A Nigerian Doctor’s Fight for Equitable Access to Vaccines

This interview is part of our latest Women and Leadership special report, which highlights women making significant contributions to the major stories unfolding in the world today. The conversation has been edited.

The co-chair of the African Union's Vaccine Delivery Alliance is an infectious disease specialist from Nigeria. The World Health Organization put Dr. Alakija in charge of the Access to Covid-19 Tools Accelerator in December of 2021. She uses the term "global north" to describe high-income countries and "global south" to describe low- and middle-income countries.

You have been critical of vaccine inequity in Africa. How did you feel when you were asked to be a special envoy to the Access to Covid-19 Tools?

I was one of the most critical voices at some of the outputs. I was the first one for vaccine inequity. My first thought was "Oh my God, they will all hate me."

The status quo was changed by a fox in the henhouse. When Tedros called to ask if I would do it, I said, "Have you got the right number?" and then I said, "Oh, no, no, no."

I spoke to my husband, and he said that Yodi had been at the forefront of saying those from the global south need to be heard. You can't say no to that table.

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What do you do in your role?

I work 16 to 18 hours a day, advising governments, health ministers, finance ministers, and the ACT Accelerator leads on vaccine shipments, deliveries, and bottlenecks. In order to advocate on the issue of vaccine equity and equitable access to health care tools, I conduct speaking and media engagements.

How do we get vaccine equity?

The value to lives in the global south is the same as the value to lives in the global north. We can only achieve it when we don't think it's appropriate for people to die from diseases that no longer exist in London or New York. We value each other the same. Some people are saying that it is not so bad in Africa. Maybe we don't need to vaccine them. We are not seeing the I.C.U.s being completely overrun because there are no I.C.U.s. There are no health centers. People are dying silently.

After working with H.I.V. and AIDS patients, you decided to pursue a degree in public health. Did you face any challenges early in your career?

When I applied to the London School of Hygiene and Tropical Medicine to study public health, I received a rejection letter that said the course was for senior level public servants, ministers or permanent secretaries from different countries around the world. We don't want you on this course because you are young.

I was angry. When I was living in London, my husband and I went to the school and demanded to see the dean, who was Richard Feachem. I asked what the meaning of the letter was after I threw it on the desk. He sat back in his chair and said, "I really look forward to the day you are running the world."

You have been vocal about the need for more women in positions of power. How do we achieve that?

The fact that the global health leaders are men has slapped me in the face so much. A lot of women don't have the decision-making power of the voice.

A group of men invited themselves into a mentoring session that I was doing for young women at a conference in Rwanda. They were in front of the only table in the room. They looked at me and said, "Oh, yeah, hi."

I climbed on a chair after I parted through them. The conference erupted. I got the mic and said, "This is what we're talking about." Even if you pull up a chair and get into a conversation, they still look at you.

Pull up a chair if they don't give you a seat at the table. Get on the table if they don't make space.

Do you think Covid has affected the lives of women and girls in Africa?

The economic impact of Covid has people selling off their daughters to marry child brides. The girls have to leave because people can't afford to feed their families.

The man will go and get the vaccine if there are a few available in the country. The woman wouldn't.

How are we able to get more vaccines?

It isn't as simple as hesitancy. Hesitancy is a function of trust. There needs to be a consistent and predictable supply of vaccines.

The health systems have to be strengthened. It has to be a part of our delivery of vaccines and our preparation for the next outbreak or the next Pandemic.