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HEALTH & EDUCATION

The Countries of the Sahel Unite for Universal Access to Quality Education

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Authors: Mohamed Ould Ghazouani, President of the Islamic Republic of Mauritania; Roch Marc Christian Kaboré, President of the Republic of Burkina Faso; Mohamed Bazoum, President of the Republic of Niger; and Ousmane Diagana, World Bank Vice President for Western and Central Africa.

In accordance with the rule and spirit of each of our Sahelian countries, and the conviction that the prosperity of nations and social inclusion in our fragile environments are at stake, education for all has always been at the core of our development strategies.

With the significant strides made over the past 15 years, thanks to our proactive policies, we are hopeful today that all children born in the Sahel can and should have access to schooling.  This will allow them to achieve their dream of a better future, to become model citizens, and to contribute to the prosperity of their nations.  Between 2005 and 2018, the number of children in school in the Sahel virtually doubled at the primary level, increasing from 5.9 to 10.8 million.   At the secondary level, enrollment increased more than threefold, rising from 1.4 to 4.6 million.  The future of our common space rests on the slender shoulders of the children and youth of the Sahel who have completed their education and training.  It is important to note and to celebrate the fact that this group includes an increasing number of young girls and women, who are not only no longer exposed to the risk of child marriage or sexual violence, but are emerging as development actors within their communities.

The progress made in education for our children comes at a significant cost to the budget, yet such a commitment is indeed necessary. Unfortunately, however, the need for significant budgetary outlays has led to a drop in the quality of learning outcomes. This is a call to action and we have marshaled our efforts to address this situation. Responding to the requirements of the education sector in the face of demographic pressure will require sustained investments in the construction of infrastructure, the recruitment and training of additional teachers, and the acquisition of teaching materials and tools.  In the Sahel region, where almost one million new children start school each year, the race against the clock is never-ending.

In order to capitalize on these achievements, our countries need to provide quality education for all and to develop competencies in each and every child.

The World Bank’s White Paper on the Sahel, published today, notes that around nine out of ten students fall short of the required standards for reading and writing at the end of primary school.  Two out of five Sahelian school children fail to complete their primary education.  This points to the vexatious issue of school dropout rates, which serve only to worsen inequalities in a context where the majority of our people have to contend with extreme precarity and where the opportunity cost incurred by enrolling their children in school is quite significant, even where education is free.

The security challenges and the impacts of climate change and the Covid-19 pandemic have served only to increase the problems of student learning, while impeding the development of a quality and inclusive education system that is equitable for all. 

In view of these findings, we, the leaders of the Sahel, meet on December 5, 2021 in Nouakchott, along with representatives of the World Bank, to make the decisions required to drive education reform over the next five years. 

Maintaining hope, going further

The actions that we take to respond to these challenges must be coordinated and integrated from the early childhood level through to continuing education for young adults.  Some of the achievements made in our countries remind us that success is indeed within reach.  The implementation in both Burkina Faso and Niger of accelerated learning strategies, in conjunction with bridging classes, has allowed thousands of young people who were failing at school to resume their education and acquire core competencies.  The establishment of school management committees in Mauritania has increased the involvement of parents in school management.  A mobile payment system was launched in Chad in 2018, with the support of the World Bank, for the remuneration of community teachers, who comprise 60 percent of the teaching staff at the primary level.  This innovative program has served to improve the attendance record of teachers, while enhancing their commitment to their profession.  Thanks to the adoption of a dynamic public-private partnership model, the secondary school enrollment rate in Mali has increased by 2.5 times since 2000.

Systems such as these have proven their effectiveness.  We must therefore redouble our efforts in this regard to find lasting solutions to the issue of quality education.  We also need to do more to advance equity and to ensure a more prominent role for women, who remain poorly represented in decision-making positions in our schools. However, even as we implement urgent interventions, we should not lose sight of our long-term vision for better governance of the education system as a tool to sustainably strengthen our schools.

