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Senegal: HEALTH - Okonjo-Iweala suggests investing in vaccination programs

Pathé Touré

Okonjo-Iweala advocated in Addis Ababa at the place of governments to favor vaccination in national budgets as it offers good profit in the economic development of countries.

The former Minister of Finance of Nigeria, Ngozi Okonjo-Iweala, now President of the Board of Directors of Global Alliance for Vaccines and Immunization (GAVI) to benefit friends of the African Development Week, held in Addis Ababa to advocate to African governments calling them to invest heavily in immunization programs because it is cheaper to prevent than to cure.

In his presentation to the Annual Meetings of the ninth conference of the Specialized Technical Committee of the African Union in charge of Finance, Monetary Affairs, Economic Planning and Integration and the Conference of African Ministers of Finance, Planning and economic development of ECA, Okonjo-Iweala demands that governments include vaccination in their annual budgets.

According to a statement, she said that priority vaccination in national budgets offer good profits in the economic development of countries. She adds that a recent study by John Hopkins University in the US shows that for every US dollar spent on vaccination, profit is 16 dollars savings in health costs.

"This is a high profit for the Ministers of Finance and Planning; and it is one of the most effective ways to spend our dollars on health. Immunization of our children and citizens save us additional health spending, "said Okonjo-Iweala.

Dr Seth Berkley, CEO of GAVI, also made a presentation, asking governments to focus vaccination into their budgets and says it only takes the political will to prevent unnecessary loss of life.

SOURCE: http://fr.allafrica.com/stories/201604070546.html

Keynote Address Delivered by Dr. Ngozi Okonjo-Iweala
Chair of the Board of Gavi, the Vaccine Alliance
at
The First Universal Health Coverage Financing Forum
Organised by the World Bank Group, and USAID
Attended by Health and Finance Ministers and Health Experts


Mobilizing Domestic Resources for Universal Health Coverage

April 15th, 2016


1. Greetings and protocols observed
• Distinguished ladies and gentlemen, it is a great honour to be here today. As a former World Bank colleague, a former Minister of Finance and now as Chair of the Gavi Board I have reflected on financing for Universal Health Coverage from many sides of the coin. So let’s put this issue of resources for health in context.

• In September 2015 the entire world committed to 17 goals and 169 targets. In addition to eradicating poverty, this sustainable development agenda will cover economic, social and environmental issues.. Economists have estimated that the cost of implementing the SDG's will run to the trillions of dollars. So countries, donors, foundations and... the private sector are being asked to fund interventions that will improve our skies to our oceans, our health, education, wellbeing etc and everything in between.. all of which are, of course, crucial for sustainable development.

• Because of the tightening aid environment given the global downturn, migration and refugees issues, domestic resource mobilization for development has become the subject of many international meetings and key note addresses on health, education, sanitation, infrastructure, climate change etc. I am a proponent of DRM- one of the first finance ministers to warn LDCs that we need to do better on this front because the resources to achieve the SDGs would not be forthcoming in the quantum needed. But I must confess some concern that DRM has become the new rallying cry of the development community in an era of scarce resources yet even with increased DRM each sector must focus hard on the justification for their prioritization.

• Given the new expanded development agenda outlined by the SDG's, the competition for resources will become increasingly fierce. As a Finance Minister I was inundated with very laudable proposals for funding from various sectors and ministries and deciding what to prioritize was often a very tough decision, as I am sure is the case for many Finance Ministers. To increase the priority given to health care from increased domestic resources, the health community, both globally and nationally, would need to make a better and more holistic case for health that includes the economic benefits of investing in health. To secure the funding needed for Universal Health Coverage, the Ministers of Health and the health community in general really need to learn to speak the language of Finance Ministers.

2. So what is Universal Health Coverage?
• At its core is the basic principle that all people should receive quality health services that meet their essential needs (to be defined) without exposing them to financial hardship in paying for them. While it is likely that all of us here already have some affordable access to healthcare, it is a basic human right that has not been met and remains beyond the reach of many people particularly in developing countries. At the core of UHC is ensuring equity in access to health care where there is currently none. Therefore it is important to design UHC with the poor and difficult to reach accorded foremost priority- to first guarantee a minimum package of essential health care to those who would otherwise be unable to afford it.

• Despite the encouraging progress in recent years in areas like reproductive health and family planning, the world is very far from universal coverage, even as regards priority services. For example, every year 46 million births are unattended by skilled personnel and 23 million infants still do not receive basic vaccines. Every year 100 million people are pushed into poverty and a further 150 million suffer financial catastrophe because of out-of-pocket expenditure on health services. Countries that are closest to UHC in terms of attainment of WB-WHO indicators are mostly OECD countries. This inequity gets to the heart of the MDG’s unfinished agenda. Unless we make UHC our focus now as we transition to the SDGs then we will continue to have preventable human suffering, especially of women and children, and this can act as a significant barrier to many if not all of our global development goals.

3. Why should we care about UHC?
• Many health ministers are already well aware of this. But it is important to understand that this issue goes well beyond health, and as such is a matter for every part of government, and every government. Not just because of the moral argument that all people should have access to health as a human right, but also because it’s simply sound economics. There is now compelling evidence to suggest that investing in health yields remarkable returns.

• A 2014 Chatham House report estimates that for LICs and MICs, health contributed to annual growth in income to the tune of about 1.8 per cent annually and for sub-Saharan Africa, the annual contribution was as large as 5.7 per cent. A recent study, published in the journal Health Affairs, gives further sense of these returns. Looking at 94 low and middle income countries, the researchers found that for every dollar invested in childhood immunisation we can expect to save US$ 16 in healthcare costs, lost wages and productivity due to illness. If you take into account the full value people place on living longer, healthier lives, then that return on investment increases even further to US$ 44. This is evidence that expenditure in healthcare is a considerable investment with significant returns.

