Scientific discoveries and medical innovations which are products of deep research are responsible for increased life expectancy in Nigeria and other countries of the world. This was the thought of Nigeria’s pride on the global health stage, Dr Chike Ihekweazu.
The former Director General of the Nigeria Centre for Disease Control (NCDC) and now Acting Director General of the World Health Organisation (WHO), was a guest on Channels Television’s Sunrise Daily programme. The public health expert revealed WHO’s plan in tackling infectious diseases and building trust.
Enjoy the excerpts:
The United States of America has pulled out of the World Health Organisation (WHO). One or two other countries have also followed. What could be the reason for their actions and what are the implications?
Thank you. It’s important to remember WHO is a 75-year-old organisation. It’s defined by its member states. Every country that joined came together around the world and decided that there are public health challenges that we have to face collectively. Despite efforts within countries, we must come together to tackle some issues that are too big and affect all of us. We have to do it collectively. At the heart of WHO is a community of nations.
If any country decides to leave, it’s unfortunate, and we hope that decisions like the one by the United States may change but ultimately, we respect that decision. We continue to work to support countries worldwide. The successes of this organisation and the work we have driven speak for themselves — driving polio elimination efforts, supporting countries. Today, there is Marburg in Tanzania, there is Ebola in Uganda. All over the world, there are challenges we cannot deal with on our own. It is the collective effort that defines the work WHO does at all levels.
There are those who would say: given some of the issues that President Donald Trump raised, isn’t this a demonstration of mistrust in the WHO?
If you look at all the issues raised, we have addressed each of them. In terms of WHO representing the values and transformation that you need to see internally, during the tenure of Dr Tedros (Ghebreyesus) who has led the organisation now for six years, there have been incredible reforms within the organisation to serve our people better. We see countries growing in their capabilities. We see a new emergent institution of public health; the Africa Centre for Disease Control is a good example. Within the WHO, we have grown. We will not be defined by one or two of those statements. We will continue to work very actively. It is very important that we explore the opinions of the leaders of the African continents. Every country has to look inside itself to decide what benefits do I derive as a country with having WHO supporting us and being part of the global community. WHO continues working actively, supporting countries. Each country must decide what benefits they derive from having WHO in their country and being part of the global community.
Well, you didn’t quite address whether or not it demonstrates mistrust. You know all of the issues that were raised around the COVID vaccines at the time. An action from the President of the United States is significant and represents one of the biggest nations in the world. Does it in any way represent a lack of trust?
There is little ambiguity about the lives saved by the COVID vaccines around the world. Our challenge on the continent is we did not get access to these vaccines as rapidly as we should have and this is being addressed through many efforts. There’s a big effort to improve our local manufacturing capabilities across the continent. We recognise that the speed to deployment of vaccines needs to be more equitable globally. That is why, in WHO right, now we are in the process of working with all our member states to agree a new pandemic treaty.
So, whatever instruments we have when there’s a threat, we can ensure that every country has access to them very rapidly. There’s very little debate within the scientific community, and the numbers are there to show; the number of lives saved.
We have a lot of work to do collectively to regain the trust of the people around the world. This is one terrible pandemic that really challenged all of us, but the next one is around the corner, and we need to learn from the mistakes that we made rather than think of discarding the baby with the bathwater. The threats of infectious diseases are there. They haven’t disappeared because we were unhappy with certain things three years ago. I was at the front and centre of this response and we struggled with winning the trust of people even in Nigeria.
There’s no ambiguity on the scientific validity of our efforts, but we have to understand that we live in a complex world. People have all sorts of theories about so many things, and we have to keep winning their trust so that they can trust us in their response. It’s the same thing in any other sector. The banking sector has to win the trust of their consumers, the army, the military has to win the trust of Nigerians. So, in public health, we have to win over the hearts and minds of people, but the evidence is there.
In our fathers’ generation, if you were born in Nigeria, you probably would have a life expectancy of 30 or 40 but because of the advances, because of vaccines, the single intervention in modern medicine that has saved most number of lives are vaccines. The fact that when you have a child, you take them for vaccinations, they no longer have measles, diphtheria, tetanus, or whooping cough, all of these are the diseases that are in our fathers’ generation. Our fathers not that long ago would have succumbed, but today we have an opportunity to live on average 50 to 60 years and we are pushing to make it even longer.