The first action step is to leverage quality education.  With this in view, we will boost support to our teachers, by providing training and enhancing the status of the profession. They will be equipped with technological and teaching tools, and work with modern and suitably adapted school curricula. We will also support our teachers by improving early childhood development to ensure that children moving on to primary school meet all the necessary entry requirements.  The investments in this area are designed ultimately to improve students’ education outcomes and to ensure that the progress of all Sahelian children can be effectively monitored.  In practical terms, the system for assessing students’ learning should be able to provide an early indication of potential cases of students at risk of failing or dropping out altogether.  Support will be provided to government teams to help them promote greater inclusiveness and security in the schools under their purview.  An independent inspection system will monitor improvements in the condition of schools.

The second action step is to leverage budgetary support. Notwithstanding the increase in our education expenditure in recent years, we need to go further than the 3 percent of GDP currently allocated to this area, a figure that is still too low when compared with the average of 4 percent for the continent as a whole or the international benchmark of 6 percent.  In order to achieve our goal of reforming the school system, we will have to enhance our support to families so as to ensure that education is seen as an investment and not merely as an expense. It is also incumbent on us to ensure, in conjunction with the relevant territorial authorities, that our schoolgirls and schoolboys receive quality nutrition, that their educational progress is monitored individually, and that school facilities and teaching tools are properly adapted to their needs. Sahelian children spend around six years of their life in school, compared to more than eight years for Sub-Saharan African children and 13 for young people in Europe.  These six years of schooling are spent in such difficult conditions that they represent just slightly more than three years of enrollment in a quality education system.  This figure has to be improved significantly and in short order.

Finally, the renewal of the school system must be based on an integrated approach, involving all stakeholders in administration, the private sector, the communities, parents, and teachers, and must consider the school system in its entirety. Funding will take account of and encourage best practices, with a view to promoting a virtuous circle in which each school is driven to implement the best possible conditions for quality education.  This is the same sense of community that brings the governments of our five countries together and drives us to act in close coordination. Our technical education institutes can learn a lot from each other and by joining forces we certainly stand to improve our results considerably.

A number of emerging countries have shown the importance of investing first and foremost in schools when preparing for the future.  Concerted and courageous action by our countries in this sector, in close collaboration with our international partners, will yield immediate positive and long-term results: well-trained young people who have confidence in themselves are the surest foundation on which to build shared prosperity for our countries.

This op-ed was originally published by Jeune Afrique, via World Bank


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HEALTH & EDUCATION

Nigeria is Pioneering a New Vaccine to Fight Meningitis – Why this Matters

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Nigeria recently became the first country to roll out a new vaccine (called Men5CV) recommended by the World Health Organization (WHO), which protects people against five strains of meningococcus bacteria. Idris Mohammed, a professor of infectious diseases and immunology and former board chair of Nigeria’s National Programme on Immunisation,  explains the new vaccine and its likely impact.

What is meningitis?

Meningitis is the inflammation of the tissues surrounding the brain and spinal cord, usually caused by infection. It can be fatal. Meningitis can be caused by several species of bacteria, viruses, fungi and parasites. The highest global burden is seen with bacterial meningitis. Around one in six people who get this type of meningitis die. One in five have severe complications

The main bacteria responsible for the disease are Neisseria meningitidisHaemophilus influenzae and Streptococcus pneumoniae. The main symptoms are sudden high fever, backache, stiff neck, headaches, nausea, vomiting and intense dislike for sunlight (photophobia). Patients with a severe infection can experience confusion, delirium and loss of consciousness. Meningitis can affect people of any age.

Meningitis bacteria are transmitted from person to person through droplets of respiratory or throat secretions from carriers. Kissing, sneezing or coughing on someone, or living in close quarters with an infected person, facilitates its spread. The average incubation period is four days but can range between two and 10 days.

Epidemics of meningitis are seen across the world, particularly in sub-Saharan Africa. The so-called “African meningitis belt” consists of 26 contiguous countries from Senegal and The Gambia in the west to Ethiopia in the east. Outbreaks have also been reported in countries outside Africa like Canada, Belgium, France, Brazil and Denmark.

Why does Nigeria have a high burden of meningitis?

