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Fighting a Pandemic, While Launching Africa’s Health Revolution

When Dr. John Nkengasong took the job as the first head of Africa’s new Centers for Disease Control in 2017, part of the continent had just …

Fighting a Pandemic, While Launching Africa’s Health Revolution

When Dr. John Nkengasong took the job as the first head of Africa’s new Centers for Disease Control in 2017, part of the continent had just emerged from a devastating Ebola outbreak. Less than three years later, Covid-19 hit.

Dr. Nkengasong is now trying to bring together the governments of a vast, diverse continent to anticipate and fight public health threats and make them less reliant on international institutions like the World Health Organization or the Red Cross. He has helped Africa speak with a unified voice, particularly about what he calls “vaccine famine,” with rich countries buying up millions of doses they do not need while Africa goes wanting.

Perhaps Ebola was a signal that something bigger was looming, he says, and that something turned out to be Covid-19. He also thinks Covid-19 could be a harbinger of something worse to come: a virus as contagious as the Delta variant but with the high fatality rate of Ebola.

The Africa C.D.C. was started in response to the Ebola outbreak, with funding from the African Union and some other donors. When Dr. Nkengasong arrived, for months there was no office, no staff and even at one point no internet; the Ethiopian government had shut it down to prevent people from cheating on university entrance exams.

But, he says: “We can do public health under the tree. It doesn’t really matter. The thing is the concepts. Are you committed to solving problems of inequity and health security?”

(This conversation was edited and condensed for clarity.)

What was it like when Covid-19 first hit the continent?

In December 2019 I was on leave, and we started hearing stories on the virus in Wuhan. I called Addis Ababa and said, “Activate our Emergency Operations Center.” I got initial pushback from my own staff. They said, “Well, this thing is happening far-off. We have Ebola going on in North Kivu.” They said, “We already are too busy.” I said, “Please, just do it, because I know that this will come.”

The continent started off well. We’d positioned ourselves. We scrambled. We trained people. It will sound ridiculous, but at the first trainings we did in South Africa and Senegal, everybody went home with a pack of 100 tests.

How are things going now? And how do you see the virus’s future trajectory in Africa?

Graves for Covid-19 victims in a Muslim cemetery in Lenasia, South Africa, in January.Credit…Bram Janssen/Associated Press

An emergency is where your house is on fire. You run around, you call 911, they come sprinkle water. That phase is over. We are now in a phase where your house is burned down. How to build a new house?

I think this virus is winning. As a continent, we are not winning. Today we have more than seven million cases with close to 180,000 deaths. And the death rates are all increasing very dramatically across the continent. Vaccination rates are very, very low. We are around 2.5 percent of the population vaccinated fully, and this is a continent of 1.2 billion people.

What about vaccines for African countries? Is Covax — the alliance backed by the United Nations — coming through as promised?

The story of access to vaccines and the role Covax was supposed to play is what I call a moral tragedy.

The intent and the design was perfect, excellent, but the execution — even the people running Covax will admit that it has not delivered on its promise.

Those countries that are funding Covax, or pledged funding, were developed countries. So they pledged. I’m not sure that they necessarily gave money. But then, they bought the vaccines, all the vaccines. So even with the money that Covax had, there was nowhere to get vaccines from.

We are not saying, donate to us. Don’t give us the vaccines. We’re just saying, let Africa come forward with their 400 million doses of vaccines — that they have paid for! By just swapping the order in which we are in the queue for vaccine delivery, I think you can begin to solve a lot of the problems.

What is the condition of Africa’s public health infrastructure?

Conducting Covid-19 research at the University Clinical Research Center in Bamako, Mali, last year.Credit…Michele Cattani/Agence France-Presse — Getty Images

Governments have not invested enough in their own public health needs.

The whole architecture — public health architecture and health security architecture — has been designed, since the Second World War, in such a way that they created a lot of dependency, Africa on the outside world.

