In January 2022, the delegates to the OBJ Weekend Strategy Retreat will come together, under the Duke of Shomolu’s dynamic leadership, on the fulcrum of OBJ’s strategic and influential engagements, to agree on the ambitious goal of national rebirth: “making Nigeria a competitive and dynamic developed economy, capable of sustainable economic growth with innovation, growing employment, greater social cohesion, and rising global ranking.” It is the inaugural Strategic Session on Leadership, Economy, and Polity with President Olusegun Obasanjo, GCFR.
There has been a suffocating need to create a knowledge-based economy and society, accelerating the process of structural reform for competitiveness and innovation; modernise the Nigerian social model for unity and progress, by investing in people and combating social exclusion; and sustain favorable growth prospects by means of an appropriate macroeconomic policy mix.
The retreat hopes to draw on OBJ’s vast experience in policy, international diplomacy, the economy, and his works on social impact and humanity.
The relationship between health and the economy should undoubtedly be one of the cornerstones of this agenda. Indeed, this relationship is complex. There is a sound theoretical and empirical basis for the argument that human capital contributes to economic growth. Meanwhile, health contributes to human capital through some channels: higher labour supply, higher productivity, improved skills as a result of education and training, and increased savings from health expenditure available for investment in physical and intellectual capital. Since human capital matters for economic outcomes and since health is an important component of human capital, health matters for economic outcomes as a key determinant for economic and social development.
The human capital theory further predicts that more educated individuals are more productive and obtain higher earnings. Good health in childhood enhances cognitive development and functions and reduces school absenteeism and early dropout rates. Hence, children with better health can be expected to attain higher educational levels and therefore be more productive human capital in the future.
In historical terms, there is a close relationship between improvements in a population’s state of health and economic development. Robert Fogel, who was awarded the Nobel Prize in economics in 1993, points out that since 1700, we have seen an unprecedented decline in mortality rates and historic economic growth in industrialized countries (Fogel, 1990, 2004). According to Fogel, the combination of two particular health effects—namely improving food and increasing the efficiency with which food energy is converted into productive labour—combined to improve labour productivity and drive other innovations—makes it possible to explain 50% of British economic growth since 1790.
I believe that the capacity to affect the economy and social models is rooted in the nature of health and the health system.
Health is considered a broad concept, containing several different aspects. Earlier, according to the World Health Organization (1948), health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
Later on, in 1984, WHO proposed moving away from viewing health as a state and toward a dynamic model of resilience that presented it as a process or a force. This revised definition states that health is “the extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment.” This captures the earlier definition by conveying the fact that to reach the state of complete physical, mental, and social well-being, an individual or group must be able to identify and realize aspirations, satisfy needs, and change or cope with the environment.
Indeed, health is a resource for living everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources as well as physical and psychological capacities. Health is a resource that allows people to realize their aspirations, satisfy their needs, and cope with the environment in order to live a long, productive, and fruitful life. Mental and social health referred to a person’s ability to handle stress, to acquire skills, and to maintain safe human interactions and relationships, all of which form resources for resiliency, interdependent living, and social stability.
I have yet to see the tell-tale signs that the impact of health on the economy and social development is a topical issue in our discussions on policies and governance. Meanwhile, the health industry plays an increasingly important role in the economy by generating a productive workforce and employment, thereby fostering social cohesion and, as a result, economic growth. For all members of the G20 countries, health constitutes a major sector of the economy; in many countries, it is the most important economy. To recall, the G20, or Group of Twenty, is an intergovernmental forum comprising 19 countries and the European Union (EU). It works to address major issues related to the global economy. The G20 is composed of most of the world’s largest economies, including both industrialized and developing nations, and accounts for around 90% of gross world product (GWP), 75–80% of international trade, two-thirds of the global population, and roughly half of the world’s land area.
It’s not rocket science that national health is indeed a foundation of economic success. No wonder our economy and social stature are malnourished and stunted in growth due to the starvation of healthy national health policies.
It has long been recognized that increased national wealth is associated with improved health, but it is only more recently that the evidence-based contribution of better health to economic growth has been established.
What is this good, better, or improved health, which is a term loosely mentioned during arm-chair criticism and formal and informal policy discussions? Good health is the outcome of health care that is available, accessible, and affordable, with acceptable standards for safety and quality, run by passionate and compassionate personnel.
