By Chizoba Wonodi, IVAC Nigeria Country Director and WAVA National Convener.
In March we celebrate International Women’s Day, when the world recognizes the achievements and contributions of women of all colors, creeds and credentials. This spirit of empowerment resonates in Nigeria, where the Women Advocates for Vaccine Access (WAVA) are equipping members with small grants to conduct advocacy for sustainable immunization financing.
WAVA is a cross-sectoral coalition of women and women-focused civil society organizations. Members span the length and breadth of the six geo-political zones of Nigeria. While addressing a diverse range of developmental issues, WAVA members make a commitment to advocating for immunization access for all women and children. I’m honored to serve as their national convener.
The first-ever small grants contest was designed to encourage WAVA members to develop and carry out bold, new and exciting strategies to galvanize action, specifically for vaccine financing at all levels. If the plan could get people to listen to our cause and act on it, the idea was considered—even if it sounded crazy.
We could not have anticipated the spectacular array of creative proposals when we launched the small grants program, on the heels of our inaugural investiture ceremony for WAVA Vaccine Champions in December 2016. Ideas ranged from engaging youth in immunization financing discussions to hosting weekly radio shows on immunization.
To provide each proposal a fair review, we assembled a crack team of internal and external reviewers in Abuja and Baltimore. Over a six-week period, five Abuja and Baltimore-based internal reviewers poured through the pages, weighing the pros and cons of one idea against its ability to contribute to our mission. Proposals that scored 70% or higher in the initial review were then sent to at least two out of the three external reviewers.
A well-deserved shout-out goes to our able and excellent external reviewers, Hon. Usman Mohammed, WAVA Champion extraordinaire; Mr. Edwin Ikhuoria, advocate par excellence; and Dr. Francis Ohanyido, jack of all trades and master of all.
Out of sixteen submissions, seven made it to the final round. From this crop, the reviewers chose the top three entries based on their average scores and a qualitative agreement in ranking by both internal and external reviewers. In the end, there were only three winners and I believe the reviewers made the best choices.
To all that participated, know that I am proud of the efforts you put forth in this round. I hope that in the subsequent rounds we will see the same level of enthusiasm—or even higher. Be assured you will get constructive feedback from us that you can use to improve your proposal and grant writing skills for other opportunities. Our unflinching commitment to the growth and success of our members demands that we don't just say, “Sorry, better luck next time.” Rather we feel obligated to give a thoughtful review of the strengths and weaknesses of your submissions.
Our vision is that WAVA members become not only top notch advocates, but also successful and sustainable organizations. Nigeria continues to need our help to ensure vaccine access for women and children everywhere.
This post is part of the #ProtectingKids story roundup. Read all the stories here.
There is a popular saying that you cannot manage what you cannot measure. This is so true for the global effort to close the immunization gap. We need to localize and measure the gap before we can close it. Having good immunization data to evaluate how well we are reaching all children is a critical ingredient for success.
I was poignantly reminded of this fact a few weeks ago when I visited Damangaza community, an urban slum in Nigeria’s Federal Capital Territory, where one of our Women Advocates for Vaccine Access (WAVA) member works. A temporary settlement, Damangaza is made of mud huts, open sewers, zero infrastructure, friendly adults and playful children. This generous community hosts more residents than it can comfortably accommodate, even welcoming internally displaced families fleeing from Boko Haram. A mere 20 minutes drive from the heart of Abuja, the contrast in wealth and access between the community and the nearby Abuja city center couldn’t be any starker.
When WAVA member, Vaccine Network, began working in Damangaza a few years ago, majority of the children had never been vaccinated. The year before, an outbreak of measles swept through the community killing many children in its wake. Although by no means hard to reach, a community like this is one of many settings where children easily fall through the cracks and are missed by immunization services.
Little wonder current data shows that one in five African children is under-vaccinated. If we are to reach that fifth child, we need accurate and timely data to tell us who that child is, where they live and why they are missed. This is a big challenge in Nigeria where the two main sources of immunization data (survey and administrative) do not speak to each other.
Survey data is obtained by interviewing a representative sample of households in the communities about their child’s immunization status. The main ones are the National Demographic Health Survey (NDHS) or the National Immunization Coverage Survey (NICS) conducted every 4 to 5 years. Survey data is richer in details and considered the gold standard. Administrative data on the other hand is based on clinic and health facility records of children who are vaccinated in fixed or outreach posts; it is collated monthly. It is therefore more available to support program management.
