A Builder of Men and Mason of Systems: Muhammad Ali Pate’s Enduring Influence ~ Chinedu Moghalu

On September 6th, 2024, Muhammad Ali Pate marked another milestone in his life—a birthday that could have been a time for personal reflection and celebration. Yet, true to his nature, Pate chose to set aside the festivities as Borno State faced devastating floods. With lives disrupted and communities in peril, Pate’s focus remained on his unwavering commitment to public service. While many may have turned inward on such an occasion, Pate spent the week ensuring recovery efforts were swift and effective. His actions reflect his lifelong mission: creating sustainable systems, empowering individuals, and ensuring communities can withstand challenges. This essay traces Pate’s journey, showcasing his dual impact on people and policies.

Pate is widely recognized for his rare ability to build both individuals and systems, leaving a lasting imprint on health sectors at national and global levels. It’s been said that “A tree does not make a forest.” Pate never worked in isolation but always focused on building people and systems that thrive collectively. As a builder of men, his mentorship has elevated numerous health professionals into key positions of authority. As a mason of systems, his strategic reforms have reshaped Nigeria’s health landscape and contributed to global health advancements. This essay traces Pate’s journey through these dual roles, highlighting his impact on both people and policies.

Pate’s national leadership journey began with his tenure as Chief Executive Officer of the National Primary Health Care Development Agency (NPHCDA) from 2008 to 2011. He confronted a fragmented primary healthcare system in Nigeria, where inadequate management structures hampered service delivery. True to the Nigerian proverb that says, “He who thinks he is leading but has no one following is only taking a walk,” Pate understood that for reforms to succeed, they had to be systemic and well-coordinated. He introduced the Primary Health Care Under One Roof (PHCUOR) policy, centralizing primary healthcare management at the state level to ensure more cohesive service delivery. This policy embodied his philosophy of inclusivity and collaboration—ensuring that reforms were not just top-down but involved local and state-level actors.

In rural Nigeria, where access to maternal healthcare was limited, Pate launched the Midwives Service Scheme (MSS) to address critical gaps. MSS deployed midwives to underserved regions, reinforcing the belief that “the health of mothers is the foundation of the health of nations.” This initiative did more than provide healthcare—it empowered women to lead in their communities. True leadership, Pate believed, was about giving others the tools to thrive—and perhaps, in this case, it was about giving midwives the right tools to catch a new generation of thriving leaders. The MSS also trained community health workers (CHWs) to extend healthcare into rural areas. More than 4,000 midwives and over 1,000 CHWs were deployed, offering essential maternal and child health services in chronically underserved areas. Pate’s approach wasn’t just about fixing systems; it was about nurturing the hands that would heal.

In 2011, Pate’s vision for national health reform took another leap when he was appointed Minister of State for Health. One standout initiative was the Saving One Million Lives (SOML) program, aimed at improving maternal and child health. Thousands of years ago, Socrates counseled, “the secret of change is to focus all of your energy not on fighting the old, but on building the new.” SOML embraced this idea by introducing performance-based accountability measures and mobilizing over $1 billion in financing from both public and private sectors. By tying financial incentives to measurable health outcomes, Pate not only saved lives but built a system where success was sustained by collective responsibility. Like a doctor encouraging patients to monitor their health, Pate encouraged the health system to check its pulse and stay accountable.

But it was Pate’s leadership in the fight against polio as Chair of the Presidential Task Force on Polio Eradication that was deft and defining of his systemic approach. Recognizing that data alone wouldn’t suffice, Pate engaged traditional and faith leaders to build community trust and boost immunization rates. Through this multi-faceted approach, Polio Emergency Operations Centers (EOCs) were set up across Nigeria, where real-time accountability and strategic partnerships helped combat outbreaks more effectively. By leveraging the influence of community leaders, Pate ensured that vaccination campaigns reached remote areas that had previously resisted them. This collaborative approach mirrored the wisdom of an ancient adage, “a person who rides two horses at the same time will end up on the ground.” Pate knew that focused, community-driven, and data-informed decisions were key to defeating the challenge of polio. His engagement with leaders at all levels helped steer Nigeria toward polio eradication, officially declared in August 2020.

After leaving his ministerial role in 2013, Pate joined the World Bank as Global Director for Health, Nutrition, and Population (HNP), where he advanced health systems strengthening across multiple regions. His focus was on integrating health and nutrition into population health reforms, ensuring that global health systems were resilient and not merely reactive to crises. As Pate scaled these reforms globally, he mentored a new generation of health professionals, fostering leaders who would carry forward the lessons from these initiatives. His leadership wasn’t just about implementing projects—it was about placing capable individuals in key positions to ensure that his vision outlived his direct involvement.

Pate also served as Director of the Global Financing Facility (GFF) for Women, Children, and Adolescents, where he mobilized resources to support low- and middle-income countries. Under his leadership, the GFF grew into a vital platform for improving maternal and child health outcomes through sustainable partnerships between governments, private donors, and development agencies. The GFF became more than a financial mechanism—it was key to building strong, responsive health systems that could deliver results for vulnerable populations.

During the COVID-19 pandemic, Pate’s expertise was called upon once again. As leader of the World Bank’s global health response, he oversaw an $18 billion support package, helping countries navigate the crisis while reinforcing long-term health infrastructure. This period tested not only emergency preparedness but also leadership in times of crisis. Pate’s ability to scale solutions for urgent needs while simultaneously building resilient systems capable of withstanding future shocks demonstrated his strength as both a builder of men and a mason of systems.

