WEBVTT

00:00:00.000 --> 00:00:07.832 align:middle line:90%


00:00:07.832 --> 00:00:08.540 align:middle line:90%
SVEA KLOSSER: Hi.

00:00:08.540 --> 00:00:10.820 align:middle line:84%
My name is Svea Closser,
and I'm a professor here

00:00:10.820 --> 00:00:13.580 align:middle line:84%
at the Johns Hopkins Bloomberg
School of Public Health.

00:00:13.580 --> 00:00:15.410 align:middle line:84%
I'm really fortunate
to be here today

00:00:15.410 --> 00:00:19.520 align:middle line:84%
with two experts from
two different countries

00:00:19.520 --> 00:00:23.000 align:middle line:84%
in our consortium,
working on this project.

00:00:23.000 --> 00:00:27.590 align:middle line:84%
We have Malabika Sarker from
Bangladesh, and Seun Akinyemi

00:00:27.590 --> 00:00:31.640 align:middle line:84%
from Nigeria, here to talk about
the importance and strategies

00:00:31.640 --> 00:00:34.250 align:middle line:84%
for engaging national
governments in disease control

00:00:34.250 --> 00:00:35.250 align:middle line:90%
programs.

00:00:35.250 --> 00:00:37.400 align:middle line:84%
Thank you so much for
being with me today,

00:00:37.400 --> 00:00:40.710 align:middle line:84%
and I really look forward to
hearing from your expertise.

00:00:40.710 --> 00:00:43.200 align:middle line:84%
So let's start with
the obvious question.

00:00:43.200 --> 00:00:45.650 align:middle line:84%
Seun, can you start
us off with what's

00:00:45.650 --> 00:00:47.990 align:middle line:84%
the importance of engaging
national governments if you

00:00:47.990 --> 00:00:50.640 align:middle line:84%
are trying to do a global
disease control program?

00:00:50.640 --> 00:00:52.490 align:middle line:84%
SEUN AKINYEMI:
Thank you very much.

00:00:52.490 --> 00:00:54.310 align:middle line:84%
And getting national
government is very,

00:00:54.310 --> 00:00:58.880 align:middle line:84%
very important in ensuring
that a polio program--

00:00:58.880 --> 00:01:01.070 align:middle line:90%
or any program that all--

00:01:01.070 --> 00:01:03.380 align:middle line:90%
works at the end of the day.

00:01:03.380 --> 00:01:06.980 align:middle line:84%
One important reason why it's
important to [? maintain ?]

00:01:06.980 --> 00:01:10.460 align:middle line:84%
national government
is for sustainability.

00:01:10.460 --> 00:01:14.950 align:middle line:84%
Many times, when donors
come, eventually with time,

00:01:14.950 --> 00:01:16.460 align:middle line:90%
they pull out.

00:01:16.460 --> 00:01:19.720 align:middle line:84%
So if national governments
have not been engaged,

00:01:19.720 --> 00:01:21.650 align:middle line:84%
they will not be
invested in the process

00:01:21.650 --> 00:01:24.280 align:middle line:90%
to keep on funding the program.

00:01:24.280 --> 00:01:28.940 align:middle line:84%
And another reason is to
ensure ownership of the project

00:01:28.940 --> 00:01:32.990 align:middle line:84%
so that the country can
see the project as theirs,

00:01:32.990 --> 00:01:38.070 align:middle line:84%
and not just what some people
are coming to do from outside.

00:01:38.070 --> 00:01:40.280 align:middle line:84%
And a third important
reason, for me,

00:01:40.280 --> 00:01:47.990 align:middle line:84%
is that to improve confidence of
the people, because many times,

00:01:47.990 --> 00:01:53.660 align:middle line:84%
when the community members
or citizens of a country--

00:01:53.660 --> 00:01:56.360 align:middle line:84%
when they don't see
their national government

00:01:56.360 --> 00:02:02.660 align:middle line:84%
leading a project, they're
kind of skeptical on why

00:02:02.660 --> 00:02:03.910 align:middle line:90%
these people are coming.

00:02:03.910 --> 00:02:05.827 align:middle line:84%
But when they see their
national government is

00:02:05.827 --> 00:02:08.570 align:middle line:84%
leading the process,
there is confidence.

