Monday, August 10, 2009

Madam Turai Yar'Adua Cancer Centre Naira Rain

It was “naira rain” about three weeks ago at the launching of the International Cancer Centre Abuja (ICCA) by Nigeria’s First Lady, Hajia Turai Yar’Adua. The Cancer Centre is expected to provide services in the areas of cancer diagnosis, treatment and research. The proposed centre is also expected to have an initial capacity for 128 in-patient beds and 20 terminally ill patients.

According to media reports, over N10 bilion was raised at that fundraising. The highest donor was Aminu Dantata, who donated a whooping sum of N1.2 billion. Others included business mogul, Aliko Dangote who also donated the sum of N1 billion on behalf of the Dangote Foundation. Niger State Governor, Dr Mu’azu Babangida Aliyu who stood in for the Governors’ Forum, made a donation of N720 million, while 15 members of the National Assembly donated a total sum of N7.5 million amongst others.

There is no doubt that cancer is a serious public health problem in Nigeria, and regrettably, its management has not been satisfactory due largely to the adverse effects of unfavourable economic factors. This experience is similar to that in other African countries which have similar economic problems. But whilst the provision of cancer treatment facilities in Nigeria is not being questioned, the long term viability Hajia Turai’s pet project remains unclear.

When I read about the project launch, the first question on my mind was, I hope this would not be another failed pet project of a Nigerian First Lady. As we know, the track record of such pet projects is abysmal. We are now used to Nbillions donated to various pet projects at federal and state level without any commensurate result. In fact, the lifespan of such projects are only as long as the tenure of their promoters. Before, it was Maryam Babangida’s Better Life for Rural Dwellers, then came Mariam Abacha Family Support Programme, and Stella Obasanjo’s Child Care Trust. Despite the amount of donations showered on all these projects, I’m yet to see any infrastructure that has survived beyond the tenure of these women.

Personally, I think it is important to challenge the principle behind Hajia Turai’s project. Firstly, what is the purpose of this Cancer centre, when there are major hospitals, with cancer treating facilities that are grossly underfunded? It is on public record that there are only four active radiotherapy centers giving a ratio of one machine to about 30 million people, as against the recommended one per quarter million by the World Health Organisation. The available spectrum of anti-cancer drugs is also very limited and such drugs are not readily available. Imaging facilities for staging patients with cancer, such as computerized tomography (CT) and magnetic resonance imaging (MRI), are difficult to come by, and when available the cost of such studies puts them out of reach of the average citizen. So why can’t the N10 billion be channelled towards providing adequate facilities at existing public hospitals? Secondly, what is the purpose of locating such a centre in Abuja, a city with a population of just approximately two million? Research has shown that cancer is most prevalent in the low socio-economic class of the society. And these are the same people who cannot afford the cost of basic medical care. In a civilized society, efforts are made to locate health services within close proximity of the working class. Therefore we need to ask Hajia Turai, for whose benefit is the Cancer Centre in Abuja? Is it for the rich and affluent of Abuja or poor masses living in Lagos, Port Harcourt or Kano?

Thirdly, I’m also not sure on whose behalf the donations from the State Governors were made. Were they personal donations or from the state coffers? I want to believe it is the former rather than the latter. If it is from the state coffers, it raises serious questions about probity and accountability. It is ludicrous for any State Governor to make donations from the treasury to a project that lacks any financial governance. By the way, who is the First Lady accountable to? The office of the First Lay is not recognized in our constitution and therefore cannot have funds appropriated to it in the budget. Therefore, who monitors how taxpayers donated by state governors are spent? And now that N10 billion has been realized how can we be sure that the entire money will be spent? I will note that to date, Hajia Turai has not told us the actual cost of the Cancer Centre project, and she is sitting pretty with N10 billion – some of which are likely to be taxpayers’ money,

Fourthly, what will be governance/management structure of the Cancer Centre? Will it be managed privately or handed over the Federal Ministry of Health? How will centre be financially maintained in the longer term? How can we be sure that ‘world class’ Cancer Centre will not be another morgue in 10 years time?

There is no point in any First Lady raising Nbillions for project that is destined for doom from word go. Our First Ladies should instead use their influence to build institutions that will outlive individuals. The problem in our health sector is not lack of hospitals. If all the hospitals in Nigeria are adequately funded, we may probably not need a dedicated Cancer Centre.

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