Global health's ‘power couple’ documents Nigeria CDC's coming of age

A new book on the Nigeria Centre for Disease Control and Prevention illustrates the blood, sweat, and tears that go into the building of a global health institution. The married couple Vivianne and Chikwe Ihekweazu who authored “An Imperfect Storm: A Pandemic and the Coming of Age of a Nigerian Institution” joined Devex Editor-in-Chief Raj Kumar for a Devex event on the sidelines of the United Nations General Assembly this week in New York City. Kumar called them “global health’s power couple.” Chikwe is the assistant director-general at the World Health Organization, but previously served as the inaugural director-general of Nigeria CDC. Vivianne is the managing director of Nigeria Health Watch, a nonprofit which advocates for better health for Nigerians. Nigeria CDC was built from the ground up. Under Chikwe’s leadership they created the first national reference lab and a lab network across the country, recruited staff, and set up and digitized a disease surveillance infrastructure. In this work, it was difficult to find funding for overhead costs. “The one thing that it's very hard to get money for is to build institutions. Everybody wants to fund you to deliver vaccines, put people on [antiretroviral therapy],” he said. “How to build the [human resource] infrastructure, the people, the financing, the management. No one wants to fund that business. So, it was a hard grind.” That hard grind required a lot of leadership time. “When you are leading an organization in a country like ours, you are mother, father, teacher, philosopher, psychologist, and in your spare time, you actually lead the organization,” Chikwe said. A few years ago, the young institution was hit with its hardest test to date: The unraveling COVID-19 pandemic. “We ended up, in 2020, responding to an outbreak and coming out of it with our dignity intact,” he said. “This book, ultimately, is a positive story of what is possible in a country.” But it was not without challenges — at the beginning of the pandemic, there were 200 intensive care beds in the public sector for a country of some 200 million, he said. “I feel what we did in this book is really curate stories of incredible Nigerians that did a lot,” Chikwe said. The pandemic was also a wake-up call for the country’s political leaders who had never really been dependent on the Nigerian health system — and could previously travel abroad for their health care needs, Vivianne said. “But suddenly, with borders shut, there was no going anywhere,” she said. “I think somehow, health has been slightly elevated in Nigeria. It's given a lot more priority, but not as much as we want it to.” The private sector around health has also really evolved in Nigeria in the wake of the pandemic, with a lot of Nigerian doctors in diaspora coming back and setting up high-end hospitals, Chikwe said. But this still doesn’t solve population-level access issues for health care. “To me, the biggest lesson is we have to keep building. We can't sit back and celebrate our success,” he said.