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Into Africa
Dr. Chikwe Ihekweazu, Executive Director, WHO Health Emergencies Programme: Ebola outbreak in Ituri, Congo "a perfect storm."
00:41:27
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- [00:00]
Oge Onabogu
What happens when a deadly Ebola outbreak collides with conflict, distrust and humanitarian crisis? As eastern Democratic Republic of Congo battles one of the most challenging Ebola outbreaks in its history, the response has required far more than vaccines, treatment centers, and emergency funding. Health workers have had to navigate insecurity, misinformation, and deep community skepticism, or all while racing to slow the spread of a rapidly growing epidemic. Welcome to Into Africa, a podcast where we explore Africa's geopolitical landscape, its evolving global role, and the challenges and opportunities shaping the continent's future. I'm your host, Oge Onabogu, Senior Fellow and Director of the Africa Program at the center for Strategic and International Studies. Welcome to Into Africa. I'm your host, Oge Onobogu. This week we're featuring an episode from the Common Health podcast hosted by CSIS Senior Vice President and Director of the Global Health Policy Center, Stephen Morrison, whom we've previously featured on Into Africa. Steve is joined by Dr. Chikwe Ihekwazu, Executive Director of the World Health Organization's Health Emergencies Program, former founding head of the Pandemic and Epidemic Intelligence Hub in Berlin, and the first Director General of the Nigeria center for Disease Control. Dr. Ehekwazu recently spent several weeks in Eastern Congo, at the epicenter of the Ebola outbreak. Together, they explore a critical question. Why is trust often the most important tool in fighting an epidemic? They discuss the realities of responding to the Ebola outbreak in a fragile region, the challenges of coordinating across multiple organizations in an increasingly complex humanitarian landscape, and while rebuilding confidence within affected communities is often the key to saving lives. Enjoy the conversation.
- [02:20]
Stephen Morrison
I'm delighted today to be joined by Dr. Chikwe Ihekwazu. Welcome, Chikwe, and thank you so much for making time to be with us.
- [02:28]
Dr. Chikwe Ihekwazu
Thanks, Steve. Real pleasure to be with you.
- [02:31]
Stephen Morrison
Dr. Chikwe Ihekwazu is the Executive Director of the World Health Organization Health Emergencies Program based out of Geneva. Prior to that, he served as the first Director General of the Nigeria center for disease control. Between 2016 and 2021, he's held positions in South Africa, in the UK in Germany, he studied infectious disease epidemiology. He's a graduate of the College of Medicine, University of Nigeria, has a Master's of Public Health from Heinrich Heine University in Dusseldorf, Germany. Thank you so much. Chique. Let's first touch a bit on your own personal story. How did you find yourself diving in in this way? This is a super impressive and very distinguished progression, but. But it's not there's. No preordained pathway. And you have found yourself in many different places at different times along that path. Say a bit about that.
- [03:28]
Dr. Chikwe Ihekwazu
Yeah, Steve, thanks. And none of this is by design. You know, I studied medicine like most of us, to pursue a clinical career and that was the dream of a young medical student. And you know, Faith took me out to Germany. I did a master's in public health. And when you, when you finish your master's, you send your CV to, I don't know what I sent it to, maybe 30 job interviews, job opportunities I found out there. I was lucky to get my very first job in public health was at the Robert Koch Institute at the National Public Health Agency in Germany. It was just at the beginning of the SARS outbreak, the first SARS outbreak. And I was then part of that initial response. So I, I was fascinated by this area of infectious disease epidemiology. I kind of stuck with it. So literally for the last, what odd, 25, 26 years I've been doing more or less the same thing in different places at different levels, but it's always been around, you know, preventing infectious diseases, finding them, responding to them, and done that for 10 years in the kind of so called global north in Germany and the UK, another kind of 10 years between South Africa and Nigeria and the last five years here in WHO. But I've been lucky to kind of fundamentally do the same things in different settings and grown in that field and yeah, couldn't imagine myself doing anything else right now.