The advances of modern medicine are really unambiguous and we have to communicate to people so that this apparent mistrust, which is really driven by conspiracy theories more than anything is minimised and we regain the trust of healthcare providers across the boards from the frontline providers, national providers, and of course organisations.
You’ve just mentioned that one of the ways in which this mistrust or distrust could have grown is through conspiracy theories. How bad is it?
Trust is one of the hardest things to measure on all the things we do. It’s very difficult really to say how bad it is because sometimes the people with the loudest voices have a lot of airtime and a lot of media space. If you think about it, we still go to doctors every time we are ill. The reason we go is because over the past 200 years, medicine and science have developed a set of countermeasures that alleviate illness. These things don’t happen through miracles. They happen through diligent research that has gone on and continues to go on as we find new medicines, new cures, new ways to prevent illness.
It’s very important that we as members of the medical, scientific, and public health community learn to communicate this a lot better, that those things enable safe child births, enable our children to survive when they go to a clinic.
What happens, none of that happens through miracles. They happen through the diligence of scientific discovery that goes on every day that has led us to these opportunities that has driven longer life expectancy.
As scientists and as public health practitioners, we may not always be the best at communicating the benefits of science to our societies, and we have to get better at that and realise that the times have gone where it was enough to just do good or support people and improve their lives.
Now you also have to explain to them in detail, and that’s what we’re learning to do. It’s a new journey for many of us, but we are on that journey and we’re here together with the government of Nigeria, Nigeria’s health sector parastatals, all of them are doing very well.
You can see the work NAFDAC is doing, the National Health Insurance Agency, the Nigeria Centrre for Disease Control which I was privileged to lead for many years, the National Primary Health Care Development Agency, all these are representatives of the ministry that the World Health Organisation works with, so that everyone’s efforts lead to a collective benefit for society.
Talking about the work that the NCDC is doing. A good number would recall the tremendous resources that were raised both by the government and the private sector during the pandemic of 2020. A lot of infrastructure was put in place at the time to ensure that, should we even have a situation like that again, we are better ready for them. But some of those infrastructures are derelict. Is there something we missed?
I think this is a question best posed to the current leaders of the health sector, but what I can’t say for sure is we may not be where we want to be, but we are definitely in a much better place than we were in 2020, and a lot of the investments. Let me give an example. One of the biggest challenges we had at the beginning of the pandemic was oxygen capacity. The capacity to provide medical grade oxygen for patients coming in respiratory distress to any hospital. At the beginning of the pandemic in 2020, we did a survey. There were only 200 functional intensive care unit beds across the public sector in the entire country. A lot of work has gone into that in improving that, and that is not only important for the next pandemic, it’s important for so many other medical conditions that you might need to address today.
There’s a lot of progress that has been made. I think we can be very proud of that, but unfortunately a lot of the work that we do in public health, whether it’s the supply of medical oxygen, the example I just gave, or a functional laboratory or emergency operation centres, none of them are big projects that are visible to most Nigerians, but you know it’s a bit like an insurance policy. You don’t want to think about it every day, but you want it to be there on the day you need it. It’s a constant building process, and I’m confident that the leaders that took over these agencies continue to push hard so that we stand tall just like we did in 2020, 2021 when we were confronted by the huge pandemic.
Everyone thought that Nigeria would collapse, we are proud that that did not happen. We should be proud of it, and we must continue to push so that our health status is strong enough to solve problems should they arise.
One thing is inevitable, emerging infectious diseases are a continuous threat. Nothing else has brought Nigeria to a standstill in our modern history across the country, across all states. We must take the threat seriously and devote the necessary human resources, intellectual capacity, and financial resources to continue to work very hard. On all these tracks, the World Health Organisation is standing shoulder to shoulder with all the health parastatals and the coordinating minister for Health, Ali Pate, to support him in his efforts in Nigeria.