Unfortunately, there is usually wide disagreement between the administrative and survey coverage estimates, with the administrative always higher than the survey for comparable years. For example, national coverage with the third dose of the pentavalent vaccine in the 2013 NDHS survey was 38% but 58% by administrative data. Put another way, survey says we reached nearly 4 in 10 kids while administrative says we reached nearly 6 in 10 kids. Which data is accurate?
Diving deeper in the NDHS 2013 raises concerns about retention in care and equity of coverage. For example, while 51% of Nigerian children get their first dose of pentavalent, only 38% end up receiving all three recommended doses, reflecting an absolute drop out rate of 25%. Furthermore, only a quarter of one-year olds received all required vaccines, while as many as 1 in 5 received no vaccines at all.
Looking the beyond the national average reveals staggering disparities by geography, residence, mother’s education and wealth quintiles. According to the NDHS, a child in the north western state of Sokoto is 32 times less likely to be vaccinated than his peer in the south eastern state of Imo. A child living in a rural area is 2.5 times less likely to be vaccinated than her mate in the city. If a child is born of a mother with no education, that child is 7 times less likely to be vaccinated than another child whose mother has secondary school education or more. Children from the poorest fifth of the wealth ladder are 11 times less likely to be vaccinated than their peers from the richest fifth.
Sobering statistics indeed. As I cradled adorable twins Hassan and Husiana in my arms during my visit to Damangaza, I knew the odds were stacked against them in terms of access to vaccination. Their mother had no education, she was in the lowest rung of the wealth ladder and they live in an urban slum. But then again, it struck me that their disadvantage can be overcome if we are intentional about finding and vaccinating children like them wherever they may be. But we will need good and timely data to do that. If administrative data over estimates coverage, we will have a false sense of accomplishment and still miss many children. If survey data is accurate but comes only twice in a decade, it is too infrequent to help us manage the program. We must find an alternative.
Dr. Chizoba Wonodi is the Nigeria Country Program Lead at IVAC.
As the global community works on ways to improve immunization data, I see a third way. This is to empower communities to generate and use their own data to track births and children’s immunization status. Through IVAC’s work on accountability for routine immunization in Nigeria, I have seen that it is possible use community structures like religious and traditional leaders or Ward and Village Development Committees to count how many children are born in the community every month. If health workers have an accurate number of births in their catchment area, the true target population, it is easy for them to measure how well they are doing with vaccinating kids.
Community structures can also be used to track dropouts or left-outs, tracing them right down to the compound and household where the children live. Such real time information will not only help the health worker do their job better, it will also give community leaders a sense of ownership of the immunization program. I look forward to the day when a village chief can tell his community’s target population and vaccination coverage; that day will bring us many steps closer to bridging the immunization gap. Data is not just for experts and nerds; it is for all of us.
Dr. Chizoba Wonodi is the Nigeria Country Program Lead at IVAC.
By Ahmad Abdulwahab
Where do you go when you need medication? Treatment for a minor injury? Vaccination for your child? Education about preventing or managing disease? In Nigeria, the answer should be your primary health care (PHC) facility. PHCs are required to provide these services and more, including clean water and basic sanitation. But the truth is many can only manage to provide a subset. Due to a lack of skilled health workers and adequate supplies, these PHCs leave communities underserved and vulnerable to disease.
Indeed, while Nigeria’s PHC system has made great strides over the years—with a shift from narrow disease-specific vertical programs to a horizontal health system focus of the new “Primary Health Care Under One Roof” reform—there remain many challenges in the health sector, mostly concentrated at the primary health care level. Rather than enumerating these, it is perhaps better to focus on one root problem and a remedy - financing and basket funds, respectively. Initially implemented in Zamfara State to improve routine immunization, the successful basket fund model has since expanded to other states, with the goal of further enhancing overall PHC service delivery.
While working as the Director of Primary Health Care in Yobe State, and later as the National Programme Manager of the Partnership for Reviving Routine Immunization in Northern Nigeria- Maternal Newborn and Child Health (PRRINN-MNCH), I learned that financing lies at the core of Nigeria’s PHC delivery challenges. It is difficult to access the necessary funds to finance basic needs in the health sector. At the state level, federal and state allocations are occasionally misapplied, resulting in incomplete disbursement of local budgets. On the local level, budgets are not earmarked, leading to delays in the release (or at times non-release) of PHC funds—often hinging upon the political will and administrative priorities of those in power.