• So where do these gains come from? These come from investing in ‘prevention’ so that you avert illness and the huge societal and economic burden that sickness entails. As we say “Prevention is better than cure”. A child when vaccinated remains healthy and doesn’t require healthcare or treatment, both of which come at a cost to governments and families, and can prevent parents from going to work. A healthy infant is also more likely to attend and do better at school. So rather than pushing families into poverty through medical bills, through a simple preventive intervention such as vaccination, you’re not only boosting the earning and spending capacity of parents, but also helping to create a more productive ‘next generation’ in the process. Put simply, keeping a child healthy, such as through childhood immunisation, helps boost a country’s economy. Ultimately it’s not just about preventing disease; it’s about keeping people healthy so they can live to their full potential.

• A review of historical studies provides further evidence of the economic impact of improving health outcomes. According to a Chatham House report, from 1970-2000 around 11 per cent of the growth in LICs and MICs can be attributed to reductions in adult mortality during this period. Further proof that a healthier population can help lead to a healthier economy. UHC provides a platform to make that possible and is a very good investment.

4. How much is needed to finance UHC in LIC/LMIC
• The big question is what will it cost? For low income and low-to-middle income countries affordability is critical. It doesn’t matter what the return on investment is if a country can’t afford it in the first place. According to the Lancet Commission for Investing in Health, between US$ 70-90 billion in additional health spending annually is needed in order to ensure that a set of key health services identified in the SDGs as important stepping stones towards UHC were universally available. That means that at current levels of health spending LICs and LMICs will need to increase health expenditures by a third.

• These are significant amount of resources but there has been some progress towards increasing resources for health. Between 1995 and 2013 global health spending increased, driven by economic growth. Indeed, total health expenditure grew more rapidly than GDP, with median spending as a share of GDP increasing from 4.9 to 6.4 per cent over the same period.

• However, although very positive this does not paint the full picture. A closer look reveals that although General Government Health Expenditure (GGHE) increased during this period, the majority of this increase was from high income countries.

• Countries would also need to ensure that catastrophic and impoverishing out-of-pocket payments (OOPPs) are kept to a minimum. OOPPs can be large and unpredictable, and can often be triggers that push a family into poverty. Because of this they act as a very real barrier to health services and economic success for the poorest members of society. To remove these barriers, it is recommended that governments commit to ensure that OOPPs represent at least less than 20 per cent of the total health expenditure and there are no OOPPs for priority health services or for the poorest families. Currently however LICs and LMICs are only halfway towards this target on average at 43 per cent and 34 per cent respectively of total health expenditures.

5. What can countries do to ensure financing of UHC?
• Of course, reaching these targets will require financing. But how exactly? Even within the poorest countries there are opportunities to increase domestic resources and improve the efficient use of resources dedicated to health. The tax base in many of these countries has been increasing over recent years due to economic growth, with the African continent being one of the fastest growing prior to the present downturn. The recent slow-down in global and regional growth means that countries cannot solely rely on this going forward.

• Improving efficiency in health expenditure can also yield more. The 2010 World Health Report suggested that around 20–40 per cent of total health spending – which would represent around $1.4–$2.9 trillion in 2012 – might be lost through waste, corruption and other forms of inefficiency. Some of the leading causes of inefficiencies include higher-than-necessary prices for medicines; use of substandard and counterfeit medicines; overuse or oversupply of equipment and technologies; inappropriate or costly staff mix; inappropriate hospital size; etc. By making the necessary changes, we can ensure that resources allocated to healthcare are used most efficiently to achieve the highest results.

• Most LICs and LMICs, even with the economic downturn, have considerable scope to raise revenue through increases in tax collection efforts and government charges. For example the IMF estimates a potential of up to 4 percentage of GDP in additional tax revenues for LICs. Developing countries can improve tax collection through more efficient tax administration, and broadening the tax base. This is not easy and can take time but is doable. In addition, there is scope within developing countries to increase tax revenues by reforming tax policy. For example, indirect taxes like VAT are still low in some countries- and this offers an opportunity for increase.

• Similarly, tackling tax avoidance and evasion, and tax incentives for companies, such as those related to natural resources can raise additional revenues in LICs and LMICs. Governments could also greatly benefit from plugging leakages in revenues resulting from corruption and the illicit flow of funds. According to Global Financial Integrity (GFI), a Washington DC-based anticorruption think tank, the global proceeds flowing from cross-border criminal activities, corruption and tax evasion is estimated at between US$ 1 trillion and US$ 1.6 trillion. In Africa alone, the High Level Panel on Illicit Financial Flows, chaired by former South African President Thabo Mbeki, estimates that as much as US$ 50 billion in illicit funds is being illegally diverted per year. That is double the amount of ODA the continent received in 2014.

• Tax innovation is another potential revenue source- Sin taxes, telecoms taxes, additional corporate and social responsible tax etc. These taxes are sometimes earmarked to specific expenditures like health care or education. But earmarking can introduce rigidity and sometimes be counterproductive. At this point in time I must tell you that your colleagues on the education side are having the exact same conversation on how to use additional domestic resources for education. And I know those in infrastructure are doing the same. I therefore think that there is room for a more cross-sectoral or multi sectoral approach bringing together at the minimum, health and education to argue for increased prioritisation as resources increase.

• This highlights the imperative need to improve the dialogue between cabinet Ministers, in particular in making the case for health and education as a strong investment.

