Roux Prize 2023 Recipient: Ibrahim Abubakar
Published October 12, 2023
On October 12 in London, Professor Ibrahim Abubakar, Dean of the Faculty of Population Health Sciences at University College London, was awarded the 2023 Roux Prize, an annual award from David and Barbara Roux and IHME that honors global health experts who have made significant contributions to improving global health outcomes.
Some of Prof. Abubakar’s greatest achievements have positively impacted millions of people. He has been instrumental in the development of health initiatives for tuberculosis and COVID-19.
Data analysis and collection have been catalytic for policy change in Prof. Abubakar’s career. His recent work on The Lancet Nigeria Commission directly led to Nigeria passing a new law mandating basic health insurance and the creation of a fund for vulnerable populations that covers 83 million underprivileged people.
Inspired by his late father’s innate desire for equality, Prof. Abubakar started a career in health care and quickly shifted into public health. His upbringing in Nigeria strengthened his values of equity and community, carrying into a decades-long career as a global health leader.
This transcript has been lightly edited for clarity
Prof. Ibrahim Abubakar: Are you coughing or do you have coughing? Let me listen to your chest, if you don't mind.
I was very clear from an early age that what I would want to do with my life is contribute to the mission and work of making things better. My dad was a civil servant and I distinctly remember going out with him, and while we had some degree of relative privilege, all around us was also poverty.
Poverty is a key determinant of whether you survive the first year of life, whether you get nutrition and immunization you require, whether you lose your life needlessly at childbirth. And indeed for that in life, whether you're able to detect chronic conditions and have a lifestyle that reduces your risk. My dad was contributing to what I think is a better society, and unfortunately for him he had an accident and the health system then was not able to provide him with the critical care he required.
And at a very early age, I lost my dad to, I think, what was a preventable situation that made me feel the society needs to do better, both in the tackling the sort of thing that drove him, the inequality and that variation in the level of care that is available, but also the fact that he wasn't able to get that level of care when he needed it.
Having finished my secondary school, it was clear to me at that point that my ability to contribute to solving even more vast inequalities at that stage of our development would be better If I studied health and health care. Eventually, when I reached a point to choose a specialty, I went into general medicine and then trained in infectious disease medicine. So I was responsible for looking after medical ward where through the early nineties we had a lot a lot of patients with HIV arriving and sadly, before the wide availability of antiretrovirals, these individuals almost universally died in our hands.
So that's the basis of my motivation to move from clinical medicine to training in public health. And for me, the common thread between my work here in London and in Europe and the work I do elsewhere, whether it's in Asia, South America or Africa, is the fact that in all those places humans are the same. We create systems where there are vast inequalities between sections of society and the health problems that arise is staggeringly similar.
So we talk about, for example, the life expectancy of an average adult in Nigeria being in their fifties. When we did some work here in London, we're able to show that the life expectancy of many of these individuals who are homeless or having problem drug use was not that different. When you take your eye off inequalities and public health, TB reemerges.
It's a consistent pattern. Sadly, from about the mid to late eighties, all the way to the early 2000s, levels of TB steadily increased in the UK to levels where the UK at one point had the highest rates of TB across Western Europe. And I'm delighted that over the last decade TB rates are actually steadily declining in the UK.
I am an epidemiologist by training and background and therefore data and analysis of data is at the core and heart of what I do. Often in policy discussions, whether local or national, when you try to influence policymakers to prioritize health, in particular the health of the most vulnerable in society, you get a lot of resistance and not a lot of attention.
It makes it even more pertinent that you have the best quality evidence, the best data, analyze and present them in such a way that is so compelling that the people you are speaking to have no choice but to respond to what you're saying.
Ultimately, as I went on in my career, I recognize that the dismal health metrics in Nigeria, similar to many countries in sub-Saharan Africa, required a rethink on how we do things that is evidence based. So, based on my existing collaboration with The Lancet, I thought producing a detailed piece of work where we bring together high quality evidence underpinned by a group of high quality scientists utilizing the very best data available, would be a good platform to influence policymakers.
And I'm really pleased and proud that because we took policymakers along with us in producing that evidence base, that a lot of our recommendations have gained traction and have been listened to. And one key area is health insurance coverage. Nigeria's health insurance coverage is of the order of 5%. And I'm delighted that based on that, the government did pass a law.
We convert that law into actual practice and we reach 100% health insurance coverage for the country.
Exchange with clinic patients: Do you have health insurance coverage. Okay. And what about you? You don't? A law has been passed called the vulnerable group fund, and we are hoping that as soon as they resource it, that individuals like you should be able to access that, and maybe their future should be different.
Muhammad Ali Pate: It is a good example of how you can use the best of what we know, the science of public health, cultivate the evidence base as to what happens in Nigeria and contextualize it and then make forward looking recommendations that actors can take and implement on the ground. I see the Roux Prize shining light on his work as an example for others who are very brilliant, who have exceptionally well-placed platforms in the global space to really see how they can connect that work with what is going on in their home countries in the Africa region or in other parts of the developing world.
Prof. Ibrahim Abubakar: Never would you think that at the end of it, when you produce evidence that would actually lead to a change in national law affecting a country of 240 million people, and with a statement directly attributing the passage of that law to the work you've done. So it was I'd say the highlight of my career.