In 2023, Pate once again showed his deep commitment to Nigeria by declining the prestigious role of CEO at GAVI, the Vaccine Alliance, choosing instead to return home at the invitation of then newly-elected President Bola Ahmed Tinubu. As the saying goes, “The River that forgets its source will dry up,” and Pate’s decision reflected his belief that his work in Nigeria was far from over. As part of programs to realize the Renewed Hope Agenda, Pate quickly introduced an expansive initiative to reimagine Nigeria’s health sector. He spearheaded the creation of the Nigeria Health Sector Renewal Investment Initiative (NHSRII) through an extensive process of engagement and dialogue with citizens and key stakeholders, setting the stage for overhauling health governance, improving health outcomes, and unlocking the potential of Nigeria’s health sector through the Sector-Wide Approach (SWAp).

More than just formulating bold ideas, Pate ensures they are brought to life with substantial commitments. Already, SWAp has attracted $1.13 billion in health-specific funding, including contributions from the World Bank’s HOPE Project, which focuses on enhancing the quality, utilization, and resilience of Primary Health Care (PHC) services. Additionally, the Basic Health Care Provision Fund (BHCPF) has been resuscitated to better contribute to delivering improved quality healthcare service delivery, particularly at the primary healthcare level. Through the efforts of the National Primary Health Care Development Agency (NPHCDA), over 8,000 primary healthcare centers (PHCs) across the country have been revitalized. These PHCs are critical to providing essential services such as maternal and child healthcare, immunizations, family planning, and diagnostics, especially in rural and underserved areas. Furthermore, the National Health Insurance Authority (NHIA) continues to expand health insurance coverage for vulnerable populations, ensuring that more Nigerians are financially protected when seeking care. This collaborative drive, aligned with the previous presidential statement on a broader $2.2 billion commitment under SWAp, evidences the ongoing transformation of Nigeria’s health system.

The creation and ongoing implementation of NHSRII embodies Pate’s talent for building systems that thrive on collaboration. The initiative was formalized through a Compact signed by the government, the people, and development partners, symbolizing a collective commitment to transforming Nigeria’s health sector.

Beyond his direct leadership roles, Pate has championed public health education. His influence extends into academia, where he chairs the Muhammad Ali Pate International School of Public Health, Ondo State, and serves as the inaugural Chair of the Julio Frenk Professorship of Public Health Leadership at Harvard. His commitment to education reflects his broader belief that strong systems must be built on the foundation of knowledge and human capacity.

Pate’s work with the Chigari Foundation, a non-governmental organization focused on community engagement and primary healthcare mobilization, further highlights his grassroots leadership. “And cooperate in righteousness and piety…” says the Holy Quran in Surah Al-Ma’idah 5:2. This verse mirrors Pate’s approach to building community-driven healthcare, where cooperation and collective responsibility are central to success. His ability to mobilize local influencers and grassroots leaders has been key in ensuring the success of immunization programs and other health interventions.

As the founding CEO of Big Win Philanthropy, Pate led transformative efforts focused on partnering with visionary African leaders to achieve sustainable health and human capital development across the continent. Through Big Win, he worked to address the underlying factors that impair brain development in children, such as undernutrition and insufficient care, helping ensure they reach their full potential. He also supported leaders in improving the quality and relevance of education to equip Africa’s growing youth population with the skills needed for a productive workforce. These initiatives reflected Pate’s unwavering commitment to strengthening governance and fostering transformative leadership across Africa, ultimately contributing to the continent’s long-term development.

This complemented his work with the Healthcare Leadership Academy and other mentorship initiatives, where he nurtured a new generation of health professionals who continue to influence policies in Nigeria and globally. His role as Co-chair of the Global Agenda Council on Population Growth at the World Economic Forum underscores his global influence on health and development policies.

Pate’s career has not only been about systemic changes but also about ensuring these changes reached the frontlines. The Midwives Service Scheme (MSS) and training of community health workers (CHWs) ensured that underserved communities had access to vital health services. MSS became one of Africa’s largest health workforce programs, training and deploying midwives and CHWs to over 1,000 rural health centers, bringing vital health services closer to the people. His advocacy for task-shifting policies, which allowed CHWs to perform critical health interventions in rural areas, demonstrated his belief that sustainable health systems depend on a well-trained and empowered workforce. The program earned international recognition for its governance and execution, including accolades from the Commonwealth Association for Public Administration and Management (CAPAM).

Pate never leaves the systems he builds to chance. His efforts in placing qualified professionals in leadership positions across national and global institutions highlight his commitment to ensuring the sustainability of health systems. As the Hausa proverb reminds us, “Even the best cooking pot will not produce food,” emphasizing the importance of capable leadership in sustaining well-designed systems. Pate knew that even the most advanced system needed the right people stirring the pot.

Muhammad Ali Pate’s career is defined by his dual role as a builder of men and a mason of systems. His strategic reforms in Nigeria laid the foundation for lasting improvements in healthcare delivery, while his global leadership continues to influence health policies across the world. Pate’s decision to return to Nigeria rather than pursue a prestigious global position reflects his unwavering commitment to his country’s health sector. As the Quran reminds us, “Whoever saves one life, it is as if he had saved mankind entirely” (Surah Al-Ma’idah 5:32). Pate’s legacy, built on mentorship, system reform, and a dedication to saving lives, will continue to shape health outcomes and inspire future generations of health leaders.

Indeed, “The footprints of the great are not erased by the sands of time.” Pate’s enduring impact—both seen and unseen—will continue to resonate long after his active work, ensuring that the systems he helped build will thrive for generations to come. His influence is not merely in the institutions he reformed but in the people he empowered, the systems he constructed, and the lives he touched through his deep commitment to humanity. And for this, we raise a worthy birthday toast to this Khādim mutawāḍiʿ lilshaʿb and pray Allah’s manifold peace upon him.

Barrister Chinedu Moghalu, a lawyer and strategist in sustainable development, writes from Abuja