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Will the controversial appointment of Africa CDC’s Director General discredit the young institution?

It takes years to build a good reputation and only minutes to destroy it
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On 19 February 2023, Congolese medical doctor Jean Kaseya was appointed by the Assembly of the African Union (AU) as the first Director General of the Africa Centres for Disease Control and Prevention (Africa CDC) after a controversial recruitment process. Given the crucial role of this continental public health agency in strengthening Africa’s public health institutions, this appointment will have a negative impact on Africa CDC’s functioning and reputation if allowed to stand.

An opaque recruitment process

The Africa CDC was established in January 2016 by the 26th Ordinary Assembly of Heads of State and Government. It was then officially launched in January 2017 and has been operational ever since. The previous Africa CDC head, John Nkengasong, who used the title of Director, resigned in May 2022 and is now leading the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which was created in 2003 as part of the US’s global HIV/AIDS response. A total of 180 candidates were considered for the post (now known as Director General), including Ahmed Ogwell Ouma, who was the Deputy Director during Nkengasong’s reign and served as the organisation’s Acting Director after Nkengasong’s departure.

Kaseya, the new Africa CDC Director General, has over 20 years of public health experience at both national and international levels. He has worked for UNICEF, the Clinton Health Access Initiative, Gavi, the Vaccine Alliance, the World Health Organization, as well as the government of the Democratic Republic of Congo. He has been appointed on a four-year contract, which can be renewed once, and will be based in Addis Ababa.

But Kaseya’s appointment has been controversial. In May 2023, one of the candidates, Magda Robalo Correia E Silva – an infectious disease physician, President of the Institute for Global Health and Development, and Guinea Bissau’s former Minister of Public Health – protested and demanded an explanation about the selection of Kaseya, adding that the underhand dealings in the selection process do 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.”

Some commentators have suggested that Robalo did not have the endorsement of her own government to apply for the position. But Robalo emphasized that the “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” because such a requirement “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.”

She added that “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.”

The appointment also prompted Rwanda’s President Paul Kagame to write a letter dated 3 March 2o23 to Azali Assoumani, President of the Union of Comoros and the new chairperson of the AU. In this letter, Kagame outlined different issues stating that “no debate was allowed on the appointment of the Director General of Africa CDC, even though three member states had requested to speak. This was the only agenda item on which debate was forbidden. Moreover, the report given by the Legal Counsel on the deliberations of the Committee of Heads of State and Government on Africa CDC gave no explanation for why the first-ranked candidate, a woman, was not selected. More troubling, besides [President Azali Assoumani], no Heads of State or Government took part in the Committee meeting, and delegated officials were mostly below ministerial level.

In light of these complaints, it seems clear that the selection process was unfair, and that political considerations seem to have trumped merit-based ones.

Most notably, the appointment of Kaseya goes against the very spirit that led the AU Commission to select a team of 10 recruitment experts from five regional blocs to help reform its recruitment system in order to make it internationally reputable and also promote transparency and restore the confidence of Africans in it. Before that, the recruitment processes of the AU were known to have irregular shortlisting of interview candidates, appointments without job applications being submitted, uncompetitive recruitment processes, and failure to make merit-based appointments. So, what are we to expect of Africa CDC if all the allegations about a diplomatic coup for Kinshasa are true?

Africa CDC’s reputation in tatters

Africa CDC was positioned by its founding director, Nkengasong, as the leading public health institution for Africa. Nkengasong, with support from African Heads of State and the leadership of the AU Commission, gave Africa one respected technically sound voice in the global health landscape. His leadership was most noticeable during the COVID-19 pandemic, especially in light of the several partnerships he developed with donors and key global health actors. This hard-gained reputation is now under threat. It takes years to build a good reputation and only minutes to destroy it.

The timing of Nkengasong’s decision to work for the Biden administration was unhelpful, as his departure from Africa CDC raised concerns about the organisation’s future and sustainability at a time when he was most needed. But Nkengasong cannot be expected to singlehandedly bear the responsibility of Africa’s emergency responses. He did his part, exceptionally well even during a global pandemic, and now someone else must take up the baton and move Africa CDC forward. Fortunately, Africa has no shortage of suitably qualified leaders that can take over from Nkengasong. However, based on the information available, Kaseya’s appointment was neither fair nor merit-based. This is the real issue here that the AU needs to address and if his appointment is allowed to stand, Africa CDC’s functioning and reputation will be negatively impacted. Africa CDC is meant to be an independent and non-political public health institution, but it now finds itself in the embarrassing position of addressing a governance and public relations scandal.

African leaders voted nearly a year ago to allow Africa CDC to transform from being a specialised AU technical institution into a public health agency which would give it greater authority and allow it to be more agile in the face of public health emergencies. The transition also gives the new Director General the power to convene African Heads of State on public health issues. These are commendable reforms which are now being undermined by old habits of recruitment.

Most importantly, Africa CDC has been facing challenges which also need to be addressed by a leader with unquestionable credibility. These challenges include large numbers of staff vacancies, weak financial and logistical management, and burdensome administrative procedures. The new Director General also has the arduous task of putting in place systems needed for an autonomous AU agency that is not reliant on the AU offices and systems for the management of human resources, financial systems and strategic communications. Additionally, he has to be proactive in pushing forward initiatives that strengthen the public health ecosystem on the continent. Furthermore, he needs to expedite the operationalisation of the organisation’s Regional Collaborating Centres. Africa CDC must also lead public and private academic and research institutions that function to develop the scientific evidence and human resources needed to inform policies and to deliver on the targets of the New Public Health Order for Africa. Given the events surrounding the Director General’s appointment, it is doubtful that these challenges can be easily and quickly resolved if political considerations take precedence over merit-based considerations.

It would be unfortunate if some African countries, regional economic communities and partners/donors were to withhold their support, financial or otherwise, for the institution as they do not acknowledge the incumbent Director General as the legitimate head. The events surrounding the appointment have left a bitter taste in the mouths of a considerable number of people and, unfortunately, the credibility and independence of Africa CDC will be questioned for months to come by African citizens, governments and international global health partners. This will inevitably have significant repercussions for the public health agency, which would have adverse impacts on Africa(ns) should a pandemic or public health crisis emerges. This appointment must, therefore, be reconsidered at the AU level.

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