Dr. Jeremie Zoungrana joined the Bill and Melinda Gates foundation as Director, Nigeria office in January 2021. He is a health sociologist and program management specialist and brings more than two decades of leadership and experience managing complex, large-scale family planning; reproductive health; maternal, newborn and child health; HIV; and community health projects across both the public and private sectors in sub-Saharan Africa.
He has had a long and multifaceted career driving Jhpiego’s operations in many African countries and currently serving as Jhpiego Country Director in Burkina Faso and IMC Chief of Party, while supporting the organization’s West and Central Africa region portfolios.
Before that, he served as Jhpiego’s Tanzania Country Director, directing a portfolio of about $75 million in program funding covering an array of projects and donors, and managing more than 600 staff. His career has also spanned Country Director roles in Rwanda and Program Manager for Cameroon, Mali, Mauritania, Niger, and Togo focused on maternal and newborn care.
Prior to joining Jhpiego in 2001, Dr. Zoungrana worked as a social worker in charge of child protection and family promotion under the Ministry of Health and Social Affairs in Burkina Faso, and he worked for Handicap International on mental health programs in Burkina Faso.
Originally from Burkina Faso, Dr. Zoungrana holds a Master’s degree in sociology from the University of Ouagadougou and a Master’s and PhD in Business Research from Monarch Business School in Switzerland.
The Bill and Melinda Gates Foundation commits huge amount of resources to a wide range of projects across Africa, and Nigeria in particular. What is your assessment of Nigerian public and private authorities’ commitment to these goals? Do you think there are areas they can improve, and what sort of improvement would you suggest for them?
Thank you so much for that, I think it is an excellent one. Yes, we know the Foundation committed a lot of money across various development projects talking about the level of commitment of Nigeria public health as well as area of improvement. So, I have to say that in that area, when the Foundation wants to make investment, or use any of our assets, it has been always in partnership with the government and we assess the commitment before engaging together because whatever we do, we have to do it with the government.
And we saw it through different programmes that become a priority for the Federal Government. We saw it through the polio virus eradication where we saw high commitment from different actors, down from the community level, and we are seeing it with the primary healthcare systems transformative endeavour.
In the context of Nigeria, everything in the health sector as well as the productive sector remain priority and we are working together with the government to make sure that we accelerate progress on these areas to ensure that people are healthy, but also, they can contribute to a productive life.
What new programmes, if any, do you have in mind for sub-Saharan Africa and Nigeria in particular?
Of course, it is not because I am a new director that everything should be new, so, I am here to ensure that we have continuity in our commitments. That remains on top, and I will not talk about new programme because our priority remains the same and we need to make sure that we fulfil them efficiently before moving to a new thing. But, of course, as we continue to implement and collaborate with different partners and the government, we need to make sure that we bring innovative approaches to accelerate progress.
We also need to ensure that we tackle the most important issues that are critical to development. In the context of Nigeria, I think we remain committed to what we want to do, and we want to make sure that we accelerate progress because in the health sector for example, there is a need to really accelerate on maternal mortality reduction, strengthening routine immunisation so that we don’t get the polio virus coming back, reducing childhood mortality.
Also, on the agriculture sector, we need to support small-holders to have more productivity, financial inclusion. So, there are a lot of tools and technologies that lead to development and these are areas we want to focus, of course with the ownership and collaboration with different partners.
Over the last 12 months, security in Nigeria has worsened, going by the numbers, and of course indices- kidnappings and killings nationwide. How does this affect the Gates Foundation’s immunisation programme here in Nigeria? A lot of immunisation is also done in hard-to-reach areas of the country, so with all of this insecurity, is it particularly going to affect immunisation plans, or is there a strategy around that?
Thank you so much. Your question is really important based on the current situation that we are all facing. Before COVID, security has been a big issue and a big concern for all of us including the Foundation. It is clear that the security issue is not without negative impact on access to services, including service provision across the country. During our Memorandum of Understanding (MoU) review with states, we have many governors who attested that there are a lot of challenges with security and these impact to key essential services like immunisation.
