 And we'll give you the very warm greetings of his excellency, President Mohamed Uwari, who keeps asking me how far we have gone with the reform process, to which I've always responded. I've always responded that it is ongoing. I think he has now realized that ongoing doesn't mean very much that we have to actually have some specifics. Health reform has always been in front of an issue for many administrations before us. And we heard from the very comprehensive presentation by Dr. Azoudou and also from the consultation people that is almost cyclical. There have been several health reform initiatives. And this administration also has taken this as a serious matter that ought to be addressed fully. And the reasons are quite obvious. Public health indices have, over the years, many existing facilities can hardly cope with the current population. They have continued to grow between 2.4 to 2.4 percent annually, making it difficult for existing facilities to cope. We are told that by the experts that we have a high-grade disease pattern with high occurrence of both poor and non-communicable disease. Most medical expenses are paid out of pocket and, of course, we are told that our pocket expenditure index is about 70. The result is that illness is not merely a physical or a physically debilitating event. It can also cause financial ruin. Our systems, both at federal and state public hospitals, have generally been adjunct in urgent and burdensome. And it is estimated that we require between 4 billion per annum that she was done to about 4.5 billion to be able to achieve universal health coverage. But with our population growth rate, that figure can only go higher. It is also evident that we cannot budget alone or by compulsory spending to fund health care. And that, I think, has been shown to us in front of presentations today that that is well and I impossible. There is also the problem of inadequate medical and biomedical personnel, an issue which becomes even more noticeable as you move from the urban to the rural areas. Suggestions we've heard already suggest ways of trying to pick up for these numbers, or this patient number. And in recent months, doctor-to-patient ratios have fallen even more. It's an account of brain drain. Previous attempts have been made to improve our health care system and we've heard quite a few of that already. But implementation as we've heard also has been incomplete and non-systemic, sometimes haphazard. And in fact sometimes the records of previous attempts have been very good. So you'll find that even in trying to, in trying to build on previous reforms that the problem acquiring information on previous attempts, a very difficult one, which should not be the case ordinarily. I mean, I think doctors would have suggested something she described as institutionalization. And that is correct. I think that just as a matter of policy, every reform effort ought to be well documented and ought to be made available across the public service and even made available on public websites and other public portals. So I think that this particular effort is one that we're going to keep the public very well informed of and we're going to keep it on public portals as well. So I think anybody who wants to understand ongoing research doesn't have to go looking in the Ministry of Health, the Federal Ministry of Health or elsewhere. It ought to be available publicly, so doing research. Or those who are just interested can not only know but participate in the process. And an important point to bear in mind is the fact that a national health reform initiative is not the same as a federal government health reform initiative. And I think this point has been made. Today, the states, according to our constitution, have responsibility for primary and secondary health care and can participate in tertiary health care as well. So any reform without the full participation of the states of course will fall short of the national health reform effort. So this is why it's so important that the states are involved at every state. I'll talk very briefly about that in a moment. So this really was a state of pity in the health sector on September 6, 2021. The President inaugurated Presidential Health Reform Committee and I was given the privilege of chairing the committee of 29 very distinguished members. The committee was to be guided by the following terms of reference. The first development of a health sector reform program for Nigeria includes collaboration with the big governments, with the Air City Administration, and taken into Congress as the diagnostic report developed by Vesta Healthcare Partners, the review report of the Federal Ministry of Health and the advisory committee and other health reform proposals that may have been submitted or may be submitted to the committee. So there's a wide range of consultating papers and reform efforts that we're supposed to look at. Second is a review of all health reforms adopted in the past two decades and factoring in the lessons learned in the development of the new health sector reform program. The third is to chart out a health system that best needs the needs of Nigerians in the 21st century, with special emphasis on strengthening primary health care, improving access to health insurance and establishing a platform that enables the country to better respond to future pandemic. The fourth is to make any other recommendation to the government as maybe considered or great towards improving health