00:02:08.570 --> 00:02:11.380 align:middle line:84%
And this is very, very
important in ensuring

00:02:11.380 --> 00:02:14.990 align:middle line:84%
ownership, accountability,
and then sustainability.

00:02:14.990 --> 00:02:18.940 align:middle line:84%
So I think it's fairly important
to engage national government

00:02:18.940 --> 00:02:21.040 align:middle line:90%
in any program.

00:02:21.040 --> 00:02:23.570 align:middle line:90%
SVEA KLOSSER: Yeah.

00:02:23.570 --> 00:02:25.700 align:middle line:84%
MALABIKA SARKER: Just to
add to what Dr. Seun said,

00:02:25.700 --> 00:02:28.790 align:middle line:84%
that it's also important
that only the government can

00:02:28.790 --> 00:02:30.800 align:middle line:90%
scale up a program.

00:02:30.800 --> 00:02:33.740 align:middle line:84%
It's no other private
or NGOs or faith-based.

00:02:33.740 --> 00:02:35.960 align:middle line:90%
Only the government can do that.

00:02:35.960 --> 00:02:38.360 align:middle line:84%
And for that reason,
it's very important

00:02:38.360 --> 00:02:42.220 align:middle line:84%
to have a responsive
public health policy--

00:02:42.220 --> 00:02:43.590 align:middle line:90%
or the public policy--

00:02:43.590 --> 00:02:47.600 align:middle line:84%
which can ensure that inclusion
and also be equitable,

00:02:47.600 --> 00:02:49.520 align:middle line:84%
like the delivery
of the service.

00:02:49.520 --> 00:02:51.750 align:middle line:84%
And only the national
government can do that,

00:02:51.750 --> 00:02:53.570 align:middle line:90%
and so it's very crucial.

00:02:53.570 --> 00:02:57.080 align:middle line:84%
I agree with completely Dr. Seun
that it's very, very important

00:02:57.080 --> 00:02:59.840 align:middle line:84%
to include the
national government

00:02:59.840 --> 00:03:01.760 align:middle line:84%
in terms of the
strategy, and also

00:03:01.760 --> 00:03:04.418 align:middle line:84%
the strengthening
the partnership.

00:03:04.418 --> 00:03:05.210 align:middle line:90%
SVEA KLOSSER: Yeah.

00:03:05.210 --> 00:03:08.960 align:middle line:90%
So how do you do that?

00:03:08.960 --> 00:03:12.950 align:middle line:84%
If you were working
for the WHO or Unicef--

00:03:12.950 --> 00:03:16.010 align:middle line:84%
one of these big agencies
that are global and working

00:03:16.010 --> 00:03:18.650 align:middle line:84%
on polio eradication-- what
are some great strategies

00:03:18.650 --> 00:03:20.570 align:middle line:84%
for engaging
national governments?

00:03:20.570 --> 00:03:23.510 align:middle line:84%
MALABIKA SARKER: I think,
like, the key for engaging

00:03:23.510 --> 00:03:27.560 align:middle line:84%
is to ensure that the national
government understands

00:03:27.560 --> 00:03:29.930 align:middle line:90%
that it's a shared vision.

00:03:29.930 --> 00:03:34.140 align:middle line:84%
It's not something that is
imposed by the external forces.

00:03:34.140 --> 00:03:36.320 align:middle line:84%
So as soon as the
government realizes

00:03:36.320 --> 00:03:38.750 align:middle line:84%
that it's a shared
vision, and there's

00:03:38.750 --> 00:03:41.990 align:middle line:84%
a mutual respect to
each other and it's

00:03:41.990 --> 00:03:45.530 align:middle line:84%
in alignment with the
national policy, so definitely

00:03:45.530 --> 00:03:47.090 align:middle line:84%
sometimes, of course,
the government

00:03:47.090 --> 00:03:49.140 align:middle line:90%
might have different priorities.

00:03:49.140 --> 00:03:51.740 align:middle line:84%
But as soon as that,
I strongly believe

00:03:51.740 --> 00:03:54.140 align:middle line:84%
that the government alleges
that it's a shared vision,

00:03:54.140 --> 00:03:56.210 align:middle line:84%
and with mutual
respect, they will

00:03:56.210 --> 00:03:59.250 align:middle line:90%
be keen to be part of that.

