Nige­ria's sus­tain­able de­vel­op­ment agenda

This be­ing the Key­note Ad­dress as de­liv­ered by Dr. Muham­mad Ali Pate, global health ex­pert and former Min­is­ter of State for Health, Fed­eral Re­pub­lic of Nige­ria. Dr. Pate spoke at the 10th An­niver­sary Col­lo­quium of Fi­nan­cial Nige­ria mag­a­zine, which held on

Financial Nigeria Magazine - - Contents -

Pro­to­col Let me start by ex­press­ing grat­i­tude to Mr. Jide Ak­in­tude, Pub­lisher of Fi­nan­cial Nige­ria and the Or­ga­niz­ers of this beau­ti­ful event for their gra­cious in­vi­ta­tion.

This event could not have come at a bet­ter time, when Nige­ri­ans – pro­fes­sional politi­cians, tech­nocrats, cit­i­zens – and friends of Nige­ria are in con­ver­sa­tions re­gard­ing both the im­me­di­ate and longterm di­rec­tion of the coun­try.

In these re­marks, I in­tend to first, sit­u­ate the dis­cus­sion on Nige­ria’s sus­tain­able de­vel­op­ment agenda within the his­tor­i­cal con­text of the global Sus­tain­able De­vel­op­ment Goals (SDGs). I will share my thoughts on where we are rel­a­tive to the SDGs, present some of the un­der­ly­ing rea­sons of our per­for­mance as a coun­try and lay out an agenda for how we can make progress on sus­tain­able de­vel­op­ment. I will use the def­i­ni­tion of sus­tain­able de­vel­op­ment from the orig­i­nal Brundt­land Com­mis­sion Re­port (1987) as: “de­vel­op­ment that meets the needs of the present with­out com­pro­mis­ing the abil­ity of fu­ture gen­er­a­tions to meet their own needs”.

His­tor­i­cal back­ground – from the MDGs to SDGs

Fol­low­ing a se­ries of mile­stones, in 2000, at the United Na­tions’ Mil­len­nium Sum­mit, 147 heads of state adopted the Mil­len­nium

De­vel­op­ment Goals (MDGs) in an un­prece­dented ef­fort to fight ex­treme poverty in a com­pre­hen­sive man­ner.

The MDGs set out goals that cov­ered in­come poverty, hunger, pri­mary ed­u­ca­tion, in­fec­tious dis­ease, ma­ter­nal and child health, gen­der em­pow­er­ment, en­vi­ron­men­tal sus­tain­abil­ity and global part­ner­ship for de­vel­op­ment. The MDGs were to be achieved by 2015.

The MDGs marked a wa­ter­shed mo­ment in global mo­bi­liza­tion to achieve worth­while so­cial pri­or­i­ties. They pro­moted pub­lic con­scious­ness, track­ing of re­sults, push­ing for po­lit­i­cal ac­count­abil­ity and gen­er­ally pil­ing pres­sure on lead­ers to fo­cus on devel­op­ments that mat­ter to the peo­ple. One of the great­est global phi­lan­thropists of our time is re­ported to have re­marked that the MDGs be­came a type of global re­port card for the fight against poverty from 2000-2015. Each coun­try then had a ba­sis to as­sess its per­for­mance in a stan­dard­ized man­ner against those im­por­tant global goals.

The MDGs worked, to a large ex­tent. Re­mark­ably, by the end of 2015, the num­ber of peo­ple world­wide liv­ing in ex­treme poverty had de­clined by more than half, pri­mary school en­roll­ment had in­creased and chil­dren out of school had re­duced by half. More girls were in school and more women in paid em­ploy­ment, sig­nif­i­cantly re­duc­ing gen­der in­equal­ity. In the health sec­tor, the global un­der-five mor­tal­ity had re­duced by more than half, ma­ter­nal mor­tal­ity ra­tios de­clined also by nearly a half. The spread of HIV and malaria had slowed down con­sid­er­ably.

These were global achieve­ments made pos­si­ble due to de­ter­mined ac­tions by sev­eral coun­tries and global sol­i­dar­ity that was rarely seen pre­vi­ously. The MDGs helped to fo­cus the in­ter­na­tional com­mu­nity on the most im­por­tant pri­or­i­ties. Our world was the bet­ter for it.

But there were many vari­a­tions and short­falls in achieve­ments, which were es­pe­cially dis­ap­point­ing for low in­come pop­u­la­tions in sev­eral coun­tries, par­tic­u­larly in Africa.