care to new Nigeria. I think the mandate writ large is to address the question of universal health coverage and this remains the key of the reform process, universal health coverage. And frankly I think that reform is always, I mean, especially for the mental reform of any system, it's always different from several changes that are made in that system. There must be an overarching objective, there must be a vision, there must be some clarity as to where what we expect to see in any particular way of reform. There must be a vision, there must be some clarity as to what we expect to see overall. I'm not talking of the individual components, I mean there are so many important things that are done. Health insurance is one, setting up an essential drugs list, all sorts of things are important. But the overarching objective of reform must be clear, what is reform headed. In the United Kingdom for instance, they have a national health service, an NHIS service. Now the NHIS is the ultimate objective of their reform. In the U.S. they don't have a similar system but they try to do something with their affordable care to bring in as many people as possible into the health care system. At least to be able to benefit from some kind of free health care system. I think ultimately what most societies hope to do is provide the people with either free or affordable care and good health care. There must be something that we are looking at. Of course, the critical objectives of the subject matter of reform, in this particular case, health insurance, primary health care and pandemic preparedness are very, very important. We must keep in mind what the ultimate objective is. It's worthwhile to note that government, the first government of Nigeria has made some significant efforts to lay some important building blocks for reform, even in the course of the life of this administration. In 2018, the president signed the bill establishing the Nigeria Center for Disease Control, the NCDC, which enabled the agency to respond to the challenges of public health emergencies and enhance Nigeria's preparedness to respond to the COVID-19 pandemic in particular and several other outbreaks of diseases that we have seen in our country. May 24th this year, the president signed into law the National Health Insurance Authority Act, 2022. This new act is an important milestone for health planning in Nigeria. And I think that this is fundamental to whatever reform that we plan to do. Health financing is fundamental, which is why I think the NHIA Act is a fundamental one, because it addresses a chief concern around universal health coverage. I think that it will mitigate the current difficulties of out-of-pocket expenditure to create a virtual cycle. It means that more money will be available for people. And for hospital facilities and sources. Ultimately, health insurance will accelerate a general health coverage through health insurance for all categories of Nigerians by mandatory mechanism in collaboration with state health insurance agencies. I understand that the National Health Insurance Summit is being planned to continue the process of ensuring full implementation of the Act. In March of this year, the Primary Health Care Summit took place. This was organized by the Federal Ministry of Health, the National Primary Health Care Development Committee, towards margining the primary healthcare system in Nigeria. And a case was made there, a very important one, for private partnerships or private sector partnerships to complement the ongoing improvements in primary healthcare infrastructure and to also support making more available health commodities and also, of course, to support the health workforce. I think that the primary healthcare component of this reform is also a very important one. And just before we came in here, I was having a short discussion with the National Ministry of Health as to why we need to do something very critical about primary health reform. And the truth is that for a population of this size, we really cannot ignore primary health reform. We must find a way, or primary healthcare they give up, we must find a way of strengthening that. And of course, there's so many suggestions I'm sure, so much will also be said today. At this national level, we've also seen a lot of the work that the Governors have been doing. And we must commend the recent launching of the Primary Healthcare Leadership Challenge Fund, which was launched by the Governors, the 36 Governors. And it's a commitment by the Governors to alleviate primary healthcare higher on their agendas. All of these events are not a point of progress. We hope we'll coalesce into one central program, which is the objective of this particular reform effort. In the past few months, the Secretary of the Committee has been working in conjunction with our various partners to develop a consultation paper. We've seen that paper, we've heard the paper, and I hope all of us copies of it. It's expected, of course, to guide and, of course, our discovery. And this committee includes experts from the Ministry of Health, from the Vesta Consultants, Bill and Melinda Gates Foundation, WHO, World Bank, the FCTO, the IFC, Global Fund, the AFNET, DPRC, which is the research arm of the NIPPS, and also have consultants from Price Waterhouse Coopers, a team, you know, I've seen a very wide range of specialists as well. The overarching principle of this process has been inclusivity, inclusivity. And I think this point