Nigeria’s new minister of health: matters arising

Nigerian President Ahmed Tinubu recently appointed a new Minister of Health who will be saddled with the onerous responsibility of sanitizing the health sector which, over the years, had been grossly neglected by succeeding governments. The new minister is Professor Muhammad Ali Pate, the son of a Fulani herdsman. Pate was born on Friday, 6 September 1968 at Misau Local Government Area of Bauchi State and grew up in the northern region of the country.

After his secondary school education, Pate was admitted into Ahmadu Bello University (ABU) Medical School, Zaria in Kaduna state. On graduating from ABU, he moved to the Gambia where he worked in rural hospitals for a few years. His service in the Gambia involved hands-on medical practice and leadership. Dedicated to serving rural communities in that country, he gained invaluable experience in healthcare provision and access. This practical engagement deeply influenced his perspective and fueled his passion for creating impactful change.

This passion later led him to read for a Master's degree in Health System Management from the London School of Hygiene and Tropical Medicine and an MBA with a certificate in Health Sector Management from Duke University, USA. His dedication to healthcare education and practice soon motivated him to impact his experience on a global scale.

Muhammad Ali Pate soon emerged as a prominent figure on the horizon of public health leadership. A physician by training, his journey in life encompassed diverse roles in the academia, in international organizations and in government service, leaving an indelible mark on global health initiatives. His expertise became recognized on an international level as he took on more and more significant roles.

He served as the Global Director for Health, Nutrition and Population, anchoring the Global Financing Facility for Women, Children and Adolescents (GFF) at the World Bank Group. His work emphasized the need to improve the well-being of women, children and vulnerable adolescents worldwide. Pate’s influence in his role as a former minister of state for health in Nigeria was also a testament to his commitment to positive change in healthcare policies and systems. As a professor of the Practice of Public Health Leadership in the Department of Global Health and Population at Harvard University, USA, his commitment to global health was further amplified through this role. This academic position allowed him to share his insights, drive research, and inspire the next generation of public health leaders.

Recognitions for Pate’s contributions include ‘Commander of the Order of the Niger’ (CON) an honor bestowed on him by the Nigerian government in 2022. This acknowledgment underscored his relentless efforts to transform healthcare systems and improve health outcomes for vulnerable populations.

Muhammad Ali Pate’s progression in the field of medicine has been glaringly characterized by a steadfast commitment to healthcare equity. From his early days in Nigeria through his impactful roles on the global stage, Pate’s dedication to healthcare access and leadership have continued to shape a legacy of positive change. As he continues to inspire progress in the field of global health, his dedication serves as a reminder that leadership and compassion can indeed transform the world of healthcare for the better.

Indeed, the resilience of the health sector in Nigeria was tested when the pandemic impacted global economies and health sectors simultaneously in 2020. Routine health programmes such as childhood immunization, reproductive and maternal health services were grossly disrupted. It was clear that the country’s health systems were not resilient enough to protect Nigerians from major public health threats. A restoration to normalcy meant there was a great need to focus more on making the necessary investments to strengthen the country’s weak health systems. At the start of 2023, it became expedient that many significant health interventions and events must take place to shape the health sector in Nigeria, as the country looked to strengthen health systems in preparation for future public health emergencies.

Then, President Bola Tinubu assigned the portfolio of Minister of Health to Professor Muhammad Ali Pate. Many Nigerians believe it was a well-deserved position for one who had a capacity to uplift the health sector from the deep gulley into which previous governments allowed it fall. The physician-turned-politician had served as a minister under Goodluck Jonathan between 2011 and 2013 and was certainly familiar with Nigeria’s peculiar problems in the health sector. Now that he is back in Nigeria’s health ministry as the boss of that very vital sector, what would Nigerians expect from him? What would advocates of a New Nigeria who mean well for Professor Pate anticipate?

As someone who has been Nigerian minister of state in the ministry of health, there is no doubt that Professor Pate understands the enormity of the responsibility on his shoulders. The Nigerian health sector has consistently faced numerous challenges that contributed to the sub-optimal healthcare delivery system in the country. Many healthcare facilities in Nigeria lack proper infrastructure, medical equipment, and essential supplies, making it difficult to provide quality care. There had been instances where major surgeries could not be performed because the hospitals had no generators and things like that. Adequate supply of water and electricity to medical clinics and hospitals in Nigeria must be a top priority that cannot be compromised for any reason. Professor Pate must make sure that such basic infrastructures are installed as a matter of expediency in all the medical facilities across the country.

The inadequate funding of the health sector in the past created conditions that practically encouraged lackadaisical attitudes in workplaces among medical staffs. It would certainly not be an unfamiliar sight observing doctors and nurses chatting away in wards where patients needed urgent attention but none was coming. They had to take the frustration of their unpaid salaries out on innocent sick patients. It should never happen. Nigerians believe that Professor Pate understands that if the health sector continues to receive inadequate funding, that constraint would hamper the development and maintenance of healthcare and its infrastructure, training of healthcare workers, and access to essential medicines. The new minister must deploy his wealth of experience in community medical care to ensure that doctors, nurses and other medical staffs are paid regularly when they should be paid. They should be comfortable in the knowledge that it is their duty to save human life and give whatever it takes to enhance the dignity of life.

