Publisher Health

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 and condensed.

Dr. Ayoade Alakija, an infectious disease specialist based in Nigeria, is co-chair of the African Union’s Vaccine Delivery Alliance (AVDA). In December 2021, Dr. Alakija, nicknamed Yodi, was put in charge of accelerating equitable access to Covid-19 tests, treatments and vaccines for the World Health Organization’s global initiative known as the Access to Covid-19 Tools Accelerator. She uses the term “global north” to describe high-income countries and “global south” to describe low- and middle-income countries.

Throughout the pandemic you have been critical about vaccine inequity, especially in Africa. How did it feel when the W.H.O. director-general Dr. Tedros Adhanom Ghebreyesus asked you to be special envoy to the Access to Covid-19 Tools (ACT) Accelerator?

I had been one of the most critical voices at some of the outputs of the ACT Accelerator. I had been agitator No. 1 for vaccine inequity. So my first thought was, “Oh my God, they will all hate me.”

It was a shake-up of the status quo; a fox in the henhouse. When Tedros called me to ask if I would do it, I said, “Have you got the right number?” And then I said, “Oh, no, no, no.” So he asked me to think about it, saying, “Your voice is needed, your steer is needed.”

I spoke to my husband, and he said, “Yodi, you have been at the forefront of saying those of us from the global south need to be heard. They have invited you to that table, you cannot say no.”

What does your role entail?

I operate 16 to 18 hours a day, advising governments, health ministers, finance ministers and the ACT Accelerator leads, coordinating with AVDA colleagues on vaccine shipments, deliveries and bottlenecks. There are also speaking and media engagements I undertake in order to advocate on the issue of vaccine equity, and equitable access to health care tools.

How do we achieve vaccine equity?

When we ascribe the same value to lives in the global south as we do to lives in the global north. We can only achieve it when we don’t think it’s OK for people to be dying in Mombasa or in Kibera of diseases that no longer exist in London or New York. When we value each other the same. Because at the moment there are those who are saying, “Oh, well, it’s not so bad in Africa. So maybe we don’t really need to vaccinate them. We’re not seeing the I.C.U.s being completely overrun.” Well, that’s because there are no I.C.U.s. That’s because there are no health centers. That’s because people are dying silently.

You began your clinical career working with H.I.V. and AIDS patients, then decided to pursue your master’s degree in public health in your early 20s. Did you face any obstacles 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 saying, “This course tends to be for really senior level public servants, ministers or permanent secretaries from different countries around the world. You are very young so we are not accepting you on to this course.”

I was outraged. My husband and I were living in London at the time, so I marched into the school and demanded to see the dean, who at the time was Richard Feachem. I threw the letter on the desk and I said, “What is the meaning of this? This is what I want to do and I am not leaving until I am doing what I applied to do.” He sat back in his chair and said, “I really look forward to the day you are running the world.” He then directed me to someone in admissions.

You’ve been vocal about the need for more women in positions of power when it comes to the world’s Covid-19 response. How do we achieve that?

It has slapped me in the face so much during this pandemic, the fact that the global health leaders are men. A lot of women tend to be No. 2s, so they don’t quite have the decision-making power, the voice.

I was at a conference in Rwanda, and there was a group of men who had invited themselves into this mentoring session that I was doing for young women. And they were standing right in front of the only table in the room. So I tapped each on the shoulder and said, “Excuse me.” And they sort of looked at me and said dismissively, “Oh, yeah, hi.”

So I parted through them and I climbed on a chair, and then on a table. The conference erupted. I got the mic and I said, “Right here, this is what we’re talking about. That even if you pull up a chair and you sort of get into the conversation politely, they look at you like, ‘eh?’”

So if they don’t give you a seat at the table, pull up a chair. And if they don’t make space, then get on the table.

Do you believe that Covid has disproportionately affected the lives of women and girls, especially in Africa?

There is another silent pandemic going on here with child marriage — people selling off their daughters because of the economic impact of Covid. People can’t afford to feed their families, therefore, it is the girls who have to go.

Even for vaccines, the prioritization in communities means that if there are a few vaccines available in the country, and people are willing to go and get it, the man will go and get it. But the woman won’t.

How do we get more vaccines in arms?

It is not as simple as hesitancy. Hesitancy is a function of trust — trust in systems, trust in governments. There needs to be a more regular, more consistent, predictable supply of vaccines.

We have to also look at the wider strengthening of the health systems. It has to be a component of our delivery of vaccines and our preparation for the next outbreak or the next pandemic or just preparation for life, really.