- [04:57]
Stephen Morrison
Thank you. Now, you recently spent several weeks in eastern Congo, in Ituri. I think you were also in Kinshasa in that period. The, this was early on in the outbreak of Ebola, centered within Ituri province. The big message, we're now approximately six weeks into this outbreak. The narrative in the initial phase was very late discovery and identification. This is believed started a new strain emerging probably in January, February timeframe. The view was that this had raced out in front of the response and gotten an unusual lead time. And so the race was on to catch up. There were great gaps, great uncertainties, lots of fear and anxiety. Now we're at the six week point. Things are slightly different here. We've seen significant progress. WHO has been in the lead at the very center of understanding and mobilizing and planning. You've partnered very closely with Africa cdc. There's still serious gaps, but there's nonetheless been some significant progress in this last phase. So could you describe for us just quickly for our audience, what's the status? What's the state of play right now across those different dimensions of testing and lab systems, of isolation and treatment, of safe and dignified burial, development of countermeasures, mobilizing, financing. You're in the thick of all of this. What can you tell our listeners in terms of where we are today?
- [06:36]
Dr. Chikwe Ihekwazu
Yeah, thanks, Steve. I think you set the scene very well. You know, this outbreak was ahead of the country by the time it was detected. So we. We had to play catch up. And in a way, we. We are still playing catch up. You know, the. The Eastern DRC context is very important with this outbreak. The Eastern DRC is almost the. The perfect storm for this to happen. You know, it's a. It's a combination of context. Firstly, some of the towns like Bunya, where really the heart of the outbreak is actually a very vibrant commercial town with trading, commerce, lots of activities. But, you know, the rest of the province, there's some really insecure areas where you have various armed gangs that control parts of it, large IDP camps in parts of it. Access is very challenging. So very poor roads from one to the other. So. And there's a huge, you know, flying. I remember landing into Bunia and just seeing the space, you know, the thick green forest and then landing into the city. So the context is very important in this. And so we got there and, you know, literally saw that there's so many people infected at the time six weeks ago, we just didn't have the capacity to provide the care required. And yet we wanted the patients to come into care. So they came into care facilities that were not ready for them. And so they were upset about the facilities and the ability to provide safe burials. And this immediately led to some tension between people infected, their communities, and the care providers. So what we have done over the last six weeks, I can summarize it in this simple phase. We've been building confidence in the response across all the areas you've mentioned. If we take providing clinical care, which is the most important for at least the patient, we now have from literally zero to over 700 beds available specifically for patients of Ebola suspected or confirmed, and we're looking to scale that up to another 300 over the next week. From zero labs six weeks ago, we have labs in 10, 10 different single, autonomously functioning labs in the area from safer burial teams that were attacked by the community because they basically couldn't provide the safe and dignified burials that we offer patients. We've turned that around with our partners, all of this, I say with partners, and are now able to have a call system where if an individual unfortunately passes away, either in the community or in a care facility, there's a centralized number they can call, a team goes out, assesses the situation, and an ambulance or hearse or whatever we have available, we train people, can go out there, communicate with the community, offer them the opportunity of a safe and dignified burial. So across all the pillars of the response, what has happened in the last few weeks is scaling. But Steve, you know, like I said, we were behind the curve from the very beginning. So what the message was that as we look harder for more cases, we will find more because the communities are sensitized, the clinicians are sensitized, we have more testing going on. So we predicted exactly what is happening now, that the outbreak will get seem to get worse before it gets better. Because we are looking harder, there's more confidence in the response. So the numbers are increasing. But I think a lot of that increase is just that. We are now finding many more of the cases in the committee that we would have done previously. But we are nowhere close to the point where we can say we're on top of this. We have to be very humble with ourselves and respond and say, listen, we're playing catch up. We're closer to the target than we were six weeks ago, but we're nowhere yet where we want to be. That we can say with confidence that we are pushing the curve downwards. But I'm confident we will get there.
