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Tackling forex shortages, medical tourism with healthcare investments 

The $1.5 billion annual spending on medical tourism  has become a major concern to economic managers. The expectation is that a well equipped healthcare sector will reduce the number of people seeking medical care abroad and cut dollar spendings on medical tourism. But that requires massive investments in the healthcare sector which the Nigerian Sovereign Investment Authority has stepped in to undertake through the Healthcare Development and Investment Company (NHDIC). The agency’s  projects have elevated the quality of domestic healthcare services to international standards to discourage medical tourism and grow economy

Key issues that have dominated the Nigeria’s economic landscape in the last decade include how to address lingering foreign exchange shortages and halt medical tourism spendings estimated at $1.5 billion annually.  

As these concerns raged, the Central Bank of Nigeria (CBN), International Monetary Fund (IMF), World Bank and other multilateral institutions have consistently advised economic managers on best approaches to tackle them.

While the CBN under Godwin Emefiele’s leadership  advocates supporting the fundamentals of the Nigerian economy through diversification from oil to non-oil sectors, the IMF and World Bank seek halt to capital controls to attract foreign capital investments.  

The Nigerian Sovereign Investment Authority (NSIA) sees investments in critical sectors of the economy, especially healthcare sector as prerequisite to halting medical tourism spendings, step needed conserving forex and supporting domestic economy. 

Obviously, the Nigeria’s healthcare infrastructure has since independence, been underdeveloped with shortage of medical personels and dilapidated facilities. 

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.

With these challenges,  Nigerians with health challenges now travel 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 decision have been far-reaching.

The NSIA’s approach was to consider the healthcare 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.

Managing Director and Chief Executive Officer, NSIA Aminu Umar-Sadiq 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.”

He said NSIA invested $22 million 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.

Umar-Sadiq said 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.

The 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.

In 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  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.

The NSIA also 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,” NSIA said.

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.

Umar-Sadiq 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 by providing bespoke leasing solutions to medical facilities by entering into strategic partnerships with original equipment manufacturers.

He said the Equilease will also 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.

On 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 on the development, Governor of Enugu State, Ifeanyi Ugwuanyi,  said 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.

“With this, Enugu State will be one of the few states equipped with world-class healthcare infrastructure and amenities,” he said.

NSIA Non-Executive Director, 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.

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.

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