A new Country Director arrived at the Abuja office of the Bill & Melinda Gates Foundation (BMGF) in January 2021. He is Dr. Jeremie Zoungrana,
a health sociologist and programme management specialist with over 20 years’ experience. Having worked across Africa, the new CD has his
work cut out for him in Africa’s most populous country but plagued with insecurity and inequality. In his first interview with the
media, Zoungrana lays out his plan for collaboration with the Nigerian
government
By Our Reporter
When Dr. Jeremie Zoungrana took over the affairs of the Bill & Melinda Gates Foundation in Abuja, he knew things would never be the same. For
over two decades, he has worked across Africa in both public and private sector as a programme management specialist. That is not all,
he has also worked across sectors, 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.
But Nigeria would be different. First there was the initial shock and realisation at the size of the country and the amount of work that
would be needed to make an impact. But then he felt like he has been in Nigeria forever.
“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,” Zoungrana said.
What is not a shock again is where his past experience would come into play in Nigeria, this time on a higher scale. “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,” he began as he responded to a question about how his
experience managing several programme would work in Nigeria.

“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,” Zoungrana said.
Nigeria has always been an important partner to the BMGF according to the co-chair, Bill Gates. It is so important Gates claimed to have expended over $1.6billion in the country, helping tackle the problems that affect the poorest people.
In the over one decade that the Foundation has committed to supporting Nigeria achieve the ‘basic’ of the Sustainable Development Goals, it
has also recorded some great victories like the eradication of polio in 2020 through massive and aggressive polio vaccination campaign.

That victory came at a huge cost, several immunizers were slaughtered in cold blood in Kano and many more suffered untold hardship. But through resilience and sacrifice, polio was eradicated.
Zoungrana credited such massive victories to the many partners the Foundation is working with and the resilience of the Nigerian government.
“The Bill and Melinda Gates Foundation through our many partners helped to build back better and is sustaining essential
delivery service, life-saving services to those who need them most.

“Together we have saved gains on routine immunization, Primary healthcare services, maternal/newborn/child health, financial services
for poor and agriculture. We also made a strong commitment to support Nigeria, to meet the minimum, the human capital development goal. Just last month, we had a Memorandum of Understanding review with six states and all of them are on track. We were able to review our
collaborative effort to deliver primary healthcare services for the people,” he said.
The Foundation has always maintained that its role is to partner with the government and provide support through its many grantees, “we
don’t work in the field,” Zoungrana remarked. But he was also quick to admit that insecurity which has besieged the country has greatly
impacted the work done in the past, reversing years of hard fought victory.

“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 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, “Zoungrana promised.
The Foundation however faces a novel challenge not just in the havocs brought about by coronavirus but now through vaccine hesitancy by
Nigerians. Currently less than five million of the eligible population has taken the vaccine forcing the federal government and some states
to mandate COVID vaccination.

“We don’t have a position on what is happening at the state level,”Zoungrana said in line with the Foundation’s principles of non-interference with the affairs of the state. He however provided a
way out of the difficult situation “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,” he said.
Vaccine-derived polio, out of school children
But despite the accolades over the eradication of the Wild Polio Virus in Nigeria, vaccine derived polio has raised the stakes as some states
have seen the resurgence recently. Should Nigeria worry about this?

“Of course, if nothing is done, it will be a rare problem of concern,” he said then continued with an optimistic smile, “but I am happy to
see that state leaders and the NPHCDA are 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. “
The new Country Director is also worried about the high rate of out-of-school children especially in the north which he described as a
“critical point”.
“ 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. If it is not improved, if there is no clear action to stop it yet, the anticipation is to see more of this thing happening. 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.”
Dr. Zoungrana said he has been meeting (virtually) with stakeholders in Nigeria, assessing the situation and presenting what would be the
best advice from his years of experience working across the sub-Saharan Africa region.
But for now, the Pan Africanist is impressed by what he has seen so far. “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.”