In our case in Nige­ria, the bot­tom line is we failed to reach many of the MDGs tar­gets. Whereas aver­age poverty rates had by then slightly de­clined, the de­clines were not enough to reach the MDGs tar­get and have since re­versed. The ob­served de­clines in ma­ter­nal and child mor­tal­ity, as well as in­fec­tious dis­eases like HIV and malaria, were also not to the level tar­geted in the MDGs. Per­haps, more con­cern­ing is that in­equal­ity had in­creased in mul­ti­ple di­men­sions.

While the aver­age sta­tis­tics for Nige­ria did not show much progress, we must also ac­knowl­edge sig­nif­i­cant in­tra-coun­try vari­a­tion in per­for­mance within Nige­ria, which makes the pic­ture even more dis­mal in some States than the aver­age for the coun­try. A state like Ondo, was able to reach its MDGs health tar­gets, even though its progress alone was not enough to tip Nige­ria over all to achieve the na­tional tar­gets. States in the north-east did not make much progress and may even have headed in the wrong di­rec­tion on some in­di­ca­tors.

Build­ing on the les­sons from the MDGsera, in 2015, the UN over­saw an­other global treaty built around a shared fo­cus on bal­anc­ing eco­nomic, so­cial and en­vi­ron­men­tal ob­jec­tives, as corner­stone for sus­tain­able global de­vel­op­ment. The 17 Sus­tain­able De­vel­op­ment Goals (SDGs) to be met by 2030, now rep­re­sent a new global com­pact, which, if achieved, will put our world in a pos­i­tive and more sus­tain­able tra­jec­tory.

The SDGs specif­i­cally deal with end­ing ex­treme poverty; achiev­ing zero hunger; good health and well-be­ing; qual­ity ed­u­ca­tion; gen­der equal­ity; clean wa­ter and san­i­ta­tion; af­ford­able clean en­ergy; de­cent work and eco­nomic growth; re­duc­ing in­equal­i­ties; sus­tain­able cities and com­mu­ni­ties; re­spon­si­ble con­sump­tion and pro­duc­tion; cli­mate ac­tion; life be­low wa­ter and on land; peace, jus­tice and strong in­sti­tu­tions; and part­ner­ship for the goals.

As you can see, these goals are mostly in­ter-re­lated and in­ter-de­pen­dent, but build on bal­anc­ing the three pil­lars of eco­nomic, so­cial and en­vi­ron­men­tal ob­jec­tives for global sus­tain­abil­ity. For each of these goals there are spec­i­fied tar­gets for coun­tries to achieve.

Cur­rent state of de­vel­op­ment in Nige­ria

Now I come to the unglam­orous por­tion of my re­marks; please bear with me. We must speak can­didly, to un­der­stand the grav­ity of the chal­lenges fac­ing our coun­try. I will try to not bore you here by dish­ing out de­tailed sta­tis­tics, which you can eas­ily find through var­i­ous pub­lic sources. I will fo­cus my re­marks more on what those sta­tis­tics should tell us.

Poverty: Re­cently, World Poverty Clock, an NGO that es­ti­mates and tracks the num­ber of world’s poor, re­ported that Nige­ria has sur­passed In­dia to be­come the

A state like Ondo, was able to reach its MDGs health tar­gets, even though its progress alone was not enough to tip Nige­ria over all to achieve the na­tional tar­gets.

global cap­i­tal of poverty, with 87 mil­lion peo­ple liv­ing on less than $1.90 per day and that num­ber is ris­ing. This is a cen­tral and one of the most dev­as­tat­ing facts on the sit­u­a­tion we have found our­selves, af­ter ex­tract­ing al­most $1 tril­lion worth of oil since our na­tional in­de­pen­dence.

We have ef­fec­tively squan­dered an op­por­tu­nity to uti­lize the nat­u­ral re­sources we ob­tained purely by chance; in­stead of in­vest­ing to up­lift our peo­ples’ lives, our po­lit­i­cal elite, by com­mis­sion or omis­sion, chose the path of short-term com­fort and pur­chase of loy­alty through eco­nom­i­cally un­wise, or cor­rup­tion-rid­dled na­tional ex­pen­di­tures, at the ex­pense of eco­nom­i­cally-sound in­vest­ments in both hu­man and phys­i­cal as­sets to trans­form our na­tion.

As we head to the SDGs end-date, in the next decade, what is at stake for Nige­ria is clear, given that, the first goal, end­ing ex­treme poverty is al­ready go­ing in the wrong di­rec­tion. Nige­ri­ans are get­ting poorer, and un­less our econ­omy is trans­formed, the prospect in the next few years do not ap­pear as bright as we think it can be.