00:03:59.250 --> 00:04:02.960 align:middle line:84%
But at the same time,
it's very important

00:04:02.960 --> 00:04:05.870 align:middle line:84%
to develop the capacity
of the government.

00:04:05.870 --> 00:04:09.050 align:middle line:84%
Whenever we come with a
shared vision or an objective,

00:04:09.050 --> 00:04:11.360 align:middle line:84%
we need to look
critically that, OK,

00:04:11.360 --> 00:04:13.520 align:middle line:84%
how much capacity
building is important,

00:04:13.520 --> 00:04:15.865 align:middle line:84%
and what is necessary,
and to engage government

00:04:15.865 --> 00:04:18.102 align:middle line:84%
in informing in the
capacity building.

00:04:18.102 --> 00:04:20.310 align:middle line:84%
SEUN AKINYEMI: In addition
to what Malabika has said,

00:04:20.310 --> 00:04:23.210 align:middle line:84%
I want to add that when
engaging national government,

00:04:23.210 --> 00:04:25.440 align:middle line:84%
you should do that right
from the beginning,

00:04:25.440 --> 00:04:26.870 align:middle line:90%
from the planning phase.

00:04:26.870 --> 00:04:30.950 align:middle line:84%
So we often talk about
community [? backed ?] suspicion

00:04:30.950 --> 00:04:32.720 align:middle line:90%
versus community involvement.

00:04:32.720 --> 00:04:36.680 align:middle line:84%
You don't to involve people when
you have done other planning,

00:04:36.680 --> 00:04:40.850 align:middle line:84%
so you want to bring them
home from the planning.

00:04:40.850 --> 00:04:44.030 align:middle line:84%
Just like she said, so that the
planning will be contextual,

00:04:44.030 --> 00:04:47.550 align:middle line:84%
you factor in the
priority of the government

00:04:47.550 --> 00:04:51.230 align:middle line:84%
and then you design
the program together.

00:04:51.230 --> 00:04:53.465 align:middle line:84%
With that, they will
feel a sense of ownership

00:04:53.465 --> 00:04:58.130 align:middle line:84%
and they'll be able to take it
forward-- even when the donors

00:04:58.130 --> 00:04:59.840 align:middle line:90%
are ready to scale back.

00:04:59.840 --> 00:05:01.340 align:middle line:90%
SVEA KLOSSER: Yeah.

00:05:01.340 --> 00:05:03.590 align:middle line:84%
So there's a real
challenge in this.

00:05:03.590 --> 00:05:06.420 align:middle line:84%
I think all of what you've
said makes complete sense,

00:05:06.420 --> 00:05:08.910 align:middle line:90%
and is very, very important.

00:05:08.910 --> 00:05:10.940 align:middle line:84%
There's a challenge in
an eradication program,

00:05:10.940 --> 00:05:13.070 align:middle line:84%
because you have to get
every country on Earth

00:05:13.070 --> 00:05:16.350 align:middle line:90%
to be involved at the same time.

00:05:16.350 --> 00:05:20.030 align:middle line:84%
And so what do you think about
some of the challenges of that?

00:05:20.030 --> 00:05:23.120 align:middle line:84%
I mean, chances are there'll
be some government that

00:05:23.120 --> 00:05:24.830 align:middle line:84%
isn't aligned with
those priorities,

00:05:24.830 --> 00:05:28.970 align:middle line:84%
or maybe is consumed
with other problems.

00:05:28.970 --> 00:05:31.880 align:middle line:84%
You know, what can you
do in that situation,

00:05:31.880 --> 00:05:34.880 align:middle line:84%
or is that just a problem
with the goal of eradication?

00:05:34.880 --> 00:05:37.280 align:middle line:90%
What do you think?

00:05:37.280 --> 00:05:39.590 align:middle line:84%
MALABIKA SARKER: Again,
like that shared vision,

00:05:39.590 --> 00:05:42.830 align:middle line:84%
mutual respect, and sense
of ownership is important.

00:05:42.830 --> 00:05:44.990 align:middle line:84%
But here, we also
have to realize

00:05:44.990 --> 00:05:48.290 align:middle line:84%
that the stages of
eradication is not

00:05:48.290 --> 00:05:50.030 align:middle line:90%
the same in each country.

00:05:50.030 --> 00:05:52.860 align:middle line:84%
The countries have a very
different sets of problem.

