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
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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

Here are four articles from The Times you may have missed.

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
  • “I have goose bumps. I feel like we’re making history.” Argentina moves toward legal abortion, which would make it the fourth nation — and by far the most populous — to legalize the procedure in Latin America, where strict abortion laws are the norm and Catholic teaching has long steered policy. [Read the story]
  • “This is a very, very typical Japanese reaction against female victim-survivors.” Shoko Arai, the only female assembly member in the town of Kusatsu, accused the town’s mayor of forcing her into sexual relations. Then the town turned on her and she was ousted. [Read the story]
  • “I’d like to be able to raise awareness on the tactics that abusers use to control you and take away your agency.” The musician FKA twigs is suing her boyfriend, Shia LaBeouf, accusing him of “relentless abuse,” including sexual battery, assault and infliction of emotional distress. [Read the story]
  • “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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On Politics: What Will D.J.T. Do?

That’s the question that could define the Republican Party for years to come, even as the president’s time in Washington winds down.
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By Lisa Lerer

Politics Newsletter Writer

Hi. Welcome to On Politics, your wrap-up of the week in national politics. I’m Lisa Lerer, your host.

Antonio de Luca/The New York Times

A lot will change for Republicans when Joe Biden becomes president next month. But their party may still be defined by the same old question: What will Donald Trump do next?

Since launching his bid for the White House in 2015, Mr. Trump has remade the Republican Party in his populist image, embracing far-right rhetoric, elevating once-fringe elements of the base and shifting conservative ideology on issues like foreign policy, immigration and trade.

Republicans hailed his ability to achieve key pieces of their political agenda — like installing conservative judges and passing tax cuts — and stayed silent on the rest, fearing the backlash that could come from crossing the president. Those who criticized Mr. Trump quickly found themselves retiring, defeated or declaring themselves political independents.

Now, Mr. Trump will depart Washington. And Republicans are wondering how much political influence Mr. Trump will take with him.

“The reality is, none of us know,” said Chip Lake, a Georgia-based political consultant. “I’m not even so sure the president knows what a post-presidential Donald Trump looks like politically.”

Already, there are signs that even in defeat, Mr. Trump continues to hold sway over his party. More than one hundred Republican members of Congress and 17 attorneys general backed a Texas lawsuit aimed at overturning the election results in four swing states and invalidating the votes of millions of Americans — despite no significant evidence of malfeasance. (The Supreme Court tossed out the suit on Friday night.)

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Across the country, Mr. Trump’s conspiracy-mongering about the election results has led to a civil war within the G.O.P. Trump loyalists in state parties, installed by the campaign in leadership posts last year, are battling with Republican elected officials, whom they see as insufficiently pursuing Mr. Trump’s efforts to undo his loss.

Those tensions worry many Republican strategists, candidates and officials. Mr. Trump drove a record-breaking number of Republican voters to the polls this year, expanding the party’s support in rural areas and among voters of color. But it’s not clear whether the new voters who turned out for Mr. Trump will become loyal Republicans if he is not on the ticket — or if he is actively campaigning against the party’s candidates.

Antonio de Luca/The New York Times

In recent weeks, Mr. Trump has encouraged primary challenges against Gov. Brian Kemp of Georgia and Gov. Mike DeWine of Ohio, prompting some loyal allies to muse about running against them. He has attacked Gov. Doug Ducey of Arizona, who is prevented from running for re-election by state term limits but has been mentioned as a possible presidential candidate in 2024.

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And then there’s the issue of Mr. Trump’s own ambitions. He’s been making plans to run again in 2024, with a kickoff as early as this month or perhaps on Inauguration Day. He’s raised more than $200 million since Election Day, funneling some of those funds into a new political action committee he formed after the election.

As they often have during the Trump era, Republicans find themselves navigating uncharted political waters. Traditionally, ex-presidents shy away from partisan combat, wading back into the fray only for the final weeks of a general election.

