NSIA: Addressing Medical Tourism, Conserving Forex For Nigeria Through Healthcare Intervention Programmes

Since independence, Nigeria’s healthcare infrastructure has been underdeveloped and this has remain a major challenge for the people and the government. Gleaning from the country’s healthcare indicators in the last three decades, one would still have reasons to be concerned as the healthcare indicators have not been too positive.

While Nigeria is blessed and have one of the fastest growing populations globally, with 5.5 live births per woman and a population growth rate of 3.2 percent annually, which in time will put the country’s population at 400 million people by 2050, the country is yet to fully establish strong systems to guarantee health security for its people.

For instance, Medical professionals in many specialized medical fields such as cardiology, oncology, nephrology, neurology, orthopedics, and many other areas are in short supply, with only about 35,000 doctors despite needing 237,000.

Nigeria also lacks manpower and skills in the healthcare sector. According to the World Health Organization, the situation, if left unaddressed, will worsen due to massive migration of healthcare workers overseas. As a result of all these, Nigeria loses at least $1.5bn every year to medical tourism, according to the Nigerian Medical Association (NMA). Of this figure, India accounts for more than half.

In essence, Nigerians with health challenges end up travelling to India, the Middle East, Europe, and other far-flung places to get care when they should receive treatment within the country. When this happens, patients also incur associated costs for logistics, accommodation, caregivers, and emotional support systems.

Worried by this development, the Nigeria Sovereign Investment Authority in 2018 took a bold step by setting up the NSIA Healthcare Development and Investment Company (NHDIC) to transform the domestic healthcare sector and elevate the quality of service to international standards. Five years since taking that step, the implications of this visionary decision have been far-reaching.

The NSIA’s approach was to consider the sector from both a social impact and commercial returns standpoint. The Authority hinged its strategy on co-locating NSIA healthcare centres of excellence within federal tertiary medical institutions.

This approach would enable the Authority provide equipment, operatorship, working capital and technical expertise while the designated partner institution would provide land, clinicians and expertise, and patient traffic.

Seeking to develop a blue ocean solution, the NSIA invested $22m in three-flagship projects and in so doing, created NSIA-LUTH Cancer Centre, Lagos, (NLCC), NSIA-Kano Diagnostic Centre, Kano, (NKDC), and NSIA-Umuahia Diagnostic Centre, Umuahia, (NUDC), concurrently.

Operational since 2019, the NLCC has treated over 7,000 patients to date. When it opened its doors, NLCC was the first to install a linear accelerator in Nigeria and today, remains the centre with the highest number of linear accelerators in West Africa.

The Centre is equipped with several top-of-the-line medical equipment including three linear accelerators, a brachytherapy system, a 1.5 Tesla MRI, a 128 slice CT scanner, a mammogram, digital X-rays, ultrasound scanners and laboratory pathology systems among others.

NKDC, Kano and NUDC, Umuahia provide comprehensive radio imaging and laboratory diagnostic services. The centres have recorded unprecedented success in terms of exponential growth in client patronage. To date, both centres have rendered diagnostic services to nearly 120,000 clients within just three years of operations.

All three centres have recorded excellent success commercially and delivered significant social impact for the benefit of Nigerians.

What was clear from operating these 3 centers, was that as long as the facilities needed to effectively diagnose are available and reasonably priced, then citizens and residents can diagnose ailments quickly, accurately and early enough to receive treatment and avoid untimely deaths.

This is why over the next five years, the NSIA will be building 23 new modern medical diagnostic centres, three Oncology centres, and six Catheterization Laboratories across the country’s six geopolitical zones.

In a bid to achieve this, the NSIA on Tuesday took over the management of the Enugu Diagnostic Centre, effectively making Enugu State to effectively joins Lagos, Kano and neighbouring Abia State where NSIA’s impactful healthcare projects are already saving lives and bringing succour to the people.

To effectively manage the healthcare facilities, the NSIA launched two of its flagship companies namely the NSIA Advanced Medical Service Ltd (MedServe) and Equilease Systems Limited (Equilease).

MedServe is being set up to serve as the vehicle to deliver NSIA’s healthcare expansion objectives.

Its goal is to provide high quality and affordable healthcare services and ensure equitable geographic access to these services across the country.

The company will develop, equip, and operate NSIA’s expanding portfolio of healthcare centres and offer first class medical services nationwide.

On the other hand, EquiLease is a specialized equipment leasing service provider. Conceived as a market disruptor, the company will provide medical equipment leasing services, leveraging its strategic advantage to catalyze investments in healthcare institutions and facilitating the acquisition of equipment to improve the quality of healthcare in Nigeria.

Equilease will partner with medical equipment manufacturers to offer innovative financing and leasing programs for advanced medical equipment.

At the onset, it will offer services exclusively to MedServe as an anchor client until the concept is proven.

The transfer of the Enugu State Medical Diagnostic Centre from the Enugu State Government to the Authority is part of the three-part event.

Following the transfer, the Centre will be rehabilitated and upgraded to deliver both Diagnostic and Oncology services covering automated laboratory services ranging from imaging to radiotherapy, chemotherapy, brachytherapy and much more.

The Centre will be managed and operated by MedServe while re-equipping will be delivered through the leasing services provided by EquiLease.

The complete overhaul of the Centre’s infrastructure will position the facility to meet the growing demand for quality healthcare services in the Eastern region of the country and beyond.

The official transfer is off the back of the agreements signed in September 2022 where both parties committed to it.

The handover of the facility signposts the commencement of NSIA’s healthcare expansion programme which will be executed in two phases.