Dr. Ahmad Abdulwahab in a group photograph with LGA Chairmen of Zamfara State, the Honorable Commissioners of the State Ministry of Health and State Ministry for Local Governments and senior officials of the PRRINN-MNCH program after a meeting on the Basket fund.
A basket fund is a promising mechanism of addressing many of these financing problems. In 2009, Zamfara State with PRRINN-MNCH established the first basket fund in the country to improve routine immunization program and delivery. A basket fund pools resources from state, local, and federal governments as well as from donors and even the private sector. These resources are then directly disbursed to responsible officers for specific PHC activities such as immunization outreach and vaccine distribution to health facilities. Zamfara’s basket fund consists of government contributions (80%) and support from developmental partners (20%) for improving routine immunization.
Over the past five years, the Zamfara basket fund has been tremendously useful in addressing the issue of financial resources. By creating a strong set of checks and balances, the basket fund has increased accountability and transparency in how, when, and where the funds are disbursed. It has helped guarantee funding for basic PHC services and also ensure coordination so that duplication of resources does not exist. As a result of the basket fund, the number of political wards with regular disbursements to finance routine immunization rose from 14% to 100%. Similarly, the DPT3 immunization coverage significantly increased in these political wards over a period of six months.
Due to this success, Zamfara’s basket fund has now expanded to finance maternal health (in particular, the Midwives Service Scheme that mobilizes midwives to rural areas), polio supplemental immunization campaign, and nutrition programs and activities. In the near future, we hope to see the basket fund encompass all PHC services.
Many states with the support of partners are now replicating the Zamfara basket fund model in hopes of achieving similar success. For example, in 2013, Kano State established a basket fund, with an agreement to gradually reduce the significant contribution of international donors until 2016, when the basket should be completely funded by the government. Even the National Primary Health Care Development Agency (NPHCDA) has recognized the efficacy of basket funding and has incorporated it into the National Routine Immunization Strategic Plan as one of the interventions that the federal government recommends all states to implement.
However, basket funds are not without their own challenges. Namely, political will is critical. The Kano basket fund was established quickly with the strong endorsement of the Deputy Governor, but achieving such commitment has been slow in other states. Additionally, coordination and alignment of priorities among partners and the government is essential, and a liaison is often needed to spearhead this process.
Dr. Abdulwahab photographed along with the Zamfara State Public Health Officials and IVAC members.
On a scale of 1-10, I would rate Nigeria’s overall PHC system at three or four. This is an improvement from scores in the negative that it would have garnered several years ago when there was little effort in strengthening health systems. There is now greater awareness among policymakers and partners that primary health care is fundamental to improving the health of the nation.
I believe the basket fund is a high impact, easy, and replicable model that can help Nigeria achieve its goals of increased accountability, effective service delivery, and improved health outcomes. IVAC’s White Paper on Basket Funds provides a timely and useful resource for states wishing to establish and implement basket funds. If basket funds continue to grow beyond specific program priorities, they will cover all PHC services. This would be the ultimate realization of our vision of “primary health care under one roof.” Because of basket funds, the issue of lack of funding for basic PHC services may become an issue of the past.
Support from states and partners during this process will be essential for the success of basket funds. To reach its full potential and move the needle on PHC in the country, there must be strong political will and clear leadership. The time has come for Nigerian officials and partners to work together to usher in a new era in which the financing, resource allocation, and implementation of primary health care activities are designed in a way that is streamlined and accountable, and serves the true functions they were intended for. That is the vision many of us working in the PHC field have for this country.
Dr. Ahmad Abdulwahab, [MBBS, MPH], is a Nigerian medical doctor and public health/health systems specialist with over 18 years of experience in the Nigerian health sector. He has worked with both Government and International organizations at state and national levels. He was at a time the Director of PHC and Disease Control in the Yobe State Ministry of Health and served as the National Programme Manager for the 7-year 65 million pounds DFID/Norwegian Government funded Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal Newborn and Child Health (PRRINN-MNCH) programme. He has also provided technical services to several International agencies such WHO, UNICEF, USAID, Netherland Leprosy Relief and Global Fund and has shared his extensive experience and knowledge of public health, policy development and health systems reform, through presentations at several national and international fora.
This post originally appeared on the Nigeria Health Watch and is cross-posted here with permission.
