Address on the National Conference on Bamako Initiative,
July 28, 1997

I am glad to address you this morning on the occasion of the opening ceremony of the national conference on the Bamako Initiative Programme. As you may recall, following the approval of new pricing of petroleum products, the Head of State, Commander-in-Chief of the Armed Forces of the Federal Republic of Nigeria, General Sani Abacha, GCON, mni, in his October 4, 1995 broadcast to the nation, promised that the resulting gain would be invested in the rehabilitation of social infrastructural facilities for the benefit of Nigerians.

To ensure an efficient and diligent utilisation of the Fund, the federal government established by Decree No. 25 of 1994 a Petroleum (Special) Trust Fund (PTF) and constituted a nine member Board of Trustees (BT) to manage the Fund and implement its mandate. The Board of Trustees was inaugurated on March 21, 1995, by the Head of State, Commander-in-Chief of the Armed Forces of the Federal Republic of Nigeria, General Sani Abacha.

As an intensive intervention domestic aid agency, the PTF is mandated to intervene in the following sectors:
· Roads, Road Transportation and Waterways
· Education
· Health
· Water Supply
· Food Supply
· Security Services, and
· Other Projects

The major components of the Fund’s intervention programme are:
a) The rehabilitation and/or upgrading of existing facilities
b) The establishment of facilities management system to ensure sustainability
c) The prioritisation of projects that are rural-based and have direct impact on the generality of our people.

Health is defined by the World Health Organisation (WHO) as a state of physical, mental and social well-being and not merely the absence of disease or infirmity. Looking at health in this context and considering the positive multiplier effect it has on the economy, one can appreciate the importance the Fund ascribes to the health sector. In 1977, the WHO commented on the very sorry state of health care in developing countries. There were shortages of drugs, poor management of public health care services, inaccessibility to health care especially at rural level – compounded by an increasingly lopsided distribution of resources for health development in favour of the urban centres, vis-à-vis the rural areas where the vast majority of the population live. In order to correct this apparent imbalance in the provision of health to all the citizens of the world, WHO convened an extraordinary session in 1978 at Alma Ata, Russia where the previous year’s report was discussed fully and a declaration of health for all by the year 2000 was made – with all nations, including Nigeria, subscribing to this noble agenda.

By 1986, it had become clear that developing countries, most especially African nations, lacked the necessary resources to provide comprehensive primary health care (PHC) to all. The African Ministers of health subsequently met in Bamako in 1987 to review the implementation and gains achieved so far through the comprehensive PHC approach. This was to stimulate a series of discussions that eventually led to the adoption of the Bamako Initiative Programme.

The goal of the initiative is universal accessibility to primary health care. The process of attaining this goal is based on substantial decentralisation of health decision making to the district level through the district development committee, a realistic national drug policy and provision of basic essential drugs, leading to a self-sustaining primary health care. In the context of the Bamako Initiative Programme, priority is given to child survival, safe motherhood and overall family welfare thereby encouraging intersectoral coordination and collaboration with other determinants of health, such as food supply, education, water, sanitation, and social welfare.

In view of the foregoing and in line with its determination to rejuvenate our national health care delivery at the grassroots level, the Petroleum (Special) Trust Fund (PTF) has ordered essential drugs worth over five billion naira for distribution to designated local government areas nationwide. Production of these drugs is going on and deliveries are expected to commence by the end of August, 1997. The drugs will serve as seed stock for the rehabilitation or establishment of sustainable essential drugs supply to the LGAs through the Bamako Initiative Programme. Thus the provision of essential drugs to the LGAs by the PTF and its other intervention in water and food supply, education, rural electrification and telecommunications programmes, provide a unique opportunity for extending the coverage of this laudable programme to rural areas of our nation.

Some of the projects to be executed include the following:
i. The rehabilitation of five existing or abandoned boreholes per LGA.
ii. The digging of ten new open wells in every LGA
iii. The provision of at least two motorised submersible pumps in every LGA where hand pumps are not a viable option
iv. The rehabilitation of two primary schools per LGA in addition to the provision of educational materials and teaching aid such as basic textbooks, stationery, chemicals and other essential requirement for learning.
v. The supply of agricultural input, livestock feeds, irrigation machinery and mass livestock vaccination nationwide to improve the production capacity and consequent earning power of our teeming rural populace.
vi. The connection of national grids of the Nigerian Telecommunications Limited and the National Electric Power Authority to local government headquarters will begin sometime this year as part of the PTF’s contribution to provide entrepreneurs with the enabling environment for profitable undertakings all over Nigeria.

The supply of essential drugs through the Bamako Initiative Programme is expected to serve as the entry point for integrated development at the grassroots level. The programme will be managed through the various local governments, district and village development committees which are already in existence in most local government areas and would only require resuscitation through reorientation and training. Where such committees do not exist, new ones shall be formed with their members undergoing the relevant training and orientation. As soon as these committees are fully established and functional, all community driven and grassroots sustainable development efforts shall be channelled through them.

Ladies and gentlemen, the PTF is embarking on a nationwide implementation of the Bamako Initiative Programme in every local government area. There is the need for you to painstakingly review the prevalent situation in the current fifty-three local governments participating in the Bamako Initiative. This will enable us to tap from the experiences gained by the operator local government areas and their respective sponsoring agencies and to outline a national framework for the implementation of the programme. The inputs and experiences of the National Primary Health Care Development Agency (NPHCDA), Overseas Development Administration (ODA)/British Council – Department for International Development, UNICEF and the World Health Organisation at the federal, state and local levels are very essential in this collaborative venture.

Accordingly, each of these bodies will contribute towards fashioning a new course that will lead to a successful implementation and the avoidance of the problems and pitfalls experienced by the pilot local government areas.

The PTF on its part will finance a few critical aspects of the programme implementation such as the infusion of drugs, support for decentralisation of services, training and manpower development for the LGAs and the provision of good quality maternal and child care.

Thank you very much.