- [10:53]
Stephen Morrison
You've chosen to join forces with Africa cdc, trying to have a unitary approach in terms of a single plan, having a unified incident management mechanism. Tell us a bit about the mobilization of financing. You've had a couple of heads of state summits, you've had a couple of. You got a big boost in the Support from the G7 summit. How are things going in pursuing such a unified approach? The US Is outside of this. We'll talk about that. I understand that, but you're pressing ahead. We'll talk in a moment about what the US Is doing and how that operates in tandem or parallel or separate from what's happening here. But tell us you made this conscious decision to team up and pursue this approach. Explain a bit.
- [11:43]
Oge Onabogu
Yeah.
- [11:43]
Dr. Chikwe Ihekwazu
You know, Steve, the concept of having a regional center for disease control that understands a region and has the legitimacy of the mandate given to it by its member states to respond, to, support the response and build the solidarity within that region is very important. You know, early in my career, I was in Europe when the European CDC was formed, and that was turbulent in the beginning as well, but eventually has grown from strength to strength and is now kind of well recognized in the ecosystem in Europe. And it's the same thing happening on the continent, on the African continent. You know, a few years ago the countries on the continent said, listen you, there are peculiar circumstances in the Africa region that requires us to have an institution that understands the region and is able to mobilize resources and expertise within the region, that works with WHO on the global level and addresses the challenges that confront the people living across the African region. So we have seen this institution grow from strength to strength. We are proud as WHO of the growth of Africa cdc. So we've decided to be very inclusive, collaborative and supportive of their very strong mandate that they have and have then decided in this outbreak. And it's not the first time. We did the same thing for the MPOX outbreak a few, about a year ago, a bit more and say listen, let's work together rather than support. Because listen, this outbreak primarily is a DRC led response. So most of the cases are in the DRC and the country is leading the response. But rather than ask the country to absorb support from who, absorb support from Africa's cdc, we say listen, let's make it easier for the country and therefore pool both the practical support we're offering and giving every day in the outbreak affected areas as well as the resources being mobilized, the work with the research organization delivering on trial clinical trials for the medical countermeasures. Just today we started the first clinical trial for post exposure prophylaxis options in the grc. So we found that working together is easier for the country, easier for us, and is generally more efficient for everyone. So no doubt there will always be teething problems when you come together to do something like this. But you know, I think that's the right way to go. And we're happy we're working together and hopefully we can all derive some benefits both in effectiveness and efficiency in responding to this outbreak that confronts the Democratic Republic of the Congo.
- [14:32]
Stephen Morrison
This must be a delicate and difficult issue for the government of drc. It is their country. There's the sovereign, sovereign consideration. But you also have the reality that much of the Kivu is under the control of M23, a sort of proxy for Rwanda. And then you have Kodeco and 80 Allied Democratic Forces in Ituri and North Kivu and a countless number of other militias with cross border supply chains and tied in with illicit mining, gold, timber, critical minerals and the like. The government of DRC just recently announced a proposed 21 day quarantine for workers who have been in the certain areas where they're likely to be exposed before they depart DRC to come to Kinshasa and be there for 21 days. What's the status of that? I know that's triggered quite a reaction and quite a debate about what a burden that might be and what a disincentive that might be against the many skilled and heroic health workers and emergency workers who are willing to come to DRC and take those risks in order to be part of the response. If you add that 21 day requirement, that changes the cost equation significantly.