By Chizoba Wonodi
Nigeria launched the introduction of the pneumococcal conjugate vaccine (PCV)into its childhood immunization schedule in Lokoja, on December 22nd 2014. PCV prevents one of the deadliest bacterial causes of pneumonia, meningitis, blood infections and middle ear infections in children. Before now, only parents with the means could afford to vaccinate their children for thousands of naira in private clinics. But now, government is offering it for free to all kids. This is a big deal, so get excited!
Launch of PCV Vaccination in Lokoja
A journey that began 6 years ago has finally come to a successful end. But it was not an easy ride. As I think about the road to this introduction, I remember all the twists and turns along the way and marvel at the tenacity and perseverance of the chief actors in this story.
In 2008, I was working for a Johns Hopkins project called PneumoAdip, which was set up to accelerate the introduction of PCV into African and Asian countries. You may wonder why anyone needs a project to do that, right? Well, it turns out that having a vaccine that works is not enough to get countries to use it, unless the vaccine is for Ebola. I bet countries will scramble for an Ebola vaccine, if it comes. But then most diseases are not like Ebola. For more silent diseases like pneumonia, it takes concerted effort to make the decision makers recognize the burden of the disease, the value of the vaccine and the actions to take on it. For example, it took Nigeria 21 years to adopt the Haemophilus Influenza b (Hib) vaccine into our routine system. The first country to use Hib vaccine in their national program started in 1991, we started 2012.
I remember sitting in the Premier Hotel Ibadan during the 39th Annual General and Scientific Conference of the Paediatric Association of Nigeria (PANCONF) in January 2008. The halls were packed, the place was buzzing, the energy was infectious, pediatricians were milling around discussing how to save babies. I had come from Baltimore to field test a pneumonia diagnostic tool and discuss the prospect of Nigeria introducing PCV into the national immunization program.
At one of the session breaks, I cornered Dr. Abanida, then Director of Immunization at NPHCDA and asked him, “Doc, when are we going to introduce penta and PCV?” “Very soon” he replied, “We will apply for both vaccines this year”. This was an unexpected and pleasant surprise. I had predicted he would commit to only penta, but PCV as well? That was great. You see, it was no coincidence that we were coming late to the penta party when countries like Kenya had introduced the vaccine 8 year before. As a country, we had been preoccupied with battling polio, especially after the major polio vaccine rejection of 2004. In addition, our systems were weak. Indeed, before 2005, we would not have been able to apply for Gavi support for new vaccines even our immunization coverage was less than 50%, less than the required threshold. To get Gavi’s help, countries have to meet certain eligibility criteria and they have to formally apply and be approved for support.
Just as Dr. Abanida had declared, in April 2008, Nigeria tendered their first Gavi application for penta and PCV introduction support. In June 2008, the reviewers granted the application a conditional approval.
Disappointed but not deterred, in September 2008, the new vaccine application team led by Dr. Oteri, then Gavi desk officer at NPHCDA, responded to the conditions and queries from Gavi. But the second submission was rejected and the country was asked to re-apply.
Three things then happened that delayed the process for the next two and half years. First, Gavi suspended all new vaccine applications due to internal processes and funding constraints. No country could apply for new vaccine support in 2009. Second, Gavi revised their new vaccine application policy, now requiring an immunization coverage rate of at least 70% instead of 50%. Third, Nigeria’s vaccine coverage dropped below 50% to 42% according to WHO-UNICEF estimate released in June 2010. This new drop caused Dr. Dorothy Esangbedo, then the President of the Pediatric Association of Nigeria, to lament bitterly and call for stronger action to shore up routine immunization.
Under the new policy and with the lower coverage, Nigeria could not re-apply in 2010. In fact, a workshop in August 2010 convened by NPHCDA to develop the third submission was truncated by the twin news that our coverage rate had dropped and Gavi coverage requirement had increased.
When Gavi began revising their policy, there had been talk and expectation in some quarters that countries such as Nigeria, who were already in the application process before the policy change, would be “grandfathered in”. That did not pan out. To help matters, Gavi delayed the implementation of the new coverage requirement by one year, which left Nigeria with one window of opportunity to apply in May 2011.
But there was one more hurdle to scale. Coverage estimates for 2010 had to be 50% or better. The National Immunization Coverage Survey (NICS), showed coverage to be 71% for 2010, but Gavi only recognizes the WHO/UNICEF estimates, which was still 42% and would only be updated in July. Nigeria needed the updated estimates to apply in May. The update would be two months late. What to do?
