Paulin Basinga is the Country Director of Bill and Melinda Gates Foundation in Nigeria, a major international donor supporting development in several sectors in the country.
On the back of the official release of the 2020 Goalkeepers Report released a few weeks ago by the foundation, Mr Basinga had a virtual interview with PREMIUM TIMES’ Ebuka Onyeji.
The Goalkeepers report is the foundation’s annual scorecard on the world’s progress towards achieving global health goals.
In the interview that held virtually, Mr Basinga highlighted some areas of concern in Nigeria’s target of eliminating Severe Acute Malnutrition (SAM), a major contributor to infant deaths.
He also spoke on activities the foundation is focusing on assisting Nigeria to tackle its health and development challenges.
SAM or extremely low weight-for-height, is estimated to affect about 2.5 million children under age five in Nigeria every year, contributing to as many as 400,000 deaths annually.
There has been a consistent slashing of budgetary allocations for Ready-to-Use Therapeutic Food (RUTF), a nutritional program designed to save thousands of lives suffering SAM.
PT: In the 2020 health budget, funds for nutrition were slashed with about N800m removed to the chagrin of nutrition advocates who are concerned about the impact of this on the country’s target of eliminating SAM. Why should funding for nutrition be prioritised?
Basinga: The Government of Nigeria has recognised nutrition as a key priority with strong policy support reflected through the National Policy on Food and Nutrition, the Agricultural Sector Food Security and Nutrition Strategy and the Health Sector National Strategic Plan for Nutrition.
Government funding for nutrition has been on the increase both at the Federal Level and across the states. The only challenge is that the amount budgeted is far less compared to what is needed and sometimes, budgetary allocation does not translate to budgetary release. We acknowledge that the COVID-19 pandemic has exerted budgetary pressure resulting in many such adjustments as flagged by the nutrition advocates.
PT: Does the foundation have any plans on investing in Nutrition in Nigeria?
Basinga: The Government at the highest level remains committed to advancing nutrition through the National Nutrition Council chaired by the Vice President. The foundation remains committed to supporting the Government of Nigeria and has been involved in addressing nutrition challenges in Nigeria since early 2000.
We support the Government of Nigeria to improve nutrition through our work in Primary Health Care, Large Scale Food Fortification, Senior Advisory Policy Support in key Sector, nutrition-sensitive agriculture and food systems, and through investments in data and policy development and implementation and Human Capital Development initiatives. Supporting the government and private sector nutrition efforts remains a top priority for the foundation.
PT: Nigeria was recently crowned with the unenviable position of the highest contributor to deaths of under 5 all over the world after the country surpassed India, according to UNICEF’s latest figures. With this in mind, what are the foreseeable challenges of tackling deaths among under 5s in Nigeria, and in what areas will the foundation want to come in?
PT: Yes, Nigeria now accounts for the highest number of under 5 deaths with 117 per 10, 000 deaths, according to the UN-Inter-Agency Group on Mortality estimates.
The challenges are not in tracking these deaths but in providing adequate resources (human, material, and organisational ) to accelerate the implementation and update of proven high impact interventions in the health sector. The government has agreed to improve its stewardship and increase its budgetary allocation and release to the health sector at both the national and states level. The Basic Health Care Provision Fund (BHCPF) approved last year is also expected to increase resources available to provide basic health care to the population especially those most at risk – poor and vulnerable. At the foundation, we believe that ALL LIVES HAVE EQUAL VALUE… and one of our key metrics is the under-five mortality.
We are engaging with the government, donors, and key implementing partners to support critical and high impact interventions to address key drivers of under-five mortality. Through our grantees, we are providing technical assistance to the government at both federal and state-level to accelerate the scale-up of global best practice interventions against key drivers of mortality such as malnutrition, diarrhea, malaria, and vaccine-preventable disease (measles, whooping cough).
We are also engaging with global partners (through our networks) to mobilise additional resources that will support the Nigerian government and partners to address this huge challenge. We have been engaging with Nigerian advocacy groups, traditional and religious leaders, and civil society groups to support their own efforts in getting their constituencies the information they need about essential services delivered at the primary health care setting.
PT: How has COVID hampered the progress of Family Planning(FP) especially FP2020 which I believe the Foundation is also among the funders.
Basinga: In times of crisis, women, children and newborns are especially vulnerable as essential services – including Family Planning, maternal, child, newborn care, and good nutrition – become increasingly disrupted. In Nigeria, the Global Financing Facility (GFF) estimates that over 2 million fewer women would receive modern FP services during the six months that has lasted the pandemic. With the supply chain disruption, women may no longer find the method of their choice, they may have to switch to a method they may not like or tolerate or even stop using contraceptive
PT: What are the implications of not investing more in FP to Nigeria’s burgeoning population?
Basinga: Family Planning is one of the key pillars to reap the demographic dividend critical to the Nigeria Human Capital Development Strategy. This dividend, however, is not automatic, and no country in the world has ever achieved the demographic dividend without making a significant investment in access to family planning. Providing women and girls with access to contraceptives is transformational – families become healthier, more productive, better educated, and it leads to sustained economic growth. Additionally, when women and girls are empowered to plan their families, they are more likely to stay in school, advance their education, participate in civic activities, and join the workforce. If Nigeria makes substantial investments to empower, educate, employ, and improve the health of its citizens—including expanded access to family planning—it has the potential to realize incredible economic growth in the coming decades
PT: How can African countries fund their UHC as foreign donor aid is shrinking due to COVID-19?
Basinga: While some countries have seen changes in their level of support from wealthier governments, we have also seen significant collaboration around funding for secure health systems such as the Gavi replenishment earlier this year which raised over $8 billion. COVID-19 needs to be the catalyst for increased support for strong health systems across the world. This is a shared global crisis that demands a shared global response because COVID anywhere is COVID everywhere. Also, as I said earlier we fully acknowledge that the COVID-19 pandemic has caused significant budgetary pressure for governments across the world; this may be an opportunity for the government to have a hard look into their expenditures and look for potential efficiencies gains.
Even in the world’s richest countries, COVID-19 is reminding us how fragile access to basic health care can be. COVID-19 hasn’t changed anything about the absolute necessity of investing in PHC. PHC is where people get all the basic health services they need: vaccines, prenatal care, and treatment for common yet life-threatening illnesses like diarrhea, pneumonia, HIV, TB, and malaria. The covid-19 pandemic has clearly shown that there is no alternative for a strong, resilient primary health care system to assure health security of the population and avoid massive human and economic losses.
PHC needs to play a major role now and post COVID, as we can stop this virus through strong, dynamic PHC systems that can deliver essential health services to all who need them, both now and after COVID-19 has run its course.
PT: In which areas will the Foundation invest in Nigeria looking at the impact of the contagion?
Basinga: In Nigeria, the Foundation remains committed to continuing supporting the Nigerian Government’s response to COVID-19 and broader health issues in Nigeria, particularly focused on those who are most vulnerable to disease. There is an array of development and international organizations working collectively together with the government and the private sector in support of the NCDC and the Presidential Task Force (PTF).
We have provided technical assistance support for Nigeria’s emergency preparedness and response, contributed to the UN basket funds to secure commodities and tests for Covid-19. We have also provided catalytic support to states that the most hit such as Lagos, etc. We will also continue to partner with the Nigerian leadership and facilitate any engagement with Africa or global response to ensure that Nigerians have access to tools and technologies to manage the COVID-19 pandemic.