Africa has about three million health care workers. That is almost nothing. So you clearly see the negligence. And our health security architecture was designed when the population of Africa was less than 300 million. Today, where are we? We are 1.2 billion people, aspiring to get to 2.5 or 2.4 billion in the next 30 years.

No people will survive with importing 99 percent of their vaccines and importing 100 percent of their diagnostics. It doesn’t make sense. We need 6,000 epidemiologists. We currently have only about 1,900 on the continent.

Are people hesitant to get vaccinated?

It still has to be a battle that is won or lost at the community level. Misinformation continues to be a serious issue.

However, when I look at the trends, what is happening on the continent, I’m very encouraged. I was in Morocco, and at the Tangier sports stadium you had long lines of young people. When I approached them, I thought there was a soccer match going on, but it was people registering online to get the vaccine. We’ve seen similar scenarios in Kigali, in Nairobi.

So vaccine hesitancy is no longer the issue. Vaccine famine is the real challenge now, not vaccine hesitancy.

What is your goal for vaccinations in Africa by the end of 2021?

A Kenyan woman receiving a Covid-19 vaccination in Nairobi last month.Credit…Brian Inganga/Associated Press

It was to get to at least 25 to 30 percent by the end of the year. But that would be dependent on many factors. Are countries that have secured vaccines ready to release those vaccines?

At the pace we are doing it, we are very deliberately moving toward endemicity of this virus on the continent, no doubt about that. Now it’s concentrated in big cities, but it will soon spread into remote areas, and it becomes very, very difficult to flush out.

You worked for the U.S. Centers for Disease Control for many years. What was it like moving back to Africa?

I grew up in Cameroon. You leave and you think you’ll go back, and then life carries you on from one part of the world to another and you just keep going.

I remember when I took the job, my colleagues said, “John, maybe you’re going through a midlife crisis? Why would you leave Atlanta and leave your job, and go and start something that you really don’t know?” But it was in me that I had to do that.

For almost a year, I didn’t have an office. I had a big name of a director, but there was no place to sit and work.

Has it been easy? Not at all.

The moment you say you have a C.D.C., the expectations are very high. Especially borrowing a name from a renowned C.D.C. like the U.S. C.D.C. put a lot of pressure and expectation on our shoulders very, very early on.

Does public health in Africa need to be decolonized?

Shirley Chisholm said that if they do not give you a chair around the table, go there with a folded chair. Don’t ask for permission to do what is your right.

Imagine, the first conference on public health in Africa will be organized by Africa C.D.C. at the end of this year.

Why is that important? It provides a platform for African public health experts to interact, share experiences, learn from each other.

Second, is that we invest in our own schools of public health and believe in our own schools of public health.

Learning a lesson is what Africa is currently doing; we don’t have vaccines, we have to produce vaccines.

If we continue on this journey driven by a new public health order, when the next pandemic hits, we’ll be fighting it very, very differently.