6. Existing external aid resources must be used more efficiently
• As a final consideration I would like to discuss how better use of external aid can help bring us closer to UHC too. Under the MDGs we saw increases in development assistance for health (DAH). In LICs, Development Assistance for Health increased six-fold between 1990 and 2014 and now accounts for up to 30 per cent of health expenditure. Despite increased domestic expenditure, most LICs especially fragile states still need considerable DAH when it comes to improving the health of their populations. Without this assistance these countries would not have seen the progress that we have made so far.

• However, in recent years we have witnessed how donor assistance priorities have shifted at a global level. Health is now just one of many competing issues on the donor agenda, along with climate change, security, humanitarian crises and refugees, among others. Therefore, we cannot expect DAH to continue to increase at the same pace and donors are increasingly looking for value for money. In this context, it is even more important that we ensure aid is put to the most efficient and effective use, allocated towards the areas of greatest need and that countries prepare for an eventual reduction in support as they grow wealthier.

• Gavi, the organisation which I Chair, is one example of how this might be achieved. Gavi supports countries to introduce new vaccines and strengthen their immunisation programmes – one of the best buys in health. It has a systematic approach to evaluating which vaccines it funds based on where it can achieve greatest value for money. And it puts sustainability at the centre of its business model with every country, no matter how poor, contributing to Gavi-supported programmes. Countries’ contributions increase as they get richer until they eventually transition out of Gavi’s support altogether. This model ensures country ownership, builds fiscal and budgetary space for immunisation and puts countries on the path to sustainability.

• In this regard, it is important that countries, and developing partners too, focus on DAH being used to help leverage domestic and even private resources to improve health financing as a means of funding improvement to our health systems.

7. Concluding remarks
• To conclude, I believe we have a strong investment case in UHC especially some of the essential elements on prevention such as immunization. We also have the potential to improve the efficiency with which present resources are used in health and to raise additional resources. But we must remember we have to argue the case. We need to put finance and health together. We need partners and allies in education. We need to leverage the external assistance we have wisely, using it to produce measurable results. Above all, we must not take anything for granted.

• Thank you.

Africans Deserve Better Insurance Against Weather Damage - Ngozi Okonjo-Iweala

The Monde

Exclusive forum of the former Finance Minister of Nigeria, Ngozi Okonjo-Iweala. now head of the board of the African Risk Capacity (ARC), a pan-African mutual risk management, it is urgent to create tools to offset the damage caused by extreme weather events.

When life is already a struggle, a sudden disaster can have devastating effects. Families and communities can be driven in a downward spiral in which it will be their perhaps impossible to escape.

Often, it is not because of storms, droughts and floods that millions of people in Africa and many other regions live in poverty. But these events can be the final blow that ends the possibilities that these families to improve their lives.
Millions of small impacts

This is why the negotiations taking place in Paris should not only focus on the huge global challenge of climate change, and the collective need to take bold action to reduce carbon emissions. They must also focus on the millions of small impacts due to climate change - and climate extremes resulting already - that affect the life chances of families across Africa and the developing countries.

Extreme weather events cause of course damage wherever they occur. But for the developing regions and the most vulnerable families, they can be the difference between hope and despair.
After all, farmers who practice subsistence agriculture have neither insurance nor savings allowing them to rebuild their lives. Likewise, national governments, regardless of their willingness to help, do not always have the resources or equipment necessary to provide support.

Humanitarian organizations and the international community continue to work to respond to natural disasters. But humanitarian aid rarely meets all the needs, and the ad hoc nature of the intervention inevitably leads to delays. Despite all their efforts, assessing needs, launching an international appeal and fundraising can take months, delaying emergency relief to those who need it most.

Such delays can be, and are, as we have seen, a fatal blow to families and communities already very fragile. Thousands of people may be forced to leave their home, never to return. Those that remain are sometimes forced to sell or slaughter cattle ensuring their livelihood.

The result is that extreme weather events are much more than cause enormous suffering and individual upheaval. They emphasize, extend poverty and can even erase the entire decade of progress in development.

Therefore, as part of action against climate change requires not only bold collective action to slow and reduce carbon emissions, but also effective systems focused on the protection of communities to natural disasters.

Empowering African countries
The good news is that programs like this already exist. Worldwide, we have witnessed the creation and development of innovative programs that improve the resilience of countries and communities on the front line in the battle against climate change.

For example, the African Risk Capacity (ARC), a pan-African mutual risk management, and the Caribbean Catastrophe Risk Insurance Facility (CCRIF, the insurance mechanism against the risk of natural disasters in the Caribbean) are solutions comprehensive, integrated and practical to meet this challenge. Both instruments have been developed at local level to enable countries to better share and manage risk, but also to better exploit international expertise and existing financial resources.

The heart of the CRA is an insurance mechanism against climate risks implemented under the aegis of the African Union with the active participation of global reinsurance markets. He enjoys the active support of international partners such as Germany and the UK, which give it interest-free loans.

The members pay annual insurance premiums, the amount of which depends on their size and risk analysis of occurrence and impact of floods, storms and droughts in their territory. This participation allows countries immediate access to relief funds, the amounts are much higher than the premiums paid when the trigger levels indicate the occurrence of a climate catastrophe.

But the CRA is more than a regional variant of a traditional insurance mechanism. A sophisticated model, developed from satellite data, allows to accurately estimate the occurrence of extreme weather events and their impact on communities.

The model is already helping to predict where the storms, floods and droughts associated with El Niño - whose effects are particularly severe this year - could have the most impact in East Africa. This early warning system not only allows the authorities to be alerted more quickly in case of potential crisis, but also the financial compensation to be paid immediately after the trigger level is achieved.

There is much more likely that the aid reaches those who need it quickly to the extent that the member countries of the CRA should establish effective emergency planning systems. Empowering African countries, the CRA reduces the time, for faster and more effective results.
Feed and food commodities

Even more encouraging, the CRA has already had impressive results. This year, even before a call for international assistance be launched to help countries hit by the rainfall deficit, mutual CRA paid 26 million US dollars (24.2 million euros) in Senegal , Mauritania and Niger.

