Ebere Okereke believes global health is about power

[on-hold music] The Trump administration's decision to dismantle the US Agency for International Development sent shockwaves around the world, but they reverberated differently in different places and institutions. There were the acute impacts, health clinics closed down overnight, aid workers stranded in conflict zones, NGOs facing immediate financial collapse. But there have been other ripple effects that are more difficult to trace, more complex and nuanced. For many political leaders and health policymakers in the countries where USAID operated for years or decades, the agency's sudden withdrawal was also a wake-up call, a seismic shift in the status quo of global health cooperation. Dr. Ebere Okereke, a global health strategist and consultant born in the UK and raised in Nigeria, has been thinking a lot about what that rupture means for the future of public health institutions. She's a prominent voice in a conversation that is still just taking shape about how these big geopolitical changes create both risks and opportunities in the quest for a more equitable global health architecture. And at the end of the day, it's ultimately another conversation about power. Here's Ebere. Dr. Ebere Okereke, thank you so much for joining me.

Thanks for having me. It's a pleasure to be here.

Let's start by learning a little bit more about you. Um, I'm curious what led you to a career in medicine, a, a career in health. What were the seeds of that decision?

Oh, I, I have to go back, uh, f- for fifty-odd years. I-- My, my, my father is a physician, and so I grew up in a physician household. I think I started carrying around the, uh, medical kit when I was four or five. Uh, so it goes back that, that far. Um, and so, uh, I didn't-- never really had any alternative, uh, career option. I never thought about anything else. If anything, my dad did try to dissuade me at one point because he felt that medicine can be a hard career on women. This is, you know, a, a long time ago. But I've always wanted to be a physician. But for public health specifically, that was a, a particular e-experience when I was about maybe eight. Uh, we had... Uh, so context, I'm, I'm Nigerian. I was born in the UK, but grew up, well, my formative years was built-- spent in Nigeria. Um, and a cousin came to visit and then became unwell, and this is through the eight-year-old lens. We all got s- taken across to this community health center, had chest X-rays and skin tests, and, uh, we heard, heard about this d-- the disease called TB. And, um, mm, it was-- I've been, till today, still very fascinated and besotted by the challenge that TB poses to, to humanity, and I very much believe that when we crack TB, we would have actually cracked equity and inequalities in health because it's such a wide-ranging disease in terms of both its, its pathology, but it, it, it-- the people who are affected and the outcomes are very much driven by societal and social factors far more than the medicine, uh, or, or, uh, and, and science. And the interesting thing as well is that the, the, the fact that medicine and science isn't cracking it is also determined by the people who get it. You know, that, that,