- [15:56]
Dr. Chikwe Ihekwazu
Yeah. Steve, you know, you're absolutely right in your description of the context in the beginning of your question. All of those things are true, but none of them are true on their own. So each of them describes an aspect of the context we're working on, but none of them is the single story that defines the context altogether. And that's, you know, that's life. That's the reality of the context we're working in now. You know, we have to. Before I get to the specifics of the 21 data, I want to put into context why, why I imagine DRC had to feel that they needed to be a little bit proactive in this case. Right. You know, what we have seen is that as countries are confronted with these outbreaks and are trying to respond, yes, some organizations are working hard to support them, but other, they've suffered other consequences with travel bans to the DRC and the neighboring countries, with trade restrictions and all sorts of punitive measures that have been instituted against this country. So rather than see it as a public health challenge that requires solidarity and response, they've had to suffer incredible socioeconomic consequences based on actions by certain countries. Now they are then responding to that by self correcting themselves and trying to almost overcorrect by instituting this 21 day instruction. I say instruction because the details are still being worked out. So what we're doing now with them in the interim is saying, listen, let's recognize that you've made this pronouncement and it's important we understand why, but let's work out procedures and processes to go not to acknowledge the trade one days, but define it within the concept of risk. Right. So not everyone going to Bunia for any reason, from trade to response, to providing clinical care to patients versus providing a public health coordinating platform, there are all sorts of reasons why people are supporting the response. So we're, we're working with them at the moment. To develop a standard operative processes, SOPs that we can then use to support them to deliver on. What they want to do is demonstrate that they are managing and mitigating the risk of people coming out of Ituri with an infection. So first is understanding why they're doing what they're doing, supporting them to get to a more irrational and practical approach to achieving their objectives. So that's what's happening at the moment. And we think at the end of the day, we will come out with a process that works for the drc, works for the rest of the world, and works for the response. Recognizing that our collective goal is to support the DRC with the human resources, the technical expertise, the research and development, the medical countermeasures, that they need to respond rationally, appropriately to the challenges that they face and that this is not only their problem. This happens to have happened in the drc, but it's a problem for all of us as a collective humanity. And we have to work in solidarity, not as charity, but in solidarity with them to confront this.
- [19:31]
Stephen Morrison
Thank you. You mentioned earlier, you made a very powerful point about the need to raise the confidence within the community in the different measures that are happening. And we know that they're in this very unstable and very fractured area of the world, that there's a lack of trust, there's a lot of fear, there's often violence. And you're trying to come into this community. The community is asking oftentimes questions of why are you here? Questioning why, questioning why are you only here at this particular moment? We have all of these other health needs and urgent human needs. Say a bit about how you cope with this. I mean, you are deploying with your partners a seasoned but very large workforce. Majority, I assume, are Congolese, but many are others who have experience drawn in West Africa and the other 17, 16 other outbreaks in DRC itself. How do you go about this? Tell our listeners how you cope with. How do you build that confidence and begin to resolve these tensions?
- [20:39]
Dr. Chikwe Ihekwazu
No, thanks, Steve. I think this is the most important lesson that we've learned from the past. You know, that no matter what the instincts are to do good, we never jump into a response without working very closely with the communities that we're serving. So, you know, immediately we started this response. The response starts with working with the committee, identifying leaders in the community to explain and understand what we're doing. Sort of sit their buy in, work with them, use their language, their processes, their people to get into the communities and explain what is happening. And sometimes we Bring them into the response. So before we open any new treatment center, a newly established treatment center, we would invite the elders in the community to come in to understand the care that they're being given. Now, this is not always easy because, you know, no matter how much you try, you're never going to easily get representatives of all parts of the community, the elders, the young people, the females, the males. So we will continue doing our best. Sometimes it's work, sometimes there have been gaps, because sometimes there's. It's not just organic dissent, sometimes there's active misinformation happening in the same communities for all sorts of reasons, where messages are sent out through social media, through other mechanisms with intent that is counterproductive to the work that we're doing. So we're very intentional not to jump in all guns blazing to do whatever we think is important, rather to hold back and carefully work with the community. The other important lesson we've learned from the past is never to only respond to the virus that we think is important for global health security, in this case the Ebola virus, right. But to really focus in parallel with the challenges the community is having, the other health challenges. So in parallel, as we are scaling the Ebola response, we're scaling as much as we can the response and the response facilities, the caregiving, both the people, the centers that are supporting the care being provided to people for whatever else they're coming to the health facility for. So if we're setting up an Ebola treatment center in a specific hospital, we make sure that the hospital itself also benefits from the response resources at that time. So it's not just the health security, but it's all the other essential, what we call a package of essential health services being provided. Now, in addition to all of this, almost a prerequisite for all of this is, you know, ultimately the country has to work for its people itself. You know, the health system has to work for the people it's supposed to provide health care for. So we are very careful and intentional. Neither WHO, nor ua, North Africa, cdc, nor any of our partners is in front of this response. This is a primarily government led response. They have to be in front, we support them from the back. They have to take the credit or the consequences of success or failure. So we are very intentional in saying, listen, you were here before the outbreak, you are here during the outbreak, and you will be here after the outbreak, so we will support you in solidarity. But ultimately you have to own the response. So in this, with these three areas, firstly, community ownership, secondly, supporting essential health services and thirdly, ensuring that this starts and ends as a country led response. We hope that it will collectively lead to an improvement over time in the opportunities to provide health care for the people of Ituri, north and South Kivu.
