A Nigerian doctor’s fight to urge rich countries to keep their promises against COVID-19

One evening at 11:30 p.m., Ayoade Alakija, a doctor, picked up her phone and heard a child’s voice on the other end saying, “Mom’s not breathing, Mom’s not breathing.”

She heard children crying in the background and then realized her mother, Elizabeth, was having trouble breathing.

dr Ayoade Alakija lives in Abuja, Nigeria and knew Elizabeth as she was the wife of one of their team members. She therefore rushed to ensure that Elizabeth was taken to the hospital immediately.

However, before Elizabeth could be taken into care, the hospital required bail in excess of $1,000.

While Alakija was transferring the money to them, she received a text message informing her of Elizabeth’s death.

Ayoade Alakija told Global Citizen: “ [Ses] four children… [ont été] sent to a village to live with family members and they will never know a mother’s love. God only knows what opportunities will be available to them when the eldest sibling becomes the primary caregiver at age 10.”

Elizabeth died during the peak of the delta wave in 2021, she had not been tested for COVID-19. She also didn’t benefit from an autopsy. Her death was therefore attributed to asthma, although in all likelihood she was not a victim of the condition.

for dr Alakija, the signs of health system failure in a pandemic are many and varied.

Speaking of Elizabeth’s husband, who is facing the death of his wife at the age of just 37, Ayoade Alakija says: “He came to greet me and his eyes were blank and haunted.”

dr Ayoade Alakija, Co-Chair of the African Union Vaccine Distribution Alliance and Physician in Abuja, Nigeria, is a strong advocate for equity in global health. Image: Photo Mansur Abubakar

In 2021, Ayoade Alakija contracted COVID-19 herself and spent ten weeks in bed. Not sure if she would survive, she had to talk to her husband about what to do if she succumbed.

Almost a year later, she is still suffering from the long-term effects of the virus, including dizziness and light-headedness.

In the early months of the pandemic, Dr. Alakija that global solidarity would end this virus for all, with the richest countries pledging to provide vaccines to the poorest countries, aiming for a global immunization rate of 70% by mid-2022. By April, the global immunization rate is below 60% , and some countries like Haiti have only vaccinated 1% of their population.

“We all prayed and hoped desperately [des vaccins] would come to save us from this terrible virus that has afflicted the world,” explains Dr. Alakia. “And then the vaccines came and we were forgotten. »

A strong advocate for global health justice and co-chair of the African Union Vaccine Distribution Alliance, Dr. Alakija stunned to learn of her appointment as World Health Organization (WHO) special envoy and co-chair of the Access to COVID-19 tool accelerator. She describes her post as “intense” and has no hesitation in criticizing big global players and rich countries that she says have contributed to widening inequalities during the pandemic.

for dr Alakija, racism is at the root of these inequalities.

“Not all lives are equal. A life in Cairo [n’est] not worth a life in Copenhagen, a life in New York is not valued as much as a life in Nairobi. »

wbs_dralakija_nigeria_mansurabubakarforglobalcitizen-05.jpg__2100.0x1400.0_q85_crop_subject_location-1050,700_subsampling-2_upscale.jpgAs WHO Special Envoy and Co-Chair of the Access to COVID-19 Tools Accelerator, Dr. Ayoade Alakija for better access to COVID-19 testing, vaccines and treatment in the South. Image: Photo Mansur Abu

At the beginning of the pandemic, when rich countries were stockpiling vaccines, getting them to countries in the South was a major obstacle. As vaccines began arriving at ports and airports in developing countries, there were plenty of photo ops and press releases.

Despite this, policies and budgets are lacking to ensure vaccines reach the last mile (a term used to describe the final leg of goods transportation to their final destination, often in remote or hard-to-reach locations).

In South Sudan, vaccine distribution costs much more than the vaccines themselves due to the lack of infrastructure, but Dr. Alakija believes that this has not been adequately budgeted for. As a result, vaccination rates were low, and South Sudan donated near-expired vaccines to neighboring countries.

“When it’s people in Geneva, New York or London who don’t know the terrain well and who make these decisions, they mean well, [mais elles] don’t understand that,” says Ayoade Alakija.

Even if dr. Alakija was struggling, she was exhausted.

“I felt like I was banging my head against a brick wall. I felt like I was screaming into space. I’m fed up with the sound of my own voice. »

When you’re the only person in a room who embodies a particular worldview, it can be an isolating experience, she explains. She admits that sometimes, as she fervently speaks out on issues of fairness, she thinks to herself, “I better not be the loud, angry black woman in every room.”

dr Alakija spends much of her time campaigning for rich countries to keep their promises, as most of them have backed down over allegedly “low” COVID-19 case rates and mortality in southern countries. However, she claims that these numbers are inaccurate.

“Morbidity data is inadequate because the pandemic measurement system is inherently unequal,” she explains.

While developed countries insist on increasing hospital admissions and saturating intensive care units, many low-income countries lack healthcare infrastructure and data.

“Where is Kibera Hospital? [un bidonville du Kenya] ? Where is Oshodi Hospital? [au Nigeria] ? We don’t have health systems. So there’s nothing to measure that they’re overwhelmed,” says Dr. Alakia.

Regardless, COVID-19 test data has been used by many countries to estimate the spread of the virus, but developing countries generally don’t have equal access to testing.

“It’s the public health equivalent of Donald Trump. If you don’t test and measure [les données sur la COVID-19], then there is no COVID,” she said. She is referring to former US President Donald Trump, who said the US would have “almost no cases” of coronavirus if authorities stopped testing.

In Zambia, a retrospective mortality survey showed one in three victims tested positive for coronavirus, a ratio far higher than the country’s official government data, which attributed just one in 10 deaths to COVID-19.

According to Ayoade Alakija, similar rates are to be expected in other southern countries. Though the data is lacking, she says the anecdotal evidence is cause for concern.

wbs_dralakija_nigeria_mansurabubakarforglobalcitizen-08.jpg__2100.0x1400.0_q85_crop_subject_location-1050,700_subsampling-2_upscale.jpgdr Ayoade Alakija is pictured at her home in Abuja, Nigeria in April 2022. Image: Photo Mansur Abubakar

She tells of many elders and family friends living in Nigerian villages who died during the pandemic and were not tested for COVID-19. Her death has been attributed to causes such as malaria, although no screening for the condition has been conducted.

“It’s necessary to talk about diagnoses so that no one is saying that victims died of asthma when they actually died of COVID,” said Dr. Alakija and remembered Elizabeth’s death.

In her eyes, great human losses are commonplace in developing countries, but she reminds that “mourning is a luxury” when the population is concerned about basic needs such as electricity or food.

She says: “We have hardened our hearts. Without them they would keep breaking. We perform the traditional rites, ablutions and practices and continue because we have to start all over again the following week. »

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