Nigerian Government to Exclude People With HIV/AIDS from National Health Insurance Plan
The Nigerian government has drafted a plan for a national health insurance program that would eventually provide coverage for "all Nigerians," but certain individuals with "[h]igh-cost illnesses" such as HIV/AIDS would not be eligible to join, the Lancet reports. The National Health Insurance Scheme aims to expand health coverage to Nigerians by implementing a national program that would use the payments of wealthier members to pay for care for low-income residents. Under the plan, enrollees would contribute 5% of their basic salary every month while employers would contribute 10%. The plan would extend coverage to an employee's spouse and up to four children under the age of 18, and all plan participants would receive identification cards. The Lancet reports that this system would "pool resources" and allow for "cross subsidization in the health sector." However, individuals with diseases such as HIV/AIDS and cancer will not be eligible to participate in the plan.
Treading Cautiously
Mustapha Sambo, executive secretary of the NHIS, said that the "cost of treating these illnesses could wipe out everything that has been collected." Anne Okigbo, a health specialist at the World Bank office in Abuja, Nigeria, stated that the insurance plan is not aimed at "stigmatiz[ing]" people with "terminal or debilitating diseases," but added that the country needs to "tread cautiously" in developing the plan. The Lancet reports that "if Nigeria allows a heavy burden to be placed on the scheme, it would run into a gridlock." Ibironke Akinsete, chair of the Nigerian Action Committee on AIDS, said that the group is "not happy" that individuals with HIV/AIDS will be excluded from the plan and plans to hold a workshop in Abuja to discuss policy issues affecting people with HIV/AIDS in Nigeria. The Lancet reports that the NHIS will be implemented in "phases," and Okigbo added that the system is still "evolving," noting that other health insurance plans "had only just started to provide cover[age] for people with HIV/AIDS." Although the NHIS was scheduled to be launched last month, it will now likely begin "about the end of the year," NHIS spokesperson Aisha Zakari said (Okonkwo, Lancet, 7/14).