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100 mg fiyatcialis 5 mg fiyatviagra 100 mg fiyatcialis 5 mg fiyatcialis fiyat eczanepostegropostegrocinsel hastalıklarereksiyon sorunuacarkent escortbahariye escortcialis 20 mgcialis 100 mgcialis 5 mgcialis fiyatcialiscialis fiyatlarıviagra fiyatviagra siparişcialis satışcialis siparişviagra fiyatlarıkartal escortbedava bonus veren bahis siteleribahisgaziantep escortviagraviagra fiyatpostegropostegropostegroDubai escortsDubai escortsLondon escortsfree instagram followersMarmaris Escortpendik escortkartal escortkurtkoy escorttuzla escorthalkalı escortbayrampaşa escortbaşakşehir escortbahçelievler escortbağcılar escortbahçeşehir escortkadın giyimfantezi babydollfantezi çorapfantezi giyimKadın üst giyimkadın alt giyimkadın ayakkabıkadın atletbluz bodybot bootiekadın ceketkadın çizmekadın elbiseelbise abiyekadın eşofman altıkadın eşofman takımıAnkara escort bayanturgutreis escortpostegroweb postegroweb postegropostegroizmit escortistanbul escortkaynarca escortviagra 100 mg fiyatviagra 100 mg fiyatgaziantep escort bayanGüvenilir bahis SiteleriBalgat escortÇankaya escortCebeci escortDemetevler escortDikmen escortEryaman escortEsat escortEtlik escortKeçiören escortKızılay escortKolej escortRus escortSincan escortYenimahalle escortAtaşehir escortanadolu yakası escortAnadolu yakası escortAtaşehir escortAtaşehir escortKadıköy escortKadıköy escortÜmraniye escortÜmraniye escortBostancı escortBostancı escortbostancı escortpostegroadana escortadana escort bayanafyon escortacarkent escortacibadem escortadalar escortafyon escortalanya escort bayanalanya escortantalya escort bayanantalya escortartvin escortartvin escortbeylikdüzü escortbeylikdüzü escortbeylikdüzü escortbeylikdüzü escortbodrum escortbolu escortbolu escortburdur escortbursa escortbursa escortçanakkale escortçanakkale escortçeşme escortdidim escortdiyarbakır escortdiyarbakır escortedirne escortedirne escortelazığ escortelazığ escorterzincan escorterzincan escorterzurum escorterzurum escortbodrum escortbursa escortbursa escorteskişehir escorteskişehir escortgaziantep escortgaziantep escortgaziantep escortgiresun escortgiresun escortgümüşhane escorthatay escorthatay escortısparta escortısparta escortkars escortkastamonu escortkastamonu escortkayseri escortkayseri escortkıbrıs escortkıbrıs escortkonya escortkonya escortkuşadası escortkütahya escortkütahya escortmalatya escortmalatya escortmanisa escortmanisa escortmardin escortmardin escortmarmaris escortmersin escortnevşehir escortnevşehir escortniğde escortniğde escortordu escortordu escortrize escortrize escortsakarya escortsakarya escortsamsun escortsamsun escortşanlıurfa escortşanlıurfa escortsinop escortsinop escortsivas escortsivas escorttekirdağ escorttekirdağ escorttrabzon escorttrabzon escortuşak escortvan escortvan escortyalova escortyalova escortyozgat escortyozgat escortzonguldak escortzonguldak escortCoinbar girişSafirbet girişcratosslot girişAsyabahis girişTempobet girişMarsbahis girişBetebet girişVdcasino girişVevobahis girişBetper girişimajbet girişHoliganbet girişJojobet girişAnadolucasino girişArtemisbet girişbelugabahis girişbetvole girişinterbahis girişmilanobet girişZeytinburnu EscortYeşilköy EscortYenibosna EscortÜmraniye EscortTopkapı EscortTaksim EscortSuadiye EscortSınırsız EscortŞişman EscortŞişli EscortŞirinevler EscortSilivri EscortPendik EscortOrtaköy EscortOlgun EscortNişantaşı