PEOPLE AND POLITICS

By

Mohammed Haruna

The NPI: Why Dr. Dere Awosika Should Go

Late 2003, the American Centre for Global Development commissioned a high powered panel of 30 former government officials, academicians, businessmen and representatives of Non-Governmental Organisations to examine the challenges that weak or failed states posed to America’s national security. Nine months later in June 2004, the panel issued its report which outlined how America’s foreign policy can be formulated to meet those challenges.

Among the commission’s members were some former government officials with at least a fairly intimate knowledge of Africa and the Third World. These included Chester Crocker, Assistant Secretary of State for Africa in the eighties, Robert McNamara, US Defence Secretary of Defence in the sixties and the longest serving president of the World Bank, and Thomas Pickering whose 50 year diplomatic career included ambassadorships in Israel, El-Salvador and Nigeria. Another member, Susan Rice, was Assistant Secretary of State for Africa under President Bill Clinton. All four are acquaintances of our president, Olusegun Obasanjo.

The panel’s report defined a weak state as one which lacked or has a weak capability in three areas, namely security, capacity and legitimacy. In other words a state was weak if it could not ensure the security of its citizens, meet their basic needs and maintain its own legitimacy.

Predictably Africa, often dismissed by Western analysts as the Dark Continent, featured prominently in the report. “Security gaps”, said the report, “have been most evident in Africa.” This, continued the report, has, in turn, meant gaps in the ability of many of its countries to provide their citizens with basic needs. “Many of the states facing security gaps” the report said, “also find themselves unable to provide education and health services”. Sometimes, however, the report said, the problem was not so much security as inadequate resources.

Finally, the report said, states which undermined rather than fostered institutions that protect human and civic rights and states which routinely disregarded the laws they themselves enacted or at best applied them selectively, invariably suffered from lack of legitimacy.

On the area of insecurity the report identified three types: major, intermediate and minor wars. Out of the 16 countries the report listed as suffering from major wars, 10 were from Africa. Again out of the eight listed as afflicted with minor wars six were from the continent. It was only in the category of intermediate war that Africa had three out of the seven countries listed. Mercifully Nigeria was not in any category even though, for a country not at war with itself, its level of insecurity created by its violent criminals and armed ethnic militias must rank among the highest in the world.

Although the country was not listed as being in the grip of any war, it ranked among the lowest in its capacity to cater for the basic needs of its citizens. Here the report listed five categories: the top 20%, 60-80%, 40-60%, 20-40% and the bottom 20%. Nigeria ranked among the bottom 20% along with wear-torn countries like Afghanistan, the Democratic Republic of Congo (DRC), Chad and Sierra-Leone.

The country scored only a little bit better in the area of legitimacy. Even here it was listed among countries with a simulacrum of democracy like Uganda, Guinea-Bissau, Mauritania and Sierra-Leone.

Nigeria, in short, was regarded by the American Centre for Global Development commission as a weak, if not a failed, state.

At this point the reader may have started wondering what all this has to do with Dr. Dere Awosika and her tenure as the national coordinator of the country’s immunisation programme since 1998..

Well, quite a lot. Dr. Awosika, a pharmacist, happens to be the pioneer National Coordinator of the National Programme on Immunisation since its establishment as a parastatal of the Federal Ministry of Health. More by design than by coincidence, the US commission on weak states chose the immunisation rate of the countries it examined as the most reliable test of a country’s ability to meet the most basic needs of its citizens. “Immunisation rates”, the report said, “are a good indicator of broader health policies and strategies. In addition, the immunisation rate has a strong relationship with infant mortality and increased literacy rates and has a reasonably positive association with economic growth”.

What this means clearly is that the credit for the success of the country’s recent immunisation programme – and by extension, the credit for the country’s status as a weak or strong state - or conversely, the blame for the failure of the programme, must rest squarely on the shoulders of Dr. Awosika as the boss of the NPI in the last seven years. Sadly the story of the country’s immunisation programme during this period has been one of a disastrous decline in our immunisation rate with all its potential for arresting the future economic growth and development of the country.

All through this decline, with its attendant scandals and controversies, Dr. Awosika has proved herself as someone with an amazing staying power that would make her an envy of the proverbial cat with nine lives.

The latest evidence of the staying power of this Iron Lady of NPI manifested itself in the Federal Government’s reversal, early this month, of its decision to sack her, presumably because of a recent threat by the World Bank to withdraw its financial support for the country’s immunisation programme.

In a letter to the country’s Minister of Finance, Dr. Ngozi Okonjo-Iweala and copied to the Minister of Health, Professor Eyitayo Lambo and to Dr. Awosika herself, among others, the Bank’s country Director, Mr. Hafez Ghanem, expressed concern about the inability of the NPI to achieve its objectives. “I am” Ghanem said, “increasingly concerned that the resources the World Bank is providing the immunisation programme in Nigeria are not achieving the full results especially on routine immunization. The immunisation rate remains low at less than 13 which is lower than in Nigeria’s poorer neighbours (e.g. Benin and Niger) and even lower than in many countries in conflict (e.g. DRC)”, that is the Democratic Republic of Congo.

Not only is our immunization rate abysmally low, the Bank said, our costs of immunization is scandalously high. “Conservative estimates”, said Ghanem, “shows costs in 2005 at $56 per fully immunized child. This is more than double the norm for developing countries”. The NPI, the Bank added, has also been extremely wasteful in the use of its resources.

Ghanem said since 2003 the Bank has provided about $80 million for polio eradication alone with little result. “I am concerned”, he concluded, “that unless the problems facing the management of immunisation services are addressed it will be difficult for the Bank to justify its continued support for immunisation”.

This threat probably forced the Federal authorities to contemplate the unthinkable; sack Dr. Awosika after so many years of polio controversy, unending feud with her chairman, Professor Idris Mohammed – a feud which prompted the president to approve the setting up of an administrative inquiry into the workings of the NPI in 2003 - and, above all, a disastrous 56% drop in the country’s immunisation rate from a high of 70% during the tenure of the late Professor Olukoye Ransome-Kuti as health minister under military president, General Ibrahim Babangida.

The Daily Trust of November 14 reported Awosika’s sack based on its information that the president himself has approved a memo from the minister of health that requested the sack. Two weeks on, the NPI Iron Lady is still sitting pretty on her chair to which she appears to be permanently glued.

The World Bank would not be the first foreign donor to complain about lack of transparency and poor results at the NPI. Other foreign donors like the European Union and the British DFID have made similar complaints in the past. Each time, DR. Awosika survived their complaints.

Late 2003, the panel which looked into the bad blood between herself and her chairman submitted its report to the minister of health. The report largely cleared her of the allegations of financial and administrative improprieties the chairman made against her. It concluded that he was “a highly self-opinionated individual.” Shortly after that he was, for all practical purposes, unceremoniously sacked.

Dr. Awosika, on the other hand, survived. She was, the report said, “a very strong personality, a type-A personality, who is achievement driven”.

If, two years on, the Federal authorities would reverse their decision to sack her and by so doing risk the health of Nigerians and that of future generations, it is not difficult to agree with the panel that she indeed possesses “a very strong personality”.

It must, however, be one of those mysteries of government that someone whose long tenure has resulted in a catastrophic decline in the country’s immunisation rate, with all its implications for the economic growth and development of the country, would be regarded by anyone as “achievement driven”, whatever that means.

Of course, the sack of Dr. Awosika alone would not overnight change things for the better at the much discredited NPI. No matter how big a tree, it, alone, would not make a forest. But then many a public servant have been sacked for a much less disastrous record than Dr. Awosika has had at the NPI. Such is the staying power of the Iron Lady of NPI