The Chikwe Ihekweazu One – Institutions Under Pressure | One2One Special Series (Ep.6)

Описание: What do crises reveal about the strength — or fragility — of institutions?

In Episode 6 of ONE2ONE’s Designing the Future of African Healthcare special series, Tokunbo Shitta-Bey is joined by Dr Chikwe Ihekweazu for a searching conversation on what epidemics and pandemics expose about systems, leadership, and state capacity.

Drawing on his experience building and leading public health institutions in Nigeria and working at the heart of global health governance, Dr Ihekweazu reflects on why some systems endure under pressure while others falter — and why health so often becomes the arena where deeper institutional weaknesses are laid bare.

This episode explores:
• What crises expose about institutional strength and legitimacy
• Why outbreak response is ultimately a governance challenge
• The political economy of “quiet institutions” (preparedness as insurance)
• How systems resist reform — and what it costs to build capacity
• Where global health cooperation breaks down in the real world

Continues in Episode 7 — Power, Independence & the Cost of Failure
   • The Chikwe Ihekweazu One – Power, Independ...  

🕒 Chapters
00:00 Opening — "this is ONE2ONE"
00:17 Setting the stakes: leadership when decisions carry consequences
00:55 Lagos, not Geneva: setting the context
05:25 The NCDC moment (2016): "the uncomfortable truth"
08:41 UK, Germany & South Africa: what strong systems teach
12:11 Preparedness as insurance (and why politics won't fund it)
13:33 Building the Berlin Hu: epidemic intelligence and innovation
19:03 The governance epiphany: Durban AIDS Conference (2000)
22:22 Institutional weakness: belief, expectations, and political design
28:18 “Almost designed to fail”: the public sector trap
33:14 COVID-19: science vs political expediency
36:17 Federalism stress-test: resistance and coordination breakdown
40:34 An Imperfect Storm: why we wrote the book
48:15 Where global health governance breaks down
51:02 Will countries share information fast enough next time?
56:39 Borders, sovereignty, & the drift of geopolitics
59:34 The single biggest worry: access to countermeasures
01:00:37 Africa’s place in global health security
01:03:18 The honest negotiation: sovereignty, preparedness, finance
01:04:11 Episode hinge: “Why is health exceptional?”


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This conversation was recorded before recent global developments affecting multilateral health institutions. In light of current debates, these reflections on institutions, leadership, and system resilience have taken on renewed relevance.

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