For a man who decided, without a gun to his head, to decline an offer already accepted, Mr Pate is not the competition here; far from it.
Following Muhammed Pate's incredibly difficult decision to rescind his appointment as CEO of GAVI- Global Alliance for Vaccines and Immunization and return home to serve his fatherland under the leadership of President Bola Ahmed Tinubu, I wrote and published an article entitled: "Finding the Pate Within Us." It was a piece in honour of a man who, in the face of grandeur and international acclaim, chose a different path leading him back to the very roots from which he had grown; it highlighted the significant personal sacrifice Mr Pate had made in placing Nigeria over and above his career goals and aspirations. How many Nigerian elites or technocrats would make such a call? I consider myself an ultra-patriotic Nigerian but faced with such an opportunity, my decision would not be anywhere near "incredibly difficult". Evidently, Pate has risen above self. He has conquered the "me first syndrome" in most of us. It would not be out of place to say that his actions are synonymous with patriotism of a higher degree, nationalism, and personal sacrifice for the collective good.
It is, therefore, shocking to read articles on news platforms attempting to politicize that which is glaringly altruistic and in the national interest. These half-spirited attempts from a muted minority argue that the distinguished professor is not a politician and as such, is undeserving of the ministerial slot from his home state. Some contend that as a technocrat, he does not understand the political economy that defines the country's health sector and may not be able to get the desired result if appointed as Minister of Health. They all surmise that politicians who have worked tirelessly for the ruling party's victory in the last presidential election deserve to be compensated with ministerial slots, which is indeed not out of place. They also prefer someone who has worked internally with an understanding of the local dynamics, which is also not out of place. What is, however out of place is the thinking that Mr Pate's eventual nomination and appointment as Minister will block the chances of compensation for the political class in his home state. Nothing could be further from the truth, especially when it is on record that President Bola Tinubu rewards loyalty and hard work.
For a man who decided, without a gun to his head, to decline an offer already accepted, Mr Pate is not the competition here; far from it. Perhaps, it is crucial that we understand the enormity of his sacrifice. Until that moment of decision came, Mr Pate was on course to assume office as CEO of GAVI - the Vaccine Alliance on 3 August 2023. In his words, upon acceptance of the offer then, he said "It will be my privilege to lead Gavi and continue to support countries to scale up critical routine immunization programmes, reach more zero-dose children, expand access to new vaccines, transform primary health care systems, and help fight outbreaks and future pandemics." A privilege now directed towards Nigeria.
A look at donor contributions and pledges to Gavi from 2021 - 2025 indicates a commitment of $21.2 billion, while donor proceeds for the same period are $21.5 billion. The consolidated financial statement audit of Gavi, as undertaken by Deloitte, indicates that cash proceeds from donors and International Finance Facility for Immunization(IFFIm) over a five-year period stood at $4.8 billion(2022), $10.0 billion(2021), $2.3 billion(2020), $2.0 billion(2019), and $1.6 billion(2018) respectively. The audit finds that with the cash receipts from these donors and investors, Gavi has a strong and consistent level of support. In view of available resources, the Gavi Secretariat forecasts that there will be sufficient resources to fund all its programmatic commitments as revised for the impact of the Covid-19 pandemic. As of the date of the last forecast approved by the board in December 2022, Gavi's estimated Qualifying Resources for its 2021-2025 strategic period totalled $10.4 billion, while its total forecasted cash outflow for the same period was US$10.2 billion. This implies the organization has approximately $0.2 billion for future mission-related investments. How else can one describe its financial solvency? Not to mention that the CEO job comes with an annual salary of US$700,000(unconfirmed), which is approximately 525 million Naira!
Nigeria's Prof. Muhammed Ali Pate clearly passed on the opportunity to lead one of the world's most impactful and financially solvent organizations at such a critical time in global history when the world is navigating the path to recovery post-Covid-19 and adopting the lessons learned to shape our world significantly.
Gavi has a remarkable track record in improving global health through immunization. Its efforts have had a profound impact, as it supports the immunization of almost half the world's children. It has helped immunize over 760 million children, effectively preventing over 13 million deaths worldwide. This incredible achievement highlights the significant role Gavi plays in saving lives and improving the health outcomes of millions of individuals.
Through its negotiation of bulk prices and support for price discrimination, Gavi works to make vaccines more affordable and accessible, particularly for low-income countries. By reducing the commercial risks vaccine manufacturers face when selling to poorer nations, Gavi ensures that even the most vulnerable populations can access life-saving vaccines. This approach has been crucial in increasing diphtheria vaccine coverage in Gavi-supported countries from 59 per cent in 2000 to 81 per cent in 2019. The impact of these efforts is reflected in the significant reduction of child mortality rates.
In addition to its achievements, Gavi remains at the forefront of the fight against malaria, one of Africa's deadliest diseases. In a groundbreaking initiative, it is leading the effort to distribute the first-ever malaria vaccine, RTS,S/AS01, to 12 African countries from 2023 to 2025. This vaccine allocation, amounting to 18 million doses, can significantly reduce the burden of malaria, which currently accounts for 95 per cent of global malaria cases and 96 per cent of deaths, with children under 5 being the most vulnerable. Gavi's dedication to addressing this pressing health challenge demonstrates its commitment to tackling diseases disproportionately affecting the most vulnerable populations.