Recent years have seen important advances in our understanding of the link between health and economic development in low- and middle-income countries, as exemplified by the report of the Commission on Macroeconomics and Health (CMH), an initiative launched by the World Health Organization (WHO) in January 2000.
The first is the impact of its size. As one of the largest service industries, the health system is one of the most influential sectors in economies. Health system output accounts for a significant percentage of GDP, especially in high-and middle-income countries. Also, a significant percentage of all workers in the countries (9% in the EU-25, 2001) are employed in the health and social work sector.
Among G20 countries, more people are employed in the health economy than in other industries like the automobile industry. The contribution of the health sector to the G20 economy constitutes a growing portion of GDP; their healthcare spending per capita is a two-digit percentage and is rising annually.
Through its sheer volume of transactional effects, productivity and efficiency in the health sector will have a large impact on these performance measures in economies as a whole.
Secondly, health is essential to promoting well-being and eradicating extreme poverty.
And the analysis shows that over the past decade, health improvements—measured by the value of life-years gained—constituted 24% of full-income growth in low- and middle-income countries.
Well-being is a positive outcome that is meaningful for people and for many sectors of society because it tells us how people perceive their life is going from their own perspective. Considering it as a valid population outcome measure, morbidity, mortality, economic status, and beyond categorize their well-being.
As per what an individual in a state of well-being will show, manifestations include the presence of positive emotions and moods (e.g., contentment, happiness), the absence of negative emotions (e.g., depression, anxiety), satisfaction with life, fulfillment, and positive functioning. In simple terms, well-being can be described as judging life positively, feeling good, and functioning progressively.
The benefits associated with well-being are numerous and health-, job-, family-, and economic-related. For example, higher levels of well-being are associated with decreased risk of disease, illness, and injury; better immune functioning; speedier recovery; increased longevity; and more productivity at work with greater earnings and contributions to their communities.
Thirdly, optimal health results in improved skills as a result of education and training enabled by optimal health.
“Health impacts every other facet of life, from a child’s ability to learn to an adult’s ability to work, so health is critical for education and financial well-being.”
“Health impacts everything—educational achievement, safety and crime, people’s ability to work and be financially healthy, life expectancy, happiness, and more,” says Thomas G. Bognanno, President and CEO of Creating Healthier Communities (CHC).
Lastly, a healthy population donates not only higher labor supply but also healthy labor. Healthy living comes with a more fit aging population, and it shows how good health increases the likelihood of late retirement. (Marc Suhrcke et al., 2005).
Here is an expert group’s recollection: “When we are healthy, we can learn, work, and support ourselves, our families, and communities. When we are sick, we struggle, and our families and communities fall behind, “(WHO, 2018).
Exceptionally, the mental and social aspects of our health, which are non-physical, affect our security and civic and social responsibilities. The effect of health on quality of life can also impact the desire to participate in civic duties like voting, social functions, and roles in the community and leisure activities, according to Healthy People 2020, an initiative of the Office of Disease Prevention and Health Promotion, USA.
The impact of psychological, mental, and social wellbeing can be better appreciated by looking at the manifestations of disordered status. People with disordered mental and social wellbeing exhibit symptoms indicating a lack of self-awareness or personal identity, an inability for rational and logical decision-making, an inability to make and maintain “acceptable” and “proper” satisfying interpersonal interactions and relationships within the social environment, and an inability to fulfill a sound social role in sharing, cooperating, communicating, and enjoying the company of others—family, friends, and community members. They are usually involved in drug abuse and other substances of addiction, have non-logical responses to issues, and commit irrational acts.
Surprisingly, these distorted mental and social well-being are largely responsible for corrupt politicians with poor leadership motivated by greed and selfishness, human rights violations by security agencies, including extra-judicial killings, and insecurity performances by non-state actors of armed robbery, banditry, kidnapping, rape, communal conflicts, murder, terrorism, and other extremism vices. leaders, bad citizens, and criminals have their non-physical well-being distorted either due to defective brain development, malnutrition, diseased brain disorders, lack of appropriate education, or improper social orientation, etc.
Furthermore, good health provides increased savings from health expenditure for investment in health, physical, and intellectual capital.
A common deviation from good health care is delayed or mismanaged treatment of health conditions, and it usually results in economy-draining further diseases, disability, and, a lot of times, death.
“An unhealthy community tends to struggle more with chronic diseases such as obesity, diabetes, heart disease, and other health challenges,” Bognanno says.