These funds were used to buy fodder and basic food for 1.3 million of the most drought-affected communities, as indicated in the computer model of the CRA. This has helped families already struggling to stay on their land while offering them sufficient room to recover.

These successes and the fact that studies have shown that every dollar paid to CRA saves more than 4 dollars in international aid, why such initiatives play a key international role to increase the resilience of countries and communities to climate change. The G7 is committed to support the expansion of this mechanism to allow additional 400 million people in low income countries means to obtain protection against the weather events of 2020.

But to achieve this ambition, it is necessary that other countries join us, and other development partners support the participation of the poorest countries and those who suffer the greatest climate risks. We can not prevent bad weather, but together we can protect vulnerable populations and provide them with the tools they need to rebuild their lives in their community.

Ngozi Okonjo-Iweala, Minister of Finance of Nigeria from 2011 to 2015, chairs the African Risk Capacity Board.

[Originally rendered in French. English Translation Credit - Google]

http://www.lemonde.fr/afrique/article/2015/12/03/les-africains-meritent-une-meilleure-assurance-contre-les-degats-climatiques_4823583_3212.html

Foreign aid

Productive economy

LOW SAVINGS: OKONJO-IWEALA DID NOT INDICT THE JONATHAN ADMINISTRATION

News Release. Abuja, April 15, 2016

Some recent media reports have distorted comments made by former Finance Minister Dr Ngozi Okonjo-Iweala regarding how lack of political will negatively impacted national savings over the past few years.

Contrary to the slant given by these loud headlines, Dr Okonjo-Iweala did not indict the Jonathan administration in which she served.

Rather, she was referring to what many Nigerians already know: the strong opposition by some governors to the Jonathan government’s efforts to save in the Excess Crude Account and the Sovereign Wealth Fund sabotaged this important national priority.

The governors’ criticism of Dr Okonjo-Iweala’s many calls for the country to save for the rainy day are still fresh in the minds of Nigerians.

It will be recalled that this opposition culminated in the Governors taking the Jonathan government to the Supreme Court in furtherance of their position that the Federal Government had no right to “compel” them to save.

Several knowledgeable persons including former Anambra State Governor, Mr Peter Obi have confirmed these facts.

So the issue of Okonjo-Iweala indicting the Jonathan administration over this very public issue simply does not arise.

We urge the media to always consult for clarification whenever the need arises.

Paul C Nwabuikwu
Media Adviser to Dr Okonjo-Iweala

6 Questions for African policymakers [Podcast]
Ngozi Okonjo-Iweala

http:///20AUB0i

'Glad to be honoured on the 2016 #PowerwithPurpose Roll. 'Ever committed to 'Do Good' and 'Do it Well.'

https://pages.devex.com/power-with-purpose.html?utm_source=social&utm_medium=twitter&utm_campaign=power_with_purpose#ngozi-okonjo-iweala

Investing in women and the girl child

What African nations need to do to diversify their economies

Unless we make access to finance easier for women in their businesses, we will be missing out on a significant portion of growth in our economies.
- Ngozi Okonjo-Iweala

When you save the life of anyone, you're contributing productively to the economy.

The importance of women in African and global economy

Ngozi Okonjo-Iweala: "The decline in development assistance is an opportunity for Africa"

Ngozi Okonjo-Iweala was the guest of the World at the Grenoble geopolitical Festival which took place from 16 to 19 March. The "Iron Lady" of Nigeria, 61, served two governments as Minister of Finance from 2003 to 2006, under President Olusegun Obasanjo, then, from 2011 to 2015, under the presidency of Goodluck Jonathan. Between these two positions, she was Executive Director of the World Bank. It now has a consulting business with Lazard and chairs the board of the Global Alliance for Vaccines and Immunization (GAVI) based in Geneva, which has fifteen years of vaccination 500 million children. This interview is excerpted from his speech in the auditorium of the Festival of Grenoble.

You are among the fifty world leaders in the magazine "Fortune" and among the twenty most influential women in the world, according to "Forbes". What it does when one comes from a modest family Nigeria?

I have trouble seeing me as a world leader, while I appreciate that gives me this way! But when I get up in the morning, I do not think about it, I wonder how to solve the next problem. I grew up in a village in southern Nigeria where I grew up to 8 and a half years by my grandmother. My parents were scholarship students in Germany and did not have enough money to take me with them. I learned real life, fetching wood, water. At 5, I could cook. This life has given me strength and a strong character. The other experience from my childhood is the Biafran war (1967-1970). My parents lost everything. I knew what it was to have nothing more.

You repeat that you are African-optimistic. How to stay after Ebola, falling commodity prices, the resurgence of Islamic terrorism in West Africa?

Africa through cycles, and when it goes wrong, people get discouraged, they feel like dropping everything. Personally, I am an unrepentant Afro-optimist. Africa has experienced two lost decades, the years 1980 and 1990. But then for fifteen years, it has experienced a growth of at least 5%. The number of conflicts has declined during this period. It was not a coincidence, it showed that good policies are bearing fruit. On several fronts, Africa has shown that it can do better than what was expected of her. Including in terms of poverty reduction and human development. All is not rosy. The growth was not enough shared, it has not created enough jobs. Now you enter a down cycle, it does what it laments, saying that it was written and that Africa is a basket case? I believe instead that we should learn from what has worked well, and continue.

What African success stories feed your optimism?

There is no perfect country. Everyone has had success in some areas. In terms of growth, the International Monetary Fund (IMF) estimated that it would be 3.4% worldwide in 2016, and 4% in sub-Saharan Africa. I pause: growth, this is not a dirty word. This is not a sufficient condition for the poor disappear, but without it, poverty may increase. There are countries on the continent that are much more than the average: Ethiopia, Tanzania, Rwanda, Senegal and the Ivory Coast, for example.