Rather than attach political meanings and sentiments to Mr Pate's homecoming, we should celebrate, knowing that a highly resourceful son has chosen to serve Nigeria in the face of global relevance and personal gain. The conversation should be about the expectations of a Pate ministership, not the fears demonstrated in some quarters. Or is someone afraid of Mr Pate for any other reason?
Mr Pate, an accomplished global health leader, significantly contributed to Nigeria's fight against polio and health system reform. As head of Nigeria's National Primary Health Care Development Agency, he successfully led efforts to combat the polio epidemic reducing cases from the highest(798) globally to just three within two years. His approach involved mobilizing resources to struggling areas and gaining communities' trust, working closely with local leaders and involving them in planning vaccination campaigns.
Mr Pate's leadership went beyond addressing polio. He recognized the need for broader health system improvements and implemented initiatives to strengthen primary care and address areas of greatest need. As Minister of State for Health, he established a global coalition to support health system improvements. He implemented innovative programs to tackle priorities such as the prevention of mother-to-child transmission of HIV.
Mr Pate's experience in philanthropy and policy, including his work at the World Bank, further strengthens his ability to contribute to global health challenges. He was pivotal in the World Bank's strategy for financing population health programs, supporting countries in building resilient health systems and responding to the COVID-19 pandemic.
Given our country's current circumstances, it is essential to recognize that forming a government representing a broad spectrum of expertise and perspectives is crucial for driving meaningful change. Mr Pate's nomination brings the expertise and dedication needed to address Nigeria's healthcare challenges head-on. His deep knowledge of the sector and commitment to serving his country makes him a powerful force for positive transformation. Politicians and technocrats can work together to deliver the most significant value for the people of Nigeria.
Perhaps the traducers are unaware, but one of the reasons why Mr Pate's likely nomination as Minister of Health holds tremendous significance is the dire fiscal situation Nigeria currently faces. The escalating public debt and growing budget deficit have severely affected various sectors, including healthcare. The country's expenditure on debt servicing has reached alarming levels, with 96.3 per cent of revenue allocated to this purpose in 2022, up from 83.2 per cent in the previous year. This demonstrates the worsening fiscal deficit and its strain on the nation's public debt stock--the rising budget deficit-to-GDP ratio further compounds the challenges, indicating the increasing burden on the economy.
The implications of this fiscal crisis on the health sector are profound. As resources become scarce, allocating sufficient funds to crucial areas such as healthcare infrastructure, medical supplies, and workforce development becomes increasingly challenging. This, in turn, compromises the quality and accessibility of healthcare services for the Nigerian population. With public spending on healthcare amounting to just 3.89 per cent of GDP, the need for increased investment and reform is undeniable.
Therefore, Mr Pate's nomination as Minister of Health becomes even more crucial in this context. His expertise in healthcare financing and health system strengthening can play a pivotal role in addressing the challenges posed by the fiscal crisis. His track record of navigating complex financial landscapes and mobilizing resources positions him as a valuable asset in ensuring that the health sector receives the attention and funding it desperately needs. His experience in engaging with international organizations and securing resources for healthcare initiatives can be leveraged to explore innovative financing mechanisms and partnerships. He can collaborate with development partners, private sector entities, and philanthropic organizations to bridge the huge funding gap and ensure the sustainability of healthcare services.
Moreover, Mr Pate's leadership in advocating for improved budgetary allocations to the health sector can drive the necessary policy reforms. By working closely with relevant stakeholders and policymakers, he can champion initiatives prioritising healthcare in the national budget and advocate for increased investments in critical areas such as healthcare infrastructure, equipment, and human resources. Additionally, his understanding of health economics and ability to navigate complex financial landscapes can contribute to developing sustainable healthcare financing models. He can explore strategies to reduce out-of-pocket healthcare expenditures, improve health insurance coverage, and strengthen health financing systems. This would not only alleviate the burden on individuals but also enhance the overall resilience and effectiveness of the healthcare sector.
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By leveraging Mr Pate's knowledge and skills, Nigeria can explore innovative solutions, forge strategic partnerships, and implement sound fiscal policies to secure the necessary resources for the health sector. This, in turn, will improve healthcare accessibility, quality, and outcomes for all Nigerians, mitigating the adverse effects of the fiscal crisis.
It is essential to recognize that investing in the health sector is a matter of social welfare and a strategic move for sustainable development. We need a healthy population that drives economic productivity, fosters social stability, and enhances overall well-being to better reap our demographic dividends. Nigeria can then be enabled to lay the foundation for a prosperous and resilient nation that prioritizes healthcare despite the fiscal challenges.
But that is not all. Have we considered the significant impact Mr Pate's emergence could have on the country's health security? Nigeria's ability to prevent, detect, and respond to public health threats, including infectious diseases, epidemics, and other health emergencies, could benefit from Pate's expertise and experience. After eight years of near-stagnation, Nigeria and, indeed, Nigerians deserve better. The narrative has to change. It can not be business as usual. Nigerians deserve to breathe!
From the standpoint of a strategist, it is imperative to state that Pate is no obstacle to the emergence of any politician as Minister from his home state. He is a wild card, portending no risk to some political aspirations. Again, he is not the competition. He is not lobbying. He brings tremendous value that must be preserved on the altar of political exigencies. Dey Play!
Henry Anibe Agbonika, a Governance and Policy Reforms Consultant, writes from Abuja, Nigeria. He can be reached at henry.agbonika@policydelivered.com
