The resilience playbook

<h1>The resilience playbook</h1>

<p>In Nigeria, fighting COVID was <em>An Imperfect Storm</em> that required creativity and optimism.</p>

<p>Written by Paul Adepoju</p>

<p>This <a rel="canonical" href="https://harvardpublichealth.org/policy-practice/chikwe-ihekweazu-vivianne-ihekweazu-public-health-book-review/">article</a> originally appeared in<a href="https://harvardpublichealth.org/">Harvard Public Health magazine</a>. Subscribe to their <a href="https://harvardpublichealth.org/subscribe/">newsletter</a>.</p>

<p class="has-drop-cap">Global health progress is often measured with indices and benchmarks, but these metrics overlook something crucial: the creativity and resilience employed to solve incredible problems, especially in places that are seen as “behind.” In <em>An Imperfect Storm</em>, Chikwe Ihekweazu offers a rare glimpse into the personal, professional, and institutional challenges he faced during the COVID-19 pandemic in Nigeria. His wife, Vivianne, a health communications expert who lead the watchdog group Nigeria Health Watch, also offers her view, from outside government, about the personal and professional challenges of the period—and her nevertheless unyielding optimism.</p>

<p>Their book not only captures the complexities of managing a public health crisis in Africa’s most populous country but also highlights the leadership and determination that drove Nigeria’s response.</p>

<p>Growing up in Nsukka, Nigeria, where his father worked as a doctor and his mother was a pioneering professor, Chikwe Ihekweazu was imbued early on with a deep respect for community service. He carried those values throughout his career, ultimately leading to his work as director of Nigeria’s Centre for Disease Control (NCDC).</p>

<p><em>An Imperfect Storm</em> is not just about the pandemic; it is about a system struggling to find its footing amid bureaucratic inertia, limited resources, and a reliance on donor funding that has plagued African public health systems for decades. It’s also a window into the complexities behind the political scenes, where public health emergencies are met not only with medical strategies but with negotiation, diplomacy, and the occasional outright defiance of traditional norms.</p>

<p>For those familiar with the public health landscape in Africa, the insights Chikwe Ihekweazu shares are both affirming and unsettling. He recounts how the banality of everyday work often delayed time-sensitive actions. For instance, there was a slight lag in announcing Nigeria's first COVID-19 case because the health ministry’s social media handler had simply gone to bed. The book is full of such moments—absurdities that illustrate the larger systemic issues at play. From VIPs demanding preferential treatment for COVID-19 testing to internal tussles between government agencies over case reporting, Ihekweazu paints a picture of a system, one of Africa’s best, in perpetual conflict with itself.</p>

<p>The book also underscores the critical role of donor funding in sustaining public health initiatives in Nigeria. Chikwe Ihekweazu reveals how, during a pivotal moment, the country’s health minister opposed expanding health security operations with money from a national emergencies health fund, preferring instead an old, comfortable reliance on donor support. This anecdote is a stark reminder of the ongoing struggle for financial independence in African health systems and the reluctance of some leaders to deviate from entrenched practices.</p>

<p>Yet <em>An Imperfect Storm</em> is not just a tale of dysfunction. It is also a powerful testament to what can be achieved when decisive leadership, resourcefulness, and a commitment to public service come together. Chikwe Ihekweazu pays tribute to the dedicated, often young staff at NCDC who worked tirelessly to build systems, streamline processes, and lay the groundwork for a more resilient public health infrastructure in Nigeria. These unsung heroes are portrayed as the backbone of Nigeria’s response, demonstrating that even in a system plagued by challenges, committed individuals can drive meaningful change.</p>

<p>In the book’s final pages, Vivianne offers a different perspective on the roots of change in a stubborn system. “It is this idealism, together with consistent family support, that has enabled us to accomplish whatever we have. Family matters under all circumstances and underpins everything that we do. With family, no storm is too great to overcome,” she writes. Her section covers the toll crises like these take on the family and loved ones of public health leaders—from obvious concern about your spouse’s risk in responding to health threats to the overlooked challenges of protecting your own children against discrimination from their peers because of the nature of their parent’s job. And then, of course, there’s Vivianne’s own work and sacrifice: sleepless nights in the midst of strategizing about how to announce the country’s first confirmed case of COVID-19, for example. Vivianne was more than a key official’s wife; she became actively involved in the development of guidelines for COVID-19 prevention and response.</p>

<p class=" t-has-endmark t-has-endmark">Ultimately, the book is a call to action for African leaders to invest more in health security—and to move away from the dependency on external support that often leaves their health systems vulnerable. <em>An Imperfect Storm</em> is more than a memoir; it is a critical, thought-provoking exploration of leadership, resilience, and the power of collective effort.</p>

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