PPPs and health financing central themes of Nigerian healthcare seminar

IFC, the Netherlands Embassy in Nigeria, the Task Force Healthcare and PharmAccess hosted a healthcare seminar in Lagos on the occasion of a Dutch trade mission to Nigeria and Ghana. As head of the trade mission, Minister for Foreign Trade and Development Lilianne Ploumen opened the seminar on Wednesday June 18th. Themed ‘Healthcare developments, collaborations and health financing in Nigeria,’ the event focused on topics such as the value of public-private partnerships in health and financing of health projects.

The invitation only seminar on Wednesday was attended by about 30 Nigerian stakeholders from the public and private sector such as Country Manager IFC in Nigeria Solomon Quaynor, chair of Hygeia Fola Laoye and Commissioners of Health Dr. Jide Idris (Lagos State) and Dr. Olaokun Soyinka (Ogun State). Being part of the Dutch trade mission to Nigeria and Ghana, the seminar was also attended by Lilianne Ploumen and members of the Dutch business delegation (consisting of 35 companies such as Delft Imaging, KIT, Cordaid, Medupof, Linet group, Brecon and TF Healthcare).

The program kicked off with keynote speeches from Dutch Ambassador to Nigeria John Groffen, Minister Ploumen, Guido Geerts, CEO of Delft Imaging and delegation leader of the Life Sciences & Health mission, and Solomon Quaynor. Geerts, mentioning the high population density in the Netherlands, explained why cooperation between the public and the private sector plays such an important role in his country’s foreign policy. Quaynor gave an overview of the World Bank Group’s activities in Nigeria and stressed the need to improve quality and efficiency of health services at a state level.

Minister Ploumen’s speech covered the Dutch approach to global health care challenges, with a focus on universal health coverage (UHC). She emphasized the importance of engaging and strengthening the private sector to achieve UHC, for example through public-private collaboration. She also expressed that she was extremely pleased and proud that the Dutch government had been able to be instrumental in funding the Kwara program as well as the development (through IFC and PharmAccess Consultancy) of the first hospital PPP in Nigeria, in Cross River State. While opening the health seminar organized by the Dutch Embassy in Accra, Ghana, the next day, she again reiterated PharmAccess’ expertise and track record in health insurance in various African countries.

Healthcare PPPs
The first panel discussion was on PPPs in the health sector. Olumide Okunola, Senior Operations Officer of the IFC, served as moderator of the panel, which consisted of Bayo Oyewole (IFC PPP Advisory services), Dr. Pamela Ajayi (Managing Director Pathcare Laboratories), Dr. Jide Idris (Honorable Commissioner for Health, Lagos State), Dr. Olaokun Soyinka (Honorable Commissioner for Health, Ogun State) and Alhaje Abdul Abdulsalam (replacing Dr. Kayode, Honorable Commissioner for Health, Kwara State).

The discussion was engaging and all panelists were quite frank about the complexity of PPPs, speaking on the fact that they should be seen as a means to an end and the fact that they come at a considerable cost for governments, since quality costs money. PPPs will not diminish the amount of money needed for health, but can help to make the budget more efficient. The Kwara Community Health Insurance Program, which aims to cover 600,000 people by 2018, was repeatedly mentioned as an example of the fact that government commitment is necessary in order for any PPP to be successful. Ajayi shared some examples from her experience on the challenges in terms of developing appropriate agreements, while Soyinka stressed the importance of PPPs and workable relationships between stakeholders. Panelists also addressed the difficulty of accessing capital for private partners.

Financing health projects
The second panel discussion was on financing health projects. Fola Laoye, chair of Hygeia, moderated the panel, which consisted of Nasiro Ikhara, Zonal Coordinator Lagos for NHIS, Monique Dolfing-Vogelenzang, COO of PharmAccess, Femi Akin Folarin, customer segments manager of First Bank and Dr. Kelechi Ohiri, Senior Technical Advisor to the Minister of Health.

Ohiri highlighted that an enabling environment is the key to unlocking the health sector’s potential and that several positive developments to this end are underway, such as the Federal Ministry of Health’s dedicated PPP desk and the recent establishment of the Healthcare Federation of Nigeria and the Private Sector Health Alliance. Dolfing-Vogelenzang stressed that while people often tend to focus on the demand side of the healthcare system, the supply side also deserves attention, especially when it comes to evaluating and improving quality at healthcare facilities.

The discussion then focused on the difficulty that healthcare providers have with accessing finance, the high risks for banks and the ‘different language’ spoken by doctors and bankers. Folarin, the representative from First Bank, heated up the discussion by stressing that, first and foremost, bankers are not out there to ‘save whales’ but are first and foremost in search of a return for their shareholders. Banks tend to perceive loan products for healthcare providers as a risky endeavor. In response to this point, Dolfing-Vogelenzang was able to explain the work of the Medical Credit Fund as one of the possible solutions for this challenge. Folarin concluded that, under Medical Credit Fund conditions, First Bank would be willing to take the risk of providing loans for healthcare providers.

The seminar was followed by a plenary session for all delegation members with Nigerian Minister Segun Aganga of Industry, Trade and Investment and Dutch Minister Ploumen.