22 February 2018

Nigeria: 'Goals of Bill and Melinda Gates Foundation'

Dr. Paulin Basinga is the Country Director for the Bill and Melinda Gates Foundation (BMGF) in Nigeria. He spoke to NKECHI ONYEDIKA-UGOEZE in Abuja on why the foundation is investing in polio eradication in Nigeria, maternal and child health, family planning and the Primary Health Care (PHC) among others. Ecerpts:

What does the Foundation hope to achieve this year in Nigeria?

I think this year is a very interesting year for the Bill and Melinda Gates Foundation (BMGF) in Nigeria. So, 2018 is a year where we have had a couple of months without any new case of Polio. Polio is one of our biggest priorities here in Nigeria in partnership with the Government of Nigeria. The government has done an amazing job towards Polio eradication.

It has been more than 12 months now that there has not been any case of polio and we are really hoping that this year, the government can continue its effort in vaccinating kids so that we will see polio in Nigeria eradicated in Nigeria and the World Health Organisation (WHO) declaring the African region polio free. So this is one of the top priorities for the Gate Foundation here.

And the second one is our support to broaden Primary Health Care financing, so we work very closely with the Federal Ministry of Health and we are supporting them with Basic Healthcare provision fund, we are working so closely with them to see that this will happen this year.

We are providing technical assistance and funding towards putting in place pilot programme so that the pilot programme will be operational and we really have to add additional resources to the financial the PHC in Nigeria. And to do that also, we will continue to work with government to secure funding for vaccine as you know, Nigeria has one of the highest number of children dying from vaccine preventable diseases and the strong impact of vaccine is clear, I am sure you have read the Bill and Melinda Annual Letter this year and they really talked about why they are investing in vaccines.

One of the reasons that they decided to start investing in global health is because when they read that paper on how many people are dying from very preventable diseases, they decided to really start working on this and you know we are very close partners with the GAVI which is Global Alliance for Vaccines and Immunisation and they provide support for a lot of countries including Nigeria. And you know that Nigeria will be graduating from GAVI support in 2022.

We are working very closely with the government to come up with a very realistic plan so that Nigeria will continue to fund the vaccines so this part of our top priority.

Another one is our work on Nutrition and our work on Maternal and Child Health and Family Planning. All those are priorities in health. And we also want to... this year in our work on agriculture and financial inclusion. Those are all very big priorities. We are working very closely with CBN - Central Bank of Nigeria to provide the technical support they may need to ensure that the poorest people have access to financial inclusion.

It is a very exciting year and we know it is a busy year as well for the government with the elections coming up, we are working very closely with the federal government and some states we are partnering with because we may need to make sure that poor people have access to financial inclusion, etcetera.

So, it's quite a very exciting year and we also working very closely with the federal government and some states we are partnering with. And also, we have had partners like the Dangote Foundation and United States Agency for International Development (USAID), United Nations Children Fund (UNICEF), and the British Department for International Development (DFID).

So, it is a very busy year for us so we will just continue to stay the course and continue partnership with the government and other partners.

Your major area of investment (intervention) in Nigeria is vaccine. Don't you think it is better for Nigeria to start manufacturing instead of always importing? And is there any way you are going to help Nigeria in this area because they have already signed an Memorandum of Understanding (MoU) with May & Baker to this effect?

Definitely. This has been a very lively discussion and the Nigerian government is a very legitimate government that made a wise decision to really start thinking of local production of vaccine and this is not what the Gates foundation will have a strong point of view. It is a very wise and great decision by the government of Nigeria and they have signed MoU and seems like it is the best way to go in the medium and long term to manufacture vaccines.

You mentioned agriculture, malnutrition, etc. among the areas that you are going to focus on this year. Do you have and idea of the total amount of money that you intend to invest this year?

So, the way we make our investment, it is not like we have a certain envelope that we will spending a year. As you know, we are a Seattle based organisation and we work through different strategy teams. We have many strategies that cut into many countries, including Nigeria. Nigeria is one of our biggest countries in Africa. So, globally, the BMGF spend close to $5 billion a year including in the US. Close to $5 billion all over the world and in Nigeria.