“Is Trump going to go out and basically announce an exploratory committee and start doing rallies? If that’s the case then I think he is able to maintain a pretty high boil,” said David Kochel, a former top adviser to Mitt Romney’s 2012 presidential campaign. “If he doesn’t do that, it could be that the party is able to start to take steps away from the Trump presidency and entertain other leaders.”

Some Republicans believe that as the fervor around the election fades, so could Mr. Trump’s influence. Others doubt whether he’ll remain focused on politics, given the financial and legal difficulties faced by his businesses and the diminished media coverage of his every move.

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“I personally believe that once he is out of office and gets back to running his business, that he may very well realize he likes doing that a lot more than he likes being president,” said Juliana Bergeron, a Republican National Committee member from New Hampshire.

Antonio de Luca/The New York Times

Should Mr. Trump mount even a quasi-serious bid for a second term, he would freeze the large field of Republicans quietly plotting the beginnings of a presidential run. Some would-be candidates may be daunted by Mr. Trump’s grip on the party base, with his expansive email list, loyal supporters and growing war chest. Others may struggle to cast themselves as the bearers of the president’s legacy should Mr. Trump himself remain in the field.

Another Trump campaign — or just the prospect of one — could also create difficult political crosscurrents for down-ballot Republican candidates, particularly those in battleground states.

In 2022, the party will again have to defend Senate seats in a number of swing states — though having a Democrat in the White House should help their chances, given that the president’s party typically loses seats in the midterm elections. Some Republicans are eager to move past the divisiveness of the Trump era and embrace a message that can win back suburbanites in states like North Carolina, Arizona, Nevada and Pennsylvania.

Throughout his presidency, Mr. Trump has delighted in backing Republican primary challengers, picking loyalists who generally win the primaries but often lose competitive general election races. If he continues to meddle in primaries as an ex-president, the fear is that the party could end up with nominees who have little appeal beyond their own base.

Of course, American politics aren’t as consistent as Mr. Trump’s hard-right political strategy. The country’s whims can shift quickly, and a political style that was revolutionary in 2016 could be retro by 2024.

As Mr. Kochel put it, pointing to the swing Republicans made over four years from Mr. Romney to Mr. Trump: “We are always one nominee away from changing the party’s image and brand.”

Drop us a line!

We want to hear from our readers. Have a question? We’ll try to answer it. Have a comment? We’re all ears. Email us at onpolitics@nytimes.com.

Biden’s cabinet picks take heat from all sides

Fighting over cabinet picks seems almost quaint after four years of the epic clashes of the Trump administration. Still, grass-roots activists, policy advocates and party leaders are finding plenty of fodder in Mr. Biden’s nominees.

Environmental activists and anti-hunger advocates aren’t happy with Tom Vilsack’s potential return as head of the Agriculture Department. Lawmakers on both sides of the aisle are raising concerns about naming retired Gen. Lloyd Austin, a recently uniformed military commander, as defense secretary — the top civilian leadership post at the Pentagon. And Republicans are already threatening to hold up the confirmation of Xavier Becerra as secretary of health and human services, questioning his lack of public health expertise.

At least a few — if not nearly all — of Mr. Biden’s nominees are likely to face opposition from Senate Republicans.

Here’s our running list of Mr. Biden’s picks so you can follow along with the incoming administration.

By the numbers: 17

… That’s the number of Republican attorneys general who backed Mr. Trump in a brief filed with the Supreme Court that sought to delay the certification of the presidential electors in four battleground states the president lost. It was the latest attempt in Mr. Trump’s increasingly desperate effort to change the outcome of the election.

Legal experts largely dismissed the lawsuit as a publicity stunt. And experts said that a statistical claim in the suit — that Mr. Biden’s chances of winning the four battleground states were “less than one in a quadrillion” — was “comical.”

The Supreme Court rejected the suit on Friday night, saying Texas lacked standing to pursue the case.

… Seriously

London man, 91, receives Covid-19 vaccination. Complains about “rather nasty lunch” and not being able to “damn well find anywhere to park.” The best interview of the week.

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