The outbreak of coronavirus disease (COVID-19) has been declared a Public Health Emergency of International Concern (PHEIC). It is no longer news that the virus has spread across countries and territories. While the virus that causes COVID-19 has now been recognised as “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)” and is transmitted through direct contact with respiratory droplets of an infected person (generated through coughing and sneezing). Individuals can also be infected by touching surfaces contaminated with the virus and touching their face (e.g., eyes, nose, mouth). While COVID-19 continues to spread, communities must take action to prevent further transmission, reduce the impacts of the outbreak, and support control measures. Africa is not immune from the ravaging pandemic of COVID-19. According to our world in data, the current statistics of 255,000 cases, 3,142 deaths, and 249,139 recovered instances have been recorded in Nigeria and account for 3.02% and 1.85% of Africa’s cumulative confirmed cases and deaths, 0.06% and 0.05% of global causes and deaths respectively.
The Covid-19 pandemic, which has ravaged economies the world over, still remains an imminent threat to the most populous black nation on earth; induced shocks to the Nigerian economy precipitated significant hardship in the country where 83 million people were already living below the poverty line (<$2/day) in the pre coronavirus era. The country’s National Bureau of Statistics, NBS, announced that 27% of Nigeria’s labour force was unemployed as of the second quarter of 2020 which rose to 33% in the fourth quarter of 2020. Nigeria’s oil-dependent economy was also hit hard by the reduction in global oil demand, with two consecutive GDP contractions of -6.1% in Q2 2020 and -3.6% in Q3 2020, plunging Africa’s largest country into recession. In 2021, the Nigerian economy began to improve, with GDP rising to 5% in Q2 2021 and 4% in Q3 2021 compared to GDP in 2020.
Considering the ravaging effect of COVID-19, the government across federal and state levels has been forced to make emergency funds available, alongside domestic and foreign donations in cash and in-kind. Based on our experiences, we believe that if emergency funds and gifts are not correctly tracked and accounted for, even amid this pandemic, these funds and donations could still be misappropriated, embezzled, and diverted into private coffers without any tangible impact and benefits.
We have seen concerns from citizens, civil society, multi-stakeholders, and global partners on the need for Nigeria to embed transparency and accountability in using COVID-19 funds. The work of BudgIT under the COVID-19 Civic and Institutional Accountability activities in Nigeria; funded by the Open Society Foundation for West Africa (OSIWA), has been focused on the need for an accountable society and opening up conversations to create sustainable systems for transparency and accountability, especially in times of medical emergencies.
In this note, we will touch on our work to build public sector accountability and the management of COVID-19 funds and resources in Nigeria.
What are the issues?
In the last ten months, BudgIT has engaged with the public sector with the mind of inquiring about public funds received by both the state and the federal government of Nigeria. In our work, we discovered that many states across the country didn’t prioritize an accountability framework that could be used to track funds received. Since it’s essential to keep track of what was received, we created our platform, www.civichive.org/covidtracka, to track what funds were coming into the states as both cash and in-kind donations. The end goal we had in mind was to stay ahead of the inconsistency and mismanagement of these resources, which is always peculiar to the country’s public sector. Knowing the mismanagement that trails public funds in Nigeria, we made it a point of duty to ensure we advocate for more robust systems of transparency and accountability for COVID-19 funds.
At the moment, it’s safe to say that our efforts were primarily frustrated by some state governments and some arms of the federal government. During our work curating resources towards COVID-19 expenses from six states; Lagos, Ogun, Niger, Enugu, Rivers, and Kano- only two states responded to our call; Lagos and Niger states. While we understood most states didn’t have the proper breakdown of how much was received and spent, we still needed to know if the resources were utilized to get the appropriate value for money.
