Bissau-Guinean doctor who missed Africa CDC job cries foul

JACKSON MUTINDA / 5 March 2023

She was a perfect fit for the job: She is the president of the Institute for Global Health and Development, former high commissioner for Covid-19, and former minister of public health in Guinea Bissau.

She is the current vice-chair and past chair of the Ethics and Governance Committee and alternate board member for West and Central Africa of the Global Fund to Fight Aids, Tuberculosis and Malaria.

Magda Robalo Correia E Silva was what the doctor ordered for the Africa Centres for Disease Control and Prevention (Africa CDC).

And the African Union (AU) recruitment team reportedly placed her top of the list of applicants.

Dr Robalo is a medical doctor with a Master of Science degree in epidemiology and a postgraduate diploma in public health and tropical medicine.

Yet, her quest to become the first woman director-general of the specialised technical institution of the African Union did not succeed.

At the recent AU Summit in Addis Ababa, the heads of state and government picked Dr. Jean Kaseya, a Congolese, to succeed Cameroonian-American virologist John Nkengasong who, since May 2022, has been leading US President Joe Biden’s Emergency Plan For Aids Relief initiative that addresses the global HIV/Aids epidemic.

Dr Robalo has protested the way the selection of Dr Kaseya was done, citing irregularities in the process and demanding an explanation.

In a letter to the chairpersons of the AU and the AU Commission and copied to heads of state and heads of other continental institutions, Dr Robalo expressed her disappointment with the decision of the committee that reviewed the report of the selection committee, and recommended the nomination of the second-best ranked candidate, “disregarding the merit of the top candidate, gender and geographic diversity.”

“I have received, today, information from the African Union recruitment team that ‘another candidate whose background and experience at this moment in time is more suitable for this position’ was selected to become the DG of the Africa CDC,” she said in the letter dated February 21, 2023.

“I am reliably informed that I was the top-ranked candidate for the position, in a rigorous selection process, which reviewed the application of over 100 candidates. According to the advertisement circulated by the AU, this recruitment was open to all African experts, and there was absolutely no requirement or pre-condition for candidacies to be backed by government’s letter of endorsement, which would have not encouraged a healthy competition, would have limited the number of candidates, reduced the quality of applications, and would have biased and compromised the transparency, ethics and equity of the process toward those with political ties and not necessarily the best qualified.

Candidates from same country

“If candidates were to be backed by their governments, each country would have had only one candidate, yet several candidates were from the same country, which was valuable for obtaining a strong crop of candidates.”

She said that the outcome of the process does not bode well for the future of the continental institution, “which is expected to be a credible, world-class institution, led by the most competent expert, selected based on merit, transparency and process integrity.”

She suggested there were underhand dealings in the selection process, which featured more than 100 applicants — including Kenya’s Dr Ahmed Ogwell Ouma, the acting director — and that the Congolese government and President Felix Tshisekedi vigorously campaigned for Dr Kaseya.

Intense lobbying

Dr Robalo said that in the session that picked the finalist, the AU heads of state were “refused the opportunity to take the floor to raise their concerns over the nomination process,” suggesting that it signals manipulation, as the final decision seems to have been unilaterally made by the new AU chair, Comoros President Azali Assoumani.

It was not lost on critics of this outcome that President Tshisekedi visited Comoros and met with President Assoumani a week to the AU Summit.

But the communique released during the visit did not mention lobbying for support for the Congolese doctor to head the crucial continental body that seeks to support African public health initiatives and capacity to detect, prevent, control and respond quickly and effectively to diseases.

‘Secret struggle’

On February 19, President Tshisekedi’s office was first to break the news of Dr Kaseya’s appointment. The DRC presidency made the announcement, declaring it a victory over a “secret struggle”.

“It is done! Dr Jean Kaseya takes over as the head of CDC,” a statement from the President’s office said, indicating heads of state had endorsed him.

Diplomatic sources told The EastAfrican that Kinshasa’s lobbying machinery rode on the Economic Community of Central African States, for which President Tshisekedi was chair. The bloc had reportedly endorsed Dr Kaseya.

Dr Robalo was one of the eight women ministers — of 16 — appointed by prime minister Aristides Gomes in 2019, taking the Public Health docket. In 2020, at the height of the Covid crisis, she was appointed to take charge of the response programme.

She has always urged women to be at the centre of the healthcare system in Africa amid barriers historically created by men.

In an oped in Health Policy Watch, Dr Robalo writes: “If leadership jobs were awarded on merit, we would see more women leaders in the sector. Why then are women the minority of health leaders? History matters. For millennia, women were traditional healers, makers of herbal remedies and birth attendants. Despite this, when medicine was formalised as a profession in Europe and North America, it was established by men as a profession for men, and women were formally excluded from training and practice.”

Formal exclusion legacy

The legacy of the formal exclusion of women continues, she argues.

Dr Kaseya’s appointment has been seen as a diplomatic coup for Kinshasa, which has confronted repeated bouts of deadly health scares, including Ebola, over the past five years, while also facing a bruising civil war in the eastern region.

The DRC presidency described his appointment as “an epilogue of a long, secret diplomatic battle waged for six months by President Félix Tshisekedi.”

The 53-year-old faces a slew of challenges in advancing a “new public health order” for Africa, as per the Africa CDC strategy.

Commentators say he will need to find new ways to make the CDC and its public health priorities stand out in the post-Covid era. This includes strengthening disease surveillance, working with countries to strengthen health systems, and responding to health emergencies.

Dr Kaseya has over 20 years of experience in public health. He has worked with Unicef in Congo-Brazzaville and Namibia and at the WHO, where he led the Meningitis Vaccine Project.

He studied at the University of Kinshasa and holds a master’s degree in public health from Henri Poincaré University in France. Prior to his appointment, he was a member of the Technical Review Panel for the Global Fund in Geneva.

Since November 2020, he has been responsible for the African Health Diagnostic Platform/European Investment Bank team (AHDP/EIB).

From June 2020 to February 2021, he served as Global Head of the Africa Polio Team for the Bill and Melinda Gates Foundation.

Source: The East African (Kenya)

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