of healthcare facilities and the proper distribution of these facilities to allow easy and immediate access to a medical facility for every patient who needs one, the affordability, and therefore the accessibility of quality healthcare to all patients. After spending trillions of naira through the Nigeria’s MDGs office, the Millennium Development Goals Report (2010) for Nigeria still indicates that the proportion of births attended by a skilled health worker stands at only 38.9%. 
Because of the challenges facing the healthcare system of Nigeria, the country faces a huge dilemma. The dilemma derives from the fact that Nigeria spends about $500 million annually on medical tourism abroad (Thisday, October 23, 2012). This poses a question on the reliability of the Nigerian healthcare system. The bigger question is that the medical tourism is undertaken by public officials who should put in place an efficient healthcare system for the country. The fact that these public officials can easily seek quality healthcare abroad (leaving the masses at home with an under-performing healthcare system) provides an incentive for these officials to run down Nigeria’s healthcare system through corrupt practices including the diversion of resources budgeted for healthcare delivery to private use.
THE BASIS FOR PARTNERSHIP: A PROPOSAL FOR A PRIVATE-SECTOR LED HEALTHCARE PARTNERSHIP BETWEEN NIGERIA AND INDIA.
The fact that India has made appreciable progress in quality healthcare service delivery therefore provides a basis for partnership with Nigeria (whose healthcare service delivery remains inefficient). As a Student of Economics, the case I make here is largely economic in nature. The Indian example could be replicated in Nigeria by encouraging Indian entrepreneurs to invest massively (with the support of Nigeria’s financial markets) in the provision of quality, affordable and accessible healthcare services. This should be facilitated through the existing India/Nigeria Bi-National Commission. The initial phase of the healthcare investment projects would be the establishment of a model Indian hospital in each of the 36 states of the Nigerian federation and a latter phase would be the establishment of primary healthcare centres in the 774 Local Government Areas (LGAs) of the country. While the Indian investors would provide the investment finance for the establishment of the healthcare facilities, the Nigerian government (at the federal, state and local government levels) would be saddled with the task of providing the enabling environment for these investments to thrive.
Specifically, the Nigeria’s ministry of Trade and Investment, her Indian counterpart and the Indian High Commission in Nigeria are expected to collaborate to ensure that all artificial hurdles that would inhibit the take-off of these healthcare investment projects are taken care of. The Nigerian government is also expected to grant tax concessions at the early stage of development of these healthcare projects until they grow to maturity.
INDIA/NIGERIA: OPPORTUNITY FOR SHARED GROWTH
Such investment in the Nigerian healthcare system provides opportunities for mutual benefit for both countries. While Nigeria would have been able to solve the problems of quality and accessibility of healthcare services and deliver fuller lives to Nigerians, returns from such investments would be repatriated to India to add more value to the Indian economy. Alternatively, such returns could be re-invested across Africa in order to reposition India to play a more formidable role in the global economy as an emerging World power. This would also strengthen the existing India-Nigeria’s relations and by extension, the India-Africa relations.
CONCLUSION
It is important that the youths are integrated into this proposed partnership to ensure sustainability into the future. When India partners with Nigeria in replicating India’s efficient healthcare system in Nigeria, it would provide opportunities for shared growth between the two countries and improve the lot of humanity in general.
Daniel Chimezie is a final year student of Economics and Statistics at the University of Benin.