AYOADE OLATUNBOSUN-ALAKIJA Dr Ayoade Alakija currently serves as World Health Organization Special Envoy for the Access to COVID-19 Tools (ACT) Accelerator, chair of the African Vaccine Delivery Alliance and chair of the Foundation for Innovative New Diagnostics (FIND). As a medical doctor with over two decades of experience working around the globe, she is an expert in global health, development and humanitarian relief. She has been a leading voice calling for the urgent reimagining of how the globe should respond more consciously to the inequities exposed by the Covid-19 pandemic. X-TWITTER @yodifiji institutional rivalries have long hindered our collective well-being. Our topmost goal must remain a world where every individual’s safety is guaranteed, regardless of the threat of future pandemics or global health emergencies. Grand declarations and ornate meetings are futile if we shy away from the grit and grime of backstage work – from battling to bridge divides to overturning the status quo, work that achieves much more than abstract grandstanding. These endeavours will edge us closer to attaining true equity in the global health architecture and justice universally. The very foundations of the institutions currently leading many interventions must be radically reformed. We must be unafraid to rebuild from the ground up, discarding the debris of outdated structures and ingrained inequities. We must build institutions that mirror the world we now live in and not the world of the 1950s. ACHIEVING AUTHENTIC DIVERSITY While we applaud diversity in boardrooms, it is not enough to merely seat a Black or Brown individual at the helm of an institution that has yet to critically examine its own misuse of power and discrimination against individuals from the Global South. True diversity and inclusion cannot be achieved through ‘black or brown washing’ an institution that remains stained by deep-seated inequalities. We must remain vigilant in addressing institutional racism
experience with polio reaffirms the need for robust community engagement and cooperative action: through training local volunteers and partnering with traditional and religious leaders, my home country saw a shift from vaccine refusal to effective vaccination campaigns and community trust. To escape the cycle of panic and neglect surrounding pandemics, we must maintain commitment and invest in our existing health systems. Strengthening infrastructure and fostering a culture of proactive planning is key. The Intergovernmental Negotiating Body is negotiating a pandemic convention or agreement, signalling a major shift towards health security for all. As the process continues, mechanisms such as the Access to COVID-19 Tools Accelerator ensure there is no gap in pandemic preparedness and response as the world remains vigilant against new and existing infectious disease outbreaks. Maintaining institutional memory, political will and sustained commitment are vital for lasting changes. Learning from past experiences, investing in capacity building and consistently prioritising health in political dialogues are the path forward. But institutions must fundamentally change so that they are authentically driven by the needs of low- and middle-income countries, which necessarily requires their engagement in governance and decision making. Systemic change is needed today. Now is a moment to rise united. We must pledge unwavering commitment to our shared mission: the vision of a thriving world devoid of health disparities segregated by geographical boundaries. The urgency is not just in the need but in the action – it is time
that resists diversity in boardrooms and staffrooms. Authentic diversity must be fostered at the individual and organisational levels through dedicated and committed leadership and role models. Failure to ensure such diversity will continue to contribute to fragmentation. As long as overt racism still exists, we will never achieve collective security and health for all. The divisive paradigm of ‘donor countries’ versus ‘recipient countries’ must be overturned. We must instead country’s voice in tackling issues and taking decisions that affect us all. The most vulnerable individuals often dwell in countries that lack wealth, but their stories, their plights, their solutions should not be silenced. understand that the possession of resources should not be the determinant of the volume of a Inspired by those who chose to abandon Omelas, rejecting happiness built on the torment of a single child, we too must be brave enough to shatter the chains of the status quo. We cannot tolerate a world that flourishes on the unjust subjugation of the less fortunate. We must undertake the solitary, challenging journey towards a world where everyone, regardless of colour, wealth or location, has an equal seat at the global table. This is our moral and economic imperative. It is a daunting journey, but a necessary one. Only then can we truly say we are navigating towards an equitable and just global health framework that leaves no one trailing behind. ▪
to transform our institutions and models. Merely discussing change will no longer suffice. We must embody it. Political leadership must unequivocally confront our shared global challenges, casting aside parochial pursuits. The traditional entrapment of insular interests and
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Health: A Political Choice – From Fragmentation to Integration
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