I think a lot of innovation have been developed together with partners to improve access in different ways. New points of services are being created for those who cannot have access and help is being proposed for some people to have some information, outreach activities are being developed. This is mainly for the internally displaced people, and also people who are in areas of difficult access. I know that other interventions are aligned to mitigate the consequence, which is also part of our area of concern, and we are working closely with states to make sure that essential services are made available.
We’ve seen in Edo State for example, where the governor is saying that COVID-19 vaccination is compulsory for people to attend marriage ceremonies, religious services and all of that. What is the Foundation’s position on mandatory COVID-19 vaccination?
We don’t have a position on what is happening at the state level, but what I can tell you is that vaccine has been a proven intervention to really bend the curve in terms of infection and it is evidence based. What we need currently is to ensure that the country get enough doses for people to be vaccinated. Of course, a lot of behaviour awareness communication has been on that for people to get the vaccine to protect themselves against the COVID-19 pandemic.
Of course, vaccine hesitancy is a clear concern and many people are coming with different solutions to address it. I do believe that if we continue to emphasise on sensitising people and also clearing rumour on everything around vaccine, we’ll get people coming to take the vaccine without being obliged to take it.
I think it is a way that people are using, many efforts are being done to sensitise and educate people on the importance of the vaccine for them.
There are a lot of misinformation in the public space already, even before the pandemic, like cholera and other diseases, but the COVID-19 pandemic actually made misinformation worse. Is the Foundation willing to fund projects to tackle misinformation in Nigeria?
Your question is really of high importance, understanding that miscommunication is a big concern across the development world. The Foundation is already working with different partners and entities to address miscommunication. As you know, miscommunication is a big barrier and feed negatively, any effort that can boost development. And you right, the Foundation is also considering helping, supporting any project that contributes to fighting against miscommunication.
As you can see, we have a communication team and this team is really following at different levels to address miscommunication and support any project in that area, as they are already supporting some of them at the country level and also at the regional level.
There has been a lot of emphasis on COVID-19, but also, the Bill & Melinda Gates Foundation does a lot of work in the area of Agriculture. What has been the effect of the insecurity on Agriculture and food security? In what areas will the Foundation be coming in, in that regard?
I think if we have to really develop on the COVID impact across every single sector, of course, agriculture is one of the main activities for many population that have been greatly affected. When you don’t feel safe, you cannot even initiate any intervention.
You have to move, and when you move to a safer place, you do not have land to continue your activity. Consequently, you will see a reduced level of productivity and of course many people put in poverty and they do not have access to food. So, this is a cycle with consequences that are glaring, but you know that even though in Nigeria, we don’t have a big programme on food security, except through the nutrition and the productivity projects that we are supporting, we know that globally, the Foundation is working with global leaders like World Food Programme, FAO, to ensure that every country at least gets the assistance to provide support to the poor, to the displaced people and those who are being affected.
Most of these interventions currently are based on humanitarian aspect, the Foundation is not yet at the humanitarian area as we are tackling the development aspect, but we are working in collaboration with other partners to be sure that they are covering the gap, understanding that responding through providing food to displaced people is just an interim solution, as the long-term and permanent solution is to ensure that we tackle the security issue definitely and that involves a lot of interventions, because it is fuelled by different factors.
Just another question on the vaccine-derived polio, which is on the rise. I think the Foundation spoke about it a few days ago. Do you see a situation whereby it could actually dissuade people from getting vaccines and then set Nigeria back on polio, which was eradicated last year?
Of course, if nothing is done, it will be a rare problem of concern, but I am happy to see that state leaders and the NPHCDA is really taking this seriously. I recently attended a meeting with traditional leaders to discuss about this fact because the gain on polio eradication needs to be maintained and it can only be maintained if we continuously support routine immunisation.
I am seeing a lot of efforts done at state level and at the ward level for people to really bring back children for routine immunisation. It is clear that Nigeria currently is the biggest country with immunised children and this is something that people are really taking seriously to address and I hope we will succeed.
About COVID-19 hesitancy. We’ve seen that the Federal government is already considering the idea of making it compulsory, mainly because a lot of people are not inclined towards taking it, and some states have actually stopped testing for COVID-19.
What is the Foundation actually doing in the area of advocacy? We have about 13 states currently who have stopped testing for COVID-19, and of course, as long as COVID-19 is present in some states, it remains a threat across not just Nigeria but the world. What is the Foundation doing as regards advocacy and also meeting with some of these people, especially the states?