EscortMerter EscortMecidiyeköy EscortMaslak EscortMaltepe EscortMahmutbey EscortLevent EscortKurtköy EscortKüçükyalı EscortKüçükçekmece EscortKartal EscortKağıthane EscortKadıköy Escortİstanbul Escortİkitelli EscortHaramidere EscortHalkalı EscortGöztepe EscortGenç EscortFlorya EscortFındıkzade EscortFatih EscortEtiler EscortEsenyurt EscortEscort NumaralarıEscort BayanlarErenköy EscortElit Escortçekmeköy escortÇıtır Escortşerifali escortCihangir Escortümraniye escortüsküdar escortCevizli EscortCennet Mahallesi Escortsuadiye escortÇapa Escortkadıköy escortÇağlayan Escortgöztepe escortBüyükçekmece Escortbostancı escortgöztepe escortBostancı EscortBeyoğlu Escortsuadiye escorterenköy escortbostancı escortanadolu yakası escortavrupa yakası escortBeylikdüzü EscortBeşiktaş Escortanadolu yakası escortBayrampaşa EscortBaşakşehir Escortümraniye escortBakırköy Escortkadıköy escortBahçelievler Escortbostancı escortBağdat Caddesi Escortataşehir escortBağcılar Escortcevizli escortatalar escortmaltepe escortAvrupa Yakası Escortkartal escortmaltepe escortAvcılar EscortAtaşehir Escortümraniye escortsupertotobetrestbet girisbetpas girisbetbabayurtdisiaugenoperationbotox bruisinghepsibahisrexbetsuperbetinbetsatbets10romabettarafbetbetparkhilbetonbahisbahsegelbahigowinxbetelitbahisdinamobetbetmatiktimebetgebze escortleopard honeyAnkara escortUlus escortTunalı escortTandoğan escortSıhhiye escortRus escortMamak escortMamak escortGölbaşı escortCinsel sağlık ürünleriCinsel performans ilaçlarıCialis fiyatCialis 20 mg fiyatCialis 100 mg fiyatCialis 30 lu tablet fiyatViagra fiyatViagra 100 mg fiyatViagra 30 lu fiyatViagra 4 lü tablet fiyatıVega 100 mgVega 100 mg fiyatVega 100 mg eczaneKamagra jelKamagra Jel fiyatKamagra jel eczaneSertleştirici haplarGeciktirici ürünlercialiscinsel sağlık ürünleribayan azdırıcı fiyatkadın azdırıcı damlasertleştirici ilaçlarcialis fiyatviagra fiyatpenis büyütücükamagra jelgeciktirici spreycialis 20 mgcialis 100 mgviagra 30 luen iyi penis sertleştirici ilaçsertleştirici haplarelazığ escort bayanhasta yataklarıkent switch fiyatmarlboro shuffleparliament aqua bluemarlboro double fusionmarlboro shufflekent switchdjarum blackdjarum blackAnadolu yakası escortAtaşehir escortBostancı escortErenköy Escortavrupa yakası escortAtaköy EscortAvcılar EscortBahçeşehir Escortözel escortlaranal escortçıtır escortelit escortAnadolu Yakası escortAtaşehir escortbağdat caddesi escortBostancı escortGöztepe Escortİstanbul EscortKadıköy EscortKartal EscortKurtköy EscortMaltepe EscortPendik EscortŞerifali EscortTuzla EscortÜmraniye escortÜsküdar EscortAnadolu Yakası EscortAtaşehir escortBostancı EscortGöztepe EscortAvrupa Yakası EscortAksaray escortAtaköy EscortAvcılar Escortİstanbul EscortAtaşehir Elit EscortAtaşehir Esmer EscortAtaşehir Genç EscortAtaşehir Olgun EscortAtaşehir Sarışın EscortAtaşehir Şişman EscortAtaşehir Sınırsız EscortAtaşehir Ucuz EscortAtaşehir Yabancı EscortAteşehir Escort BayanBağdat Caddesi EscortBağdat Caddesi Olgun EscortBağdat Caddesi Sarışın EscortBağdat Caddesi Şişman EscortBağdat Caddesi Ucuz EscortBağdat Caddesi Yabancı EscortBostancı Elit EscortBostancı Çıtır EscortBostancı EscortBostancı Esmer EscortBostancı Olgun EscortBostancı Sarışın EscortBostancı Yabancı EscortGöztepe EscortGöztepe Genç EscortGöztepe Olgun EscortGöztepe Şişman EscortGöztepe Sınırsız EscortGöztepe Ucuz EscortKadıköy Anal EscortKadıköy Elit EscortKadıköy EscortKadıköy