Meet the man leading the struggle against COVID-19 in Africa

An interview with Dr. John N. Nkengasong, winner of the Boris Mints Institute Prize for Global Challenges.

 DR. JOHN N. NKENGASONG grew up in Cameroon and has more than 30 years of public health experience. (photo credit: African Union Commission)
DR. JOHN N. NKENGASONG grew up in Cameroon and has more than 30 years of public health experience.
(photo credit: African Union Commission)

“If you brought the people who fought the 1918 pandemic and showed them what we have done,” says Dr. John N. Nkengasong, director of the Africa Centres for Disease Control and Prevention (Africa CDC), “they would look at us with total admiration.

“Within four weeks, we were able to determine the sequences of the virus and develop a diagnostic test. Within one year after research and development, we developed a vaccine, went to clinical trials, and put it into people’s arms. They would be envious of us.

“Yet at the same time,” he continues, “after admiring us, they would be in total shock about our behavior. Why is a region like Africa only about 5% fully vaccinated? It would be hard to explain to them why we have the tools but are struggling to distribute the vaccines.”

On October 17, the Boris Mints Institute at Tel Aviv University presented Dr. Nkengasong, one of the leading scientific voices in Africa’s struggle against COVID-19, with the BMI Prize for Global Challenges, a $100,000 award, for his substantial efforts in managing the pandemic, his public actions focused on practical and applicable solutions and his overall impact on global policy. The broadcast of the presentation is available on the Boris Mints Institute website, at www.bmiglobalsolutions.org/.

Dr. Nkengasong grew up in Cameroon, trained as a virologist and has had more than 30 years of experience in the field of public health, having worked for the United States Centers for Disease Control and Prevention and associate director of laboratory science and chief of the International Laboratory Branch at the Division of Global HIV/AIDS and TB.

 GETTING VACCINATED in Abidjan, Ivory Coast, September 23. (credit: Luc Gnago/File/Reuters) GETTING VACCINATED in Abidjan, Ivory Coast, September 23. (credit: Luc Gnago/File/Reuters)

The Africa CDC has been instrumental in the fight against the pandemic on the continent, and Dr. Nkengasong says the launch of the CDC in Africa in January 2017 was exceptionally fortuitous, coming just three years before the pandemic hit. “Context is important,” he says. “After the Ebola crisis, a massive outbreak that killed 11,000 people in West Africa between 2014 and 2016, the heads of states realized that it was important to make a continental agency to be relied on to fight infectious diseases on the continent.”

When COVID-19 arrived in Africa, Dr. Nkengasong says, the Africa CDC was at the center of things. “The Africa CDC and the African Union [a union consisting of 55 member states in Africa] agreed to make a joint continental strategy, which has been fundamental in our ability to fight COVID, underpinned by what we call ‘the 4 C’s’ – the need to coordinate, cooperate, collaborate and communicate – that have guided the strategy.” 

Dr. Nkengasong says better coordination among health agencies is essential in handling outbreaks of this type. “We should step back and look at the health security architecture for the world, which will require greater cooperation, coordination, partnerships and communication to deal with this challenge,” he notes. 

The development of the various vaccines against COVID-19 has been a major success, he says, but he adds that it is imperative that it be distributed widely. “The only formula to come out of the crisis quickly is to vaccinate quickly. Israel is a good example of a model. You vaccinated 70% of the population, and then the Delta variant came and challenged us. We have to be humble enough to say that we have made significant progress with this virus, and we know a lot about it, but there is a lot that we still don’t know. The only way to contain it is to keep vaccinating at speed and at scale. Less than 5% of the African population have had two vaccinations.”

Dr. Nkengasong says CDC Africa’s goal was to have 60% of the population fully vaccinated by the end of next year, but he adds that the lack of access to the vaccine will make that difficult. The African population is quite willing to be vaccinated, and he cites a recent study that says between 60% and 95% of the population want the vaccine. The problem is the lack of supply.

Looking back, Dr. Nkengasong says the multilateral system has failed Africa. “When the crisis started, the continent was promised that vaccines would be made available through COVAX [a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations, and the World Health Organization]. The principles and values behind COVAX were very strong, but it hasn’t translated into action.” He says it is difficult to explain to 1.2 billion people in Africa to wait for the vaccine when China, Israel, the United States, and other countries have ample supply. “Where are those vaccines coming from?” he asks plaintively. 

Dr. Nkengasong is very grateful to the Boris Mints Institute. “I am extremely thankful for the Boris Mints Prize. I am accepting the prize on behalf of the African CDC and the African Union Commission, but it is due to the efforts of a large number of people who work with me and trust in me as their leader to guide the response to the terrible pandemic, whose trajectory in Africa is uncertain and unpredictable. This prize is in honor of the hardworking CDC staff in Africa.” 

His hard work in combating COVID-19 has not gone unnoticed. Recently, US President Joe Biden nominated Dr. Nkengasong, a US citizen, as ambassador-at-large and coordinator of US Government Activities to Combat HIV/AIDS Globally at the State Department. This appointment awaits Senate confirmation.

The work the Boris Mints Institute does in promoting science in discovery and innovation is vital, in Dr. Nkengasong’s view. In the 21st century, says Nkengasong, pandemics and challenges in disease trends rely largely on good research, which the Boris Mints Institute fosters. Nevertheless, he says, “it is all irrelevant if it is not translatable into making an impact. Taking diagnostics, vaccines, and therapeutics and making sure that they get into people’s hands and impact human lives is critical, and this is the interface between the work that the Boris Mints Institute promotes as well as the work that Africa CDC does.”

Dr. Nkengasong says researchers need to be mindful of what he terms the “valley of death,” which is the phase between research and successful innovation. It is essential that products reach their intended destination. In that spirit, he will be donating the $100,000 prize to support vulnerable populations in his native Cameroon, where two regions have been in crisis for the past four years. “This would be a good translation of getting scientific discoveries that emerge from institutions like the Boris Mints Institute to the community,” he says. 

What are the lessons that can be learned from the current pandemic? “In addressing this pandemic and preparing for the future,” says Nkengasong, “there are three key things. First, we have learned from this pandemic that we are more vulnerable than we thought. Second, we are more connected than we thought. Within two months, 165 countries were impacted. Lastly, are the inequalities that exist. These are key things that must be addressed to get rid of this pandemic and prepare for the next pandemic.”

As our conversation approaches its conclusion, when I ask Dr. Nkengasong the question that’s on the minds of many – “Will we ever be allowed to walk around without a mask” – he answers, “It depends on how quickly we vaccinate. If we vaccinate quickly, hopefully by 2023 we will all be moving without masks again around the world,” he says, if vaccinations will become available everywhere. 

Chuckling, Dr. Nkengasong recalls a recent visit to Venice. “For close to two years, I have not felt the warmth of a handshake. We were getting out of the boat to go to the hotel, and the man waiting for us extended his hand to help us out of the boat. Imagine that – we don’t hug anymore, and we don’t shake hands anymore. It was really a different experience to feel the hand of another human being.” 

This article was written in cooperation with the Boris Mints Institute for Strategic Policy Solutions to Global Challenges.