A partnership to tackle malnutrition, childhood killer diseases

Dangote Foundation, Bill & Melinda Gates Foundation commit to boosting nutrition, routine immunization in Nigeria
Determined to boosting routine immunization (RI) against childhood killer diseases and ensuring that Nigeria is ultimately certified polio free by end of 2017 by the World Health Organisation (WHO), the Dangote Foundation and Bill & Melinda Gates Foundation (BMGF) have signed a new memorandum of understanding (MoU) with Borno, Kaduna, Sokoto and Yobe States.

According to a joint statement by the foundations, strengthening RI takes sustained financial and human resource commitment and it is important that the changes being made during the short MoU period must be “habit forming” changes that are kept in place well after these MoUs end.

The statement noted that the goal of these MoUs is to change the State’s own RI programmes and health system for the long term; the total cost of the six MoUs is $42 million between 2013 and 2018; and the Foundations and the states will provide $14 million each while the federal government will provide the vaccines.

Also, the foundations have signed new MoUs for cold chain with Katsina and Zamfara states.

Dangote Foundation and BMGF have entered into a one-time, 15-month tripartite MoU with Zamfara State and Katsina State to strengthen their cold chain system.

The foundations in a joint statement said: “This is not an in-depth RI MoU like we have established in other northern states. Under the terms of the last round of the Governors’ Immunization Leadership Challenge, the two Foundations committed to recognizing Zamfara State and Katsina State each with $1 million in grant award funds ($500,000 from each Foundation) for their success in remaining polio free in 2013.

“Dangote Foundation and BMGF’s funding will support the purchase of cold chain equipment, while the states have committed to releasing funds to support equipment installation, operation, and maintenance. The two Foundations’ money has been released to United Nation Children Fund (UNICEF) to enable them to do the procurement. The procurement includes walk-in coolers for satellite cold stores, as well as the solar direct drive dual refrigerators to be used at the facility level.”

The Dangote Foundation and BMGF has also announced a combined commitment of $100 million over the next five years (2016-2020) towards ending under-nutrition in Nigeria. This commitment is expected to improve the lives of at least five million families by 2020 and was announced by Alhaji Aliko Dangote and Bill Gates, last week, during a press conference in Abuja.

Meanwhile, there has been huge progress in the fight against the wild poliovirus (WPV) and Nigeria was able to interrupt the transmission. July 24, 2015 marked one year since the last child in the country was paralyzed by WPV, in Sumaila Local Government Area in Kano State.

According to stakeholders, the key now is to keep up the efforts so the trend is not reversed but an estimated 250,000 children in Borno State have not been immunized due to insecurity.

While it is an important indication of progress to have 1.5 years without a case of WPV, Nigeria needs to go through July 2017 without a case anywhere in the country to be declared polio-free. Surveillance must be maintained at global-level standards so that we are not missing anything.

Also, despite rapid economic growth, Nigeria is home to the highest number of stunted children in Africa and the second highest globally. Almost one in five Nigerian children are acutely malnourished and more than one in three children suffer from stunting. With its vital role in child health, growth and cognitive development, better nutrition will be essential to unleashing the potential of Nigeria’s next generation.

Guided by the belief that all lives have equal value, the BMGF works to reduce inequity around the globe. We fund new ideas and encourage innovative partnerships so shared resources will do the greatest well for the most people. In developing countries, we focus on improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty.

The foundation invests in proven approaches to improving nutrition, such as focusing on that 1,000-day window, immediate and exclusive breastfeeding, and food fortification and supplementation. Its long-term goals are to prevent 1.8 million malnutrition-related deaths by 2020 and to develop and test new solutions to address the burden of malnutrition that cannot be alleviated using existing interventions.

Dangote Foundation, the philanthropic endeavor of Aliko Dangote is the largest private foundation in sub-Saharan Africa.

Aliko Dangote believes that supporting social and economic change through investments and interventions that improve the lives of the less fortunate can make a positive difference in the growth of a nation. His vision is one where no Nigerian child should suffer and die of under nutrition and disease. Dangote Foundation’s goals are to: help reduce the number of lives lost to malnutrition and disease; support income generation activities and education programs that help lift people out of poverty; and be responsive to people who are affected by natural disasters globally, by providing emergency relief.

Bill Gates said: “Nutrition is one of the highest impact investments we can make in Nigeria’s future growth and prosperity. We know that well-nourished children are more likely to grow up to be healthy, fend off preventable diseases, achieve more in school and even earn higher income as adults.

“This partnership builds on our foundation’s strong commitment to Nigeria – one of several countries where we are working closely with the government, the private sector and civil society to improve health and development outcomes.”

Dangote said: “In the spirit of our new partnership, we encourage even more deliberate and significant commitments from the Government of Nigeria at all levels to step up investments in nutrition. It is time to make strategic investments in interventions to eliminate malnutrition in Nigeria. This will be achieved through a massive scale-up of interventions, matched with effective coordination of efforts and innovative sustainable solutions. We have to ensure that children who are already malnourished receive help and are prevented from dying while we improve the conditions that led to them being malnourished in the first place.”

In a joint statement, the two foundations said they would begin a joint planning process to determine the details of the partnership. Programmes will include community-based approaches and proven interventions linked to behaviour change, fortification of staple foods with essential micronutrients, the community management of acute malnutrition and investments in the local production of nutritious foods. A key objective will be improving the livelihoods of households by supporting nutrition-sensitive agricultural programs that can increase family income, improve diets and empower women and youth.

The two foundations also welcomed the increased political attention to under-nutrition in Nigeria and noted that leadership will be critical to future progress.

Gates

Meanwhile, in late 2012 in Kano, and mid 2014 in Bauchi, Dangote Foundation and the BMGF, entered into MoUs with the states to build a systematic statewide approach to strengthening routine immunization and by extension, a significant part of the primary health care system.

Dangote Foundation and BMGF contribute to a ‘basket fund’ that pools our resources with each State, with progressive responsibility for the budget passing to the State. Annual work plans support all areas of the statewide programme, and have a knock-on effect in strengthening some of the systemic issues that hinder primary health care (budgeting, coordinated work planning with all partners aligned, accountability frameworks, performance management).

The third year of our collaboration in Kano was just completed, with a fourth year extension agreement that was recently formalized on January 20, 2016. In Bauchi we are one and a half years into the three-year MoU.

Traditional Rulers and Leaders have played a critical role in the success of the fight against polio. During the course of the last several years they (Northern Traditional Leaders’ Committee) have contributed in two substantial ways: (a) they’ve provided the polio program with badly needed credibility in the face of a concerted campaign to distort fears about vaccine safety and rumors of a ‘Western’ plot. The Emir of Kano, for example, created a sensation when he went to the urban Local Government Area of Ungogo in 2014 and consumed an entire vial of Oral Polio Vaccine in front of a huge crowd to make the case that there are no impure elements in the vaccine; and (b) they have been the single most effective partner in reducing incidents of ‘non-compliance’ – that’s when families refuse to allow children to be immunized during the campaign by the house-to-house team.

Over several years, the incidents of non-compliance have reduced significantly, and now comprise less than one per cent of the approximately 19 million children missed for immunization during a campaign in northern Nigeria. In some areas of certain states, such as Sokoto, Kaduna and Kano, non-compliance accounted for more than 25 per cent of missed children five years ago.

In 2009, the Federal Government and the Nigeria Governors’ Forum signed what is called the “Abuja Commitments”. These Commitments outline specific actions that the State Governors and the Local Government (LGA) Chairmen are supposed to do every month/quarter to ensure polio eradication. These include public actions such as holding meetings with traditional leaders and actively participating in the polio campaigns.