00:05:52.860 --> 00:05:54.800 align:middle line:84%
For some countries,
it's almost eliminated.

00:05:54.800 --> 00:05:56.985 align:middle line:84%
There's a question for
the sustainability.

00:05:56.985 --> 00:05:58.360 align:middle line:84%
There's a country
still suffering

00:05:58.360 --> 00:06:00.230 align:middle line:84%
from endemic polio
[? education. ?]

00:06:00.230 --> 00:06:03.590 align:middle line:84%
So the objective, our
goal of the program,

00:06:03.590 --> 00:06:06.370 align:middle line:84%
have to be realistic
and country-specific.

00:06:06.370 --> 00:06:08.170 align:middle line:84%
Then we can go to
different countries

00:06:08.170 --> 00:06:11.470 align:middle line:84%
and make sure that the countries
can participate, because we

00:06:11.470 --> 00:06:13.840 align:middle line:84%
should not have a blanket
approach that every country

00:06:13.840 --> 00:06:18.250 align:middle line:84%
have to eliminate by
2021, so that if we

00:06:18.250 --> 00:06:21.190 align:middle line:84%
are very sensitive about
the context and the problem

00:06:21.190 --> 00:06:24.250 align:middle line:84%
and the capacity of
the government also.

00:06:24.250 --> 00:06:28.660 align:middle line:84%
And then, I think, each
country can take participant,

00:06:28.660 --> 00:06:31.120 align:middle line:84%
and then we can achieve
the realistic goal

00:06:31.120 --> 00:06:32.123 align:middle line:90%
and the approach.

00:06:32.123 --> 00:06:32.915 align:middle line:90%
SVEA KLOSSER: Yeah.

00:06:32.915 --> 00:06:34.373 align:middle line:84%
SEUN AKINYEMI: In
addition to that,

00:06:34.373 --> 00:06:36.040 align:middle line:84%
I think that some
[? organizations, ?]

00:06:36.040 --> 00:06:38.660 align:middle line:84%
of the UN through the
World Health Association,

00:06:38.660 --> 00:06:40.930 align:middle line:84%
We'll talk about
World Health assembly,

00:06:40.930 --> 00:06:43.890 align:middle line:84%
where all the
countries of the world

00:06:43.890 --> 00:06:47.022 align:middle line:84%
are participating [INAUDIBLE]
their ministers of health.

00:06:47.022 --> 00:06:48.730 align:middle line:84%
I think through such
[? organizations, ?]

00:06:48.730 --> 00:06:52.320 align:middle line:84%
we can ensure that
people have a buy-in.

00:06:52.320 --> 00:06:55.380 align:middle line:84%
Although, when they get to
their different countries,

00:06:55.380 --> 00:06:57.500 align:middle line:90%
this has to be domesticated.

00:06:57.500 --> 00:06:59.680 align:middle line:84%
But at least through
such [? organizations, ?]

00:06:59.680 --> 00:07:02.850 align:middle line:84%
it's very important
if you can discuss.

00:07:02.850 --> 00:07:04.820 align:middle line:90%
People can raise objection.

00:07:04.820 --> 00:07:07.720 align:middle line:84%
We can talk about
their own preferences,

00:07:07.720 --> 00:07:10.060 align:middle line:90%
and then this can be fine tuned.

00:07:10.060 --> 00:07:13.720 align:middle line:84%
And then it can be domesticated
in individual countries

00:07:13.720 --> 00:07:16.007 align:middle line:90%
[INAUDIBLE].

00:07:16.007 --> 00:07:16.840 align:middle line:90%
SVEA KLOSSER: Great.

00:07:16.840 --> 00:07:18.440 align:middle line:90%
Well, thank you both so much.

00:07:18.440 --> 00:07:20.830 align:middle line:84%
This has been
incredibly illuminating,

00:07:20.830 --> 00:07:22.720 align:middle line:84%
and I really
appreciate your time.

00:07:22.720 --> 00:07:23.230 align:middle line:90%
Thank you.

00:07:23.230 --> 00:07:24.120 align:middle line:84%
SEUN AKINYEMI:
Thank you very much.

00:07:24.120 --> 00:07:25.750 align:middle line:90%
MALABIKA SARKER: Thank you.

00:07:25.750 --> 00:07:33.000 align:middle line:90%