In our findings, we also saw that most of the resources were converted to private use and some for political purposes due to proper record keeping. Suppose we are to rate the state of accountability around COVID-19 funds in the states across Nigeria. In that case, we will place
them poorly, and this also stems from the fact that most state governments were able to get away with the mismanagement of the funds as the government provided no legislation to punish offenders. While the FG was quick to sign a six-month jail term for anyone who defaults the laws relating to social distancing and wearing of face masks across the country, it seemed that the resources available were free for all. As of the time of compiling this discussion note, the FG is yet to release the audited statement of the Presidential task Force for COVID-19 since inception. While this is not shocking, it shows that the drive for transparency and accountability around the resources is not taken as seriously as one would have thought.
As part of BudgIT’s effort to get the audited statements for the COVID-19 spending of the FG, a coalition group was formed in November 2021, which sole aim is to ask questions from the FG requesting the release of the breakdown of COVID-19 funds to the general public, till now, all we have got is radio silence from the government. While CSOs across the country keep calling on the National Assembly to release the details of the audited statements to the public, it seems we keep hitting roadblocks.
The opacity in the administration of COVID-19 Funds continues to remain a serious challenge; this is why the advocacy which gave birth to the Open Treasury and the NOCOPO platforms remains laudable as this gave access to know the types of materials purchased and to who payments were made to during the peak of the health care crisis.
The leaders’ body language in the public sector, both at the state and federal level, continues to send a message of hate towards the quest for transparency and accountability. It’s sad to note that the red and blue house leaders refused to release the content of the audited statements for COVID-19. While we are not a law enforcement agency, we will continue to lend our voice in advocating for the institutionalising of transparency and accountability even beyond COVID-19.
Who are the critical stakeholders?
It is essential to note the critical stakeholders in public health care; the health workers, schools, insurance companies, the government, and the patient themselves.
Early enough, in the course of the work done, we discovered the power of building coalitions, especially creating platforms for other civil society organisations with an interest in getting clarity to the expenditure of COVID-19 funds. Concerning this, we built partnerships with the law enforcement agency, specifically the Independent Corrupt Practices Commission (ICPC); this became important because while we advocate and point out issues with the mismanagement of COVID-19 funds and resources, we can’t make arrests.
While Civil society and the government sometimes do not agree on issues mainly regarding transparency and accountability, both parties must work together to create a framework that can help improve investment in health, thereby improving the quality of healthcare infrastructure. And making sure we are very well prepared for medical emergencies. We are also leveraging the Open Government Partnership to advocate implementing the existing national action plans for health.
There are different dimensions to national security: food security, economic security, cyber security, human security, health security, etc. None is more important than the other. However, nothing is more fundamental to a state’s security than the health of its people. If people are unhealthy, they can’t work, which means they can’t contribute to the economy. If they can’t contribute to the economy, the government can’t provide services and infrastructure, leaving the state or country vulnerable to natural and economic security threats.
According to the World Health Organisation (WHO), health security encompasses the “activities required minimising the danger and impact of acute public health events that endanger the collective health of populations living across geographical regions and international boundaries”. It is the responsibility of governments globally to protect the health of their populations.
In November 2018, the Federal Government of Nigeria developed a five-year costed National Action Plan for Health Security (NAPHS) as an approach to close identified gaps in health security to prevent, detect, and respond to public health threats. The NAPHS (2018 – 2022) provides a roadmap to improve health security in Nigeria; to be achieved through a multi-sectoral approach hinged on the principles of ‘One Health’ with significant participation from stakeholders from relevant government ministries, departments and agencies, and partners. These include the Office of the National Security Adviser and the Federal Ministries of Health, Agriculture and Rural Development, Environment, Mines and Steel Development, Finance, Budget, and National Planning, Defence, Transport, Science and Technology, Justice, and Information.
The NAPHS is a well-thought-out plan, and successful implementation will increase Nigeria’s capacity to protect its citizens from public health threats. The One Health approach it adopts decentralises health security, therefore making it everybody’s business, not just the responsibility of the Ministry of Health. The partnership with other government ministries and agencies, and partners who bring cross-disciplinary expertise is critical to the plan’s successful implementation.