Eskort BayanlarKadıköy Genç EscortKadıköy Yabancı EscortKartal Çıtır EscortKartal EscortKartal Eskort BayanlarKartal Esmer EscortKartal Sarışın EscortKartal Sınırsız EscortKartal Ucuz EscortKaynarca EscortKaynarca Genç EscortKaynarca Olgun EscortKaynarca Şişman EscortKurtköy EscortKurtköy Escort BayanKurtköy Ucuz EscortKurtköy Yabancı Escort BayanMaltepe Anal EscortMaltepe EscortMaltepe Genç EscortMaltepe Olgun EscortMaltepe Şişman EscortPendik EskortPendik Eskort BayanlarPendik Sarışın EscortPendik Şişman EscortPendik Sınırsız EscortPendik Ucuz EscortTuzla Anal EscortTuzla Elit EscortTuzla EscortTuzla Yabancı EscortÜmraniye EscortÜmraniye Masöz EscortÜmraniye Olgun EscortÜmraniye Ucuz Escortepoksi zeminepoksi zemin kaplamaepoksi yol çizgisişişli escortAcıbadem Escortİçerenköy EscortKozyatağı EscortKüçükyalı EscortKadıköy EscortKartal EscortMaltepe EscortPendik EscortKurtköy EscortŞerifali EscortAnadolu Yakası EscortKadıköy EscortAtaşehir EscortBostancı EscortAtaşehir EscortKadıköy EscortKurtköy EscortAnadolu Yakası EscortAnadolu Yakası EscortAtaşehir EscortBostancı EscortKadıköy EscortAnadolu Yakası EscortKadıköy EscortAtaşehir EscortBostancı EscortMaltepe EscortGöztepe EscortPendik EscortErenköy EscortGöztepe EscortSuadiye EscortGöztepe EscortMaltepe EscortŞerifali EscortKartal EscortKurtköy EscortPendik EscortKurtköy EscortPendik EscortAnadolu Yakası EscortKartal EscortMaltepe EscortAnadolu Yakası EscortKartal Escort BayanKurtköy Escort BayanMaltepe Escort BayanPendik Escort BayanAnadolu Yakası EscortKartal EscortKurtköy EscortMaltepe EscortPendik EscortTuzla EscortKurtköy EscortPendik EscortTuzla EscortAnadolu Yakası EscortMaltepe EscortKartal EscortBostancı EscortÜmraniye EscortAnadolu Yakası EscortKadıköy EscortAtaşehir EscortTuzla EscortGebze EscortAydınlı EscortMutlukent EscortPendik EscortAnadolu Yakası EscortKurtköy EscortÜmraniye EscortBostancı EscortKartal Escort BayanPendik Escort BayanKurtköy Escort BayanMaltepe EscortAnadolu Yakası EscortBostancı EscortKartal EscortMaltepe EscortÜmraniye Escortbağdat caddesi escortgöztepe escortistanbul escortkartal escortkurtköy escortmaltepe escortpendik escorttuzla escortüsküdar escortataköy escortavcılar escort bayanavrupa yakası escortbahçeşehir escortbakırköy escortbeşiktaş escortbeylikdüzü escorterenköy escortetiler escortgöztepe escortikitelli escortkartal escortkurtköy escortmaltepe escortmecidiyeköy escortpendik escortşirinevler escortşişli escortsoğanlık escortataşehir escortkaynarca escortümraniye escortgebze escorttuzla escortavrupa yakası escortavrupa yakası escortavrupa yakası escortavrupa yakası escortavrupa yakası escortavrupa yakası escortavrupa yakası escortavrupa yakası escortavrupa yakası escortatalar escortcevizli escortescort bayanmaltepe escortbeylikdüzü escortavcılar escortesenyurt escortbahçeşehir escortşirinevler escortataköy escortbeylikduzuescortev.comescort beylikdüzüWhatsapp aerobeylikdüzü eskortbahariye escortmoda escortsex hikayeleriadana escortadıyaman escortafyon escortağrı escortaksaray escortamasya escortankara escortantalya escortantep escortardahan escortartvin escortaydın escortbalıkesir escortbartın escortbatman escortbayburt 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escortvega 100 mg hapseofuck googledolandırıcı hesap satışıviagrabacklink almetin2 pvppvp metin2metin2emek serveradana escortadana escortanadolu yakasi escortpendik escortistanbul escort