JUNE 1, 2013 will mark the 10th anniversary of the passing away of the medical icon and foremost nationalist, Professor Olikoye Ransome-Kuti. The event will be marked with a public lecture titled: “Tackling health and social inequity in Ekiti State” to be delivered by Dr. Kayode Fayemi, Governor of Ekiti State at the Lagos University Teaching Hospital. The lecture is being organized by the Women’s Health and Action Research Centre (WHARC) in collaboration with the Ransome-Kuti family and the National Primary Health Care Development Agency (NPHCDA). The event promises to attract family members, friends, associates and students of our dear Professor Olikoye Ransome-Kuti and will enable a re-enactment of the passion and deep fervour that he so well demonstrated for social change in his life time.

For those who were too young in 2003 to know this man, Professor Olikoye Ransome-Kuti epitomizes the best and the most profound in the delivery of health care services that this country has ever witnessed. He has been Nigeria’s longest serving Minister of Health, holding the portfolio during the military era, 1985 to 1993. Of all the things that have been said about the military regime of President Badamosi Babangida, the appointment of Professor Olikoye Ransome Kuti as Minister of Health proved to be a masterstroke and one of the most instructive selling points in his entire presidency. Kuti’s major contribution to health care was his entrenchment and domestication of the principle of primary health care in Nigeria – an approach that was first introduced into the international health lexicon in 1978. To date, Professor Ransome-Kuti remains the foundational architect of primary health care in Nigeria, which the country adopted early in its formation. He has been the sole advocate, the principal doctrinaire and the grandfather of this philosophy, which he nurtured from the beginning until his death. Indeed, almost all practitioners of primary health care in Nigeria today are either his students or his disciples.

Additionally, it must be remembered that Professor Olikoye Ransome-Kuti has done more than anyone else to position Nigeria’s health problems in national and international consciousness. Apart from being the Minister of Health, he was an international ombudsman that placed the nation’s health problems in the agenda of several international agencies. He spoke passionately and eloquently at several international meetings, which meant that the country could not be ignored when it came to the allocation of global resources for the promotion of health.  Indeed, some of the benefits the country is witnessing today in terms of increasing in-flow of global funds for health promotion are partly attributable to the strong foundation laid by Professor Olikoye Ransome-Kuti during his tenure as minister. He also made sure that health, which was hitherto invisible in the development agenda of the country, received priority attention by all successive governments. This priority attention peaked during the tenure of President Olusegun Obasanjo, partly due to the advice and support offered by Kuti to that administration in the first four years of its existence.

Someone once asked me why I have been so resolute in talking and writing about Kuti several years after he died, especially when I was neither his student nor his contemporary. The answer I often give is that he mirrors my way of life, someone with whom I share similar philosophy and ideology about how Nigeria can and should be transformed. These are principles based on social egalitarianism, transparency and accountability, concern for the less privileged, a worldview that is objectively analytical and not ethnically driven, and a devotion to personal integrity.  Professor Ransome-Kuti epitomized all of these, and as I am also an advocate for social transformation myself, I regard him as a worthy role model that can help the country identify a purposeful and focussed direction of growth for itself.

There were two encounters I had with Professor Kuti in his lifetime that remain indelible in my mind till this day. The first was when as a junior lecturer at the Obafemi Awolowo University in 1988, I sauntered into his ministerial office in Lagos demanding to be offered a scholarship to enable me present a paper that elucidated the determinants of the high rate of maternal mortality in Nigeria at a conference in London. In less than five minutes, my request was approved by Honourable Minister Ransome-Kuti.  He only needed to confirm that my paper had been accepted for oral presentation and that I had no other support for the conference. He however requested that I should forward a report of the conference to his office as soon as I returned, and that if I published the paper, he would like to read it. I later published the paper and forwarded a reprint to him, which he acknowledged in writing. He also subsequently established a programme for the compulsory reporting of maternal deaths by all teaching hospitals to the Federal Ministry of Health. I do not know, but I suspect that the reading of my paper may have encouraged him to do so. As I have now increasingly grown in the discipline, my experience is that this kind of dispassionate and kind treatment of a citizen and of an issue by a public official is extremely rare in this country, and can only be done by someone strongly devoted to social change.

The second encounter I had with Kuti was when I met him at a hotel in Nairobi, Kenya in 2002, about 10 months before he died. I had entered the hotel restaurant and saw him sitting alone on a table. I immediately went to him, introduced myself as a Nigerian and requested to join him. I ended up spending two hours with him, and having the opportunity to listen to him narrating his experiences in administering the health sector in Nigeria. He recounted how he raised several funds for the health sector and started several positive initiatives for health promotion, but how these have been mismanaged by those charged with the responsibility to manage the sector, in particular the Primary Health Care Development Agency at the time.  I saw a thoroughly disappointed man, visibly angry at the wastefulness and corruption of policy makers and programme managers in managing the health resources of the country. It was from him I first learnt the doctrine which I now profess around the country that Nigeria’s health problems, especially our inability to meet various health development targets is not due to lack of funds but is due to the mindless and inappropriate deployment of available funds and the lack of experience and capacity of those charged with managing health resources. Actually, I think I became Kuti’s ardent disciple from that discussion I had with him in Nairobi, because I reasoned that it is only when we do things differently and manage our resources more professionally and accountably, that we would be able to improve the nation’s health sector. Unfortunately, since he died the situation has not improved, with no one of high note willing to speak for the sanitization of the sector.

In conclusion, the tenth anniversary of the death of Professor Ransome-Kuti provides an opportunity for this country to re-dedicate itself to those basic principles for which he offered patriotic services to the country. A strategic re-focussing on the principle of better management of the health sector, using simple but effective methods in addressing the health needs of all citizens is one way to remember him. A Kuti doctrine of health promotion encompasses several domains in health governance, including the following: a commitment to improving primary health care, increased political prioritization of the health sector, improved health care financing with a determination to deploy available resources more wisely and more accountably, ensuring that only the best and experienced managers with proven track record are allowed to manage our healthcare institutions, and finally a resolute devotion to reducing the level of corruption and impunity at all levels of our national life. May the gentle soul of Professor Olikoye Ransome-Kuti continue to rest in perfect peace.  Amen.

• Okonofua is Professor of Obstetrics and Gynaecology, University of Benin.