We’ll Soon End Global Malaria Scourge – Dr. Mandara

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.