Pop­u­la­tion: A “big ele­phant in the room” is Nige­ria’s pop­u­la­tion dy­nam­ics. We have a large and fast-grow­ing, youth­ful pop­u­la­tion. By the year 2050, it is likely that our pop­u­la­tion, based on cur­rent es­ti­mated growth rates, will be more than 400 mil­lion, mak­ing us the 3rd or 4th most pop­u­lous coun­try in the world.

There are eco­nomic ben­e­fits for a na­tion from hav­ing a youth­ful pop­u­la­tion when they are gain­fully em­ployed. This po­ten­tial ben­e­fit, also called the de­mo­graphic div­i­dend, re­sults when the share of the work­ing-age pop­u­la­tion is larger rel­a­tive to the non-work­ing-age, de­pen­dent pop­u­la­tion.

For a coun­try to re­al­ize the de­mo­graphic div­i­dend, it must first un­dergo a de­mo­graphic tran­si­tion (change in the pop­u­la­tion struc­ture), which means a shift from higher fer­til­ity and child mor­tal­ity to rel­a­tively lower fer­til­ity and child mor­tal­ity.

Dur­ing the tran­si­tion’s early stages, mor­tal­ity rates among chil­dren fall. When child sur­vival im­proves, par­ents are likely to feel more con­fi­dent about re­duc­ing de­sired fer­til­ity rates and women be­come bet­ter able to par­tic­i­pate in the broader labour force.

The crit­i­cal stage is when the labour force grows more rapidly than the pop­u­la­tion de­pen­dent on it (the de­pen­dency ra­tio starts to fall), free­ing up re­sources for in­vest­ment in eco­nomic de­vel­op­ment and an op­por­tu­nity for rapid eco­nomic growth, pro­vided the right so­cial and eco­nomic poli­cies are in place. These poli­cies in­clude those re­lated to re­pro­duc­tive health, ed­u­ca­tion of girls and em­pow­er­ment of women, and re­duc­ing child mor­tal­ity, en­abled by good gov­er­nance and de­cent eco­nomic growth.

The pe­riod dur­ing which a de­mo­graphic div­i­dend (eco­nomic ben­e­fits of a youth­ful pop­u­la­tion) may be re­al­ized can last a few decades. Later, when the older ones also in­vest their sav­ings or through pen­sions, fur­ther ex­ten­sion of the div­i­dend oc­curs. This as­sumes they have the sav­ings or pen­sions left to in­vest.

Our present sit­u­a­tion is that the north­east, north-west and north-cen­tral zones have re­mained with sta­ble pop­u­la­tion struc­ture in the last 5 decades, with con­tin­ued high child mor­tal­ity, higher fer­til­ity and de­pen­dency ra­tios. The south­east, south-west and south-south zones are al­ready un­der­go­ing de­mo­graphic tran­si­tion with age­ing be­com­ing prom­i­nent par­tic­u­larly in the south-east, po­ten­tially rais­ing the de­pen­dency ra­tio in that zone as well. This im­plies our de­mo­graphic tran­si­tion is slow, vari­able and achiev­ing the div­i­dend is not guar­an­teed.

Hunger and Nu­tri­tion: Ac­cord­ing to the re­cent Mul­ti­ple In­di­ca­tor Clus­ter Sur­vey, while in­fant and un­der-five child mor­tal­ity have im­proved com­pared to 2011 lev­els, the preva­lence of child­hood wast­ing, and stunt­ing are all go­ing in the wrong di­rec­tion, par­tic­u­larly in north­ern Nige­ria.

In some ar­eas in the se­cu­rity-chal­lenged north-east, stunt­ing rate is more than 60% among chil­dren un­der-five years old, while over­all, 43% of Nige­ria’s chil­dren are stunted. Ma­ter­nal un­der­nu­tri­tion, for both macro and mi­cro-nu­tri­ents, is still high.

The most con­se­quen­tial ef­fect of child­hood mal­nu­tri­tion oc­curs in the brain – a mal­nour­ished child’s brain’s neu­rons (the “grey mat­ter in­fra­struc­ture”, to quote my good friend Dr. Ak­in­wunmi Adesina) are clumped ab­nor­mally – re­sult­ing in cog­ni­tive deficits, lower in­tel­li­gence, lower school per­for­mance and ed­u­ca­tional at­tain­ment, and lower life­time in­come.

In ef­fect, by al­low­ing our chil­dren to be stunted at this high level, we are by ex­ten­sion al­low­ing our na­tional econ­omy to be stunted way into the fu­ture.

Health: Re­gard­ing health and well-be­ing, the pop­u­la­tion health sta­tus of Nige­ri­ans is still sub-op­ti­mal when com­pared to other coun­tries in the African re­gion who have lower hu­man and ma­te­rial re­sources.