- [24:39]
Stephen Morrison
Thank you. The other side of the security equation is the threat posed by armed groups. And we mentioned the M23 in alliance with Rwanda, controls much of the Kivus, controls the Goma city and the airport, the international airport. You have other groups that have been around for quite a while. The Allied Democratic Forces Kodeco in Ituri in North Kivu. In the 2018-20 outbreak, the UN Secretary General appointed David Gresley as a coordinator to begin to address some of these security issues. There's always been and always will be in these situations a concern with trying to get a cessation of fighting, trying to get some safe corridors, trying to get cooperation to protect the patients, the citizens that need to come for services and care, but also to protect the providers and the infrastructure from this. What do you think is needed in this instance? I realize that those forms of security are really outside your writ, but they're essential to your ability to do your job.
- [25:49]
Dr. Chikwe Ihekwazu
Yeah, Steve, you know, we learned from every outbreak. We learned a lot from the big West Africa outbreak and we learned a lot from the 2018-2020, 2021 DRC outbreak. And of course, during an outbreak like this, you have to respond to the realities confronting you at the time. And David did a great job during the 201820 Ebola outbreak. In this particular circumstance, I was like, you know, in, in Bonaire for two weeks, in DRC for three weeks. There's no doubt about that. The, the challenges that we face, they're not just health sector challenges, the challenges around security you mentioned, but there's also around food and nutrition. There are challenges on shelter, on access, and all of that ultimately affects the response. If you don't deal with access to the communities, to medical evacuation, to supporting communities with food, you cannot just deal with the health aspects. So the Director General of WHO, Dr. Teddos, together with Tom Fletcher, the emergency response coordinator walking out of ocha, have come together and also appointed a senior Ebola coordinator for this outbreak. Julian Hannes has just got to DRC this week, arrived Kinshasa and is in Bunya from Friday. And he will ensure that the entire UN infrastructure, wfp, ocha, unicef, all the other agencies with their different mandates are there to support the response led on by the health sector. And security is one of them. But we have realized that using security forces has to be limited to really those circumstances where there's absolutely no other way to address the challenge. So we are not prioritizing at all securitizing the response in any way. There are many other mechanisms of community engagement to, you know, win over the hearts and minds of the same groups. All of them are at risk of this virus. They're not protected in any way because they belong to CODECO or ADF or any of the other groups. So I'm confident that with community engagement, with the right type of leadership, that we can work with them and really, really minimize to the extreme the need for security forces to support the response directly. Having said that, there are many other opportunities for Monusco to support the work we're doing. They have a big contingents in the area. They work on access roads, on supporting rapid rehabilitation of bridges, for instance, rapid development of bridge infrastructure where it's needed to solve a unique problem. So I think that lots of resources are available to the UN writ large that will be made available and accessible to the sponsor as we proceed over the next two weeks. And really grateful to have Julian in the field to lead that coordination work.
