Co-Founder Aig-Imoukhuede Foundation, Aigboje Aig-Imoukhuede Speaks on New ways of Working with the Private Sector to Beat Malaria.

At the GBCHealth, CAMA and Wilton Park virtual dialogue: Sustaining progress in the fight to end Malaria.

Let me start by asking a question which I have often asked before. Why must Africa always bear the burden of pandemics long after the rest of the world has conquered them and put them to bed?

Malaria is one pandemic that wears me out, and I pray that this would not be the case in Africa for the covid 19 Pandemic. We know that Africa is the burden bearer, the load carrier for malaria. 94% of these cases are in Africa. Nigeria tops the list with almost 30% of these malaria problems.

Almost 400,000 Africans die every year from malaria, mostly in sub-Saharan Africa. You know by comparison, after 15 months, cumulative covid-19 deaths in Africa are under 130,000. I am pointing to this to say that covid-19 is a big problem, and the world has rallied, including private sectors. It tells you when you look at the gap in terms of how the rise in the covid-19 challenge has been, compared to the malaria problem that is clear, present, and still with us.

The front line for the war against malaria is the primary healthcare system. If we consider Nigeria not because it is the country I am from, but because Nigeria accounts for 30% of cases and the worse predicament of Malaria in Africa. Unfortunately, the primary health system is the weakest link in the health Sector. Our Primary Health Centres (PHCs) are poorly equipped and have become home to rat, rodents, and reptiles.

Beyond the infrastructural problems, the PHCs do not have skilled labour. Nigeria has one of the worst doctor’s population ratios in the world. Nobody wants to work in the primary health centres in rural areas. Drug availability is a cause for concern, with less than half of all the PHC facilities having the listed essential drugs in stock.

Now we know that the government alone cannot win the fight against malaria. The government also has the added burden of the covid-19 pandemic. But then, why must government alone bear this burden? Government spending in Nigeria accounts for only 12% of GDP, with the rest coming from the private sector. Africa in this regard, twenty years ago, the private sector controlled a fraction of the resources at its disposal. Today, we have several Africa unicorns owned by Africans who would be game-changers if they choose to join the fight against malaria.

20 years ago, I would not have said this with the confidence I speak today, but because some of the richest in the world today are Africans. Along with the co-founders at the Private Sector Health Alliance of Nigeria (PSHAN) Nigeria’s private sector health focal point NGO Aliko Dangote, Jim Ovia and I approved for PSHAN to lead, The Adopt-A-Health Facility Program (ADHFP) with the primary aim of delivering one global standard primary health centre in each of the 774 local government areas. We want to address the deficiencies in the primary health centre system, ring-fenced funding for the primary health sector in a coordinated manner but, the funding will come from the private sector first.

Now, PSHAN is a focal point. Issues of leadership and steering and convening and pushing through when necessary to make things work are things that we have been building up at PSHAN.

We spent almost a year working on this programme, at a significant cost. Our feasibility studies cover the entire nation- local and involved international experts in public health, finance, law, and logistics.

I speak to these things to let you understand that it is not just having the roundtable with the private sector, you must have involved leadership, and those leaders must be ready to front-run where others are not prepared to go. If you hit your head against the wall of challenges and problems, and they come crumbling down. It brings stronger leaders of the private sector together.

In terms of the approach, we are trying to build a non-profit impact investment instrument right now. I used to be the President of the Nigerian Stock Exchange and also Chaired another Debt Exchange. So, you will find that those who are leading these projects are very versed in finance and investment. But this is all philanthropy in the sense that there is no economic return. Although there is no direct economic return, there is a social health impact return. It is probably more important than how much you get from the money you invest in this.

It is going to be tax-efficient for organisations thus ensuring sustainability. Also, we are using funding from the private sector to demand that the state governments, who are responsible for the PHCs match what the private sector is doing and operate in an integrated manner. We seek economies of scale, economies of scope, standard formats of governance, standard formats for Monitoring and Evaluation (M&E) etc. And we are going to create a national logistic superstructure to support the supply of drugs going to the rural areas to penetrate. I ask the question, ‘’Why can’t I get genuine malaria drugs in my village?’’

In my village, I still see people drinking bottles and cans of coke. So, what is it that coke knows? What knowledge and skills does their leadership possess that can be transferred to the primary health sector?

One of the other speakers, Robert, commented on the leadership ability of the public sector to lead and drive innovation. I also spoke about this issue recently and how the Africa Initiative for Governance (AIG) and the Aig-Imoukhuede Foundation, the umbrella body for my focus on improving governance in Nigeria, particularly in the public sector, is addressing this.

One of the things we are doing in a few weeks is launching the AIG Public Leaders Programme for Africa, starting with 50 students a year. We will increase the number to a hundred or two hundred high potential public servants in the coming years. It is a very rigorous process to get into this programme. It is a four-month programme run by the faculty from the University of Oxford Blavatnik School of Government. It is going to address the issues of innovation and leadership in the public sector. Thanks.