Ini­tia­tives over the last 10 years in the health sec­tor, such as drives to in­crease

As we head to the SDGs end-date, in the next decade, what is at stake for Nige­ria is clear, given that, the first goal, end­ing ex­treme poverty is al­ready go­ing in the wrong di­rec­tion. Nige­ri­ans are get­ting poorer.

im­mu­niza­tion, de­ploy mid­wives and com­mu­nity health work­ers to pri­mary health care cen­tres, and re­sults-based fi­nanc­ing such as Sav­ing One Mil­lion Lives, started dur­ing the Yar’Adua/Jonathan era and ex­tend­ing to the present day, have led to im­prove­ments in in­fant and child mor­tal­ity.

How­ever, we still carry a dis­pro­por­tion­ate bur­den of ma­ter­nal and child mor­tal­ity, as well as in­fec­tious dis­ease, such as mother-tochild trans­mit­ted HIV in­fec­tions. We face triple bur­den of dis­ease – back­ground in­fec­tious dis­eases like malaria, tu­ber­cu­lo­sis, HIV, pneu­mo­nia; ris­ing non­in­fec­tious dis­eases like di­a­betes, hy­per­ten­sion, heart dis­ease, can­cers and men­tal ill-health; and ris­ing new and old forms of in­juries.

Many of our cit­i­zens are fi­nan­cially vul­ner­a­ble to the risk of ill-health. Only a few elites can af­ford good health care in the pri­vate sec­tor or abroad. The Na­tional Health In­sur­ance scheme has be­come dis­tracted and stag­nated. Un­less we break through, the prospect for uni­ver­sal health cov­er­age is noth­ing but empty rhetoric.

Ed­u­ca­tion: Nige­ria’s ed­u­ca­tion sys­tem is in a state of cri­sis. At the ba­sic ed­u­ca­tion level, pub­lic ed­u­ca­tion is largely dys­func­tional and of poor qual­ity. Pri­vate ed­u­ca­tion for those who can af­ford is the op­tion that, most well-to-do par­ents choose. In some parts of the coun­try, lit­er­acy and nu­mer­acy rates among 5-16-year-old chil­dren are only about one-third. More than 10 mil­lion chil­dren are out-of-school.

We have be­come numbed to ac­cept­ing a form of so­cial apartheid, where chil­dren of the poor are left to a bro­ken ed­u­ca­tion sys­tem while the elites send their chil­dren to pri­vate schools or abroad. Mean­while, all avail­able ev­i­dence shows that na­tional in­vest­ment in qual­ity ed­u­ca­tion is among the best in­vest­ments that a na­tion can make

for its fu­ture. In ad­di­tion, we are grossly un­der-in­vest­ing as a na­tion in re­search and de­vel­op­ment at the level of our ter­tiary in­sti­tu­tions.

Youth em­ploy­ment and gen­der: The prospect of our reap­ing a de­mo­graphic div­i­dend de­pends not only on qual­ity ed­u­ca­tion, but skills and eco­nomic op­por­tu­nity for our youth, girls and women.

Youth em­ploy­ment is cur­rently at the high­est lev­els of 33.1% (NBS). This does not in­clude un­der-em­ploy­ment. Girls and women are sys­tem­at­i­cally marginal­ized in the po­lit­i­cal and eco­nomic are­nas. This rep­re­sents huge lost op­por­tu­nity for the coun­try to boost its de­vel­op­men­tal prospects, beyond achiev­ing the SDGs.

Con­trary to pre­vail­ing rhetoric, when one looks at ac­tions, it is clear we do not yet, as a na­tion, value suf­fi­ciently the in­put of our youth in the po­lit­i­cal, so­cial and eco­nomic are­nas.

Ur­ban­iza­tion: Link­ing ris­ing poverty, fast pop­u­la­tion growth, poor health and ed­u­ca­tion, youth un­em­ploy­ment, with the back­ground trend of in­creas­ing ur­ban­iza­tion, you will see even more chal­lenge in terms of Nige­ria’s sus­tain­able de­vel­op­ment.

De­mo­graphic tran­si­tion is slow, vari­able and achiev­ing the div­i­dend is not guar­an­teed.

Muham­mad Ali Pate, global health ex­pert and former Min­is­ter of State for Health, Fed­eral Re­pub­lic of Nige­ria

A cross-sec­tion of par­tic­i­pants at the Fi­nan­cial Nige­ria mag­a­zine’s 10th an­niver­sary col­lo­quium

From left: Ar­shad Rab, CEO, Eu­ro­pean Or­gan­i­sa­tion for Sus­tain­able De­vel­op­ment; and Muham­mad Ali Pate, the two key­note speak­ers at the Fi­nan­cial Nige­ria col­lo­quium

A view of the stage

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