Chikwe Ihekweazu: Foremost Epidemiologist and Game-Changer in Disease Control

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Dr Chikwe Iheakweazu,

On 20 February 2019, an interesting article was published in the prestigious journal, Nature, about Dr Chikwe Iheakweazu, former director-general of Nigeria Centre for Disease Control (NCDC). Taking a panoramic view of his sterling personality and the remarkable achievements that had adorned his career trajectory so far, the writer captioned the piece, “This Nigerian doctor might just prevent the next deadly pandemic”.

Months later, that prediction soon became a reality – perhaps in a way that was much bigger than either the writer or Iheakweazu himself could have imagined. In December of that year, COVID-19 happened. Beginning first as a cluster of cases of “viral pneumonia of unknown cause”, affecting people in faraway Wuhan, China, the disease soon became a global pandemic, spreading across the world in the form of an unstoppable wildfire. By the following year, the pandemic had paralysed economies and stifled social life in many places. But worse of all was the infection rates and death toll.  By December 2020, cases had risen to 83,832,334, with 1,824,590 deaths globally.

What made the situation more alarming was that the developed countries of the world with advanced healthcare systems were not spared the grim statistics of infections and deaths. For instance, the United States, by December 2020 ending had recorded 20 million infections and over 350,000 deaths. One can then imagine what the situation should be in  the developing world. Indeed, forecasts from health and economic experts about Africa had been gloomy and really frightening. This was linked to the continent’s generally weak health systems, high population density and informal economy.

 

Doomsday averted

Nigeria, especially, was expected to be the worst affected by these doomsday forecasts, considering that the country is the most populous on the continent, with one of the least-funded health systems and consequently parading some of the worst health indices. Thankfully, however, four years earlier (precisely in August 2016) President Muhammadu Buhari had made a decision that would turn out to be one of the best things to happen to Nigeria in recent times. He had appointed Iheakweazu as the director-general of the NCDC.

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NCDC is the national public health institute for Nigeria – a federal government agency under the Federal Ministry of Health. Modelled after the United States’ Centres for Disease Control (CDC)), the agency is saddled with the responsibility of protecting Nigeria’s teeming population from the impact of communicable diseases through the coordination of public health preparedness, surveillance, laboratory, and response functions for all infectious diseases. As at when Iheakweazu was appointed, NCDC had just been made an independent government agency, even though its actual beginning can be traced to 2011, when some departments in the Ministry of Health (the Epidemiology Division, the Avian Influenza Project and its laboratories) and the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) were moved to form its nucleaus.

The appointment of Iheakweazu was particularly auspicious, not just because of the expanse of his expertise and experience as an epidemiologist and public health physician but because he had been brimming with concern over Nigeria’s ill-preparedness for disease outbreaks. In terms of experience, before his appointment by the Nigerian government, Iheakweazu had, at different times, worked in senior public health and leadership positions in several National Public Health Institutes, including Germany’s Robert Koch Institute (RKI), the UK’s Health Protection Agency and the National Institute for Communicable Diseases South Africa (NICD). He had also led several short-term engagements for the World Health Organisation (WHO), mainly in response to major infectious disease outbreaks around the world.

But, as already noted, it was his concern for the state of things in his country that first caught the attention of the government. He once wrote on a blog in 2010: “Nigeria needs a central, well-resourced centre for infectious disease prevention and control, or one day we will pay the price the hard way.” As he would later reveal, shortly after publishing the post, the then Minister of Health, contacted him and they had a robust discussion.

When the call to serve eventually came (first in July 2016), Iheakweazu jettisoned his concerns about poor health financing and bureaucracy for the greater good of his fellow countrymen. And even though he found the situation on ground to be similar to what he had envisaged, he determined that once he had accepted the call, there was no turning back. Despite very limited resources and mostly decrepit infrastructure, Iheakweazu motivated himself and the handful of staff he met on ground to give their very best. Unsurprisingly his tenure as the pioneer DG (2016-2021) brought comprehensive transformation, efficiency and recognition to the NCDC.

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Before the emergence of COVID-19, Iheakweazu had led effective responses to large outbreaks of infectious diseases, as well as a re-emergence of monkeypox and yellow fever in the country. The NCDC soon became a household name in Nigeria and also drew the attention of world leaders and international organisations that were eager to provide funding for its operations. Indeed, in recognition of the great work Iheakweazu was leading at the NCDC, the Director-General of WHO, Tedros Adhanom Ghebreyesus visited the agency in 2018, while former Prime Minister of the UK, Tony Blair visited in 2019.

With the solid structures and the qualified and well-motivated workforce that Iheakweazu had put in place, Nigeria was already  well prepared by the time the first case of COVID-19 was recorded in February 2020. To the surprise of many, Nigeria, through the NCDC, was one of the first countries to recognise and prepare for the risk posed by the pandemic. Iheakweazu and his team stirred the government and other stakeholders to start planning the response for the outbreak, very early, albeit with limited resources. A multi-sectoral National Coronavirus Preparedness Group was established by NCDC as early as January 2020. This group included representatives from the Port Health Services of the Federal Ministry of Health, Office of the National Security Adviser, Federal Ministry of Agriculture and partners including World Health Organization (WHO), US Centres for Disease Control and Public Health England.

By the time the first case was confirmed, the NCDC preparedness group had transitioned to an Emergency Operations Centre, while the federal government instituted a Presidential Task Force on COVID-19 (PTF). Thus, with the high level of preparation and the constant efforts of the NCDC, led by Iheakweazu, Nigeria’s infection rates and death toll were far lower than many had feared.

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The NCDC, under Iheakwazu’s leadership developed proactive and reactive communication strategies. The weekly press conferences with the Presidential Task Force provided him an opportunity to engage directly with the media. In addition to this, he ensured that the agency worked very hard to respond to several daily media requests, developing key communication messages every week, utilising various media channels to reach all sections of the Nigerian society, with necessary information and sensitisation that proved useful in averting what might have been a national tragedy.

Throughout his tenure, Iheakweazu more than doubled the size of the NCDC staff, set up a network of molecular-biology labs across the country and become the steward of multimillion-dollar grants intended to diffuse the threat of disease outbreaks in the country.

 

Background and recognitions

Ihekweazu was born in 1971 to Nigerian-German parents. His father was a Nigerian doctor and the mother, a German professor. His childhood was in the small university town of Nsukka where he obtained his foundational education; his secondary school education was obtained at the Federal Government College Enugu (FGCE) from 1983 to 1989.

Ihekweazu holds an MBBS from the University of Nigeria, Nsukka, a Diploma in Tropical Medicine at University of Heidelberg, Germany, a Masters in Public Health from Heinrich Heine University Düsseldorf, Germany, a Fellowship of the European Programme for Intervention Epidemiology Training, as well as a Fellowship of the UK’s Faculty of Public Health.

The celebrated epidemiologist has been variously recognised for his efforts at building a lasting foundation for the success of the NCDC, as well as preventing and managing disease outbreaks in Nigeria and beyond. He was in November 2001 appointed assistant director-general at the World Health Organisation (WHO).

Ihekweazu is married to Vivianne Ihekweazu and they have two children.

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