Under the programme, the NSIA will develop 23 new modern medical diagnostic centres, three oncology centres, and seven catheterization laboratories across the country’s six geopolitical zones.

Delivering his remarks on the three-part event, Mr. Aminu Umar-Sadiq, the Managing Director and Chief Executive Officer, NSIA said “Over the past five years, we have built a strong and successful portfolio of healthcare service delivery centres.

“The transfer of the Enugu Centre for upgrade and rehabilitation is one of the steps in our journey towards making healthcare accessible and affordable for all Nigerians. The Centre is one of the 23 centres to be upgraded for Oncology and Diagnostic services.”

Speaking further he described MedServe and Equilease as transformative, market-disrupting entities that will deliver a unique set of connected solutions to bridge the gaps in Nigeria’s healthcare industry.

He added that the outcome from the creation of these entities is expected to strengthen the industry’s value chain and unclog the constraints created by insufficient financial investments, inadequate manpower capacity and substandard services.

He said, “NSIA also recognizes that a significant number of existing medical facilities and indeed care providers are unable to afford new equipment, in part on account of the high upfront costs and currency mismatch constraints. These centers therefore settle for inadequate equipment, or indeed none at all.

“To address these challenges, NSIA has also created a wholly owned company, called Equilease Systems, which will help to reduce the burden of equipment acquisition by qualified hospitals, medical facilities and care providers.

“Equilease will do this by providing bespoke leasing solutions to medical facilities by entering into strategic partnerships with original equipment manufacturers.

“To optimize the value proposition before making the offering available to third-parties, Equilease will launch its operations by first entering a leasing arrangement with MedServe for its required medical equipment, allowing Medserve focus on the operatorship and optimal utilization of its equipment. In addition to leasing, Equilease will also test the possibility of expanding its services to include in sourcing of operations and maintenance as well as other value-added services.

“Upon conclusion of the proof-of-concept period between EquiLease and Medserve, Equilease can then commence offering external clients a comprehensive leasing solution for their medical equipment needs, borrowing from all the key learnings of its proof-of-concept engagement with Medserve.

“So today, Enugu joins Lagos, Kano and neighbouring Abia State where NSIA’s impactful healthcare projects are already saving lives and bringing succour to the people. NSIA is excited at the prospect of playing a central role in improving the quality of medical services and expanding healthcare infrastructure across the country starting with Enugu, through Medserve and EquiLease.”

Speaking at the event, the Governor of Enugu State said the physical and mental well-being of the workforce in any state is a function of the quality of healthcare services available.

Ugwuanyi stressed that the journey to achieving the strategic partnership between the federal government through the NSIA and his administration was one of the deliberate, bold and courageous steps taken by his government to stem the tide of healthcare deficit in the state.

He stressed that the project would address the issues of capital flight, medical tourism and preventable deaths arising from the lack of diagnostic testing centres in part of the country.

The Governor said, “Healthcare inexorably determines the direction of the economy. The partnership with NSIA to transform this facility with the promise of significantly better equipment and services will go a long way towards contributing to healthcare security in the state.

“With this, our state will be one of the few states equipped with world-class healthcare infrastructure and amenities.”

Also speaking at the event, a Non-Executive Director at the NSIA, Dr. Ogechi Pascal-Ejiogu said the NSIA, in partnership with the Federal Ministry of Health, has signed a series of agreements to modernize and expand healthcare services through private sector participation.

Under these agreements, she explained that the NSIA is looking to developing the capacity of specialist hospitals and diagnostic centers to provide advanced medical services across the country under phase II of its healthcare expansion programme.

She stated that the Enugu State Diagnostic Centre will be the NSIA’s first in this phase.

According to her, “Our vision is to elevate the Centre to world-class status. We intend upgrading the centre using state-of-the-art equipment so that both patient and nearby hospitals are supported with accurate and timely medical results regarding health conditions.

“The centre will also provide oncology treatment. It will double as a cancer care centre for the south-east and south-south region.

“When we are done with the rehabilitation and re-equipping, it will be transformed into a full-service location for diagnostics and oncology.

“Under the auspices of His Excellency, Governor Ugwuanyi and the good people of Enugu State, we shall assume ownership of the Enugu State Diagnostic Centre and commence the process of retrofitting it into a world-class diagnostic centre, fitting for the people of Enugu and environs to receive first class service.

She noted that the NSIA board remains passionate and committed to addressing the gaps in Nigeria’s healthcare ecosystem and also to providing high quality medical services across the country.

“Our goal is to reverse medical tourism and simultaneously transform Nigeria into the Africa’s medical hub.

‘More importantly, we believe that access to quality medical services is a fundamental human right and all Nigerians deserve to have it,” she concluded.

The NSIA is an investment institution of the Federation set up to manage funds in excess of budgeted hydrocarbon revenues.

‘Its mission is to play a leading role in driving sustained economic development for the benefit of all Nigerians through building a savings base for the Nigerian people, enhancing the development of Nigeria’s infrastructure, and providing stabilization support in times of economic stress.

In his remarks, the Enugu State Governor-elect, Dr Peter Mbah, commended the efforts and partnership between the federal government and the administration of Governor Ifeanyi Ugwuanyi of Enugu State over the official handover of the state-of-the-art Enugu Diagnostic and Oncology Centre built by the state to aid quick and early diagnosis of diseases and for the treatment of cancer.

While describing the event as laudable and remarkable in the history of the state, the Governor-elect who was represented by the Deputy Governor-elect, Barr. Ifeanyi Ossai, said the centre would help to attend to the medical needs of not only the people of the state but the southeast zone and the country at large.