- [29:01]
Stephen Morrison
Thank you. Let's talk a bit about the United States role. Right at the beginning of the second Trump term, President Trump announced the withdrawal from who. It took a year for that to be completed, and early in January that was completed, something we've opposed and continued to argue should be reversed. So now we're in this outbreak. Normally, the US Would be in the center of deliberations with WHO and with the other parties, but it's not. And there may be some technical or informal consultations that are possible because of the history of human relations, deep human relations, and because of a knowledge and awareness that there needs to be a sharing of ideas and data. In this period, the United States has stepped forward with very significant commitments totaling up to now about 725 million. The president's put in a request to Congress for a supplemental funding of 1.4 billion. Many of the awards under that 725 are going to these same actors that you're talking about. It's going to UNICEF, WFP, IO, International Organization, Migration, NGOs like Samaritan's Purse, FHI 360, Mercy Corps, International Medical Corps. Say, how does this work? How do you work around the breach, in the formal relationship, in an operational environment here where cooperation is really essential? And these partners that the US Is funding are the ones that you're dealing with On a day by day basis. So tell us how this all works out.
- [30:38]
Dr. Chikwe Ihekwazu
Yeah, Steve, maybe I'll start from the phrase you use that collaboration is really essential. You know, the nature of the world we live in doesn't change because a government change or an administration changes. Right? The risks that we face are the same. People who travel the same are our exposure to each other is the same. So the context doesn't change because our politics changes. So whether we like WHO or not, we will always need a platform to bring the world together to respond to specific infectious disease threats. And that is what is happening. And the only organization that has the mandate of most countries in the world to do so at the moment is who. So whether money is given to IOM or UNICEF or wfp, all of them ultimately need to work with the one organization that has the technical expertise to do this work on behalf of member states in any member state, where the threat emerges. And that's exactly what we've done, continue to do and will continue to do into the future. Now, our doors are always open to collaboration. Our mandate is to protect the health of the citizens of the world, irrespective of the country they're in, and we will continue to try and do that. On the personal level, I miss not working with colleagues in the US cdc. I have worked with them throughout my career, from the very first outbreak I worked on and the first SARS outbreak in the early 2000s up till recently. And that hasn't changed. The biggest deficit at the moment, you can throw as much money on this as you want, but ultimately, what the world is missing the most is the technical expertise, the technical collaboration that we had with the country that arguably has the most of this globally. And, you know, not being in the field with them is strange. In 2024, in my very first Ebola outbreak, I remember in South Sudan, I sat with a number of colleagues every day working on this response. They were from the US cdc, from WHO at the time. I came from the Health Protection Agency in the UK working with who, and we sat together, thought together, were confronted with very difficult challenges without the countermeasures that we had today, Right? And we worked. And there was no separation technically on what hat we all had. We were focused on the single mission. So we miss the most the technical collaboration of the uscc. And this is an area where, you know, we're grateful for the resources available to the other organizations to support the response. But this is a context where one plus one doesn't even add up to two in terms of how the Resources enable the response versus a situation where we had in the past where bringing our resources together led to an output that was much more than a combination of its parts. So I hope they're back at some point. But whether they're back or not, the risks and challenges that we collectively face don't change in any shape or form.
- [33:57]
Stephen Morrison
Thank you. My colleague and friend Beth Cameron and I published a piece in the University of Virginia Miller center on Monday making this very point that the CDC Special Pathogens Unit and its leadership in Atlanta and the BSL4 lab there, these are exceptional capabilities that provide very high expertise that needs to be integrated for the best response. And by not having that integration, we're paying. Everyone's paying a price. That's the price of this separation coming home very clearly. And I hope we can find a path, a very pragmatic path to overcome that gap.
- [34:39]
Dr. Chikwe Ihekwazu
Yeah, everyone is paying a price, and not only a prize in the present, because when I talked about my first ebola outbreak in 2002, I was at the bottom of the food chain, right? I learned from these colleagues and we learned from each other. We bring different things to the table in WHO. For many years, many U.S. cDC colleagues were integrated into WHO because they were seconded from USCDC into WHO, and we worked together. So my point is, yes, there's an immediate impact on this outbreak we're all responding to, but there's a longer term impact on the relationships built, the intergenerational opportunities that you build over the years that we are interrupting. And even if that interruption is fixed by whatever mechanism, it will take years to build back what we've lost. Having said that, yeah, we hope we get the opportunity of rebuilding sooner than later.