Nigeria’s 19 northern states are within the African meningitis belt. A few southern states such as Osun, Ogun and Anambra are also affected. The major factors that determine meningitis infection include a hot and dry environment and dusty atmospheric conditions.

Between 1 October 2022 and 16 April 2023, Nigeria reported 1,686 suspected cases of meningitis, including 124 deaths, for a case fatality ratio of 7%. The highest proportion of reported cases is among children aged 1 to 15 years. Factors that contribute to meningitis are all present in northern Nigeria. Low or no vaccination; presence of carriers; under-nutrition; overcrowding; scarce rainfall; low humidity; high temperatures. It’s often over 35°C, sometimes as high as 45°C.

The general population can’t afford nutritious foods that can boost the immune system. Add to these factors the level of education, poor hygienic conditions and overcrowding, and perfect conditions for an epidemic outbreak are complete. Although the burden of epidemic meningitis is highest in the north of Nigeria, there is sporadic infection countrywide.

What’s specific about the meningitis strains in Nigeria?

There are five strains of meningitis in Africa: serotypes A, C, W, X and Y. Infectivity and clinical features (symptoms and signs) are the same with the strains. These features were established by serotype A, which was the first and dominant strain in the country. The severity of the infection may be higher with the new variants, such as group C meningococcal, as seen in some cases in north-western Nigeria. Serotypes W, X and Y may have similarly higher severity because the organisms are new to the country. Immunity to them is therefore not strong enough.

What makes this new 5-in-1 vaccine so special?

For more than a century, epidemics of meningococcal meningitis have ravaged the African meningitis belt. Some of the earliest prevention attempts involved the use of sulphur drugs and penicillin based antibiotics.

But these were not successful in preventing outbreaks. Mass use of sulphur-based drugs for prevention had to be abandoned because by the 1970s Neisseria meningitides had become resistant to these drugs.

The next obvious line was to consider vaccination with available polysaccharide vaccines. These use specific pieces of the disease-causing germ, like its protein, sugar, or the casing around it. They give a very strong immune response that targets key parts of the germ.

There was only one such vaccine available at the time. This was the A+C vaccine (Institut Meriuex), which had never been used routinely or on a large scale until an epidemic in Bauchi in 1978. The vaccine terminated that epidemic within a few weeks.

Since then, several researchers like John Robbins have advocated intensified mass vaccinations with the polysaccharide vaccines. But the WHO was reluctant, with fairly good reason.

Polysaccharide vaccines are poorly immunogenic, meaning not able to elicit protective immunity to the disease – particularly in young children, because they do not have immune memory. So the vaccines are not cost-effective or sufficiently protective.

The 1996 outbreak in northern Nigeria affecting over 120,000 people and causing 12,000 deaths – and described by the WHO as the largest in recorded history – changed the narrative. A joint WHO/PATH “Meningitis Vaccine Project” facilitated by the Bill and Melinda Gates Foundation produced the highly effective conjugate meningitis A vaccine (known as MenAfriVac). Over 260 million people in the African meningitis belt were vaccinated with it. This led to the virtual elimination of meningococcal A serotype.

But serotypes C, W, X and Y then emerged. Hence the critical importance of the 5-in-1 (also known as MenFive, or Men5CV). Proper and sustained vaccination with the 5-in-1 vaccine should put paid to epidemics of meningococcal meningitis in Africa.

What impact will the new vaccine have on meningitis control in Nigeria?

By containing the five most important serotypes causing meningitis in Nigeria, this vaccine is bound to have a far reaching positive impact on control of the disease. Among all the 26 African countries within the African meningitis belt, Nigeria is by far the most populous. Thus an epidemic of the disease affects many people.

Before the year 2000 hardly a case of serotype C, W, X, or Y had been reported in Nigeria. The success of group A conjugate MenAfriVac introduced in 2010 in Burkina Faso has changed the pattern and periodicity of epidemic meningitis, and the real challenge and menace of replacement serotypes underscores the critical importance of the 5-in-1 conjugate meningitis vaccine. Its impact will be huge.

