Friday, August 12 2022

Dr Matshidiso Moeti is the doctor who heads the World Health Organization (WHO) Regional Office for Africa, a sprawling landmass of 47 countries. Here’s a look at the woman behind the stats – and the challenge she faces in dealing with an existential threat.

From poverty to public service

Dr. Moeti has poverty, inequality and progress layered into his life and career – as well as his bones and lineage. His father grew up in poverty in a township in apartheid South Africa, one of seven children. Her mother, a maid, managed to move the family to Johannesburg for education. He got a scholarship to medical school, where he met Moeti’s mother. Like his mother before him, he moved the family so his children could get a better education, this time to neighboring Botswana, where Moeti grew up and went to school. His parents dedicated their lives to health care and politics. Moeti trained as a doctor in London – then followed in their footsteps. Amazing rise of two generations – from slave to director of the WHO – fighting fiercely against racism, inequality, poverty – and pandemics. (His two daughters, one in development, the other in journalism, but both with degrees in economics, are fighting similar battles through different lenses).

Dr. Moeti understood the link between health and economics early on as a pediatrician in Botswana. “Most of the men left home to work in the mines in South Africa, which shattered family structures,” she recalls. “Children were fatherless, teenage pregnancies were common, and I learned firsthand of the direct health impact.” A few years later, she was on the front lines of the AIDS epidemic, leading the HIV program in Botswana, Africa’s worst-affected country. “It was painful and trying. South Africa’s economy is based on migrant labour. People are constantly on the move between South Africa and its neighbours. Mobility makes people and countries vulnerable to communicable diseases. Truckers are the main vectors of infection. Today, she notes, Covid is spreading in part because of the same mobility patterns. “People are moving more in emerging middle-income countries .” More … than half of the registered cases have been to just five countries – South Africa, Egypt, Algeria, Nigeria and Ghana.

Fighting pandemics (and inequalities) through prevention

“Today, Africa is at a turning point,” she says. The virus arrived later and was imported – from European visitors and Africans returning home in droves as their situation became untenable abroad. “Public health capacity is weak, but we closed early, which bought us time.” Trying to set up Tests, the best defense when you don’t have much offense, “was a nightmare,” she says. “The global market for testing supplies is entirely skewed.” And the economic realities of low-income countries, where many people live hand-to-mouth, and in crowded townships, make lockdowns impossible, or the push to reopen even less resilient than in rich countries. It also hits Africa new middle classes hard. “There is a lot of suffering”, she sighs, “I expect an increase. And we don’t have the resources. We can’t assume people can afford masks, so we may need to provide some. The highest priority is to treat early. “We don’t and won’t have ventilators.”

The real test, she says, is to help countries improve testing, tracing and isolation. If you cannot treat the disease, you must break the chain of transmission. “In middle-income countries, we have been successful in sourcing and coordinating purchases. We need to help people to help themselves, to go out and find cases rather than waiting for sick people to arrive. Communication plays a key role in a context where “many believe that we are not at risk, because it is hot here or because our populations are young. It’s just in China and Europe. We need to harness social media and craft a people-centered response targeting the most vulnerable. »

“Dr Moeti was a leading voice and one of the first voices we heard,” says Hannane Ferdjani, a journalist who presented a detailed, country-by-country review of the handling of the Covid crisis in Africa. in his podcast. Beyond the noise. “She played a particularly important role in speaking to African leaders, speaking the truth to governments and not biting her tongue,” says Ferdjani.

Of risk and connectivity

How do I wonder if Moeti continues to go against the intimidating tide that is approaching? “I’m encouraged by the positives,” she admits. “The continent is not overrun, as many predicted. The countries mobilized, the African Union mobilized, politically and practically. They coordinated money, connections and supply strategies – it’s not often we see this. I am inspired. At great expense, countries like Uganda, for example, have managed to reduce their numbers by investing in public health. Burkina Faso, a low-income country with a conflict crisis, has managed to contain large clusters with good interventions.

“At first we thought we were going to witness a massive disaster,” said Mo Ibrahim, a Sudanese businessman quoted in the newspaper. FinancialTimes. “The numbers so far don’t show that,” he says. “African governments have probably reacted better than governments in the UK or the US.

“Our priorities have been validated. We need to make sure the devastation everyone has been waiting for doesn’t happen. People have been incredibly willing to sacrifice,” Moeti says, recalling an Exodus-like scene in Brazzaville, Republic of Congo, where she lives and works. “It was biblical, public transport was banned and thousands of people marched – miles and miles of people.”

Going forward, she is aiming for bigger and more sustainable advances: universal health coverage, more nurses, labs and surveillance systems to be ready for future pandemics. Technology will help. The ability to connect between remote healthcare workers, groups and regions, the arrival of e-health initiatives and new ways of working. All of this, she knows, will expand access and improve monitoring and responses “for next time.”

In the meantime, she’s been working “crazy hours” and hasn’t seen a weekend in a long, long time. She admits she’s perplexed looking at the rich world, and The American threat abandonment of the WHO. These countries did not understand something that she learned very early. “We are all connected. Our thinking about risk needs to improve. Communicable diseases are moving everywhere. more vulnerable brunettes It’s not a matter of ideology, just pragmatism.

Like Dr Gro Harlem Brundtland, former Prime Minister of Norway and former head of the WHO, as well as recent co-chair of the Global Pandemic Preparedness Council, said recently: “We have to work together. No one is safe until everyone is safe. Global cooperation is the only option. We must do better for all of us.

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