The emails and phone calls started going back and forth advocating for a solution. At IVAC we pushed for different options: allow Nigeria use the NICS to apply, allow a phased introduction, so that states that meet the coverage criteria can be supported to introduce the vaccine, while effort be made to raise coverage in the other states. Dr. Mohammad Ali Pate, then Minister of State for Health, was very vocal in his advocacy to find a solution. Eventually and exceptionally, Gavi allowed Nigeria to apply for penta and PCV in May 2011. Then in July 2011, penta was approved and PCV was conditionally approved. All decisions were subject to the 2010 WHO/UNICEF DTP3 coverage estimates being >50%.
After the July 2011 conditional approval for PCV, Nigeria worked on responding to the conditions attached to the approval by strengthening the cold chain system. Then, 15 months later, in October 2012, Gavi gave the final approval for a phased roll out of PCV to begin in 2013. However, due to global supply constraints and other operational issues such as strikes in the Nigerian health sector, the first child could not be vaccinated till December 2014.
I didn’t go for the launch, but my colleagues went, and it was gratifying to see the culmination of everyone’s effort. Big thanks should go to the NPHCDA, Gavi, UNICEF, WHO, Pediatric Association of Nigeria, CHAI and all other groups who have pushed hard to see this happen.
First Nigerian Child to receive the Free Pneumococcal Conjugate Vaccine
As I look at the grainy picture of baby Collins, who is the first child to be vaccinated, cry out in pain from the shots of the first PCV vaccination, I wish I could tell him,
“Baby, don’t cry, laugh instead, even though that injection is painful. You are getting a shot a life. Something that babies before you did not get, but thankfully those after you will receive. If we are able to immunize 87% of your fellow babies every year with this vaccine, we can save about 200,000 lives by 2020. Isn’t that something to laugh or even rejoice about? Yes indeed, it is cause for celebration. I only wish it didn’t take six long years for this to happen. Think of all the babies we could have saved in that time. Anyway, you are too young to understand all this. After all, what do you know? You are just a baby. You probably just want to suck you mother’s breast right now, forget all this noise and go to sleep. So I’ll let you be.”
Dr. Chizoba Wonodi (MBBS, MPH, DrPH),
Nigeria Country Programs Lead, Johns Hopkins International Vaccine Access Centre,
Advisor, Saving One Million Lives Initiative,
Advisor, Gavi’s Strategic Demand Forecast for vaccines.
This is the second in a series of profiles to help IVAC partners and friends get to know our team. This one features Chizoba Wonodi, an epidemiologist who leads IVAC’s Nigeria work. We caught up with Chizoba just before she made a big move back to Nigeria with her family. After living in Baltimore for 10 years, Chizoba will now represent IVAC in country, and she will dig deeper into efforts to work with the Nigerian government and other stakeholders to improve routine immunization and increase accountability.
Tell me a bit about your background and when you joined IVAC.
Before coming to Baltimore, I worked as a physician in Nigeria, concentrating mostly on adolescent sexual and reproductive health and HIV/AIDs prevention. I came to Johns Hopkins for my masters in public health and, after that, I went on to the DrPH (Doctor of Public Health) program, completing both programs as a Gates Institute Scholar. In 2006, in my third year of the doctorate program, a colleague introduced me to the PneumoADIP project that would later morph into IVAC. I thought the whole concept of accelerating access to vaccines was novel and cool and I wanted to be part of it. So I sought and got work as student research assistant with PneumoADIP.
When I graduated from my doctoral program in 2009, I joined the Hopkins faculty knowing I wanted to focus my work on Nigeria. My desire has always been to take what I learned at Hopkins and apply it to my home country. At IVAC, I have been able to do just that. My work is to support the Nigerian government in developing effective policies and programs to deliver life-saving vaccines to children. We work alongside many organizations, including the WHO and UNICEF, in helping the government build stronger immunization systems. We do this through policy and operations research, translating evidence to policy, and brokering or advocating for relevant interventions. Instituting accountability within the health system is also a big part of my work in Nigeria.
Chizoba Wonodi with her niece. (Photo credit: Tyrone Shoots)
What inspires you to work in global health?
I think the potential to make a difference on a large scale drew me to global health. I came to this realization after medical school, when it was time to choose a clinical specialty. I considered pediatrics because I love children, but I didn’t have the affinity for one-on-one interventions when thousands were dying of preventable causes. I wanted to change things at a broader level. With public health, you can see how the policies and programs you implement affect large populations.
What does it mean for you to be doing work to help Nigeria?