Other countries have had success primarily political. Ghana, where the alternation was made without objection or violence, has shown maturity. Nigeria, where one predicted a crisis in elections in 2015, while President I served very elegantly conceded defeat.

There are also regional specificities. To the east and south of the continent, governments have begun to raise the logistical barriers to trade through agreements and infrastructure. To the west, countries have stood together against security threats and violations of democratic rules. We need every part of Africa is inspired by recipes from the other.

Further development will require a lot of money. Where will it come in this bear market? On Lend African countries? Funds promised during the COP21?

Financing is one of the most important points. Let me first recall that development is now funded largely by Africans themselves. There are more than twelve countries [of 54] in which the external development assistance represents 40% of the budget or more. The assistance of developed countries will decrease, it will move toward migrants and refugees. There are also scourges that Africa is not responsible but which it is the first victim, such as global warming. The rest of the world should help the continent, but I think it will not do enough. And that's a good thing! Instead of lamenting, losing their time begging, African countries need to find more local resources. The IMF believes they can on average raise taxes to 4% of their GDP. We will need technical help to increase tax resources and gaps that multinationals use to hide their income. Furthermore, ten countries have a pension fund system that hold a total $ 380 billion [335.5 billion euros]. These funds must be invested in development.

Will Africa be more selfish? Taxing imports more to develop domestic trade?

Africa does not trade enough with herself, that's obvious. But this issue is often dealt with logistical issues. It's very important to remove all these barriers for goods, capital and persons can circulate freely. For a truck no longer forced to stop as many times on the road between Abidjan and Lagos, between Nairobi and Kigali. But it is equally important to know what you want to exchange. If we produced all the same commodity, the same grains, what are we going to sell and buy? African countries must begin to specialize in industry, assembly or channels of food values.

Some economists are very concerned for Nigeria, which could greatly suffer from the fall in oil prices. Others say the contrary, that its economy is strong enough to turn the corner ...

Both are right. But one thing saddens me. When I was finance minister the first time, the volatility of oil prices, and therefore state resources, cost at least three points of growth in the country. We then established a stabilization mechanism and opened an account for the oil surplus. Who posted up to 22 billion. In 2008, when prices fell from 148 to $ 38 a barrel, no one has heard of Nigeria because the country has been able to tap into this fund. And that, I am very proud. When I returned to the department in 2011, he remained only 4 billion on this account while the price of oil was very high! I tried again to put money aside. The President agreed, but the governors have not accepted. I suffered a lot of attacks from them and now that the country would really need this account, these same people accuse me of not having saved! If Nigeria had been more careful, he would not be here today. It hurts me. We have the mechanism, we had the experience, but we were prevented to act.

As minister, you have preferred to deal with Americans, Chinese or Europeans?

I like to deal with everyone, but especially with the Africans! Indeed, investment is increasingly from Africa and emerging countries such as China, Mexico, Brazil, Turkey. They ask the same conditions, but it is easier with them, they understand us better.

France seems to have woken up. For two years, the Elysee Bercy or Medef multiply missions in Nigeria. President Hollande visits elsewhere in Abuja in May. What Nigeria to gain?

I would put the question this way: what France has to gain? The answer: a lot. If you're not in Nigeria, you're not in Africa. Of course, Nigeria has problems, but it will work out. This is the first African economy, the consumer goods market is growing, as are the non-oil sectors. Africa accounts for only 5.8% of foreign trade of France and Nigeria 0.6%. This is to say nothing! It has great potential to improve these figures and France is right to try.

What are your failures and your successes in the fight against corruption?

You answer would take a whole day. On my first experience as minister, I wrote a book, Reforming the unreformable (ed. The MIT Press, 2012). For the second, it was really difficult. Nigeria subsidizes fuel. About $ 6.7 billion that it costs, we found that 1.5 billion was fraudulent. One importer claimed that his boat was waging its oil while at the other end of the world, according to maritime classification society Lloyd's Register Marine. I told the President that we would stop paying. What happened ? They kidnapped my mother 83 years. During the first three days, their only demand was my resignation. I was supposed to go on television and announce my resignation. This was one of the worst moments of my life. Can you imagine what happens in your head if you have to be responsible for the death of your mother? I will not go into details, but you must understand that in a country like this, if the fight against corruption, we must be prepared to pay a personal price. My father asked me not to resign. The president asked me not to resign. At the end, everyone began looking for him, and the kidnappers released.

Stop corrupt, that's good. But we must put in place a system that prevents them from flying. The French are not more honest than Africans but, in France, there are strong mechanisms that prevent stealing and, if applicable, punish thieves.

The payment of salaries of civil servants, for example, was done in cash, which opened the possibility of leaks. With the help of the World Bank and the British aid agency DFID, we have developed an integrated payment system and a biometric register of employees because we discovered that we were paying employees and ghost pensioners. Everything was almost ready in 2006, when I left, but when I came back in 2011, it was late! Finally, we did it. I know, this technology is less sexy than arrest, but we have to block upstream corruption. And if you master the technology you can control corruption.

[Translated Version]

Original interview available on http://www.lemonde.fr/afrique/article/2016/03/31/ngozi-okonjo-iweala-la-baisse-de-l-aide-au-developpement-est-une-chance-pour-l-afrique_4893215_3212.html#rPUGHHDQ6q70AMeS.99

They Call Me Okonjo Wahala

At the opening ceremony @UNECA2016 Conference of Ministers with Seth Berkley, CEO of Gavi, the Vaccine Alliance.

