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
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.