It is a privilege because not everybody has the opportunity to come to Johns Hopkins, a world-class institution, and receive training from the best in the field and work beside them. It is wonderful to be able to take what I learned here back to Nigeria and try to make a difference there. However, it isn’t just about taking knowledge back, but also learning from the dynamic changes that have occurred in Nigeria.
Can you explain the kind of dynamic changes Nigeria has gone through?
There is more human capacity than before. In the last decade, a crop of globally educated public health revolutionaries – if I may call them that – have returned home with cutting-edge knowledge, skills, and attitudes. They’ve melded the global perspective with their local knowledge and sensibilities and have become a force for change. They resist doing business as usual and push for decisions to be evidence-based. They are forging partnerships in unusual places, demanding accountability, and focusing on results not just inputs.
Chizoba Wonodi at the National Vaccine Summit in Abuja, Nigeria, April 2012. (Photo courtesy of Tyrone Gibson)
In the vaccine world to be exact, there has been a growing awareness of and greater access to new vaccines. For instance, Haemophilus influenzae type B (Hib) vaccine was introduced last year, hopefully next year, pneumococcal conjugate vaccine (PCV) will follow. Although it took more than 15 years for these new vaccines to become available in the country, the momentum is shifting rapidly as more stakeholders acknowledge the importance of immunization. In April 2012, we saw a massive outpouring of support and promises at the National Vaccine Summit. Many hands are now on deck to help prop up the routine immunization system, and we are seeing positive results. Top among the donors is GAVI, who provides the single largest investment in routine immunization in Nigeria. As more partners come on board, the program space gets crowded and the pace quickens. It is all very exciting. However, one has to be nimble and responsive, to be relevant.
What has been your most rewarding or memorable experience at IVAC?
Seeing the impact of the policies we’ve helped influence result in access to new vaccines for children has been most rewarding. I remember when I came to the PneumoADIP and we were working on the introduction of PCV into developing countries. At that time PCV was considered too expensive for poor countries, but by getting countries to recognize the burden of pneumococcal disease, by convincing vaccine manufactures that there was a market beyond Europe and America, and by mobilizing the right financing, we (and others) helped accelerate PCV introduction into Africa and Asia.
Six years later, it is gratifying to see PCV introduction has outpaced earlier projections. This means many more children (in the millions) are being vaccinated and protected than we ever thought possible. There aren’t many opportunities where you get to contribute to change as big as that.
At the National Vaccine Summit in Nigeria (left to right): Dr. Ado Mohammad, Executive Director of the National Primary Health Care Development Agency; Dr. David Okello, former WHO Representative for Nigeria; and Dr. Chizoba Wonodi, Epidemiologist and Nigeria Projects Lead at IVAC. (Photo courtesy of Tyrone Gibson)
Wow, that sounds wonderful but also very demanding. What do you do in your free time to relax?
I like to cook. I watch the Food Network to learn new recipes. I love Asian food so I started learning to cook Chinese and now Korean food.
Speaking of cooking and eating, if you could have dinner with anyone – alive or dead – who would you pick and why?
I would choose Nelson Mandela. I don’t think there is anyone in the world as loved and as esteemed. I would like to feel the essence of the man and understand what makes him stand out so much. It would be a wonderful opportunity to learn from someone who has so much compassion, knowledge, and wisdom.
So through our conversation so far, it is obvious you are very proud to be Nigerian. What about Nigeria do you like best?
I love the people. We are proud and very happy people. In fact, there was a study that found Nigerians are the happiest people on earth. You wouldn’t think that given all our challenges and issues; but that is just who we are. We are very welcoming and very hospitable. And I love that when you meet a Nigerian, they proudly proclaim they are Nigerian.
What is your wish for Nigeria?
My immediate wish is that the 2015 elections will come and go flawlessly without any major upheavals. I also hope that the bloodshed in the north will stop so people can get back to living their lives. And I wish that Nigerian leaders would recognize and build our biggest resource – our human resources. Part of that includes making sure girls are educated. Once girls are educated, half the job is done in terms of alleviating poverty, adopting healthy behaviors, and nurturing the next generation.
Lastly, if you could visit anywhere in the world, where would that be and why?
Bhutan. I had a colleague that worked at the Hib Initiative who visited Bhutan. It is very difficult to go there, and you need to have a special reason to visit. My colleague went as a part of a vaccine delegation and she said the country is just pristine, the air is clean and clear, and you can hear birds chirping everywhere. I would love to see that country which has been unspoiled by modern life.