I believe that when you find problems, you should also find solutions.
- Ngozi Okonjo-Iweala

An interview session with Le Monde newspaper during the Festival of Geopolitics in Grenoble University, France -- discussing issues around French-African economic relations

Educating our girls

In studio with Rajesh Mirchandani for CGD [Center for Global Development] podcast

Fighting Corruption in Nigeria

Very encouraging to hear that a meningitis A vaccination campaign is now underway in South Sudan. #vaccineswork

At the CEO Forum, Abidjan: Let's focus on policies to support the private sector and create more jobs for our youth

We must unite to end tuberculosis by combating poverty, driving research for new cures and vaccines #EndTB #WTBD2016

Speaking at the Africa CEO forum holding in Cote d'Ivoire

by Ngozi Okonjo-Iweala

The “Africa rising” story of the past decade, fueled by 5 percent average annual growth, is in danger of faltering, due to the impact of global uncertainty, depressed commodity prices, and weakly performing economies like China. Don’t be lulled by the IMF’s 2016 forecast: yes 4 percent growth will outperform global expectations, but continued commodity price volatility and global uncertainty are giving rise to a fresh bout of Afro-pessimism. To change the narrative, and — more importantly — the reality it describes, African policymakers must urgently answer these six questions.

1. How do we ensure steady financing for our significant needs for sustainable development in an increasingly uncertain global environment?
This is perhaps the fundamental question. Slowing growth and low commodity prices will be around for the next few years, causing an inevitable, but hopefully temporary, macroeconomic setback. This increases vulnerability to a retrenchment in external finance. Several African countries have issued Eurobonds (to the tune of $21 billion during 2013–15) and foreign investors hold a growing share of domestically issued debt. Foreign direct investment, which tends to be concentrated in natural resource sectors, is also likely to pull back. A cutback in external funding will put badly-need infrastructure investment and social programs on hold, dealing a blow to long-run growth. African countries need to work with the donor community to avert such a situation.

Economic diversification, creating jobs and tackling inequality, which are discussed below, are a vital part of the long-run challenge in Africa and also feed into two key global achievements of 2015: the adoption of the Sustainable Development Goals (SDGs) in September and the agreement on climate change at COP21 in Paris in December. But diversification requires well-developed infrastructure, telecommunications, power, roads, rail, water, etc. The World Bank estimates Africa’s infrastructure financing needs alone at US$93 billion annually. Climate-friendly and sustainable infrastructure will cost even more. But Africa offers the best opportunity for low-carbon, resilient, and sustainable infrastructure development because so much is greenfield and still to be built. Directing the necessary financing from international public and private sectors into African infrastructure development can reap important positive externalities for the whole world.

Africans rightly argue that they are victims, and not perpetrators, of today’s climate-related challenges. So will the international community rise to the occasion? The reality is weak global growth, coupled with domestic challenges on unemployment and immigration, makes it unlikely that developed countries will fully honor promises for additional financing to implement the post-2015 development agenda. Africans will have to mobilize the majority of their own resources. In fact the New Climate Economy estimates that 50–80 percent of the resources required for the development of sustainable infrastructure will have to come from countries’ own domestic resources.

This means African countries must ensure a quantum leap in domestic resource mobilization (DRM). The opportunity clearly exists to substantially increase tax and other revenue efforts, including limiting tax evasion and illicit financial flows. Across sub-Saharan Africa, tax revenues account for less than a fifth of GDP, while they correspond to over a third in OECD countries. African countries will need to almost double their tax revenues to help finance the SDGs. The good news is that tax revenues on the continent are growing rapidly. Through reforms between 1990 and 2004, Ghana raised tax revenues from 11 to 22 percent of its GDP, for example. Admittedly this is difficult. Raising non-oil tax revenues was something we saw as an opportunity in Nigeria and struggled with.

What is needed is a significant improvement in capacity, systems and processes in these countries — a worthwhile investment for governments and a small fraction of aid budgets that donors can support. In addition, DRM should also involve leveraging public resources innovatively to tap private-sector resources. Estimates indicate approximately US$380 billion in total pension assets under management in just 10 African countries, and these resources are growing rapidly. Between 2008 and 2013, Nigeria’s pension industry grew from US$7 to US$25 billion. In Ghana, the pension industry is expected to grow 400 percent between 2014 and 2018.

2. How do we truly diversify our economies?
Diversification has become a slogan. Everyone talks about it but the debate on how to truly diversify is shallow. The discourse reflects lazy thinking as if diversification could happen in just a few years. The vision of what needs to be done is often truncated into the short time frame of politicians, instead of carefully laying out the various stages to achieve a truly diverse economy — notwithstanding the abundance of 10-, 20-, and 30-year-long economic plans that are crafted in almost every country, and then gather dust.

There are plenty of models to follow: Dubai, Singapore, Thailand, Malaysia, Mexico, Indonesia, and South Korea are admired by Africans as economies that have managed to transform themselves. But the discussion often stops there without recognizing that Dubai, for example, started more than three decades ago to ask the question: What should life be like after oil? And it set out to implement a step-by-step vision of a services economy, putting infrastructure and incentives in place to build up financial services, tourism, medical services, real estate, media, arts, and culture. Singapore and South Korean are no less inspiring because they had few or no natural resources to rely on.

What these countries also had was leadership that was relentless decade after decade in pursuing the diversification and transformation of their economies — either through entrenched but benign dictators or democracies in which generations of leaders and citizens agreed on a vision of a broad-based economy.

Sub-Saharan Africa has the foundation for diversified growth that several of these trailblazers did not: value-added agriculture and agro industry, processing and transformation of mineral resources, petrochemical complexes, manufacturing of durable and consumer goods, tourism and entertainment, and an emerging information technology sector.

