Steve Omojafor: PPP in Healthcare Best Way to Engender Development

Sir Steve Omojafor, OON, is a Board Director of the Institute of Human Virology Nigeria, IHVN, and former Chairman of Zenith Bank. In this exclusive virtual interview with Rebecca Ejifoma, Omojafor spoke extensively on the new IHVN Campus and its plans to train large and skilled clinical researchers in preventing infectious and non-infectious diseases across Africa. He also deliberated on the need for public-private partnership in health care delivery as the best way to engender development to Nigerians and West Africans

What is so remarkable about the successful completion of the IHVN new campus?

Apart from the continuous provision of prevention, treatment, and care services to people living with HIV and others affected by other infectious and non-infectious diseases, IHVN will, through this International Research Centre of Excellence (IRCE), promote public/private partnership for quality health services, capacity building and research in West Africa and will bring quality health services within reach of millions of Nigerians. It will also provide world-class infrastructure for collaborative studies on diseases of relevance to the local community such as HIV, TB, Malaria, Cancer, non-communicable diseases, and emerging infectious diseases.

What is the IHVN new campus for, and for whose benefit?

A key focus of IHVN through its new Campus is the development of the next generation of African researchers in preparation for future epidemics through mentorship, training, and capacity building. The new Campus has prerequisite human resources and is setting up a state-of-the-art laboratory infrastructure for clinical diagnosis, clinical trials, storage, and management of bio-specimens. The campus is also for collaborative groundbreaking research, training, and capacity building to curb future infectious and non-infectious disease outbreaks in Nigeria and the West African sub-region. The Institute has an extensive network with renowned research Centres and facilitators within and outside the country, which ensures up-to-date information during training, mentorship, and capacity-building exercises.

What were the financial, technical, and operational risks involved in this project?

During the conceptualisation stage, there was palpable apprehension that funds may not readily be available to complete the project; however, the Board was focused on exploring all available avenues – including active fundraising support and appeals to high-net-worth individuals and corporate organisations. The primary technical challenge faced by the Management and the Board was selecting the best available main contractor for the project. This involved interviewing both local and foreign contractors. We had extensive deliberations, followed by visits to the project sites of the shortlisted contractors. We finally settled for a reputable local contractor.

A project as big as this requires good maintenance including human, technical and financial resources to serve as cover against adverse operational risks. We were concerned about this, but the Board/Management was assured of adequate technical competence and financial resources for the Project take-off and completion. Also, adequate provisions had been made for fire prevention and fire-fighting equipment – including fire hydrants strategically located on the campus, fire hoses on every floor of the buildings, and smoke detectors and fire alarms on every floor of the building.

You mentioned something about training and its significance. What kind of training are you talking about?

As I said earlier, the International Research Centre of Excellence (IRCE) was established to promote public/private partnerships for quality health services, capacity building, and research in West Africa. Our Research Centre conducts biomedical research focusing on HIV/AIDS, malaria, tuberculosis, and non-communicable diseases such as cancer and diabetes. It has, in this regard, provided capacity building to health care providers and ancillary workers across all implementation and research activities of the Centre and the Institute of Human Virology Nigeria. For example, as of December 2021, the Centre has provided over 48,000 health professionals with training and the capacity to identify and manage diseases such as HIV, TB, and other non-communicable diseases. The Centre is managed by an Executive Director, Professor Alash’le Abimiku, and Professor of Medicine in the School of Medicine of the University of Maryland in Baltimore, USA. It is worthy to note that Prof was the first to identify the prevalent HIV in Nigeria in 1993 while working as a postdoctoral fellow under the tutelage of Professor Robert Gallo, the globally recognised co-discoverer of HIV.

What are we going to do with our research and training programmes in Nigeria? Simply, we’re going to continue and expand on what we’re already doing – training and retraining our health care providers, who’re mainly medical doctors, clinical laboratory scientists, pharmacists, nurses, statisticians, and other social workers, on how to handle the various types of diseases that Nigerians grapple with. Even in journalism and communications, proprietors place a high premium on training and retraining their personnel to serve the public better.

We need to identify areas practitioners are best suited in terms of expanding their knowledge and capabilities to handle challenges effectively, in terms of research findings in their specialised areas. That’s the direction we’re going. So, our focus is on training and retraining health providers to suit multiple thematic areas of health intervention in Nigeria and beyond. I may not have the exact figures currently, but over 47,904 medical scientists, research experts, and health providers have been trained by the Institute including medical people and institutions who’re already either working directly with us or who’re coming to do part-time research findings. Indeed, we’re busy turning out a lot of researchers, scientists, and medical people.

