‘MAYOWA TIJANI, TheCable’s business and development editor, speaks exclusively with Bill Gates, co-chair of the Bill and Melinda Gates Foundation, on the recently released 2020 Goalkeepers Report, eradication of malaria, controversies around COVID-19 vaccines, tax sentiments — and the removal of fuel subsidy in Nigeria.
TheCable: In the last 20 years, global human development index (HDI) data has shown that the world has become better almost every year. But for 2020, that progress has stopped. As someone who has invested billions of dollars into this, how does that make you feel?
Bill Gates: I am still optimistic that we can catch up on the immunisation we missed and then get back on track for the gradual improvements that — over the last 20 years — have been very strong. There are certainly challenges: the pandemic is creating a lot of economic problems for Nigeria. Both the domestic economy [and] oil exports make things challenging.
I truly do believe that if we can improve the primary health care system… we can literally save millions of lives, even specifically in Nigeria where even before the pandemic, primary healthcare systems were not performing as well as we would like. I spent three hours this morning with my friend, Aliko Dangote, in a conference call with state governors talking about their commitment to primary health care and how they are going to deal with all the challenges, and I do another three of those calls tomorrow. Our foundation believes that Nigeria’s primary healthcare can get improved and save, literally, millions of lives, despite the recent setbacks.
TheCable: According to the 2020 Goalkeepers Report, 25 years of progress has been lost in just 25 weeks. How long or how quickly do you think it’ll take a country like Nigeria and possibly the rest of the world to recover from this particular setback?
Gates: The best case will be in two years, but realistically, even for the health system, it would probably take some years. For some of the economic setbacks, like we talked about poverty increase, 37 million additional people. That may take more than three years because across developing countries, we haven’t been able to run large deficits like a lot of the rich countries have to try and fill in the economic gaps that the pandemic has created. The opportunity in Nigeria is to do a lot better. I mean there are parts of the north where the vaccine coverage, when really properly measured, is under 30 percent and that’s why we see a very high under-five death rate, among the highest in the world, which is definitely tragic.
TheCable: You spoke about 37 million people going into extreme poverty this year alone and we know that a good number of those people are from Nigeria. As an impatient optimist who wants results as quickly as possible, what do you think the Nigerian government and its partners can do to get as many people out of poverty as quickly as possible?
Gates: There are many aspects of poverty reduction. The most immediate is health; you know, if kids are surviving, they are able to be educated and be more productive, if you’re getting rid of malnutrition, both physical and mental capacity of the country is greatly increased. I’d still put primary healthcare at the top; then you have the quality of education, the quality of infrastructure, things like stability, and the court systems working well.
Right now, lots of the people (Nigerians) don’t trust that their tax money is well spent and so [it is important to] build credibility so that over time, the tax collection can be much higher. Nigeria has about the lowest domestic tax collection of any country in the world, so it is very tough to fund infrastructure and education. You have to overcome that sense of if the taxes were collected, will they actually go to the right thing? One area that you can really show that very clearly is by having the health supplies there, having the health workers show up, be clear what those health goals are, then people will very quickly see lives saved. Our deepest expertise is in this health area because that is just a critical area that still lags behind, particularly in the north — even behind countries that are substantially less wealthy.