People stand when Dr Matshidiso Moeti enters a room at the World Health Organisation's Africa headquarters in the Republic of Congo and they listen intently to what she says.
Small in stature and big in presence, Moeti is the first woman to lead WHO's regional Africa office, the capstone of her trailblazing career in which she has overcome discrimination in apartheid South Africa to become one of the world's top health administrators.
As WHO Africa chief, Moeti initiates emergency responses to health crises in 47 of the continent's 54 countries and recommends policies to strengthen their health care systems.
Since her appointment in 2015, Moeti has grappled with the world's deadliest Ebola outbreak, in West Africa. She has also has had to handle lingering criticism of WHO's spending and hiring in Africa as it also deals with allegations of sexual assault by contractors during Congo's Ebola crisis.
From 2020, the start of her second term, Moeti has faced her toughest professional and personal challenge: helping Africa respond to the coronavirus pandemic as the continent trails the rest of the world in testing and vaccination efforts.
She has become one of the world's most compelling voices urging better consideration of Africa's people — especially women, who've in many ways been hit hardest by COVID.
Her identity as an African woman has been both a strength and an obstacle on a continent where much of society is still dominated by patriarchal systems.
“I'm certainly doing my best to be there not only as a technician and a manager and a leader, but also very much as a woman from the region, from the continent,” Moeti, 67, told The Associated Press during a recent visit to WHO Africa headquarters in Republic of Congo. “I feel very privileged.
“At the same time ... I'm looking forward to the day when it will no longer be notable that there's a woman leading an organization — when it will have become part of the norm.”
Moeti has made strides within WHO Africa to follow through on her word — starting a leadership program that has helped promote more women by ensuring that female applicants for jobs are taken as seriously as men.
Improved gender parity is evident at WHO Africa, where nearly equal numbers of men and women walk around the sprawling campus, about a 20-minute drive outside Brazzaville along the Congo River.
In her time in office, Moeti said, she is proud to have shifted the ratio of men to women — now, four female directors and four male directors flank her in the grand conference room where meetings and Zoom calls are held. Prior, it was three women in the presence of six men.
One of the women at the table is Dr. Mary Stephens who says that seeing Moeti as regional director means a lot to her and others in Africa, where women historically and traditionally have had to take a back seat: “It gives us hope and an indication that it can happen for any woman on the continent.”
Emergency work like hers, Stephens said, “adds another layer of challenge to it for a woman, because you're deployed to difficult situations and it is perceived to be a job that not all women can do. Well, we have been doing this work. I've been doing it for almost 10 years now, and we are progressing.”
In Africa, women have suffered disproportionately during the pandemic — with lower vaccine rates, economic turmoil, rising pregnancies, other healthcare issues, increases in domestic and gender-based violence — and Moeti has made addressing that inequality a cornerstone of her work.
“Very often I'm thinking about those people who are most frequently disadvantaged and missed by the health services ... the kind of adolescent girl, that person who is transitioning from being a child taken care of by the child health services to being a woman of reproductive age with all the vulnerabilities that that that implies in Africa,” Moeti said.
She thinks of women she knows and sees. The woman who braids her hair, who lost work because of the lockdown and is scared of the vaccine. An elderly woman who must carry her load of food up and down steep hills. Women selling produce at marketplaces forced to close their stalls.
The way out of the pandemic is to reach these women with awareness campaigns and economic aid, she said.
To this end, Moeti tries to get out into the field monthly.
She's frequently joined by government officials and journalists, and the convoy can attract a crowd — as with a recent trip to the dense Ouenze neighbourhood of Brazzaville.
Women and men jostled to get a glimpse of their health minister, the mayor and Moeti, at a small yard outside a health center.
In a colourful tailored top and WHO vest, Moeti listened with the others to 25-year-old biochemistry student Arnie Mayeyenda explain COVID-19, prevention methods and vaccination efforts to residents. Moeti leaned over to listen to a translator as the student spoke — nodding in encouragement.
“Many people aren't aware of the presence of the virus, so we need to let them know about it and how to avoid getting it,” Mayeyenda said, explaining how Africa still lags behind other parts of the world.