For donors, diversification delivers on several critical SDGs:

Goal 1 to end poverty
Goal 8 to promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all
Goal 9 to build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation
Goal 10 to reduce inequality within and among countries
Goal 13 to take urgent action to combat climate change and its impacts
The journey toward diversification is long, but policymakers must start down this road now.

3. How do we improve the quality of growth and create jobs?
Recent growth in Africa did not bring a corresponding increase in jobs. Except in a few countries, like Nigeria, where growth actually occurred in the non-oil sectors, growth in most African countries was linked to their commodity sector. And growth benefited only a few, leaving, especially, young people and women behind. In fact inequality, measured by the Gini coefficient (with 0 denoting perfect equality and 100 perfect inequality) rose in several African countries between 2006 and 2013.

Country 2006 2013
S/Africa 57.8 63.1
Nigeria 43.7 48.8
Rwanda 28.9 50.8
Ghana 40.8 42.8
Tanzania 34.6 37.6

Source: UNDP World Development Reports for 2006 and 2013

Policymakers should answer this: is growth occurring in sectors that create jobs such as agriculture, manufacturing, and services? Who is left behind? How can taxation and income redistribution redirect resources better, and include those at the bottom of the ladder via social safety nets?

These were questions we were starting to ask and answer about our own growth story in Nigeria. The idea was not to question whether we needed growth but to improve the quality of growth.

4. What type and quality of human resources do we need to underpin our development aspirations?

As African economies diversify, matching skills to emerging job opportunities will be critical. Many Africans feel that despite the progress made by the continent on health and education indicators under the Millennium Development Goals (MDGs), our education and health systems are broken and need fixing. On a continent where 70 percent of the population is already under 30, and that is home to half the worldwide total of primary-school-aged children not in school, basic reading, writing and technology skills, followed by vocational, technical, and entrepreneurial training, must be priorities. Nigeria, especially, should act decisively here — Africa’s most populous country also has the largest number of children out of school, at 8.7 million in 2010.

But we must simultaneously strengthen weak health-care systems to tackle endemic diseases that sap productivity (such as malaria), and to provide preventative care for adults and, especially, for children (through vaccinations and routine immunizations). Stronger health-care systems will also help the world cope with future epidemics: the World Bank estimates the devastation wrought to the economies of Guinea, Liberia, and Sierra Leone by the Ebola virus at US$2.2 billion, or 16 percent of the combined GDP (2014) of the three countries. Sierra Leone’s growth rate for 2014, for example, was forecast at 11.3 percent prior to the crisis, but fell to 4 percent. The impact on other African economies due to the neighborhood effect was also significant.

5. How do we trade better with each other?

African goods and services accounted for just 16 percent of trade within Africa in 2013, and just over 3 percent of world trade. One problem is what we are making. Most African countries produce the same type of commodities, and trade them with very little value added. The continent’s industrialization drive, very much a part of the African Union’s 2063 development agenda, needs to focus on the issue of specialization to enhance inter-African trade. Industrializing through trade was the focus of the Economic Commission for Africa’s 2015 Economic Report on Africa. Countries with the requisite manufacturing base should consider what can be processed or manufactured, and traded with others.

One encouraging signal is the growing volume of intra-African investment, which rose as a share of the continent’s overall foreign direct investment from 8 percent in 2003 to close to 23 percent in 2013. This could be harnessed to achieve greater industrialization and increased trade of differentiated goods and services between African countries. This can be a virtuous circle which adds value and volume to Africa’s trade with the world.

But there is another problem to consider: logistics. Policymakers must make it easier to move goods across borders, by improving connectivity between countries, and reducing bureaucratic hurdles and administrative costs. For example, road transport tariffs across Africa are estimated at US$0.05 to US$0.13 per ton-kilometer, compared to the average of US$0.01 to US$0.05 for all developing countries. This must come down so Africans can more easily trade with each other.

There are some examples of significant improvements. The East and Southern African regional blocs , COMESA and SADC, have made some important gains in this area. For example, paved roads along the central corridor connecting the ports of Dar es Salaam, Tanzania, to Bujumbura, Burundi, increased from 57 percent in 2006 to 87 percent in 2010. There have also been efforts to improve rail infrastructure to increase efficiency and reduce costs. The African Development Bank estimates that the ongoing Rift Valley Railway project between Mombasa, Kenya, and Kampala, Uganda, would double the volume of trade while reducing marginal costs by 30 percent.
6. How do we focus on good economic management?

African policymakers should remember that much of the successful growth over the past decade and a half was down to good macroeconomic policies and good economic management. It will be difficult to succeed in all the areas outlined above unless the fundamentals are right. This means that prices in the economy have to be right, starting with the exchange rate. This is a tough call in 2016 for commodity-dependent African economies which have been hit by declining export earnings, but rates that are largely market-determined can ensure a softer landing. Some countries need temporary controls to curb injurious capital outflows and this is understandable. But these countries should have an exit policy and a plan for better management of the exchange rate in order to avoid a hard landing. Inflation rates, debt levels, adequate foreign exchange reserves, current account, and fiscal deficits are all key indicators to keep in reasonable territory to provide the solid framework within which real sector issues, such as the ones outlined above can be tackled and implemented.

Africa offers incredible opportunity for diversified economies based on low-carbon, sustainable infrastructure. We can meet the Sustainable Development Goals and the Paris climate agreement — indeed, we must — and we can change the “Africa failing” narrative. But African leaders must answer these development challenges now.