We believe that at some stage, this pool of trained manpower will impact the various medical institutions in Abuja and around Nigeria.

How does this new campus help the institute meet its goal of training large and skilled clinical researchers in preventing infectious and non-infectious diseases?

IHVN has many programmes and activities in no fewer than 23 states of the country, and with laboratories that it is supporting in most of the geopolitical zones of Nigeria. For example, it is supporting the Biosafety Level 3 laboratory for diagnosis of Multidrug-Resistant TB at the National TB /Leprosy Training Centre in Zaria and 17 PCR laboratories across the country for early infant diagnosis and viral load tests, and repositories to receive, process, store and ship samples. IHVN’s presence is felt all over the country, especially in rural areas. Our personnel transverse the country to disseminate information on HIV, Tuberculosis, Malaria, and other infectious and non-infectious diseases. We have personnel moving around the country collecting samples for diagnostics in our specialised labs in Abuja and regional Centres of the country and supporting in treating the sick and managing chronic diseases etc.

Undoubtedly, keeping records and reporting the same to Abuja are quite tasking and better done in a well-coordinated environment – hence the need for this new IHVN Campus and exit from all our rented apartments and properties that the Institute used for almost two decades. So, the new IHVN campus and its world-class International Research Centre of Excellence now host specialised laboratories to better understand the manner of the development of diseases and immune responses to infectious diseases in Nigeria. This will help the country to improve its capacity to diagnose, control and treat diseases. Before moving into our new Campus, critical laboratory facilities and tools were spread over rented apartments, buildings, and offices in different parts of the country.

When you look at our operational map, you discover that we’re spread around Nigeria. Wherever we go, we look at the medical institutions and facilities, and personnel. We look at the medical requirements of the people. Getting people who’re infected to come out, to be tested and treated and to build a database that enables us to know where we should be directing our attention is a major task for IHVN. In Port Harcourt, Rivers State, we maintain a huge presence because of the prevalence of multifarious medical problems such as male and male sexual relationships, gender violence and little kids being abused.

Our trained personnel go around collecting relevant data on the prevalence of these cases. All materials returned to the labs go back to the training rooms, and workshops, and determine what each area requires. These are not activities to be effectively coordinated and implemented in rented and inadequate offices and buildings. Like a mustard seed, IHVN’s multi-disciplinary staff strength has grown to almost 600, spread across the country from just two pioneer and visionary staff, led by its indefatigable Chief Executive Officer, Dr Patrick Dakum, and versatile Chief Operating Officer/Managing Director, Dr Charles Olalekan Mensah, both of whom gathered in Chelsea Hotel in the Central Business District, Abuja, in 2004 to plough the ground and give the Institute a solid foundation. Today, we have a new Campus – an imposing Twin Towers – for effective coordination of multifarious activities from different parts of the country for analysis and exploring medical and scientific solutions to the nation’s health care problems.

What inspired this project? Could it be the outbreak of COVID-19?

The inspiration for this project predates the outbreak of COVID-19. It started soon after IHVN became one of the prime implementing partners of the United States of America’s largest public health investment in the world. IHVN, which is now a local non-governmental organisation, was established in 2004 to address the HIV/AIDS crisis in Nigeria through the development of infrastructure for treatment, care, prevention, and support for people living with HIV with funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR).

It initially started as an affiliate of the Institute of Human Virology, University of Maryland School of Medicine, USA, established to address the HIV/AIDS crisis in Nigeria through the development of infrastructure for the prevention, treatment, care, and support for people living with HIV. The Institute has since grown and extended its areas of service to include tackling other infectious and non-infectious diseases in Nigeria. Before the scourge of COVID about three years ago, IHVN has been tackling HIV/AIDS, Tuberculosis, Malaria, Cancer, and all kinds of diseases plaguing Nigerians.

It’s been a long-running institution. In 2015, the idea was mooted to place all our services under one premise where we can holistically plan our strategies and be of more relevance to our local community and, of course, communities around us in and out of Nigeria. Essentially, IHVN is a nonprofit making organization that’s supported by Grants from PEPFAR, Global Fund, United States Agency for International Development (USAID), US National Institute of Health (NIH), and other donor agencies. Our services are virtually free and humanitarian. These streams of funds enable us to provide care and support to over 653,000 patients and ARV drugs and treatment to over 538,000 people living with HIV under the PEPFAR programme.

