Africa CDC gets new heads

Dr Jean Kaseya’s Challenge: Advancing Public Health in ‘Post-COVID’ Era

Kampala, Uganda | AGENCIES | Nine months after John Nkengasong left Africa CDC to head PEPFAR, the African Union has now elected a Director General for the continent’s leading public health institution who has the task of finding new ways to engage continental and global leaders in Africa’s public health challenges in the post-COVID era.

A new Director-General has been appointed to the Africa Centres for Disease Control and Prevention (Africa CDC). He is 53-year old Jean Kaseya, a Democratic Republic of Congo national who also has a track record as a seasoned international health professional, with past stints at the World Health Organisation (WHO) and Gavi, the Vaccine Alliance and the Clinton Health Access Initiative.

Kaseya immediately underlined his intention to work closely with the World Health Organization (WHO) on challenges that range from expanding universal health coverage in Africa, to strengthening local manufacturing capacity as well as disease surveillance in the post-COVID period.

“Today, after the confirmation, my first call was with Dr (Mashidiso) Moeti, Regional Director, WHO/AFRO region to reiterate my commitment to work closely with WHO to address health issues in Africa,” he stated, putting aside the rift that opened between the Africa CDC and WHO last year over the degree of autonomy that Africa CDC should have in declaring regional public health emergencies.

Kaseya was appointed by African Heads of State following an election that took place on the sidelines of the 36th session of the African Union, which was held in Addis Ababa, Ethiopia, 18-19 February.

While a total of 180 candidates vied for the position, Kaseya and Dr Magda Robalo from Guinea-Bissau were the finalists for the position. Africa CDC acting director Dr Ahmed Ogwell Ouma from Kenya was also in the running.

The win by Kaseya has been seen as a diplomatic coup for Kinshasa, which has confronted repeated bouts of deadly Ebola outbreaks over the past five years, while also facing a proxy war with M23 rebels in its eastern region.

A statement by DRC’s presidency described Kaseya’s appointment as “an epilogue of a long, secret diplomatic battle waged for six months by President Félix Tshisekedi”.

Finding new opportunities

Kaseya will face a formidable series of challenges in advancing a “new public health order” for Africa, as per the Africa CDC strategy elaborated over the past few months, said Dr Javier Guzman, Director of Global Health Policy at the Center for Global Development.

Kaseya will need to find new ways to make the Africa CDC and its public health priorities stand out in the post-COVID era – amongst the multiple other challenges that Africa faces in trade, finance, climate change and diplomacy.

In his election manifesto issued as part of his bid for the position, the new director general highlighted the need for more accountability at the centre. He also aims to propose an African Air Tax to be paid by airline passengers with the proceeds going to financing Africa CDC’s health support to countries.

Nkengasong, an experienced public health professional with prior experience at the US Centers for Disease Control, drove the African agency to unprecedented prominence during the pandemic. He staged weekly press briefings on the pandemic, and positioned the agency as a leader in deals to finance and distribute COVID-19 vaccines, and later, manufacture them locally. He also worked with African Union (AU) member states to strengthen disease surveillance and reporting capacity, not only for SARS-CoV2 but more broadly.

But COVID-19 is no longer the priority that it used to be, Guzman noted. Instead, many countries are now preoccupied with a burgeoning fiscal and debt crisis, as well as multiple other competing priorities. These include accelerating the African Continental Free Trade Area, the main agenda item at the 36th AU Assembly, as well as confronting the growing effects of climate change and the war in Ukraine on food security, and beyond.

“Dr Kaseya needs to bring a clear and focused vision to Africa CDC’s agenda, secure financial sustainability and build efficient operations, proactively reset the continental/regional balance, and secure the place of Africa CDC within a changing global health architecture. He will have the challenging job of maintaining the status of Africa CDC as the leading public health institution for the continent and delivering on the promise of an autonomous public health agency, a status granted by the African Union Assembly in February 2022,” Guzman said.

From general practitioner to Africa CDC

With a mix of national and international public health experience, Kaseya has a background that is, in some ways, similar Nkengasong’s own when he took on the Africa CDC position in 2017.

Kaseya began his career as a general practitioner at the General Hospital in the DRC’s capital, Kinshasa. In June 1998, he became the Chief of the Health Zone of Kahemba in DRC’s Province of Bandundu, which lies just north east of Kinshasa.

The following year, he became the DRC Health Ministry’s chief of immunisation, supporting national, regional and district levels on planning, implementation, supervision, and monitoring of mass campaigns for polio, measles, tetanus, yellow fever and vitamin A supplementation.

In this capacity, he also supported national, regional and district levels on planning, supervision, monitoring and assessment of a WHO-promoted Expanded Program on Immunization, building on the momentum of the smallpox eradication effort to ensure that children everywhere could obtain a basic set of life-saving vaccines. Participating in national meetings and technical commissions brought him greater prominence nationally.

In July 2000, Kaseya became a senior advisor to the DRC president, counselling the president on health and youth issues including social development, social protection, and youth empowerment.

“I had to develop the vision of the President and draft his speeches in relation to these sectors. I had to review policies and related documents submitted by the Government to facilitate endorsement and signature by the President. I had to attend national and international meetings to discuss the President’s vision around Health, Education and Youth empowerment,” Kaseya stated.

He also worked with the U.S. CDC, USAID, the Global Fund and UNICEF, leading multimillion-dollar projects on malaria, HIV/AIDS and primary healthcare. At Gavi, the vaccine alliance, Kaseya served as country representative and head of a Gavi-funded project implementation consortium of NGOs that also include the Red Cross and Rotary.

In January 2008, Kaseya joined the WHO as a technical coordinator for the organisation’s Meningitis Vaccine Project (MVP). The following year, he joined Gavi, the Vaccine Alliance as a senior programme manager, leading the GAVI program for African countries.

Most recently, he worked with the Clinton Health Access Initiative as Senior Country Director for DRC and as Global Team Lead for the initiative’s African Health Diagnostics Platform/ European Investment Bank project. In this capacity, he was responsible for increasing access to high-quality, reliable and affordable diagnostic services in sub-Saharan African countries.

From Nkengasong to Kaseya

When Nkengasong left Africa CDC in May 2022 after being appointed by the U.S. Senate to lead the U.S. President’s Emergency Plan For AIDS Relief (PEPFAR), he described the Africa CDC as a now ”formidable” public health agency. Several weeks later, the AU’s Executive Council adopted an amended statute for Africa CDC as an autonomous health body.

Africa CDC’s promotion to a more independent status was not without controversy. An internal memo circulated by WHO raised concerns over proposals to empower the African health body to declare a regional “public health emergency of continental security” as part of the agency’s elevated status.

While the process of appointing a new director general was underway, Ouma Ogwell, the centre’s acting director, led the development of a strategy for a “new public health order“. Among other goals, the strategy aims to strengthen African institutions for public health, strengthen the public health workforce, expand local manufacturing of health products, increase domestic investment in health and promote action-oriented and respectful partnerships.

Ogwell, a Kenyan epidemiologist, reportedly sought, but failed to secure the permanent appointment as CDC director. Even so, the pillars of “new public health order” are expected to remain guiding principles for a Kaseya-led leadership, as well.

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Source: Health-Policy Watch