Africa: Meet the Man Putting together Africa’s Healthcare plans
His friends make jokes about him. He has two left feet, they say. He can’t hold a decent tune either. Such an embarrassment for a man who was born in Imo State, South Eastern Nigeria.
Imo State is popularly known as Nigeria’s eastern heartland. And if the only native you ever spoke to was Alex Ezeh, you would understand why. While he cannot dance and he cannot sing, much to the dismay of his friends, family and countrymen, the 52-year-old is all heart, and his heart beats for Africa. Now one of the foremost researchers on the continent, the man who adopted the Africa Population Health Research Centre (APHRC) in its infancy and raised it to young-adulthood, made his first foray into research by studying fertility patterns, trying to understand the factors that influence the decision-making process around child-bearing.
At the time he was studying sociology at Imo State University and it was then that he realised that the future of Africa was wrapped around its demographic profile. He decided to figure out what that would mean for the continent. This is how he ended up at the University of Ibadan University studying for a Master’s degree in sociology with a focus on demography.
Fundamental driver “Understanding people, their distribution and the implications of both is central to our experience and existence. Human behaviour is the fundamental driver of change on the planet,” says the man who went on to acquire yet another Master’s degree in demography, and ultimately a PhD in the same field from the University of Pennsylvania in the US. It is no surprise then, that he found himself at the helm of an institution that publishes more than one hundred research papers every year, all with a specific focus on human activity. But before he got the call to join APHRC, he was working for Macro International (now ICF International), a company that runs demographic and health surveys in middle and low-income countries.
At Macro, he had started off with a focus on demography, publishing an impressive number of scientific papers around African demographics. Three years into it, he switched focus and tried his hand at applied research and development, where he spent his days researching American adolescents, investigating substance abuse and mental health. He was happy. He had a good job, a wife, a young family and a green card. He tells an interesting story abouat his green card. “I got my green card as an outstanding researcher, just on account of my CV, citations and papers – I didn’t need anything else to persuade them.
The lawyer that handled my application asked for $150 (Sh15,450) to do a cover letter and that’s all it cost me. I had a good profile and it served me well.” So, yes. Life was beautiful and Ezeh was enjoying it. His wife Nkee was a nurse, his children were in school, he was doing good work and all was well with his world. It was at this point when he got a call from the Population Council here in Nairobi, asking him to relocate. The offer was to join the council as a senior fellow, assist in charting a path for the APHRC — which at that time was a fellowship programme within the Population Council known as the Africa Population Policy Research Centre — and “prove that Africans can think and do research”.
The year was 1998. At first Ezeh struggled with the decision because moving back to Africa had not been part of the plan. In the end, it was the idea that Africans needed to do their own research and impact their own policy decisions that prompted him to make the move. Ezeh made the decision to relocate to Nairobi in August of 1998, not too long before the US Embassy was attacked by terrorists. Friends and family cautioned him against a move to Kenya but the decision had been made. So he returned to Africa and threw himself into the work of proving that Africans were capable of rational thought.
But two years later when his contract expired, he was ready to go back to the States where he had secured a faculty position at the University of Georgetown. He had always dreamed of being a professor and the dream was finally within his grasp. Were it not for the fact that Francis Dodoo — a Ghanaian who was then the director of APHRC — was also leaving, Ezeh would have returned to the US and never looked back. But Dodoo had been his comrade-in-arms, his research partner, and together they had transformed the centre from a non-publishing house, into a source of top-quality scientific papers that were being carried in the world’s most prestigious health and population journals.
Dodoo had to leave but Ezeh very quickly realised that he had to stay. If he had left at that point, the centre would have lost all its funding, forcing it to shut down completely. APHRC was founded in 1995, Ezeh and Dodoo joined in 1998 and by the year 2000, the non-performing centre had begun to turn the corner. “Looking at what we’d been able to do – including expanding research into urban Africa – I felt that we were onto something good and it was difficult to stand by and watch the centre close down.
So I decided to stay.” That decision meant that he had to move his family from Pennsylvania to Nairobi, Kenya. His wife Nkee quit her American nursing job to become a housewife, and the children settled into a new Kenyan way of life. It’s been 18 and a half years since Ezeh attached his name to what has been the meteoric rise of the Africa Population Health Research Centre. He says it is one of the best decisions he’s made in his entire career. “We’ve been able to demonstrate that Africans can do some of the best research in the world and not only can they do it, they can teach others to do it. Some of the work I’m proudest of is supporting universities across the region to strengthen doctoral-level training, and to uplift their junior faculty to become more engaged in research.”