IHVN is the first Principal Recipient for the Global Fund TB Public Private Mix Scale-up in Nigeria for 2019-2020, which was later renewed for 2021 to 2023. This grant has enabled us to identify 97,871 TB cases via the notification of non-national TB providers in private and non-governmental facilities that the Institute is supervising. The Institute has also identified 9,036 bacteriologically confirmed drug-resistant TB cases while 6,515 drug-resistant TB patients enrolled for treatment under its programme. We have also provided HIV Testing Services, Prevention of Mother-to-Child Transmission of HIV, Antiretroviral Therapy, and TB/HIV, services in 10 states of the country as a sub-recipient to FHI360. Other programmes that the Institute is handling include the USAID/Nigeria Tuberculosis Local Organization Network (TB-LON) five-year project to scale up TB services and find missing TB cases and sustainable TB control in Lagos, Ogun, Oyo, and Osun states. It also handled the Strategic HIV and AIDS Response Programme (SHARP) Task Order 1 and 3 USAID-funded projects to address the HIV scourge in Sokoto, Zamfara, Niger, Kwara, Kano, Jigawa, Bauchi, Yobe, Borno, Adamawa, and Kebbi states. Our achievements since inception and these additional responsibilities account for some of the reasons to have a Campus where these activities and our programmes can be properly coordinated, implemented, and managed.

Given the donor funding your Institute receives, what is the significance of private-public partnerships in terms of financing development projects in Nigeria?

Let me start by expressing delight that the government is cooperating effectively with the Institute to implement some of our projects. Initially, the relationship was quite strong and mutually rewarding, but over the years, especially in the last number of years, the Institute has had to go it almost alone. Now, talking about public-private partnerships; of course, we seriously believe in it, because it’s one of the best collaborative ways to bring development to the doorsteps of Nigerians, instead of relying solely on the government to provide every amenity for over 200 million Nigerians. The Global Public-Private Mix (PPM) project that the Institute has been involved in since 2017 is significant in increasing the private sector contribution in finding more people needing tuberculosis treatment services. If the University of Maryland didn’t come to our aid through PEPFAR, this Institute may never have come into being, and the support that the Government of Nigeria has received so far from the Institute wouldn’t have materialised.

Our funding partners in these collaborative efforts include US Centres for Disease Control and Prevention (CDC, Atlanta), Global Fund to Fight AIDS, Tuberculosis and Malaria, and USAID to mention a few. Today, some of our most senior lead persons including the CEO are faculty members of the University of Maryland. Some of them were indeed facilitating full-time at the University before they were seconded to Nigeria, to bring the Institute to life.

To finance the construction of our new Campus, as one of our contributions to improve health care delivery in Nigeria, we surely needed a lot of funds. To start with, we embarked on sensitising our corporate bodies in the country, selling the Institute to them, and letting them know exactly what was needed to run the services we were projecting. And then we held a big fundraising event here in Lagos. We invited corporations, manufacturing companies, medical companies, Banks and many more. That’s about six, seven years ago, before we embarked on the It was successful, but a far cry from what we needed to start. We also called on our Bankers and we got the biggest support from Access Bank PLC. We also extended our pleas to various other Foundations and Institutions. The overall response was quite low, but we trucked along. We were determined as a Board of directors that whatever it took, we were never going to abandon the project. So, we spread our tentacles much wider – both internally and externally. Expectedly, we got results and moved to the site. As we get set to commission the project I can safely disclose that the Twin Towers have gulped over six Billion Naira – certainly, no mean feat! The Board and Management give immense appreciation to all friends, donors and corporations that partnered with us on this journey.

With this new building in place, how would it impact the performance and provision of efficient health facilities and services in Nigeria?

The new building is already providing a world-class environment for the implementation of research, diagnostics, treatment and care, and all other clinical and socio-psychological programmes and activities of the Institute in the most efficient ways. It will also impact the performance and provision of efficient health facilities and services through the improvement of what we’ve achieved so far in several health programmes and in the newer ones that we’re embarking upon.

Remarkably, IHVN has contributed to Nigeria’s capacity to control the spread of HIV. As of December 2021, 653,260 patients received care and support for HIV/AIDS, and 538,937 received antiretroviral drugs and treatment under its Action to Control HIV Epidemic through Evidence (ACHIEVE) Project. It should be emphasised that IHVN’s programmes are scientific and evidence-based, backed by excellent quality assurance and control mechanisms in all its operations.

According to Professor Alash’le Abimiku, the Executive Director of IRCE, her desire and expectation for the Research Centre in terms of communication is to reach out to virtually every state capital and major city in Nigeria in the areas of collaboration with all the medical institutions, government medical Centres, and other health institutions to propagate the quality of services that the Research Centre will provide for the good of the country. So, moving forward, the Research Centre will be developing a compendium of institutions that will be benefiting from our medical health services.