We do most of our investments through grants and currently have close to 300 grants across many organisations in Nigeria. We work at the Federal level and across many states and we have engagements in those states. Across all those development grants that we put in place, we work very closely with the government and very closely with the states to really agree on how much we will be putting in and basically we try our best to match the funds that the states will put forward. This is because we strongly believe in the government taking ownership of their own programmes because we are catalytic.

So, in the next one year, the BMGF will be spending close to $1billion across agriculture, financial inclusion including many programmes. We provide very detailed report to the ministry of Budget and National planning listing all the investment that we make into public and you can access them and we are very happy to send you all the details of our investments.

Nigeria achieving a polio free certification is very crucial as we almost got it some years back, what is the Foundation doing to ensure we achieve this status?

The government of Nigeria has been at the forefront of fighting polio and moving towards a polio free Nigeria, and this year, the government has committed all their funds towards polio eradication efforts, but there are still close to between 160-200,000 children in Borno state close to Lake Chad who have not been reached.

If the government can vaccinate those kids to make sure that there is no poliovirus, I think we are very close. We treat this a top priority and we are very close to eradicating polio, we are very pleased with government's efforts so far and when this is done, it will be the second disease that would be eradicated from the world.

How transparent have you been in your dealing with the Nigerian government?

For us, transparency is key, this is why as you have seen, Bill and Melinda have put out a letter which is responding to the 10 toughest questions because we believe that we have to be very transparent and we have to be very clear in terms of what we invest in. So, if you have any question on any of our investment, they are available on the website.

Also, it is a time for us to be open to our partners and to also ask ourselves very tough questions. We work with the Ministry of Budget and National Planning and we are transparent about everything we spend and we support in Nigeria.

You spoke about PHC, are you aware of the situation of the PHC systems in Nigeria? Because the Federal Government said they wanted to reactivated about 10,000 Primary Health Care centres and after that promise, it has been over a year ago, only two have been reactivated. What is your opinion and what do you think can be done because most of the diseases that people suffer from can be addressed at the PHC level. Are you comfortable with the situation of PHC in the country?

We are aware and we follow very closely the situation of healthcare and we are very excited when the government unveiled the plan to revitalise primary healthcare. A strong PHC is really the backbone of the health system and a way to provide a universal health coverage (UHC) and tackle malnutrition and maternal mortality and child mortality. And when you look at the size of the economy of Nigeria, and the status of the PHC, it is quite challenging. PHC situation in Nigeria is quite challenging and we are supporting the government to take on those complex challenges to revive the PHC. We have signed specific MoU with the Kaduna State Government for example.

We work very closely with the Kaduna state government to design a very strong PHC revitalisation plan. We work closely with the National Primary Health Care Development Agency (NPHCDA), we have the same MoU with the Niger and Nasarawa states.

In Kano state, we are working closely with them. And we strongly believe that when you look at the way PHC is of low status in Nigeria, there is a need to really implement the National Health Act that was signed in 2014. It truly matters that we put in place a consolidated fund that will go towards supporting PHC. So this is why we are providing the technical support to the Federal Ministry of Health (FMoH), NPHCDA and National Health Insurance Scheme (NHIS) to really set up that basic operation fund because that is the fund that will really help to move the PHC forward.

Does Bill and Melinda profit from the money that they invest in Nigeria?

This is a very good question and we got lots of those questions. It is also very linked to the toughest questions that Bill and Melinda responded to. The very short answer to that question is, No. The Foundation, Bill or Melinda do not profit from the money invested in Nigeria or anywhere in the world. So there is nothing hidden about the Bill and Melinda Gates objectives or our objectives as a Foundation.

We do this work to help as many people as possible and to advance equity around the world. We really focus on the poorest and we tend to do our best to lift them out of poverty and to really provide them the opportunity to lead healthy and productive lives. Like you would see in the Letter, Bill and Melinda talked about coming from a family that believes in leaving the world a better place than they found it. So they are giving away their fortune because it's just meaningful work.

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