Saturday, December 12, 2020

In Her Words: ‘You really need that perspective’

Dr. Ngozi Okonjo-Iweala on the dearth of women in healthcare's most senior ranks
Ngozi Okonjo-IwealaReuters
Author Headshot

By Alisha Haridasani Gupta

Gender Reporter

“There is no concentration of intellectual power that God gave to men only.”

— Dr. Ngozi Okonjo-Iweala, chair of the board of the Global Alliance for Vaccinations and Immunization (Gavi)

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In Her Words invited female leaders to share their thoughts on what a post-pandemic world mightlook like. We are publishing their views in this newsletter throughout December.

This week, we hear from Dr. Ngozi Okonjo-Iweala, chair of the board of the Global Alliance for Vaccinations and Immunization (Gavi). She is the former finance minister and foreign minister of Nigeria and a co-author of “Women and Leadership: Real Lives, Real Lessons.”

Although the frontline health care workers are mostly women, you’re one of the few women at the leadership level in male-dominated global health. Does that affect how on the ground efforts are run?

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There is no concentration of intellectual power that God gave to men only. It only makes sense, whether there’s a pandemic or not, to have equal distribution of men and women in global health.

More and more women are training as physicians, but we need those women to also get to the management levels. Since our frontline workers in this area are mostly female, we need a consciousness in leadership of women’s issues so we can design systems that make it possible for health care workers to do their jobs.

It reminds me of the stories we were seeing at the start of the pandemic when nurses in China struggled to get access to tampons and pads because of poor planning.

Exactly. You really need that perspective.

When we get a Covid vaccine, how can leaders ensure that everyone has access to it? What does that step-by-step plan of action look like?

When we say ‘everyone has access,’ we mean that not only people in rich countries but also people in poor countries have access. Vaccine nationalism with Covid is not going to work. You are not safe, even in a rich country, with all your people vaccinated, until everyone in the poor countries are also vaccinated.

To do that, there’s only one game in town and it’s called the COVAX facility, which has been developed by Gavi, the Coalition for Epidemic Preparedness Innovation (Cepi) and the World Health Organization.

The idea of the COVAX facility is to be able to ensure that poor countries have equitable and affordable access when these vaccines become available. Right now, on one side, we have 92 member countries called the advanced market commitment side, which are going to be subsidized. We’re raising money in order to lower the cost of the vaccines for them. On the other side are 94 self-financing countries. They are going to purchase vaccines through the COVAX facility. When we procure in bulk, for both the self-financing countries and other countries, it lowers the price. The more volume you can guarantee to manufacturers, the lower the price will be. So these countries that are part of the facility, even though they’re also procuring vaccines for themselves directly, when they join they get lower prices and they help lower the prices to poorer countries.

So far, we’ve raised $1.8 billion and we need $2 billion this year. But we need $5 billion for 2021 and our objective is to manufacture two billion doses.

What are some of the logistical challenges of distributing the vaccine?

Getting a vaccine approved and licensed is one thing; getting it distributed is a whole other thing because you need strong health systems. For example, the vaccine developed by Pfizer and BioNTech needs to be stored in about minus 80 degrees Celsius — this is very rare. Most of the vaccines require around minus 20 degrees, so they’re much easier to store and transport. So it’s going to be a challenge, particularly for tropical countries.

What lessons can the global health community learn from this pandemic to prepare for the next one?

There’s one big lesson: No one country can do it alone. You really need global solidarity and global cooperation.

No. 2 is that no country really had strong enough health systems to deal with this. It’s astonishing for people around the world to find that even the health systems of rich countries could not stand up to this. So we’ve got to put more investment into strengthening the health systems of all countries.

And the third thing is that we need to build a resilient response system for future pandemics. COVAX is actually part of a thing called the ACT Accelerator (Access to Covid Tools Accelerator). If we can invest in this framework now and institutionalize it, we can save the world trillions of dollars in lost economic output in the future. When there’s another pandemic, we can just say ‘Let’s go to the ACT accelerator’ and get what we need.

Write to us at inherwords@nytimes.com.

What else is happening

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Abortion-rights activists celebrate outside the National Congress in Buenos Aires, Argentina, on Friday, as Argentina’s lower house approves a bill that would legalize abortion.Natacha Pisarenko/Associated Press
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  • “I found the courage to ask for the column that I’d always wanted to read.” Deb Price, the first columnist in mainstream media to cover gay life in order to normalize same-sex relationships in Middle America, died on Nov. 20. She was 62. [Read the obituary]

In Her Words is written by Alisha Haridasani Gupta and edited by Francesca Donner. Our art director is Catherine Gilmore-Barnes, and our photo editor is Sandra Stevenson.

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