has been made repeatedly today. And this is reflected in the membership of the committee, whose representation from the states, professional health companies, private sector, distinguished medical academicians, et cetera. And you also notice that we also approve the co-option of additional MDAs and also sub-national representation, facilitated by the Nigeria Governance Forum and the Commissioners of Health Forum, NGOs as well as individuals with experience in the business of healthcare. Indeed, if there's anything we learned from the COVID-19 pandemic, and especially it's aftermath, is that healthcare, especially public health emergencies, cannot but have a multidisciplinary, a multi-sectoral approach. And the results, serious health reform must have the same multi-sectoral approach, which is why we have ministerial, agriculture, ministerial environment, very well represented today in all of our deliberations and of course, we're very actively involved in the process. So that's several other ministries. And was particularly convinced state governors who through the National Economic Council and the Governance Forum have worked together with the federal government on healthcare and healthcare reform. Every month at our meetings, the National Economic Council meetings, we have a presentation on public health where either on goal, some of the public health challenges and issues. And we also have the departments that devote to capital development, education and healthcare in particular. So they've been very much a part of the, of their focus for National Health Reform. I'm very much a part of that, of the movement towards National Health Reform. I think there in mind the difficulties, and this has been pointed out very eloquently, the difficulties of a national health where you have states, components as well as the federal government. I think we've done very well in, the state governments have done very well indeed. I have no doubt that we have the right calibre of people on this property and who will be working through this reform process to address the mayor challenges of the health sector. I believe that everyone has received most of the material including, I hope the recommendations and the memorandum that have been submitted or at least the salaries of the memorandum that have been submitted. I hope that we will read this documentation. It's a lot of documentation. I don't know that many people would rather listen to some of the comments but I hope that you will read them just so that our contributions at this level will be as informed as possible. This retreat will be the first of the committee to meet in person, especially for deep dives with thematic areas and the subcommittees. And I expect within the next two days at the very least we will at least define a future trajectory for the future of the proposed recommendations for reform. I hope the draft document will be ready by January, the end of January. I hope we'll be able to have the draft document ready but the important thing is that, the important thing is how much work we're able to put all of this. And I hope that because we have a lot of, there's a lot of ground work that we've done through the past few months we will at least be able to focus on the issues that have been highlighted. I must say that reforms can be very complex indeed. I've been involved in quite a few as I'm sure some here have been. And the other ones are that the silver bullets are no perfect approaches to reforms. And this is especially true in huge areas like healthcare reform. As we've seen, previous efforts already have shown us that you certainly cannot have a silver bullet but we must take into account all the previous efforts. These are some of the lessons we've learned from previous efforts must be built on. You may have several smaller, you also have several smaller any career reforms going on at different times. And even while this, you cannot stop a state from doing something about the healthcare system. So it's a very dynamic process and there are many moving ones. And we've got to bear that in mind so that when we adopt a flexible approach that is able to take all of this into account, all they are required to do in my own opinion is to at least ensure that we set broad parameters and a vision which will enable us to track and incorporate other reform initiatives. And we must ensure that we are the right people around the table which I have shown that we already have given those who are here today. And that there is wide-ranging consultation and that all views are properly considered and that we keep our vision very clear through the process. And we develop a robust and viable implementation process. So let me, as I choose to mention for commendation in particular, our development partners, I want to thank them very much for the commitment of their time and resources. It's obvious that we saw the importance of this particular effort and they supported us to the fullest by actively participating in this series of activities which led to this particular day. And they supported, finally, and morally in every possible way. I must also commend all the members of the Presidential Health Reform Committee and our Secretary answering the call to service for their hard work also, their dedication and commitment to this process. So while thank you all for making the time for this, I hope that our deliberations to be and will yield some results that will benefit of our people. Thank you very much.