Ngozi Okonjo-Iweala is a former finance minister of Nigeria, and a distinguished visiting fellow at the Center for Global Development.

http://www.cgdev.org/publication/ft/six-questions-african-policymakers-must-answer-now

Candid Conversation on Gender and Opportunity with Managing Director Christine Lagarde and former Nigerian Finance Minister Dr. Ngozi Okonjo-Iweala.

by Ngozi Okonjo-Iweala

LAGOS – Africa’s rise is in danger of faltering. After years during which the continent’s economy grew at an average annual rate of 5%, global uncertainty, depressed commodity prices, and jittery external conditions are threatening to undermine decades of much-needed progress. Ensuring the wealth and wellbeing of the continent’s residents will not be easy; but there is much that policymakers can do to put Africa back on an upward trajectory.

First and foremost, policymakers must secure the financing needed to pursue sustainable development in an uncertain global environment. The World Bank estimates that Africa will require at least $93 billion a year to fund its infrastructure needs alone. Climate-friendly, sustainable infrastructure will cost even more. And yet, as long as global growth remains weak, Africans cannot count on developed countries to fully honor their commitments to help attain the Sustainable Development Goals.
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Africa must rapidly develop its own resources, beginning by nearly doubling tax revenues. Across Sub-Saharan Africa, tax revenues account for less than one-fifth of GDP, compared to more than one-third in OECD countries. This means there is plenty of room for improvement. From 1990 to 2004, for example, Ghana reformed its tax system and raised revenues from 11% to 22% of GDP. Admittedly, such progress is difficult; in Nigeria, we saw an opportunity in raising non-oil tax revenues, but struggled to seize it.

Another source of domestic resources is the roughly $380 billion in pension assets held by just ten African countries. Policymakers should be leveraging these considerable sums.

At the same time, African countries will have to find a way to diversify their economies. Diversification requires investment in the future, in the form of education and well-developed infrastructure, including telecommunications, power, roads, rail, and water.

There are plenty of models to follow: Dubai, Singapore, Thailand, Malaysia, Mexico, Indonesia, and South Korea are all admired by Africans as economies that managed to transform themselves. Dubai, for example, set out more than three decades ago to prepare for a future without oil. The government implemented a step-by-step transformation of the country into a service economy, putting in place the infrastructure and incentives necessary to build up financial services, tourism, medical services, real estate, media, arts, and culture. South Korea and Singapore, which had few natural resources on which to rely, are no less inspiring.

The secret behind these countries’ success is relentlessly focused leaders, whether entrenched but benign dictators or democratically elected politicians with a shared vision of a broad-based economy. Sub-Saharan Africa has paths for diversified growth that many of the trailblazers did not: value-added agriculture and agro industry, the processing of mineral resources, petrochemical complexes, manufacturing of durable and consumer goods, tourism and entertainment, and an emerging information-technology sector.

As the necessary measures for diversification are implemented, policymakers must ensure that the economic growth they are pursuing creates jobs. Sadly, this has not always been the case. Much of the recent growth has benefited only a few, leaving many behind – most notably young people and women. From 2006 to 2013, inequality rose in many of the continent’s most important economies, including South Africa, Nigeria, Ghana, Tanzania, and Rwanda.

These were challenges that we were starting to address in Nigeria when I was finance minister. We knew that we needed not just to secure growth, but also to improve the quality of that growth.

To that end, policymakers must ensure that growth is channeled into sectors that create jobs, such as agriculture, manufacturing, and services. They may also have to redistribute income and strengthen social safety nets to protect better those at the bottom of the ladder.

Matching skills to job opportunities will be crucial. Some 70% of Africa’s population is under 30, and the continent is home to half the world’s primary-school-age children who have been deprived of the opportunity to study. Offering Africa’s children basic reading, writing, and technology skills, as well as vocational, technical, and entrepreneurial training, must be a top priority.

Weak health-care systems must also be strengthened in order to tackle the endemic diseases that sap productivity, such as malaria, as well as improving preparedness for outbreaks of deadly epidemics. The stakes are high. The World Bank estimates the Ebola outbreak shrank the economies of Sierra Leone, Guinea, and Liberia by 16%.

As the world economy sputters, African countries will have to develop trade with one another. In 2013, African goods and services accounted for just 16% of trade within the continent, and just over 3% of world trade. One problem is that most African countries produce the same type of commodities and trade them with very little value-added. Policymakers must encourage greater specialization; differentiated goods and services will add value and volume to trade.

Logistics pose another obstacle to intra-African trade. Policymakers must make it easier to move goods across borders, by improving connectivity between countries and reducing bureaucratic hurdles and administrative costs. For example, road transport tariffs across Africa are estimated at $0.05-$0.13 per ton-kilometer, compared to the average of $0.01-$0.05 for all developing countries.

The Rift Valley Railway project, which will eventually link Mombasa on the Kenyan coast to Kampala in Uganda, is a good example of the benefits that investments in transportation could provide. The African Development Bank estimates that it will double the volume of trade between the two countries, while reducing marginal costs by 30%.

As they make these investments, policymakers must not forget that much of Africa’s recent growth can be credited to good macroeconomic policies and sound economic management. Extending the continent’s rise will require strengthening the continent’s economic fundamentals.

This means ensuring that prices in the economy are correct, starting with the exchange rate. Some countries may need temporary controls to curb damaging capital outflows, but policymakers should aim for a market-based exchange rate and a solid plan for governing inflation, debt, foreign-exchange reserves, current accounts, and fiscal balances.

Africa’s potential can hardly be overstated. The continent is well placed to build diversified economies based on low-carbon, sustainable infrastructure. But policymakers cannot simply assume that Africa’s rise will continue. They must take the right steps to ensure that it does.

Author's Bio
Ngozi Okonjo-Iweala is a former finance minister and foreign minister of Nigeria, a former Managing Director of the World Bank, and a distinguished visiting fellow at the Center for Global Development.

IMF International Women's Day Celebrations

With Christine Lagarde, discussing women's empowerment at the IMF International Women's Day Celebrations.