Idris Mohammed is a Professor Emeritus, Gombe State University

Courtesy: The Conversation


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EDITORIAL

Islamic Finance Shaping the Future: A Reflection on the International Summit on Financing Primary Healthcare Infrastructure in Nigeria

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On November 30th, 2023, the International Summit on Financing Primary Healthcare Infrastructure in Nigeria took center stage in Abuja, bringing together global leaders, financial experts, and healthcare professionals to deliberate on a critical theme: “Islamic Finance: Exploring New Sources of Financing for Primary Healthcare Transformation in Nigeria.” This landmark event, which was organized by DUKE Consult Limited in strategic collaboration with the Africa Islamic Economic Foundation, Ghana and Glocal Healthcare Systems Ltd, India, marked a significant step towards addressing the healthcare infrastructure challenges in Nigeria through innovative and sustainable financing mechanisms.

The Urgency of Healthcare Infrastructure Transformation

Nigeria, like many other developing nations, faces substantial challenges in its healthcare infrastructure. The need for adequate facilities, skilled healthcare professionals, and sustainable funding mechanisms has become increasingly urgent, especially in the wake of global health crises. The summit recognized that achieving robust primary healthcare infrastructure is pivotal to ensuring the well-being of the population and addressing health disparities.

Islamic Finance as a Catalyst for Change

The choice of Islamic finance as the central theme reflects a strategic move towards diversifying sources of funding for healthcare infrastructure. Islamic finance principles, rooted in ethical and equitable financial practices, provide an alternative framework for generating funds. By exploring these principles, Nigeria aims to tap into new avenues that align with its cultural values while fostering inclusive economic development.

Key Discussions and Agreements

The summit facilitated in-depth discussions on the potential of Islamic finance to transform Nigeria’s primary healthcare infrastructure. Attendees deliberated on the principles of Islamic finance, such as risk-sharing, profit and loss sharing, and ethical investment, as tools for shaping a more sustainable healthcare future.

One of the primary outcomes was the establishment of collaborative initiatives between the public and private sectors, leveraging Islamic finance instruments to fund healthcare projects. The summit also saw the formation of partnerships with international organizations and financial institutions, showcasing a commitment to shared responsibility in addressing Nigeria’s healthcare challenges.

Emphasizing Inclusivity and Cultural Sensitivity

An essential aspect of the summit was the emphasis on inclusivity and cultural sensitivity in healthcare financing. Recognizing that Islamic finance aligns with Nigeria’s cultural and religious values, the summit underscored the importance of tailoring financial mechanisms to the specific needs and beliefs of the population. This approach ensures that healthcare development is not only economically sustainable but also culturally resonant, promoting widespread acceptance and participation.

Looking Forward          

The International Summit on Financing Primary Healthcare Infrastructure in Nigeria has set a precedent for innovative and inclusive approaches to addressing healthcare challenges. As Nigeria strives to achieve its healthcare transformation goals, the incorporation of Islamic finance principles serves as a beacon for other nations facing similar challenges.

In conclusion, the summit marked a pivotal moment in Nigeria’s journey towards sustainable healthcare development. By exploring new sources of financing rooted in ethical principles, the country is forging a path towards a healthier, more resilient future. As the initiatives launched at the summit unfold, they have the potential not only to transform healthcare infrastructure but also to serve as a model for other nations seeking innovative financing solutions in the pursuit of universal health coverage.


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HEALTH & EDUCATION

Highlights of the One Day International Summit on Financing Primary Healthcare Infrastructure in Nigeria

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By our special correspondent

A one-day international Summit on Financing Primary Healthcare Infrastructure in Nigeria under the theme: Islamic Finance: Exploring New Sources Of Financing For Primary Healthcare Transformation in Nigeria was held in Abuja, the Capital of the Federal Republic of Nigeria on the 30th of November, 2023, at the NICON Luxury Hotel, under the distinguished Chairmanship of His Excellency, Senator Ibrahim Shekarau, former Executive Governor of Kano State.