APHRC has also been able to transition from pure research to policy formation. A good number of studies done by the centre have been used to shape government policy, particularly in the areas of reproductive health, family planning, education and the specific needs of urban populations. The ultimate goal is to partner with government to create issue-based policy that is firmly grounded in research. Ezeh is the first to admit that none of his success would have been possible without his team. Together, they have overcome a plethora of obstacles. Their first challenge was to ensure that the centre was duly registered, and in the year 2000 it was listed as an independent charitable entity in the US. As an American charity, US donors were able to give the centre core support.
“We also registered the centre as a not-for-profit corporation here in Kenya through the Registrar of Companies,” Ezeh confirms. Within a year, they had all their registrations sorted and were completely independent of the Population Council. They also signed a headquarters agreement with the government of Kenya. In 2001, the centre separated its books of account from the Population Council and in 2002, staff moved out and took up residence at Shelter Afrique Centre in Nairobi’s Upper Hill. Ten years later in 2011, they moved into their current home, an expansive campus in Kitisuru that cost more than two hundred million shillings to build. Back in 2002, the centre had received its first major grant from the Rockefeller Foundation to the tune of $2.57million (Sh283,250,000), covering a three-year period. Its annual budget was then about $1 million (Sh103,000,000).
It is now, on average, about $13 million (Sh1.3 billion) a year. With the initial grant, Ezeh invested in systems and processes, including hiring a consultant to assess his staff to determine who had the key competencies that the centre needed going forward. Tough decisions were made and a number of staff members were let go, leaving behind a core team of researchers and administrators. That process, a radical surgery if you will, turned the APHRC inaugural team into an extremely efficient machine. Together, the team members determined to place the institution before their careers, putting aside self-interest and focusing on building the centre’s reputation instead.
It wasn’t long, however, before problems came calling. In 2004, the Rockefeller Foundation announced that it was going to stop its funding. The centre faced imminent closure if the team could not find the money to keep its doors open. “So we folded up our sleeves and started writing proposals. We started in 2005 and almost anything you can apply for, we applied for! In the first six months of the year, we had done more than 18 proposals and by the end of that year more than 13 had been funded,” Ezeh says. The challenge then became to build the human resource capacity to implement all the funded initiatives.
Ezeh affirms that the growth of APHRC started proper in 2006, at the point when they actively began seeking out the best African researchers to implement all the initiatives they had received funding for. Since then the centre has grown by 30 – 40 per cent every year. Africa for Africans In seeking qualified staff to implement their new projects, Ezeh very quickly realised that there was a gap in the training of African researchers who had been trained in Africa, especially when you compared them to their Western counterparts.
This gap was readily apparent during the interviewing process and Ezeh traced it back to the quality of education in Africa. He began to see that the discourse around research in Africa was out of date, that the research methods employed by investigators trained in Africa were weak, and that a good number of African researchers were unable to independently defend their research. These realisations prompted the centre to launch the Consortium for Advanced Research Training in Africa (CARTA) and the African Doctorate Dissertation Research Fellowship programme (ADDRF).
Between the two programmes, the centre has supported 370 PhD candidates across Africa, providing training on the conceptualisation of research, data systems, research communication, academic leadership and policy engagement. Ezeh is quick to point out that the success of APHRC has not been accidental. The team has worked hard to put the centre firmly on the global research map.
The man at the helm has been very aware that as an African institution, there are no second chances – you only get one chance to get it right. “We have never had the luxury of messing up, so from the onset we did good research and accounted for all the money we received up to the last cent. Ever since our very first month of independent operation in August 2001, we have gotten professionals to set up our systems and audit our accounts. We’ve worked with KPMG, Deloitte, Ernst & Young and PwC and it hasn’t come cheap, but it has been a good investment to make,” says Ezeh. Indeed, Ezeh’s insistence on absolute financial integrity has served the centre well, allowing it to take the loan that was needed to fund the construction of the APHRC Campus in Kitusuru.
