Few Ministerial appointments have sparked as much excitement in their respective sectors as Dr Muhammad Pate has in the health sector. Both local and global actors are thrilled about a Minister whose competence and broad experience are in no doubt. His passion for his country is undeniable, especially given the role he gave up as Chief Executive Officer (CEO) of GAVI, the vaccine alliance, to "serve his country." He will not be learning the ropes from the start, as he previously served as Minister of State for Health from 2012 to 2014.
This time, Dr Pate is starting at the Ministry of Health with an expanded portfolio as the newly appointed Coordinating Minister of Health and Social Welfare.
When Dr Pate arrives at the Ministry of Health in Abuja, the first thing he will notice is that not much has changed, especially in terms of infrastructure. He will still arrive in the Federal Secretariat's dark car park and go to the lifts, one of which is reserved for Ministers (when it is working). He will, naturally, be greeted by a crowd of employees of the Ministry celebrating his return and singing his praises. He will then proceed to the first floor, including his office, which has been recently renovated in stark contrast to the rest of the building. He will meet the directors and a Permanent Secretary with most of the fiduciary responsibilities, and eventually, he will meet the heads of the many parastatals in the sector. They will all share their joy at his appointment.
Unfortunately, our health indices have not improved sufficiently since his tenure as the Minister of State for Health. When we examine the number of preventable deaths that occur each day, especially among children under five and pregnant women, health clearly has not been a high enough priority. He will look at the number of people with health insurance, the number of functional primary healthcare centres, and the state of federal teaching hospitals and medical centres, and he will find that not much has changed. He will find Nigeria far off from attaining the health-related Sustainable Development Goals by 2030. Yet, there does not seem to be a great enough sense of emergency. The constraints and opportunities will be similar to when Dr Pate left; the difference is that he will not need two years to learn what they are; he will already know what the challenges are.
Following President Goodluck Jonathan's election in 2012, Dr Pate was selected to join the cabinet, but he stepped down in under two years. Very few people have resigned from Ministerial appointments (or any government appointment) in Nigeria. Resigning is just not something that people do. There are so many pressures against this, the fear of reprisal, the anger of your community and many more. So, when Dr Pate resigned as Minister of State for Health, many people were intrigued and wondered the reason. Although there were rumours, he kept the reasons to himself with dignity and assured the government of the day of his continued support.
In his short time as Minister, he launched significant initiatives with the ambitious objective of "Saving One Million Lives ". This was the first time a Minister of Health in Nigeria provided Nigerians with a clear, unambiguous objective in health terms. While he ultimately did not remain in the Ministry of Health long enough to deliver on this, his vision was bold, and the objectives were clear. It, therefore, stayed the course and became the centre of many other initiatives in the sector.
Dr Pate previously held the position of Executive Director of the National Primary Health Care Development Agency (NPHCDA) for over three years. In this role, he initiated the agency's transformation to the scale last seen during Professor Olikoye Ransome Kuti's era. At NPHCDA, he initiated the innovative Midwives Service Scheme (MSS), recruiting retired midwives nationwide to support underperforming antenatal clinics to reduce Nigeria's high maternal mortality rates. NPHCDA took the scheme further by launching the Expanded Midwives Service Scheme (eMSS) to increase the availability of skilled attendants. The scheme's state-level implementation can be seen by the 200 midwives recently recruited in Niger State.
Since he resigned ten years ago, Dr Pate has developed his portfolio even further. He initially started on a track in academia at Duke University's Global Health Institute. From there, he became the Chief Executive Officer of Big Win Philanthropy. He was then appointed Julio Frenk Professor of the Practice of Public Health Leadership in the Department of Global Health and Population at the Harvard T. H. Chan School of Public Health. While at Havard, the World Bank came calling just before the pandemic, and he went on to become its Global Director for Health, Nutrition and Population and Director of the Global Financing Facility for Women, Children and Adolescents. He resigned suddenly in 2022 and returned to Havard to continue supporting the development of public health professionals. While in this role, he was shortlisted and appointed to become the next Chief Executive Officer of Gavi, the global vaccine alliance, in February 2023. In what to many people was a surprise move, he passed up on the role to instead return to Nigeria to serve as the just appointed Minister of Health in Nigeria.
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We invited Dr Pate to speak at the first Nigeria Health Watch, Future of Health Conference in 2015, themed "Defining the Health Sector of our Dreams in Nigeria", just after President Muhammadu Buhari had won the presidential elections and before his swearing-in. During that talk, he reflected on his time as Minister and shared three stories, all focusing on the critical importance of accountability. That talk is as pertinent today as it was then.
Dr Pate is getting something very few others ever get, a second shot at a very similar role. Coming out of the pandemic, with most health indices worse than ever, he has his work cut out. With Nigeria's expertise in all aspects of health and healthcare globally, we really have no reason not to deliver.
We at Nigeria Health Watch wish him every success and the best as he assumes his new role.
