Lagos — Nigeria's health sector may soon witness another round of crisis that may put a peg on efforts by the Federal government to advance its health policy as the Nigerian Medical Association (NMA) has sounded another of warning against appointing a non-professional as minister.

Fearing that Prof. Dora Akunyili may be appointed to head the ministry, the NMA said it is waiting for allocation of offices to the ministers before taking up its next line of action.

Speaking in a statement made available to journalists in Abuja last weekend, the NMA said so far, it has not seen any thorough-bred medical professional with deep clinical experience on the list submitted to the senate.

It expressed fears that a neophyte may be appointed to head the ministry which it said demands high level professionalism and know-how.

In the statement signed by its President, Dr. Prosper Igboeli and Secretary General, Kenneth Okoro, the association said: "We once again reiterate that the most appropriate health professional to lead the Federal Ministry of Health is a patriotic medical practitioner with integrity, sound administrative acumen, rich clinical experience and untainted record of service. It is only such a medical practitioner that is imbued with all the knowledge required to head the health team."

NMA's warning comes against insinuations that Prof. Akunyili may head the health ministry as the former Information and Communications minister has her background in pharmacy.

Though the association expressed hope that Acting President Goodluck Jonathan would not work to upstage the health sector, it reminded that "in this critical period, we need a health minister; who will fast-track the current improvement in our health indices with improved immunization coverage, commendable reduction in the transmission of wild polio virus cases and mobilization of resources to combat malaria and maternal mortality among other areas."

The NMA however called on its members to remain calm and await the outcome of the ministerial screen at the senate which begins today noting that Jonathan will not turn his back on the profession at this critical time.

"Our members are therefore enjoined to remain calm as we believe that the Acting President has due regard for medical doctors and will certainly carry them along," the statement further read.

Expressing hope that Jonathan "will neither marginalize the members of the medical profession nor ignore their patriotic contributions to nation-building," the NMA however noted that "it is curious that in the list of 32 nominees, there is no medical practitioner."

NMA's statement confirms widely held views in the health sector that clinical practitioners are not comfortable with having a pharmacist, whom they consider of lower grade and value, to head the ministry.

A recently reported statement credited to the leadership of the Nigerian Medical Association (NMA), regarding the criteria for the incoming Minister of health, if correct, is unfortunate, uninformed, ignorant and self serving. An excerpt of the published statement states that "… the most appropriate health professional to lead the Federal Ministry of Health is a patriotic medical practitioner with integrity, sound administrative acumen, rich clinical experience and untainted record of service. It is only such a medical practitioner that is imbued with all the knowledge required to head the health team”.
The NMA could have done us a favor by providing empirical evidence substantiating this claim, otherwise this statement is so old thinking, not helpful and may be considered an underhanded pre-emptive attack against Prof. Dora Akunyili. In the USA whose political system we adopted, Health Ministers/Secretaries are not required to be medical doctors. The recent United States Health Ministers/Secretaries, namely Donna Shalala (Bill Clinton’s administration), Tommy Thompson (GW Bush’s administrations) and Kathleen Sebelius (Barack Obama’s administration) are neither medical doctors nor healthcare practitioners. They were never disparaged by the American Medical Association or other healthcare trade associations either. They performed very well which is what matters, and had enduring accomplishments: Children Health Insurance Program (Donna Shalala), Medicare Reform and HIV/AIDs initiatives (Tommy Thompson), Healthcare Reform (Kathleen Sebelius). This is more than one can say for Nigeria’s recent health ministers, most of whom were medical doctors.

Contrary to NMAs omnipotent assertion, no one profession is “imbued with all the knowledge.” Developed economies have embraced a multi-disciplinary team approach to patient/health care delivery, to maximize patients’ outcomes.

Patient Care/Healthcare delivery is getting more complex and sophisticated - medicine is transitioning from population medicine to personalized/pharmacogenomics medicine. This reality must be embraced by NMA, or risk becoming irrelevant.

While I have no confidence in our current political dynamics and who it decides to appoint to what, I want to make it clear that one criterion we do not need in a ministerial appointee, let alone the health ministry, is “a know-it-all”. With the exception of the Attorney General’s position (the nations lawyer), where professional qualification is required in addition, the essential criteria for all ministerial positions should be; a solid academic accomplishment, experience, commitment, courage, and a track record of innovation and accountability.

The NMA is an age-old organization of noble medical professionals, with enormous potentials to reshape and rebuild our healthcare system and hold our elected officials who fly out abroad for every minor ailment accountable. The NMA appears to be missing in action or afflicted with aphonia, except when advocating for her narrow selfish interests, such as fighting for their remuneration or against other healthcare professionals for turf, status or matters of personal interests. NMA must advocate for the NIGERIAN patients.

As one from a family of mostly healthcare practitioners, comprising Physicians, Nurses, Pharmacists and healthcare scientists, I can vouch that Nigeria has in her midst, the smartest doctors anywhere in the world. They deserve better than the sub-standard and simplistic representation offered by the current NMA leadership. Mediocrity and intellectual malaise afflicting Nigeria’s leadership must not be allowed to settle in the NMA.