National Wire About Nigerians, Nigerian Business and Other Stories
Bill Gates, co-founder of the Bill and Melinda Gates Foundation, has led numerous philanthropic efforts in Nigeria, investing in Africa’s largest population more than any other African country. His foundation addresses health, nutrition, poverty and agriculture issues, engaging research and data to proffer solutions. Recently in Abuja, Gates discussed his interventions and emphasised farmers’ freedom to choose between improved and regular seeds to make Nigeria a food exporting country instead of a net importer that she currently is. He also talked about AI, nutrition and healthcare in Nigeria. DAYO EMMANUEL was at the session and here reports.
Last year, we discussed the potential of AI in eradicating malaria. Its real that AI relies on data sets and analyzers, but there’s curiosity about its practical application. Given that malaria shares symptoms with other diseases, how does AI accurately diagnose it and are there technologies to prevent misdiagnosis?
Well, we actually have very accurate blood tests for malaria. Malaria presents, in terms of blood antigens, in a very, very specific way. And those are, you know, very low cost, little finger prick, point of care type tests.You know, AI is a direct, doesn’t directly solve malaria. We use AI to design new vaccines, to design new drugs, to, you know, we have a technique for killing mosquitoes called gene drive that will probably be a necessary part where you reduce mosquito
populations or modify the mosquito to not be able to carry the malaria parasite. So, you know, all our work gets accelerated by those new tools.
You discover drugs faster. You know, another area AI will be used is in health delivery. Eventually, you know, through your cell phone, you’ll be able to ask questions and get medical advice and
if you’ve seen AI now, it works in the voice realm as well as it does in the text realm. You know, the foundations work with partners to make sure that African languages, including Nigerian languages, have good data sets so that the accuracy is not much different than we used to believe it would be.
How can Nigeria leverage AI in healthcare, given the weak infrastructure? What steps can ensure AI complements rather than replaces doctors?
Well, you know, there’s a lot of near-term work to be done to make sure that kids
get the vaccine. They need – you know, the coverage levels are not as high here as they should and that partly explains why the under-5 mortality is still pretty high. You know, it’s gone down, but not nearly as much as it would if we were reaching all the kids with vaccines. You know, measles is a very good example of where, you know, we should be able to get measles testing to near zero, but they’re still quite high. So and those are very dragging positions. We actually have to get the vaccines out. We have to educate mothers that it’s very important for the health of the child. We have to have the stock in place and the workers in place. So, you know, we’re – a lot of the work is very basic stuff.
AI is not in any – not in the next few years going to relieve us of the need to really deal with the basic execution. That, particularly in the northern states, you know, we’re getting those coverage levels up as high as we should. But eventually, the relative role of AI versus doctors, that’ll play out over the next decade.
You know, there’ll be some things that AI actually is as good or better at, but, you know, you can imagine in original health systems, the economic opportunity to make healthcare more efficient is kind of unplayable. In a sense, the countries with the greatest shortage of doctors benefit the most because, you know, you’ll be able to get medical advice, you know, in your native language, in your village, including, you know, whatever
data you make available.
So it’ll be very individualized but, you know, that stuff is being piloted in the next two or three years. If you go at full speed in the next five or six years, it will be deployed at scale globally.
How has the new $7 billion African fund for innovations in gender equality, combating inequality, hunger, violence, and racism performed over the past two years?
Well, you know, I came to Nigeria a long time ago. That was ages ago. You know, helping reduce health equity and inequity in the world as our top priority, including getting rid of diseases like measles and malaria and polio and, you know, so we spend a lot in Asia, but we spend even more in Africa.
The country we spend the most on in Africa is Nigeria. It makes sense
because of the population and because of the incredible needs that are here and, you know, so that means that I’ve literally spent billions in Nigeria. You know, I feel glad that the things like the child mortality rate has come down,
but we could do a lot better. So as we spend more money in the future, what it’s going to be to improve the primary health care because the impact per dollar in that is dramatically greater than anyone else.
So we fund research on new tools, like new vaccines, and then we fund the delivery through partners like Global Health. Health is the biggest by quite a bit. The next biggest would be the work we do in agriculture.
I’d like to know what the foundation is doing to push for the adoption of the e-motive bundle as recommended by the UN to stop avoidable deaths from
postpartum hemorrhage.
Adoption of the e-motive bundle to stop postpartum hemorrhage. Some of our most exciting work is in this mother and child area. We were trying out the idea that if you put a drape under a mother who is delivering, that would let you see how much bleeding is taking place.
In the trial, we have two cut-off points where you can start after 200 milliliters of
bleeding to get these very cheap anti-bleeding drugs that cost about $2. The current WHO standard is that you should treat women if they bled over 500 milliliters. But there’s actually been no tools to measure that, so often women who even exceed that level don’t get treatment. But what we showed in the trial was that if you use these drugs at the current recommended level, you saved a little over 50% of the bleeding deaths. But if you did it at the lower level, you actually saved 70% and so we got the WHO to change their recommendation.
And now we’re trying to get it pulled out that you have this plastic map that’s very
inexpensive to measure the blood loss. Then if you need it, then you use the $2 of
drugs that actually stop the bleeding and that study was supposed to go on for three years. But in six months, the effect was so dramatic, it ended the trial early, which almost never happens. But if something is so miraculous, then it’s unethical to continue the trial
because half of the mothers are receiving placebo so that you can show the intervention difference. But it was very, very dramatic. We’re trying to do the same thing for other maternal conditions like preeclampsia and gestational diabetes. So all the things that drive the level of maternal mortality, which unfortunately are still fairly high in Nigeria.
