A Nigerian doctor's fight for equitable access to vaccines

This interview is part of our latest Special file Women and Leadership , which spotlights the women who are making significant contribut...

This interview is part of our latest Special file Women and Leadership, which spotlights the women who are making significant contributions to the great stories unfolding in the world today. The conversation has been edited and condensed.

Dr Ayoade Alakija, an infectious disease specialist based in Nigeria, is co-chair of the African Union Vaccine Distribution Alliance (AVDA). In December 2021, Dr. Alakija, nicknamed Yodi, was tasked with accelerating equitable access to Covid-19 tests, treatments and vaccines for the World Health Organization’s global initiative known as Access to the Covid-19 Tool Accelerator. It uses the term “global north” to describe high-income countries and “global south” to describe low- and middle-income countries.

Throughout the pandemic, you have criticized the inequality of vaccines, especially in Africa. How did you feel when WHO Director-General Dr Tedros Adhanom Ghebreyesus asked you to be the Special Envoy for the Access to Covid-19 Tools (ACT) Accelerator?

I had been one of the more critical voices during some of the ACT Accelerator rides. I had been the #1 agitator for vaccine inequity. So my first thought was, “Oh my God, they’re all going to hate me.”

It was a disruption of the status quo; a fox in the chicken coop. When Tedros called me to ask if I would, I said, “Do you have the right number?” And then I said, “Oh, no, no, no.” So he asked me to think about it, saying, “Your voice is needed, your leadership is needed.

I spoke to my husband, and he was like, “Yodi, you’ve been at the forefront of saying that those of us in the South need to be heard. They invited you to this table, you can’t say no.

Credit…Alaye M

What does your role consist of?

I operate 16-18 hours a day, advising governments, health ministers, finance ministers and ACT accelerator officials, coordinating with AVDA colleagues on vaccine shipments, deliveries and bottlenecks. I also undertake speaking engagements and media engagements to advocate for the issue of vaccine equity and equitable access to healthcare tools.

How to achieve equity in vaccines?

When we assign the same value to lives in the global south as to lives in the global north. We can only achieve this if we think it is not acceptable for people to die in Mombasa or Kibera from diseases that no longer exist in London or New York. When we value ourselves in the same way. Because right now there are those who say, “Oh, well, it’s not so bad in Africa. So maybe we don’t really need to vaccinate them. We don’t see intensive care units being completely overwhelmed. Well, that’s because there’s no intensive care. This is because there are no health centers. It’s because people are dying in silence.

You started your clinical career working with HIV and AIDS patients, then decided to pursue your Masters in Public Health in your early twenties. Did you encounter any obstacles at the start of your career?

When I applied to the London School of Hygiene and Tropical Medicine to study Public Health, I received a rejection letter saying “This course tends to be for very high level officials, ministers or permanent secretaries from different countries around the world. You are very young, so we do not accept you in this course.

I was outraged. My husband and I were living in London at the time, so I walked into the school and asked to see the Dean, who at the time was Richard Feachhem. I threw the letter on the desk and said, “What does this mean? This is what I want to do and I will not leave until I have done what I applied for. He sat in his chair and said, “I really can’t wait to see the day you rule the world.” He then directed me to someone in admissions.

You have expressed the need for more women in positions of power regarding the global response to Covid-19. How to achieve it?

It has slapped me so much during this pandemic, the fact that the world’s health leaders are men. A lot of women tend to be #2, so they don’t quite have the decision-making power, the voice.

I was at a conference in Rwanda, and there was a group of men who had invited themselves to this mentoring session that I was doing for young women. And they were standing right in front of the only table in the room. So I patted everyone on the shoulder and said, “Excuse me.” And they kind of looked at me and said dismissively, “Oh, yeah, hi.”

So I separated them and climbed onto a chair, then onto a table. The conference broke up. I took the microphone and said, “Here, this is what we’re talking about. That even if you pull up a chair and politely enter the conversation, they look at you like, ‘huh?’

So if they don’t give you a seat at the table, pull up a chair. And if they don’t make room, get on the table.

Do you think Covid has disproportionately affected the lives of women and girls, especially in Africa?

There is another silent pandemic going on here with child marriage – people selling off their daughters due to the economic impact of Covid. People can’t afford to feed their families, so it’s the girls who have to leave.

Even for vaccines, prioritization in communities means that if there are a few vaccines available in the country, and people are willing to go get them, the man will go get them. But the woman won’t.

How to get more vaccines in the arms?

It’s not as simple as hesitation. Hesitation is a function of trust—trust in systems, trust in governments. There must be a more regular, consistent and predictable supply of vaccines.

We also need to consider broader health systems strengthening. It has to be a component of our vaccine delivery and our preparation for the next outbreak or the next pandemic or just the preparation for life, really.

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Newsrust - US Top News: A Nigerian doctor's fight for equitable access to vaccines
A Nigerian doctor's fight for equitable access to vaccines
Newsrust - US Top News
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