However, there have been a few challenges in implementing the plan. In a workshop with NAPHS focal persons, titled “A Critical Review of NAPHS as an Effective Budgeting Tool for Epidemic Preparedness in Nigeria”, convened by Nigeria Health Watch in July 2020, some of the challenges affecting implementation were discussed. They included: no immediate availability of domestic funding for outbreak response at all levels, low budgetary allocation to health security, a weak commitment of the Ministries, Departments, and Agencies (MDAs) directly involved with implementing the NAPHS.
One key recommendation to improve the NAPHS was the need to engage with Heads of MDAs, the International Health Regulations (IHR) focal persons of each MDA, and other key decision-makers in budgetary allocations MDAs.
The COVID-19 pandemic has brought the need for stable and sustained funding for epidemic preparedness and response. A significant challenge in the implementation of the NAPHS is the limited availability of funding. To address this challenge, on Tuesday, April 27th, 2021, the Nigeria Centre for Disease Control (NCDC), the agency coordinating the implementation of the NAPHS, in partnership with the Federal Ministry of Finance, Budget and National Planning invited NAPHS technical leads and the budget officers from relevant MDAs to a workshop with the theme: An Intersection of Health Security and Health Financing. The workshop’s objectives were to improve the knowledge of NAPHS thematic leads on the national budgeting process, equip budget officers in need to mainstream budget for health securities in their annual budget and the necessary synergy between budget officers and the NAPHS technical leads in each MDA.
While defining the potential action points relevant for key stakeholders in the public sector, it is obvious that without synergy across all levels, it becomes challenging to implement plans by the government. therefore, it remains vital for the provision of the following:
1. Funds: This remains the most critical aspect for implementing any laid down plans; for the past five budget cycles, the FG has not been able to commit 15% of the total budget to take care of health in the country, as stated during the Abuja declaration. Lack of funds also posed a significant challenge to the implementation of NAPHS, a solid framework created by all public stakeholders to prepare the country in times of health crisis.
2. Punishment for waste: The law enforcement agencies need to promptly act on the reports and petitions submitted. This will help deter other public servants from engaging in such acts. What stolen funds do to the whole polity is reduce the availability of necessary funds meant for infrastructural and human capital development in the health sector.
3. Implementing laid down plans: Concerned stakeholders also need to be innovative in implementing laid down objectives, which will help record progress in the country’s health sector.
4. Very well thought-out framework: While studying NAPs and NAPHS, it’s noted that most times, the cost is not well spelt out at the beginning of the plan, then due to cost and unforeseen circumstances which could have been planned for at the start are not well factored into the strategies.
5. Pressure groups: Coalition groups consisting of government and civil society actors should be created. This group of people has to consistently place before them the government’s plans and provide solutions when the going gets tough.
Implementing these plans will boost synergy between the public sector and all relevant stakeholders.
Enforce the Fiscal Responsibility Act for audit disclosures: The Fiscal Responsibility Act “Enforcement” section, Part XII, Section 51, permits any citizen to enforce the law’s requirements after obtaining prerogative orders or other remedies from the Federal High Court. This action gets appropriate authorities to disclose audited reports (including COVID-19 spending and the NASS’s concealment audit of N36.3 billion COVID-19 funds) and provide audited reports within the statutory 6-month period following the fiscal year’s end.
The Federal gGvernment needs to swivel from its current budget implementation report model to one that shows quarterly cash releases to each line item allocated in the budget; this can also be made available via the open treasury portal, NOCOPO or the COVID-19 Resource Tracking Dashboard for relevant expenditure.
Having access to information is critical. Governments, donor agencies, and civil society organisations should disclose real-time, locally relevant, and openly accessible information on all aspects of COVID-19, including its spread, treatment, the fund received and spending. Stakeholders should collaborate more, ensuring stakeholder groups complement one another, resulting in increased efficiency, reduced time, and more transparency. Information sharing is one method of fostering collaboration.