The groundbreaking event, which was organized by DUKE Logistics & Consult (Nigeria) Limited, Abuja, in strategic collaboration with the Africa Islamic Economic Foundation, Ghana and Glocal Healthcare Services Limited, India, was held to explore innovative healthcare financing models that leverage Islamic finance instruments such as sukuk (Islamic bonds), waqf (endowments), and takaful (Islamic insurance), etc. in providing sustainable and long-term financing for primary healthcare transformation in Nigeria; and to foster collaboration between the various states of the federation to share best practices and experiences in leveraging Islamic finance for healthcare projects.

The summit featured keynote speeches and discussions on various topics related to Islamic finance, healthcare infrastructure development and digital health solutions: The role of Islamic Finance in healthcare Infrastructure Development in Nigeria, by Prof. Ahmad bello Dogarawa of the Ahmadu Bello University, Zaria; Digital Health Solutions Innovation: The Glocal Story, by Mr Shailesh Kumar, of the Glocal Healthcare Systems Limited, India; Digital Health Transformation: Opportunities & Challenges, by Hon Dr Abdel Majeed Haroun, former Minister of Agriculture, Republic of Ghana; Africa Healthcare Infrastructure Program (AHIDEP), by Hajiya Aishatu Usman Muhammad of the Gombe State University, Gombe, The foregoing presentations were supported with expert and insightful discussions by Dr Aisha Ahmed, an Islamic Finance expert and consultant, Abuja and Mr. Muhammad Lawal Shu’aibu, CEO, LCM Consult Limited Abuja.

One of the key discussions revolved around the role of Islamic Finance in healthcare infrastructure development in Nigeria. Participants delved into the potential of Islamic Finance to provide sustainable funding for the construction and maintenance of healthcare facilities. This topic explored innovative financing models that align with the principles of Islamic Finance, such as waqf (endowment) and sukuk (Islamic bonds).

Another captivating topic discussed at the summit was “Digital Health Solutions Innovation: The Glocal Story.” The term “Glocal” refers to the combination of global and local perspectives. The Summit focused on the Glocal Story, which highlighted its cutting-edge digital health solutions that bridge the gap between global advancements and local healthcare needs. Experts shared success stories, case studies, and best practices, showcasing how technology can revolutionize healthcare delivery in Nigeria by improving access, affordability, and quality of care.

Furthermore, the summit covered the topic of “Digital Health Transformation: Opportunities and Challenges.” This presentation highlighted the importance of adapting digital health solutions to the specific needs and contexts of Nigeria. It addressed how these innovations can improve healthcare accessibility, efficiency, and quality, particularly in underserved areas. Participants explored the potential benefits and challenges associated with digital health transformation in Nigeria. They examined how technological advancements, such as telemedicine, electronic health records, and artificial intelligence, can revolutionize healthcare delivery and management in the country.

The presentation of the Africa Healthcare Infrastructure Development Program, the flagship initiative of the Africa Islamic Economic Foundation, offered participants a glimpse of the functions of the Program. The presentation shows that AHIDEP is a great platform to connect with international organizations and investors who are interested in supporting healthcare initiatives in Nigeria. However, to showcase the importance and potential of a healthcare project to potential investors, potential beneficiaries would have to prepare a comprehensive proposal outlining their healthcare infrastructure development goals, strategies, and the potential impact.

The discussions also touched upon the importance of involving stakeholders and ensuring efficient management of healthcare infrastructure projects. Furthermore, the discussions elucidated in detail how Islamic finance can support the innovation and implementation of digital health solutions tailored to the Nigerian context. The conversation revolved around leveraging technologies like telemedicine, mobile health applications, and electronic health records to enhance access to healthcare services, especially in remote areas. The importance of collaborations between local and international stakeholders for effective digital health transformation was also emphasized.

Overall, this one-day event, the international summit on financing primary healthcare infrastructure in Nigeria provided a platform for experts, policymakers, and stakeholders to discuss strategies and explore new sources of financing for primary healthcare transformation in Nigeria. It showcased the potential of Islamic Finance as a viable option and emphasized the importance of digital health solutions in shaping the future of healthcare in the country.


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