What were the challenges encountered in building IHVN Campus and how were you able to sail through them?

Starting this project was not a piece of cake. On the Board of Directors are notable Nigerians from varied backgrounds and experiences including Finance, Accounting, Medical, Management Consulting, Banking/Insurance, Communications etc. With these high-calibre directors, decisions were thorough and painstaking –devoid of any emotions. Architects, Structural Engineers, Quantity Surveyors and Project Managers were jointly interviewed and selected. We were delighted to have found capable Nigerians in the Building Industry and they have done the country proud with the quality and high standards achieved on the job from start to finish.

And the building turned out magnificent, didn’t it?

Extremely! We’re looking forward to the commissioning of the masterpiece to showcase it to our visiting partners from within and outside the country.

What incentives are you hoping to receive from the FCT Ministry to complete the remaining phases?

I understand that the construction of the campus is in phases. Now, that’s a difficult question, because when we commenced construction, we did expect some partnership from the government, which eventually didn’t materialise. But it must be said that with increased pressures on the provision of a good motorable access road, provision of electricity, drainage etc., the FCT Minister is beginning to respond and we look forward to sustaining a good relationship. This is also being extended to the Federal Minister of Health.

What kind of collaboration exists between your Board and the IHVN Management?

The relationship between the Board and the Management is very closely-knit. Board meetings are held quarterly, attendance is very good and discussions – very fruitful. Even during COVID-19 meetings held regularly by Zoom, work continued seamlessly. We have a reputable firm of accountants that ensures accounting books are well kept and professionally presented. The Board provides guidance, expertise, experience, and support required by the management. Management, on its part, ensures that papers, information, and documentation that the Board needs to hold effective and efficient meetings are put in place.

The Board comprises Chairman, Professor Emeritus Umaru Shehu, CFR; Dr Umaru Abdul Mutallab, CON; Professor Aba Omotunde Sagoe; Professor William Blattner (American); Mr Foluso Phillips; Ms Josephine Tapgun; Dr Patrick Olabiyi Matemilola; Mr Ralph Oluwole Osayaemeh; Sir Steve Omojafor, OON; Barrister Kanu Godwin Agabi, SAN, CON; Dr Patrick Dakum, Chief Executive Officer and Dr Charles Olalekan Mensah, Managing Director/Chief Operating Officer. And of course, the Management ensures that the Institute carries a happy workforce made up of medical professionals, scientists, laboratory experts, accountants and administrative cadres.

Remuneration is good. The conditions of service are great and the working environment is most cordial and friendly. The Institute’s strength is in its people and this makes for a diligent workforce, ever ready to put in their best.

The world can’t wait to benefit from the excellence of this Institute! Absolutely. That’s why I feel excited that THISDAY is taking the lead in helping propagate the essence and goodness of the new Campus. Having put in place this magnificent edifice which houses both IHVN and its IRCE, we can afford to shout from the roof-top, for Nigerians and the world at large to learn about it and utilise our state-of-the-art facilities for the good of mankind.

What’s your relationship with IHVN and the building of its new campus?

My relationship with the Institute of Human Virology Nigeria (IHVN) dates to 2011 when I was appointed a Board Director of this prestigious institute to contribute my quota to its growth and development. Coming from a background in marketing communications for many years, I’m aware of the health issues and the challenges the country faces in terms of quality health care services. The management of the institute nominated me to the Board to help formulate communication strategies and guidelines for excellent care delivery for families and institutions alike. So, my appointment on the Board was keyed toward the improvement of the country’s healthcare delivery system.

No sooner had I joined the Board than the idea to build a Campus for IHVN was floated. A committee was subsequently set up by the Board, of which I became a member of the Board’s Building Project Committee. The Committee is headed by a prominent Nigerian – Dr Umaru Abdul Mutallab, CON. My role on this committee has been significant and worthwhile, given my background and experience in the corporate world. From the commencement of the IHVN Campus to its completion, it has been an interesting journey. This is a legacy that all of us at IHVN are extremely proud of. My role on the Project Committee has been to support the Chairman of the Committee in driving the project to its completion, which we’ve achieved with abundant support of other members of the Board.

For funds, we held both internal and external fundraising activities leading to the success of the project. With the completion of the Twin Towers, there are plans for the commencement of the second phase of the Campus, which will comprise a Conference Centre and a Residential Lodge. The Management is at the stage of reviewing the designs with the consultants. We’re trusting God for the resources to commence the second phase as soon as feasible. The Mission of the Management of IHVN to remain resolute in providing effective and efficient healthcare service delivery through this infrastructure is highly commendable. And the board is equally poised to render all logistics support.

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