Professor Pate already knows from experience that Nigeria has a shortage of qualified healthcare professionals, including doctors, nurses, and other essential personnel. This results in a high patient-to-doctor ratio and overworked healthcare workers. Nigerians want to believe that Pate would do something positive about the consistent shortage of medical staff in the country’s health sector.

Another prominent area that Professor Pate would have to tackle is the many well-trained healthcare professionals who leave Nigeria in their droves in search of better opportunities abroad due to factors like better pay, improved working conditions, and job satisfaction.

It is the expectation of Nigerians that Professor Pate will look into the possible recruitment of trainee nurses and support workers straight from secondary school. He should put adequate strategies in place and ensure that there is proper coordination between secondary schools and nursing schools across the country. One way to achieve this is for the federal government to emulate what happens in the more advanced democracies where student nurses are paid some money to stay in school and the course is free. The need for adequate staffing of medical facilities with enough nurses and paramedical staffs cannot be taken for granted in Nigeria’s case and Professor Pate already knows that.

The minister would need to consider the very low Health Insurance Coverage offered citizens at this stage. A significant percentage of the Nigerian population lacks access to health insurance, making healthcare services unaffordable for many individuals and families. This appears to be difficult in the face of a failed national insurance coverage. Therefore, other factors have to be connected for it to work. For instance, in the UK, if you don’t have a national insurance number that contains your personal details, you will not be allowed to open a bank account, you cannot get a contract, you cannot get treatment from any hospital, your children cannot go to school and so on. Nigerians need to adopt the system other big countries use to run their government services fluently. Professor Pate should think about that.

The minister needs to ensure adequate primary healthcare services. Over the years, focus on primary healthcare had been severely limited and that led to a lack of preventive care and early intervention. This often resulted in the progression of diseases that could have been managed effectively at an earlier stage. In the same vein, there will be a need for the minister to review the rural-urban disparities in healthcare delivery. Healthcare services are often concentrated in urban areas, leaving rural communities with limited access to medical care. This exacerbated health disparity between different regions is the reason there is a proliferation of quacks and patent medicine shops all over the rural areas. Luckily, the minister is an expert in these areas of service delivery and Nigerians are looking forward to better days of medical service delivery in the rural and urban settings under Professor Pate’s leadership.

There is the area of poor quality control and regulation to look into as well. There are challenges in ensuring consistent and high-quality care due to inadequate regulation, monitoring, and enforcement of standards in healthcare facilities. Nigeria faces a high burden of infectious diseases, such as malaria, tuberculosis and HIV/AIDS, which require substantial resources for prevention, treatment and control. Health education and awareness campaigns are limited at this point in time, leading to poor health-seeking behavior and delayed treatment for many health conditions.

To address these challenges, the minister would require a comprehensive and multi-faceted approach. The minister must get the federal government to allocate a larger portion of the budget to the health sector to improve infrastructure, facilities and healthcare workers’ salaries. The federal government should also invest in training and retaining healthcare professionals, offering competitive compensation packages and improving working condition. The government should increase the coverage of affordable health insurance schemes to make healthcare services accessible to a larger proportion of the population. The government should focus on strengthening primary healthcare services to provide preventive and early intervention measures, reducing the burden on higher-level facilities. The government should develop and expand healthcare infrastructure and services in rural and underserved areas to improve access for all.

Government should implement stringent regulations and quality control measures for healthcare facilities to ensure consistent and high-quality care. Government should invest in comprehensive disease prevention and control programs, including vaccination campaigns and health education. Government should launch campaigns to raise awareness about health issues and promote healthy behaviors within communities.

It is the hope and aspiration of the people of Nigeria that the new minister would utilize technology, such as telemedicine, to reach remote areas and provide healthcare services where physical facilities are lacking. And finally, government must collaborate with international organizations, NGOs, and private sector entities to leverage resources and expertise for healthcare improvement.

Addressing the challenges in the Nigerian health sector requires a long-term commitment from the government, healthcare professionals, civil society, and the international community. It demands a combination of policy changes, increased funding, capacity-building initiatives, and a strong focus on improving access to quality healthcare services for all citizens.

These are no mean feats. But Nigerians are generally confident that with his vast experience, Professor Pate would move the country’s health sector forward towards the standards adopted by the more advanced democracies of the world. We welcome the new minster and hope he will not disappoint the new generation of Nigerians who believe Nigerians can build up Nigeria into a formidable nation-state, the gateway to African economy and a nation of happy contented people.

Asinugo is a veteran journalist, author and publisher.