- [35:36]
Stephen Morrison
Thank you. I want to ask you to comment on the one controversial issue that remains unresolved here, which is the proposal to establish a at a Kenyan air base north of Nairobi. A facility would be developed with both civilian and U.S. military capabilities for, I'm assuming, for both treatment and for quarantining. They're moving ahead with this, but it's not been fully defined who is it serving and for what period of time, et cetera? The question I have for you is, is there in principle a very strong case to try to build, whether it's in this case in Kenya or somewhere else, to build a facility that's very near to the actual hot zone where you could provide care and treatment for non Congolese workers, not just Americans, not just Canadians, but folks from who are non Congolese who do become infected or exposed and perhaps infected. What's your feeling? I mean, I can see a case for having proximity so that the travel time is short and to reassure those non Congolese, heroic non Congolese providers, that there is this fallback position.
- [36:55]
Dr. Chikwe Ihekwazu
So, Steve, you know, I won't comment on the specifics of the project. I don't know enough about it to have an opinion on the validity of the decision and the investments being made. But you know, I will say the most important thing when there's a fire is to go where the fire is burning and try and stop it there, rather than, you know, build a protection or whatever, you know, outside of the area and hope that in case someone is burnt, that we have a burn facility to support the patient. So, you know, I'm very focused and my team is very focused on the source of the outbreak at the moment. We're intensifying our response. We, we know what to do. We're doing it despite the difficult context. And we believe that if we put all our resources into stopping this outbreak in Ituri and North Kivu, then we can render any other attempts more or less redundant. And so our focus remains on this, confident that we are making progress. Definitely not out of the woods, but we're in a much better place than we were.
- [38:03]
Stephen Morrison
Thank you. Thank you. In closing, we ask our speakers to speak to what gives you hope and optimism in this situation. And I would add to that if you could tailor your remarks to what are the mess? What are the couple of key messages you think would most benefit Americans hearing from you?
- [38:22]
Dr. Chikwe Ihekwazu
You know, what gives me hope is having been spend the time I spent in itui. It is not like they're waiting for us to come and save them. Right? They own this problem. They're working very hard on it. They're very conscious of the challenges they face, the consequences on their ambitions, their economic ambitions, their ambitions to live healthy, happy lives like the rest of us. So they're very focused on this. And yes, there's been some disruption by a virus that is not their fault that has emerged in their context. Some of it is hard to understand and they're grappling with that. But they're definitely on top of the attempts to control this. The other thing is maybe for our colleagues in the States is, you know, the US built the greatest public health agency in the world. We looked up to it for its expertise, for its resources, for its inspiration. I led the Nigeria cdc. We built it against the imagery of this great public health agency in the U.S. all the systems, whether I did a program called the European Program for Intervention Epidemiology Training. It was developed against the model of the Epidemic Intelligence Service that was built out of the US cdc. So I think on the one hand, every citizen of the US should be proud that they have inspired a generation of national public health agencies. One of the youngest is the one in the drc, the INSP Institute Nationale Sante Public, a new national public health agency barely five years old, that is at the heart of this response. So I think the US should be proud that even if they're not in this outbreak, they have inspired the institutions that are responding to it. On the other hand, I do feel a sense of sadness that they're not part of the response. So, you know, depending on how you look at the glass as half full or half empty, you know, there's a lot to reflect on on what we need to move ourselves collectively into the Future.
- [40:36]
Stephen Morrison
Thank you, Dr. Chikwe Ahekwazu. Thank you so much for this time and thank you so much for your leadership and all that you and your colleagues at who are doing in this very dangerous emergency moment. Thank you.
- [40:51]
Dr. Chikwe Ihekwazu
Thanks Steve. I'm confident that together with the solidarity of the rest of the world, we will get ahead of this, learn a lot, and be better prepared for the next one.
- [41:00]
Stephen Morrison
Thank you.
- [41:06]
Oge Onabogu
Thanks for listening to Into Africa. If you enjoyed this episode, please subscribe. Wherever you listen to your podcast, you can find more analysis from the Africa Program on on our website, CSIS.org or find us on social media. Search for SISAfrica on X, LinkedIn and Instagram.