The precipitous surge in non-communicable diseases (NCDs) (cardiovascular diseases, cancer, diabetes and chronic respiratory diseases) in Nigeria is highlighting the pathetic state of our healthcare system. Nigeria’s health institutions have failed miserably, such that any tangible repair is expected to take quite some time. The rotten state of affairs, and the urgent need to refurbish physical, preventive, curative, rehabilitative, diagnostic and research infrastructure is widely recognized.

To strengthen Nigeria’s capacity to respond to the growing threat of NCDs however, certain fundamentals need to be addressed. First, is the alarming exodus of Nigerian trained doctors to foreign Countries. Few weeks ago, a Professor related his difficulty in seeing a medical doctor for a routine physical examination.
According to him, it took him a full year to secure an appointment to see a medical doctor at a top government hospital in Ibadan. Now, this is a Professor; an educated, privileged member of the society. Considering his experience, what are the odds that poor Nigerians can access good medical care in reputable hospitals? Due to the general poor sanitation of hospitals, tiresome queues, daunting paperwork, overall gruesome administrative procedures and costs, many Nigerians are discouraged to go to the hospitals except in the case of emergencies.

It is however, common to get to Nigerian hospitals in the case of an emergency and find that, for whatever reasons, there are no doctors available. It is important to highlight that for many non-communicable diseases, prompt diagnosis and early treatment is critical for survival/full recuperation. If you cannot see a medical doctor promptly, what are the chances of receiving treatment, timely recovery and getting on with life? There are at least 25 medical schools in Nigeria, some of which graduate over 60 doctors, yearly. Somehow, despite such throughput, Nigerians have no convenient access to professional and affordable medical care.

The second but equally important issue is medical quackery. Organized and non-organized quackery is rife in many parts of the Country. While many private outfits provide impressive health care services, their medical practices are largely unregulated and so, many others for a wide variety of reasons, are a dangerous bane to the Country. Individuals ranging from well trained nurses to auxiliaries and other unlicensed practitioners deliver babies, (mis)manage chronic diseases such as high blood pressure, diabetes and so on in their homes or shops, many times resulting in fatal complications and death. These egregious practices are a direct
consequence of the general shortage of doctors and other qualified healthcare professionals, as well as a sad reflection of just how bad things have gotten.
If we choose to be serious, Nigeria has the capacity to develop appropriate standards and schemes to mitigate these challenges. Obviously, medical intellectual drain has to stop. More political and professional efforts should hence, go into retaining Nigerian doctors. First, many more doctors should be employed by general hospitals. If available public hospitals are already fully staffed, we can build more hospitals. This is not as financially and logistically complicated as many hospital administrators, health directors, political leaders, policy makers and other relevant authorities make it seem. Secondly, doctors’ remuneration should be improved and further financial and professional incentives provided to motivate doctors. It is
imperative to ensure proper postgraduate training to effectively squash the need for young doctors to seek better professional training abroad. By many accounts, the residency program in many Nigerian teaching hospitals is thoroughly flawed, yielding frustrating results on all fronts. Specialists should focus on reforming medical postgraduate training systematically and institutionally. Also, it is necessary to create conducive working conditions for doctors, and this can be achieved by boosting infrastructure and creating overall conditions that let doctors treat patients more effectively.

To tackle quackery, it is important to ensure affordable quality healthcare at all levels, provide routine support for well-trained health workers in remote areas and enlighten Nigerians about the dangers of exposure to sub-standard medical care. Improved surveillance to identify defaulters and conscientious implementation of appropriate sanctions when necessary is another important approach. Enforcement of professional ethical statutes and efficient regulation of medical practice to prevent negligence and malpractices in whatever form is extremely important.
We need sustainable, cost-effective, culturally sensitive and evidence based interventions. It is therefore, necessary to boost research into the general causes, risk factors, management and prevention of chronic diseases in Nigeria. Strategic and effectively implemented funding for medical and pharmaceutical innovation is necessary. Due to variations in genetic predispositions, diet, socio-economic, lifestyle and environmental factors, it is imprudent to transfer knowledge from advanced nations. It is also necessary to generate data on the economic and social implications of the rising incidence of NCDs across all socio-economic
groups in Nigeria. The output of such endeavors should inform the design of a national framework for the prevention and control of NCDs. The most important targets to develop long-term stamina against the health, economic and developmental impact of NCDs, are to strengthen the country’s healthcare system, generate useful local data for medical practice, and empower citizens- by creating awareness and making research output public to inspire behavioral changes that can yield health benefits. Subsequently, we could develop multi- stakeholder partnerships regionally and internationally to consolidate our defense against the
scourge of NCDs.