The flooding situation in Nigeria which has claimed the lives of close to 500 people and displaced more than a million people is a cause for concern. This flooding began in July but did not get much attention from the Nigerian government and the media until early in October. While listening to the news, I kept asking myself why the government did nothing until now. News reports indicate that there have been early warnings of this disaster. And of course, no one is thinking of the health implications of the flooding; increase in vectors, food crisis and psychological issues among victims.

This reactionary mindset and apathy indeed pervades as well in many Africa nations. During the famine last year in the Horn of Africa, the Ethiopian and Kenya government would not even admit there was a famine in their countries. Sadly, such disasters affect the health and well-being of the people especially the poor. Someone may argue that they lack the capacity to respond to such events but I would ask: Why do they have to wait for a disaster to occur before they discover that there are capacity shortages? Hundreds die, thousands die, many are displaced and yet African governments do not plan for the future to prevent such events from reoccurring.

This paucity of planning within the governmental framework in some African countries has broad implications for their health systems. Health infrastructure is not on the priority lists of most governments. For instance, in three West African Countries-Nigeria, Ghana and Cameroon, health expenditure is less than 9% of total government spending. Health systems in Africa are severely challenged, overburdened and dependent on external funding from donors. The current state of health infrastructure in many African Nations is in no way positioned to meet future health challenges. As someone who spent most of my life in Nigeria, I am a witness to the poor state of the health infrastructure, especially in rural areas. This has led a number of Nigerians to seek succour for their health issues in many Asian and Western countries. The current situation attests the need for better health systems planning to include health financing policy. How can we get the government to be more committed to health systems planning and policy?