In 2014, the centre acquired three adjacent acres. The additional acreage came at the cost of $1 million (Sh103,000,000) and it will be used for the second phase of APHRC’s infrastructural development, which will include training and residential facilities to support CARTA and ADDRF. APHRC is also in plans to launch three Masters’ degree programmes in collaboration with Moi University, Eldoret, the University of Gothenburg in Sweden, University of Amsterdam in the Netherlands and University of Warwick in the UK. Faith, family and work are my three pillars Like every successful man, Dr Ezeh has a strong woman beside him.
He readily admits that he wouldn’t be where he is today without the support of his wife, Nkee. He met her while he was studying for his undergraduate degree at Imo State University. He was in his final year; she was in her first. At the time, he had just gotten saved, having been raised a Catholic, and as fate would have it, Nkee was also a member of the university’s Christian Union. They became friends and all paths led to a firmer union.
Years later, when Ezeh was reading for his MA in demography at the University of Ibadan, he applied to continue his studies at the University of Pennsylvania in Philadelphia. Nkee is from Western Nigeria and when the moment came for Ezeh to propose, he had to package his feelings in a letter, which he then sent by post in 1989. As it happens, on the same day that he received a letter from the University of Pennsylvania offering a place and a full scholarship, he received a missive from his Nkee saying yes to his proposal. “It was a lovely day, one of the best days of my life!” he says with a joy that is palpable. And so they got married in 1991 and Nkee joined him in Pennsylvania, where they had three children: a girl, Ebube (23), boy Drie, (20), and girl Zite (18).
Their last born daughter Chigo (14), was born in Nairobi in 2002. All the children now live in the US, the first two in college, the third just out of high school and the baby in boarding school. Nkee is an urban and regional planner by training but switched to nursing when she and her husband emigrated to America. When the family moved to Nairobi, she became a stay-at-home mum to take care of the children who were still young and to support Ezeh who routinely worked 12 – 15 hour days. Ezeh says that the family has thrived because one, they have been able to hire help on the domestic front, and two, Nkee has been fully available to both her husband and her children.
The man at the helm of one of Africa’s foremost research facilities says that his faith, his family and his work are the three things that keep him going. “Trying to create a healthy balance between the three has been my biggest challenge! My work takes up 75 per cent of my time, but that’s what it has taken to build the centre and to raise it to this level. Without the support of my wife I would not have been able to do it.” Dr Ezeh has worked with some of the best brains that this continent has to offer.
He has a strong belief in personal and professional integrity, and the long-held notion that to get ahead, one must take risks. Indeed, it is apparent that Ezeh is not averse to risk taking because after almost 20 years at the helm of APHRC, he is again embarking on a new journey. Last year in November he indicated to the board that he was ready to move on to other things. While he quickly shares that he is committed to staying at the centre at least until August, he is reluctant to delve into the details of his next adventure. His dream has always been to teach, so there is a likelihood that he could find his sweet spot as senior faculty at a US university where he would be closer to his children. After 18 years in the trenches, that would be a welcome change.
An unsung hero Alex Ezeh was only the second person from his village to go to college. His posted unremarkable grades on completion of his first degree in sociology at Imo State University, but by some miracle was accepted to study a Master’s in the same discipline, this time with a specialisation in demography at the University of Ibadan. At Ibadan, he began his studies for a doctorate degree in demography, but switched school’s mid-stride, eventually graduating with a second Master’s and a PhD from the University of Pennsylvania in the US.
This son of Africa who was born to an illiterate wine tapper and a house wife, both of whom have since passed, has ended up presenting the best of the continent to the world. “African researchers are marginal to the whole scientific discourse on Africa. We contribute very little and are on the side lines watching the game as other people write about us. “APHRC has done a lot to redress this balance, not just because we have a campus but because we have proven that given the right environment, Africans can do the best science possible.
We have given people the platform to create knowledge, but we have to continue to present our papers on the international stage so that we can speak about our issues. “And look, nobody cares if you’re Kenyan or Nigerian. To the world you are African. We’ve been divided for far too long, starting with the separation of African countries by national boundaries that have no meaning. But I believe in the capacity of Africa to change its narrative. “When I die, I want to be remembered for truly believing in the African renaissance and the capacity of Africans to create a different narrative. We as a people can get it right — if we work together.”