As a journalist and part-time farmer, I’m concerned about food security in sub-Saharan Africa, especially with Nigeria’s food inflation rising to 39% in July. Given your foundation’s work on food fortification, how are you helping farmers increase their yields? How do you use data to support this transition from traditional to mechanized farming, considering climate change and farm conflicts?
Yeah, so it’s actually surprising that Nigeria in particular is a net food importer because you have lots of land, and if you produced it anywhere near the productivity that, say, Europe or the United States or China produce at, you’d be a net food exporter and if you’re a food exporter, then when the currency shifts, you actually benefit.
This is because your costs are lower, but you’re getting paid in dollars and so raising agricultural productivity in Nigeria is a very important part of economic
development. It’s not the only part, but it’s very important and there are, whether it’s
better chicken genetics, or even chicken vaccines, or cow genetics, or high quality dairy, or maize, or rice, or cassava.
And we have a cassava variety that has over twice the productivity of the traditional strains and that avoids the key cassava diseases. So the good news is that there will be these things. We fund a group called the CG System, which is the group that does overall seeds and then they work with the Nigeria National Agricultural Research Group. The
country looks at different seeds and decides which ones to recruit. But in the pipeline, they’ll make their own decision.
But in the pipeline, both in maize and cassava, there’s some incredible things that work on chickens, actually. It’s being rolled out now and scaled up. In that case, it would be better in terms of the size of the eggs and the amount of egg laid and you can do that. Like I talked before, improvement is great for nutrition. It’s great for women’s empowerment.
So even in the face of population growth and climate change, it’s pretty clear that new approaches, including weather prediction, getting advice to farmers through the digital channel, and tracking plant disease to seed, like wheat grass does, that we can achieve very ambitious goals in agriculture. So that’s why we have only a second to our health
program is our agricultural work.
Nigeria is facing her worst nutrition crisis in a decade, driven by insecurity and climate change. What innovative strategies can we implement to tackle malnutrition? Are you suggesting food subsidies as a solution? Additionally, how can we better understand and address the specific nutritional deficiencies affecting children?
We funded most of those studies and there’s a lot now that’s understood about having enough protein in your diet, which includes things like milk and eggs and so raising the bar for different nutrient things. You know, a key thing is the nutrition of the mother and that’s why we’ve gone. When it used to be when you did your MME and to name visits, you were given iron and folic acid and that’s all. But we’re showing people that that should be switched to a group of vitamins that help and MMS. As I said, downstairs, there’s 3 million bottles of that coming in for pilot rollout. So, you know, even though it costs a tiny bit more money to do MMS, it’s very, very little. The benefits to the mother and child are very significant. So, you know, there’s – it won’t be solved overnight. The current economic conditions are driving up the stunting levels right now. So that’s very concerning because if you’re malnourished, that affects your life long. If at age 5 you’ve been malnourished, you can’t recover. That is a permanent in terms of your physical and mental capacity. So, you know, in order to
avoid kids being vulnerable to diseases and so that they achieve their potential, it’s a very high priority for us. You know, if we don’t have these interventions, it does make a significant difference.
How do you effectively communicate the benefits of climate-adapted, nutrient-rich seeds, especially in light of concerns about their cost, financial sustainability, and mixed results, like those seen in Zambia?
Thank you. Well, every farmer gets to make their own decision about the seeds. The improved seeds – some improved seeds are public domain. So, there’s nobody getting the loyalty or making a profit from the design of the seed.
Everything we work on is public domain seed. So, there’s another trait, which is hybrid, where if you use the hybrid seeds, you get more productivity. The only drawback to hybrid is you do have to go back and buy the hybrid seeds, which you can choose to do that, or you can choose to just reuse your seeds. Our seeds are all public domain. The hybrid seeds, you pay because there’s somebody doing that seed replication and bringing the scale of that seed replication up so that if
you want to get the hybrid productivity benefit, the amount of pain for that is very low. That’s one of the measures we have as we work with partners. The place where this is a very big deal is in maize. A lot of traditional seeds are subject
to an incredible number of diseases, including all farming work, and they just have very low productivity. So, farmers will decide. I don’t know the Zambia case, what seed they’re talking about. We don’t do specific work in Zambia, so I don’t know what it is they’re referring to. We are trying to give farmers more choices and give them the opportunity to have productivity that China, the U.S., Brazil, Europe, they all have this gigantic productivity. For Nigeria, it’s a question of if you want to buy food from the U.S., Brazil, Europe, and import it, you can. But it’s going to be tough to solve that nutrition problem if you’re having to go buy food from other places.
Your foundation supports biotechnology applications, but there are concerns about certain resistant products. How is your foundation addressing these issues, and how do you collaborate with governments on this matter?
Well, things like, you know, beefy coffee has been eaten by hundreds of
millions of people. Beefy maize, you know. That’s what we eat. That’s what China eats. That’s what India eats. There are some people, mostly in Europe, I’m not just in Europe, but mostly, who think that you shouldn’t use new technology for
seed as you know, for those countries, the cost of food is so low in Europe. If they want to use inefficient farming techniques, it’s okay. They can afford it.
They’re very rich. They have no malnourished kids. They have no kids who die of malnourishment. We were at a hospital today looking at a kid. You won’t find that kid in places that have high productivity farming. So, you know, it’s up to the regulatory approval of these
things. Each country gets to make its own decision. If there was any evidence against these things, real scientific evidence, you wouldn’t think the United States would feed everyone every day.
