My three-year tour of duty as the Executive Secretary of the National Health Insurance Scheme (NHIS) was marked by a bruising and very public battle against a cabal of corrupt, Lagos-based Health Maintenance Organisations (HMOs) who were for a very long time, holding Nigeria’s healthcare financing system by the jugular and their protectors in government.
The moment they realised I wasn’t going to play their corrupt game, they unleashed their paid foot soldiers to write a blitz of petitions against me to all anti-graft agencies (EFCC and ICPC), the National Assembly (NASS), and the Presidency. There were unrelenting, paid, negative media campaigns and choreographed public hearings at the NASS.
So, when the dark-suited men of the EFCC came calling, I knew it was a continuation of my unfinished battle with corruption at the NHIS and a clumsy attempt by President Tinubu’s government to silence me. It reminded me of the phrase “going to the mattresses” from Mario Puzo’s novel “The Godfather,” which essentially means “hunkering down” to fight like I did in my days at the NHIS.
In the heat of these battles, I had the rare privilege of having a private audience with President Mohammadu Buhari, facilitated without my knowledge by a prominent Islamic Cleric and close associate of the President (name withheld).
I can clearly remember telling the President, “Your Excellency, sir, you gave me this position without knowing me or anyone lobbying on my behalf; I made a promise not to you but to our creator that I was going to be a good custodian of that which I was entrusted with, so help me God.”
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I reminded him that though he had the power to fire me at any time without giving any reason, I would fiercely fight any attempt by anyone to impugn my honour and integrity, which I have earned over my lifetime.
I also told him that my wife and children were pressuring me to resign my appointment because they said it was not worth it to serve a thankless nation. I explained to them that I would fight to the end because I wasn’t going to leave our family with any stain of corruption.
He just sat silently, looking at me, probably thinking about which planet this “young man” was from because he did not seem to know how Nigeria had changed. Indeed, he said this is how bad things have become in Nigeria. He told me that whatever I was going through would build and strengthen my character going forward.
There is no way of spinning it; the truth is that no hospital in Nigeria functions optimally, and that is why those who can afford it seek healthcare outside the shores of this country. But the vast majority of Nigerians, especially the most vulnerable among us, do not have such options.
Nigeria’s healthcare system faces serious challenges, with many hospital wards looking distressing, like abattoirs and primary healthcare clinics are abandoned. The healthcare financing system has been hijacked by corrupt “middlemen” called HMOs to the detriment of patients and healthcare providers.
There is a mass exodus of healthcare workers out of Nigeria because of the conditions of our healthcare facilities, lack of work tools, and poor wages.
Millions of Nigerians have simply stopped taking their medications because they cannot afford them and have resorted to traditional medicines and prayers, resulting in increased disease-related complications and deaths.
Since President Tinubu assumed office, hospitals all across the country have been seeing an exponential rise in the number of children admitted with diseases of severe malnutrition (Marasmus and Kwashiorkor). This is an indication of the severe hunger in the land due to excruciating poverty, runaway inflation and low purchasing power.
Children of the poor continue to die needlessly from diseases that are preventable by vaccines, like measles, diphtheria, diarrhea, pneumonia and meningitis, due to a lack of access to healthcare.
NHIS is an Agency that can make an impactful difference in the lives of millions of citizens and mitigate the many daunting challenges in the nation’s healthcare system.
My mandate as the CEO of the NHIS was to increase the number of Nigerians insured regardless of their ability to pay, reduce their out-of-pocket payments, hold everyone in the chain from the NHIS, HMOs, and the hospitals accountable, and most importantly, be a good custodian of what I was entrusted with: our people’s commonwealth.
When I assumed office in August 2016, no one in the Scheme could tell me the exact amount of money the NHIS had and where it was lodged. I, therefore, employed the services of an independent accounting firm to conduct a forensic audit of all NHIS accounts.
The Federal Government of Nigeria (FGN) had earlier directed all Ministries, Departments and Agencies (MDAs) to transfer all their funds from commercial banks to Treasury Single Accounts (TSAs) with the Central Bank (CBN) by the end of September 2015. This was almost a year before I assumed office.
The accounting firm presented its final report to me in the last quarter of 2017. The report revealed that thirteen commercial banks had outrightly refused to remit over one hundred billion Naira of NHIS funds to the TSA Account in the CBN in direct violation of FGN’s directive.
The senior government officials I reached out to for assistance in the recovery of these trapped funds included the then governing board of the Scheme, Minister of Health Prof. Isaac Adewole; CBN Governor Godwin Emefiele; Chief of Staff to the President late Abba Kyari and the Attorney General of the Federation. My spirited efforts yielded no positive result.
Additionally, the Accountant General of the Federation illegally withdrew a total of N10 billion in two trenches (N5 billion twice) from NHIS TSA account without consulting me or getting my approval as the CEO. The Minister of Finance, Kemi Adeosun, rebuffed my repeated requests to see her and discuss these illegal withdrawals. I then reported her to the Secretary to the Government of the Federation, Engr. BD Lawal, who called her in my presence and asked her to see me, but she never did until her unceremonious exit from President Buhari’s government.
During one of my two suspensions from office, I got an unexpected call from a gentleman who introduced himself as Ibrahim Magu, the Acting Chairman of the EFCC. He asked me to come over to the Commission. On arrival, I was ushered into a conference room where he had assembled several senior officers of the Commission. He walked in, and after a few pleasantries and introduction of the officers, he asked me to provide these officers with all documents related to NHIS funds held illegally by HMOs, Banks or any organisation or individual. He then briskly walked out of the room.
True to his words, the EFCC under him swung into action and started recovering billions of NHIS money from Banks and HMOs based on the documents I provided. In a letter to the NHIS Executive Secretary that came after me regarding repatriation of the first trench of recoveries to the NHIS, the Acting Chairman signed the letter himself and graciously mentioned my name and acknowledged my efforts in the Commission’s recovery efforts.
If the current leadership of the EFCC had taken the time to do some due diligence, they would have found out that I have a nine-year history and a big file at the Commission on my fight against corruption during my time at the NHIS.
Recovering NHIS (now NHIA) funds still held illegally in the vaults of commercial banks and by HMOs for the good of our people should be an urgent national priority for the EFCC.
May God Almighty continue to guide us to do that which is right and just.
Usman Yusuf is a professor of Haematology, oncology, and Bone Marrow Transplantation