I think you have a very good question and as far as COVID-19 hesitancy is concerned, this is something that the Foundation is fully aware from the beginning, and it has been for many other vaccines. I can tell you polio has been one of them, where for many years, there was a big problem here in Nigeria. With advocacy, and again advocacy is not a magic bullet where you can just start today and tomorrow you will get a result, but it is a long-term effort to be done.
The Foundation is working, at the federal level, we are supporting different entities and also at the state level, we provided few grants to address the vaccine hesitancy among the health workers and also at the community level.
In addition to us, we know we have many partners who are also making efforts to address this situation. As I mentioned, part of the engagement with traditional and religious leaders was also to help them have a good understanding. I don’t think no one will refuse to take something that he believes is good for him.
We need to make effort in communicating and this is where I see communication being a very important tool to address the long-term goal, rather than the short one. So, there are different ways to administer the vaccine, and of course, the best is the sustainable one, convincing people, making them aware of the importance. This is the way to go.
What lessons and experiences are you bringing to your work here in Nigeria and how significantly different is this from your past experiences?
Great! I think it is linked to my past experience. I have to say that as I mentioned, my background, I worked in public health most of the time. I have been with one university for more than 20 years, working in different positions and implementing different programmes in West Africa, Southern Africa and East Africa. I have been working with government, private sector as well as civil society and media. I used to be an implementer, which means you take a programme, you assess the need and then you got to the field, you implement, you get results and then you come back.
So, what is different here is I am playing a similar role of director but in the donor side, making decisions to fund someone else to implement the activity or co-fund or collaborate with other partners, is the difference. So, I think wearing this lens of experience through different health sector areas including agriculture and financial services for poor, is a unique opportunity for me to of course apply in Nigeria the lot of innovation happening somewhere else that can be shared here. I am not saying necessarily it will work here, but we can always share.
So, this long-term experience implementing can also be applied, providing support, remember that one of our assets is our own staff expertise, sharing experience in building the capacity of other partners is something that I do believe I am bringing here. Also, working with a good team here based on my past experience managing big teams, I think it is something that I am looking forward to sharing with all of them, including the vision too in terms of development, especially in the public health area.
Of course, coming from Tanzania to Nigeria, Nigeria, based on how we see ourselves, is a different kettle of fish. Considering your work in Tanzania versus what you have to now face in a bigger and more diverse country like Nigeria, you have been around for some months now, have you had like a shock in the kind of experience you have had in Tanzania and what you are having here?
First of all, you need to know that I am African, West African, raised and born in Burkina Faso, so I feel like I have been in Nigeria forever. The shock of course is in terms of size, but it wasn’t really a shock. I was honestly impressed by many things. First, the government strata are not the same as other countries, this is a federal government with state level full responsibility and ownership.
I can say also in terms of population, Nigeria is made up of a big population. Some states are similar to some of the small countries that we have. But, the most important thing is the resilience of Nigerian people, despite COVID, security issue and all other issues like unemployment, the innovative ways of addressing things that I can see, the dynamism I am seeing.
That is something that I will say could be a shock for somebody who is not used to it. That was a very good impression and the vision that you have to really develop the country was a good thing I saw.
Now, a lot of schools are currently closed especially in northern Nigeria, so many have been shut down due to banditry. Do you foresee an increase in the number of out-of-school children in the coming weeks or months? And if you do, what advise do you have to curtail this impending disaster, so to speak?
I think you are touching a very critical point that is so important in the development world, especially when it is about education that even before COVID or the security issue, access to education has not been effective everywhere, especially in the northern part of this country.
Then, we now have security issues as well as COVID, where schools are being closed and many being displaced. I do believe that with expectations, that it will be improved. I think people are trying to see what the best way will be to address access to school for the majority of children, especially young girls. There are some innovative tools for people to have access online using tablets, but there are some limitations here because some of these people still do not have access to simple telephone or radio and there has been a concern.
The Foundation currently does not have a big programme especially on education, but it is a matter of concern and our team is thinking about how we can contribute to addressing some of these issues because they are development priorities as well, if you want the next generation to be part of the development.