Chronic diseases not only reduce life expectancy, but they also have a dramatic depleting effect on the economy. It has been reported that 70-90 percent of different nations’ annual healthcare expenses are for people with chronic health conditions.
The extreme negative well-being and poverty effects of the defective health of the population were seen during the COVID-19 pandemic.
According to the World Bank Group – Global Economic Prospects, January 2022, “as the world enters the third year of the COVID-19 crisis, economic developments have been both encouraging and troubling, clouded by many risks and considerable uncertainty.” ….The global recovery is set to decelerate markedly amid continued COVID-19 flare-ups, diminished policy support, and lingering supply bottlenecks. In contrast to that in advanced economies, output in emerging and developing economies (EMDEs) will remain substantially below the pre-pandemic trend over the forecast horizon.
Finally, health status is “reversibly” influenced by the range of factors that are known as determinants of health – personal factors (like biology, genetics, and individual behavior), social, economic, policy, health services (availability, accessibility, and quality) and environmental factors. More analysis of the determinants showed that the availability of resources to meet daily needs, through education and economic empowerment, is inevitably needed for optimizing and maintaining the health of the population.
Therefore, health and education are co-led determinants of economic development and poverty reduction.
What is the fate of our country in this complex relationship? In Nigeria, a developing country, the predominant disease burden is attributable to communicable diseases, maternal and perinatal conditions, nutritional deficiencies, and non-communicable diseases (such as cardiovascular disease, diabetes, injuries, and mental health problems). This over-load is mercilessly over-loaded further with the peculiar challenges of Nigeria’s health system. One might be familiar with some of these challenges: severe shortage and imbalanced distribution of healthcare professionals, exacerbated by the unending exodus of Nigerian trained healthcare workers, primarily doctors and nurses, to abroad practice for better pastures and prospects; intra- and inter-professional conflicts and strikes; poor attitude to work; patients’ non-participation in health care plans; poor healthcare financing; wasteful use of scarce resources; deplorable healthcare services and outcomes; fragmentation of healthcare services and outcomes
The overload on health in Nigeria is substantially complex, but obviously, a solvable problem and the nature of the threats is such that they will require multifaceted inter-sectoral policies to prevent them from arising and integrated multi-disciplinary management strategies to handle them.
It is little wonder that as the SDGs cover a broad range of social and economic development issues and social justice, all the goals relate directly or indirectly to SDG 3: Ensure healthy lives and promote wellbeing for all at all ages, and the SDGs further calls for the promotion of multidisciplinary and transdisciplinary research and health in all policies across different sectors.
Can we solve this complex, economic-stunting problem? Yes, we can! It will profitably require inputs from many disciplines, including all cross-sectoral stakeholders in and beyond the health sector – pure sciences, social and environmental sciences, humanities, and engineering, all of which are essential for implementing health research and policies and improving the health of the entire populations. This need for inter-disciplinary action extends to health policy through “Health in All Policies,” which is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity.
Health should thus become an important part of all policies, including international development, security, foreign policy, the environment, and the economy, in addition to social welfare, labor, health, and research.
The end products of the multi-sectoral collaboration through “Health in All Policies” can take a lot of forms. Communities benefit from walking trails and bike paths, access to healthy food and playgrounds, access to accessible healthcare services, schools and places of employment, safety and security of lives and properties, as well as affordable housing, Bognanno says.
In the long run, upcoming new health challenges such as rising levels of obesity, particularly among children, mental illness, microbial resistance to antibiotics, and newly emerging epidemics and pandemics remind us of the possibility of stagnation or even roll-back in the health status of the population and economic development in the longer run. Because of these trends, we have growing concerns and are sufficiently concerned to warrant a thorough rethinking of the new public health policy model.
If taken together, the above submissions provide a passionate argument for Nigeria to invest in the health of its populations, not only because better health is a desirable objective in its own right, but also because it is an important determinant of economic and social growth, development, and competitiveness.
I have made a modest contribution to the debate on the future of the Nigerian economy and social model, playing my role by bringing together for further reflection the information underpinning this argument. Please be concerned and offer your valuable reviews, comments, and contributions. It’s for our health and the economic development of our nation!
The high-level group of delegates to the OBJ Strategy Session on Nation Building would note that Nigeria needs strategic investment in human capital through health and education, as the productivity and competitiveness of Nigeria’s economy are directly dependent on a well-educated, skilled, and adaptable workforce that is able to embrace change.
