In 2015, nearly half of the world’s population was
at risk of malaria with 91 countries and areas undergoing transmission of the
disease which remains life threatening till today. In a chat with select
journalists in Abuja recently, Dr Mairo Mandara, Country representative, Bill
and Melinda Gates Foundation in Nigeria disclosed that the Foundation is
already working with researchers towards the elimination of malaria. CHIOMA
UMEHA provides the excerpts:
What would you say has been the organisation’s
biggest success since the 10 years of Bill and Melinda Gates Foundation
interventions in Nigeria?
Basically, the Bill and Melinda Gates Foundation
was established on the premise that all lives have equal value, because we
believe all lives have equal value. We believe that every human being is
entitled to live a healthy and dignified life. Everybody who is unable to do
that, we believe we should try hard, not just Gates Foundation, we all, as
human beings, have the responsibility to ensure that everybody live a productive
life. It is in this vein that the Gates Foundation looks at itself and said
with monies made from Mr. Gates and also endowment from Warren Buffett, we
said, where is it that we have comparative advantage? We can actually leapfrog,
we can make impact.
Initially, when the Foundation started, we had
fantastic researchers, the best in the world. We still have fantastic
researchers, the best in the world. We looked at countries that had the biggest
challenges in the world through research. We funded a lot of research; we are
still funding a lot of research on how to stop malaria. We want to stop malaria
from the earth. Can you imagine an earth where there is no malaria? We believe
it is doable. When we talked about a world where there is no polio, people
thought Mr Gates was joking. But, now, we have only three countries in the
world, Afghanistan, Pakistan and Nigeria. And, Nigeria is almost there, but for
the insurgency of Boko Haram, where we have pocket of cases of children that
were not immunized.
We are going to eradicate polio. After we
eradicate polio, we are going after malaria. Can you imagine everybody saying
forever no malaria? Those are the kinds of big targets we are putting up. In
Nigeria, our biggest investment has been in polio eradication. We’ve
strengthened routine immunization. Immunization because we believe that no
child should die because of preventable diseases for every disease that we have
vaccine for, every child should be immunized. No child should die of
meningitis; no child should die of whooping cough. These are diseases that in
other parts of the world, they’ve been taken care of. So, we are investing
heavily on immunization of children.
You have donated so much to various
non-governmental organisations and institutions of government in Nigeria for
health care services, how have you ensured that your monies are being
judiciously spent?
For the grants that we give, we have systems of
checks and balances. Actually, some of the people, we use group like KPMG, they
are the people that run after NGO that we work with; they audit them and give
them reports. If we find any NGO wanting, we ask them to give us our money back
straight. If they don’t, we take them to court. We have very stringent systems.
How do you determine the funds that go into
countries where you work?
The way we work is this: we don’t wake up and say
Nigeria should be given $100 million. No. we do baseline. We look at what the
needs are. It is the need that determines what the amounts are. For example,
this year, we signed a health MoU with Kano. We are doing primary health care
in Kaduna, we are doing a lot of agriculture in Ibadan, with IITA. In Lagos, we
are doing financial inclusion. So, we know what we are going to do. Amount of
money we are going to put on that will be determined by what is needed.
There is no fixed amount. On the average, for all
the works we do, when we started about five years, we spent approximately N35 million
per year. But, now, we spend about N250 million per year. Every six months, we
give a report of how much we have spent to Ministry of Budget and National
Planning.
Every six months, I signed, we deliver to them,
and we put it in their system, which is open, which you can access from Budget
and National Planning (website) You can see all the dollars, how much they have
put in the country. and, it has been captured in the system. I recently signed
the last one in January. In June, we are going to do another one.
What are the criteria for selecting the states you
work with? It seems most of your interventions in Nigeria occur in the North.
Why?
No. May be it is because people see us working on
polio. Polio is a northern nuisance. I don’t think anybody wants us to go and
work on polio in their states; polio is a menace. Because people see us working
on polio, and we are very active with polio, people think we are in the north.
How do we select our states? The selection of our states for health, we look at
the number of criteria. Three years ago, we were in 25 states and the FCT. We
decided that we are all over the place. We don’t have enough money. We need to
be focused on a few states and have impacts. While we demonstrate we can make
impacts, we can make impacts. Then, we can expand to other states.
So, we went through rigorous analysis. One of the
key things that we take care of is that the main thrust of people that we care
for are people who live below one or two dollars a day; the poorest of the poor
is our constituency. So, what is the highest burden of the poorest of the poor
in Nigeria? Where do you have the poorest people? Where do you have the worst
health indicator? You can look at your demographic health survey, where do you
have the poorest unqualified people? Kano, Lagos, Kaduna, because of the
population. We selected those to start with. And, for us, these are the key
most populous. If we are able to saturate, we make a big stride in Nigeria.
But, mind you, this is just health. When we look
at agriculture, in agriculture, we work along certain value chains. For
example, rice; we do a lot of research. We do a lot of work in cassava. A lot
of these of these researches are in IITA, Ibadan. It is not true that we only
work in northern Nigeria. Once we eradicate polio, then that notion will
disappear. Then, we won’t have to focus on polio affected areas.
In what area have you made the greatest
investment?
Our greatest investment is stopping children dying
unnecessarily because of preventable diseases. Children in America and the UK
and in other countries like Ghana and Rwanda don’t die because of meningitis.
We invest in the production of those vaccines. We buy those vaccines, we pay
for those vaccines to be brought so that these children will be vaccinated and
that they don’t die.