Later, Mayeyenda said Moeti and her work inspire her as Africa tries to catch up, and she recommended that the leader also visit universities to speak and show young women that a future in science is possible for them, too.
The pandemic has also worsened existing gender inequities in key spheres, according to WHO Africa. Women constitute 70 per cent of the health and social workers in Africa and are on the frontlines of COVID-19 response, yet 85 per cent of national task forces are led by men, according to the U.N.
After cheering and celebration — part of the usual fanfare of official visits — Moeti and the officials headed to a hospital, where nurses lined up to welcome them. In a tight corner, she and the health minister spoke with a woman being tested for COVID, reassuring her.
Africa has shown lower rates of COVID-19 cases compared with the rest of the world, but that's likely due to lower testing levels.
Countries have struggled to treat the sick, and vaccination rates are low, with just over 13 per cent of all of Africa's 1.3 billion people fully vaccinated at the beginning of March. That's far behind the global rate of 56.6 per cent, according to Our World in Data Moeti has nearly 40 years of experience in public health, but the coronavirus pandemic has confronted her with new challenges.
“The difficulties have really been about learning about this new virus, adapting quickly and helping countries to do the same,” she said.
She noted Africa faces unique challenges — at the start of the pandemic only a handful of the continent's countries could test for COVID-19, now virtually every nation can do that. Africa has been dependent upon imported vaccines which resulted in lengthy delays as rich nations bought the inoculations first.
The UN-backed COVAX initiative, meant to ensure equitable access to vaccines, did not make its first deliveries to African countries until a year into the pandemic, and even then had uneven distribution.
But now steady supplies of vaccines are arriving across the continent and Africa is creating labs that can manufacture vaccines.
With hindsight, Moeti says she wishes she'd focused more on Africa's low-income countries that needed help getting vaccines. She is pleased that the continent's countries can now get specific vaccines and reliable delivery dates, she said.
A major controversy during Moeti's term erupted in Congo where a commission found that WHO-contracted staff members were among aid workers who perpetrated sexual abuse during the Ebola crisis from 2018 to 2020.
Moeti said policies have been implemented to be sure this does not happen again, including more stringent management of the hiring and supervision of contract workers.
Moeti remains optimistic about Africa's path out of the pandemic — and WHO's role in that progress.
With a demanding schedule, she lives on the WHO campus and her office is just a few meters from home. It's sacred ground, with assistants making sure she's not disturbed. Her sprawling desk is neatly organised, with the United Nations and WHO banners behind it, the backdrop on her many Zoom conferences. Her collection of African sculptures and paintings enlivens the office.
Warm with colleagues and journalists but private, she offers few details about her family, saying simply that they have been her refuge during the pandemic. Sunday afternoons are reserved for her two daughters with whom she enjoys lengthy Zoom calls. Responding to their pleading, she now wakes up and doesn't look at her phone until she has eaten breakfast.
Only recently has Moeti found time for activities outside work: listening to jazz, exercising on her stationary bike, tending a vegetable garden in her yard.
The women in her family helped her to achieve so much, she says. Moeti's mother was a doctor, and her grandmother a teacher who was widowed with seven girls to raise in a South African society that looked more favorably on educating sons.
Moeti speaks of her as a hero — "a very determined, soldiering-on type of woman.”
Moeti also acknowledges that she was privileged to be raised in a family that valued education above all else.
When she was young in apartheid South Africa where segregated, sub-standard Bantu education was enforced for Blacks, she had to commute to Swaziland for schooling and faced scrutiny at the borders of the small country encircled by South Africa. The commute was too much, so her parents moved the family to Botswana where they could get better, non-racist education.
The importance of education has been a constant in her life. When she pursued a master's degree in London, she was separated from her daughters for a year, and her marriage to their father eventually ended. She is now remarried to an epidemiologist who has worked on many outbreaks and commutes in and out of the country, she said.
Despite the challenges she has faced, she wouldn't change her life, she says. Her family and education continue to motivate her to improve Africa's health care. Thinking of young African girls suffering during COVID-19, Moeti says she wants to help improve their lives, inspire them and make them into leaders.
She wants them to know: “I'm a child who was in the South African township and running around the streets. I hope that will encourage them."
