The Africa director for the World Health Organisation is in demand as the continent ripostes against the global pandemic affecting the developed and developing world.
It is one of those rare mornings in Brazzaville when Doctor Matshidiso Moeti doesn’t have a full roster of meetings with international public health officials or is rushing for a plane headed for an African capital. For, as the Africa regional director of the World Health Organisation (WHO), Moeti has been focused almost entirely on the continent’s response to the coronavirus pandemic since February.
Launching the teleconference with some expertise, Moeti explains that she has become a veteran of “Zoom diplomacy”. As we poured our respective coffees in Brazzaville and Paris, she described how, as the pandemic ricocheted across the world, the WHO moved into areas way beyond its public health mandate, demanding her round-the-clock attention on diplomatic and economic, as well as medical, matters.
Health and diplomacy
“We know that health is a vital aspect of diplomacy. The impact of the COVID-19 pandemic goes far beyond health. Economies have been devastated and life as we know it has been upturned.”
Unlike most of the rest of the world, Moeti and the top officials of the WHO have maintained their airborne commuting across the globe as they advise and coordinate with governments struggling to shape medical and organisational responses to the crisis.
“Finding solutions involves delicate regional and international diplomacy and negotiations not just to tackle the health crisis but to revive livelihoods and economies without jeopardising people’s health.”
Moeti’s core aim before the pandemic was to push through the WHO’s universal health coverage support across Africa – a bold plan to upgrade primary health care even in the most remote locations, but also to harness the latest innovations in digital medicine.
Well before Africa was battling with the coronavirus pandemic, Moeti and her team were working on a pan-African programme to reduce response times for public health emergencies. After West Africa and Central Africa were hit by an Ebola epidemic, WHO officials worked with governments to cut the time it takes to bring an outbreak under control from 418 days in 2016 to 51 days by 2018.
Quicker to react
To some extent, those measures helped the region move more quickly when COVID-19 struck. Along with Asia, most African countries acted faster with lockdowns, travel restrictions and social distancing than their counterparts in Europe and the Americas.
Besides the economic price of what she regards as “absolutely necessary preventative public-health-driven policies,” Moeti’s main worry is the undermining of the continent’s other health priorities. That shift was made clear with a warning from the Gates Foundation that increases in global coverage of children for all vaccines were at risk from a diversion of resources to fight the pandemic.
“COVID-19 has caused disruptions to health services, in part because resources have been repurposed,” says Moeti, “and also because of fears in the community that, in seeking healthcare, people might get infected.”
After the pandemic’s first wave in Africa, there is now a wide-ranging campaign to re-establish critical public health services. Teams of WHO advisers are working with governments to provide technical guidance, running information campaigns, “ensuring that children who missed their doses can catch up rapidly, as well as responding to outbreaks of measles, cholera and other diseases by mass vaccination campaigns, with precautions to keep vaccinators and communities safe.”
Although some medical authorities have seen the pandemic as an aberration, Moeti takes a more holistic view, explaining how the most successful approaches to this year’s crisis have borrowed heavily from previous public health emergencies. Before she joined the WHO, she worked as UNAIDS team leader for Africa and the Middle East at the height of the HIV/AIDS epidemic, which required both an aggressive public information campaign and finding resources to extend access to anti-retroviral therapy.
Those lessons are playing out now: “There is a lot we can do now to suppress transmission of COVID-19 and protect vulnerable groups. The speed of research and development this year means that we are also learning more every day and applying new technologies and tools to strengthen the response.”
There is no doubt that those responses, drawing on experience from recent epidemics in the region, have helped contain the pandemic there. Africa has just over 1.1 billion people, or 17% of the world’s population, and the death toll there has been about 35,000, or about 3.5% of the global figure.
But those figures – and how far they are based on good policy or due to climatic, demographic and environmental conditions – should give no grounds for complacency. Moeti relentlessly repeats the WHO mantras about social distancing and the need for comprehensive testing regimes.
Wake-up call for policymakers?
She does harbour some optimism that the pandemic will be a wake-up call for policymakers and public-health professionals. Already, she says that high-level discussions have started about international health regulations, the relationship between the WHO and member states and the limits of the WHO’s authority.
“And it’s those matters that need to be considered if we put in place an organisation that is going to be the custodian of these rules. It needs to have some level of space and authority to take action, and to make sure that we mutually support each other.”
These are issues that Moeti clearly feels strongly about after a life on the frontlines of public health. “My parents were both medical doctors. My father worked on smallpox eradication and my mother pioneered maternal and child healthcare in Botswana.”
When her mother was appointed as Botswana’s delegate to the World Health Assembly in Switzerland “she encouraged me to skip classes for a week and come to Geneva. This was my first time to see global health work in action and I was inspired that I might play a role in this collaboration.”
Apart from the joys of family, Moeti finds respite in the jazz greats: “I love listening to Miles Davis, Sarah Vaughan, Nina Simone – and unwind by dancing or cycling.”
Above all, what keeps her in this frontline role during the pandemic is “learning of the fortitude of individuals, and the young people who are creating and innovating to make a difference in Africa and globally.”