"The hidden cost of disease transmission associated with unsafe injection practice is considerably higher than the cost of preventing the disease." This is a quotation of the World Health Organization, which recommended in 2000 that all developing countries adopt AD syringes by 2004.
It is important to note that the Nigerian Federal Government had passed a law which became effective in 2008 requiring the use of "safe" syringes.
Our 23 million dollar single-use by design and manufacture syringe factory became the flagship project of our nonprofit Pan African Health Foundation, whose mission is to develop locally owned and operated, nonprofit medical supply factories in Africa, with the twin economic development objectives of generating sustainable employment and improving public health.
The factory was commissioned in October 2008. Training and trial production were completed in the spring of 2009. The factory and its product were certified by Nigeria's National Agency for Drug Administration and Control. By December, this year, the factory is to be at full production, with 300 employees. At that point, the factory will be manufacturing more than 160 million syringes per year at World Health Organization standards. A planned expansion will increase the annual capacity to 800 million syringes.
Project Delivery Method
We used the program and construction management, design-build delivery method that provides unique opportunities for achieving sustainable economic development in Nigeria. Sustainable economic development can be achieved best in Africa through projects that create jobs, provide training in partnership with local universities, engage and support local businesses, and create value by using local materials. Thus, by engaging local entrepreneurial interests in mutually beneficial partnerships, many barriers to achieving successful projects can be eliminated. These business partnerships would be strategic in nature. They should be based on trust and respect for local partners and could thrive with transparency and accountable management.
OUR EXPERIENCE ON THE SYRINGE PROJECT IDENTIFIED FOUR GUIDING PRINCIPALS FOR SUCCESS
• First, Sustainability –A well-conceived project should include all relevant stakeholders in the Ministries of Health, Finance, Foreign Affairs, Labor, Local Government, Media and opinion leaders at the local and national levels; and, where appropriate, external financing and technical support services should be identified and consulted. Finally, with almost no exception, very few public-private partnership projects are sustained over the long term without dependable financing and host country support at the presidential level.
• A second precondition for successful projects is the creation of a valid Partnership in which respect is shown for host country leadership. Project operational frameworks must incorporate key project decision-makers with vested interests in the project. U.S. investors and those providing technical assistance, themselves, must think this way in planning investments in Africa. The Port Harcourt Syringe Factory succeeded in large because the host country project leadership was respected. Frequently, we were able to have critical Project impact because we made arguments on their merits and not because we were the "experienced Americans." Thus, respect for host country project leadership and other host country leaders made it possible for our foundation to have a major impact on project outcome.
• Another guiding principal for success would be the Audit and Evaluation component which is the "Third Rail" in building a sustainable project. The genuine partnership between our foundation and the Rivers State leadership enabled an effective evaluation and audit process. Host country project leaders welcomed the audits and evaluations because they did not view the Foundation as an "outsider" but as a respected member of the partnership seeking one goal...a sustainable, successful project. The Pan African Health Foundation/US financial contribution to the project was nominal, but our advice and participation were critical and well earned. The Syringe Factory Project was never referred to by the host country partners as their project but always as our project; and our Foundation always was involved when major host country decisions were discussed. During this four-year project, there were few weeks that passed without written or voice communications among project leaders.
• Fourth, Information Technology provided the means and method for coordination and effective problem resolution. One of the core principles of building a sustainable health project is effective use of information technology. Each health project must have the technological capacity to share information, map and track funding and schedules. Projects that lack this capability misuse budgets, personnel, and compromise project goals. No African health project should be undertaken without such technological capacity.
An important by-project of a well-conceived project that adheres to the four principles I have described produces a sense of great National Pride. I observed this in the people of Port Harcourt, Nigeria at the plant opening ribbon cutting ceremony last fall; and, our successful syringe project was recognized at the Clinton Global Initiative's Fifth Anniversary Board Meeting in New York City last week.
Further Remarks
The city of Port Harcourt, close to the site of this new syringe factory, is the capital of Rivers State and the epicenter of the region's oil industry. Despite its metropolitan population of nearly 3.7 million, Port Harcourt stands a mere shadow of the prosperous and livable city it once was. As Rivers State Governor Amaechi described in his address at the Conference of Speakers: "Today, our streets are narrow and congested. Our drains are blocked. Potable water is nearly absent. Our neighborhoods are rough, dilapidated, and dangerous."
Health issues such as these should be addressed in a holistic manner so that local populations and governing bodies take ownership of health improvements; and, the improvements should be sustainable while addressing comprehensively the circumstances that contribute to poor health.
Opportunities, based on our foundation's recent experience, suggest that a favorable climate exists in Rivers State – and other similarly situated political jurisdictions in Africa, for investing in health systems infrastructure such as municipal water works and associated distribution systems, waste disposal systems, as well as precise and reliable power for clinics, hospitals and their critical medical equipment.
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*Major General (AUS, Ret.) Roger R. Blunt, P.E. is Chairman of the Board, President, and Chief Executive Officer of Maryland based Essex Construction, and Managing Member of Tradewinds Africa with an office in Accra, Ghana. A West Point graduate and Registered Professional Engineer in the District of Columbia, he holds Masters Degrees in Civil Engineering and Nuclear Engineering from the Massachusetts Institute of Technology and the Doctor of Public Service Degree from the University of Maryland Eastern Shore. After an early career in the U.S. Army Corps of Engineers, which included service in the Far East, Europe, and the Middle East, General Blunt retired in 1986 and was awarded the Distinguished Service Medal. He became a laureate of the Washington Business Hall of Fame in 2001, was named a Hero in Business by the Retired Military Officers Association in 2002, and received the 2003 Hall of Fame Award of the American Minority Contractors and Business Association. In 2004, he received the Parren J. Mitchell Foundation's Lifetime Achievement Award and was inducted into the Maryland Chamber of Commerce Business Hall of Fame in 2005.
General Blunt is Chairman and President of the Pan African Health Foundation/USA, whose Nigerian affiliate built an auto-disable, single-use syringe plant with an annual production capacity of 160 million syringes in Rivers States' delta region. Over the years, General Blunt has consulted or participated in economic development activities involving military facility design, guidelines for sustainable development, housing, commercial construction, and rural farm to market roads in several of Africa's countries including Saudi Arabia, Niger, Burkina Faso, Nigeria, Ghana, and Liberia.
