Welcome to hardtalk with me, zeinab badawi. If covid 19 were to spread right across africa, it could be a human catastrophe. Many feared that the continent is simply not ready to cope with the crisis. Its Health Systems are already under strain and could buckle underfurther pressure. My guest is ngozi okonjo iweala. She is a special covid 19 envoy for the African Union as well as being chair of gavi the Global Alliance on vaccines and immunisations. As the world races to find a vaccine, what is she doing to ensure that lower Income Countries are not forgotten . Dr ngozi okonjo iweala, welcome to hardtalk. Thank you, zeinab. So, in april the World Health Organization was warning that within 3 6 months there could be 10 million covid 19 cases on the continent. We are now roughly at around 700,000 cases, nearly 15,000 deaths, it looks like an extreme exaggeration. The experts cant get it right, can they . Well, zeinab, we just dont know. According to the africa cdc in addis, the cases are accelerating in africa at about 100,000 a week now. So we have not reached our peak on the continent, and we dont know the trajectory of this pandemic yet. But the fact of the matter is you may never know because testing is so sparse in africa. I mean, some countries ghana, senegal in the west are doing pretty well because they were used to the Ebola Outbreak and so on. But really, you are just completely in the dark. I wouldnt say that, zeinab. I mean it is true that testing is not where it is supposed to be. We are supposed to be testing about 12 million a month and we are doing about 6 million now. So we are halfway where we need to be. But i think that has improved greatly over the months and i think as we get countries get more test kits, and more support, this should improve but youre right at that testing is way behind. All right, your own nigeria is one of the worst affected countries on the continent alongside south africa, and egypt. And youve had about 750 800 deaths so far in the country and the governments approach there is to focus on clusters of outbreaks rather than mass testing. Is that a better approach . Well, im not an expert on the issue but, given the scarcity of resources for testing, i think we have observed that the incidence is quite different in different parts of the country. So it seems smart to start where there are these clusters and then spread out from there. I think the nigeria cdc is doing quite well in terms of trying to give information and direct people where to go, and it works very closely with the africa cdc head doctor, and i think they are doing a really greatjob. Alright, how worried are you . Because there is this idea that because africa has the youngest population of anywhere in the world, 60 of the population is under 25, only 2 of the population is over 65, and that therefore that gives the people a measure of some kind of protection against covid i9. I wouldnt be sanguine about this. As we have seen in other countries, young people between the ages of 19 40 are beginning to get it even in the United States. So, we cannot say that, because of youth, we are escaping. It is true we have a low number of deaths on the continent and that is something to be happy about or at least pleased with. But we cant be sanguine that young people what i can say, zeinab, is that because of cultural issues on the continent, most older people in the population do not stay in homes so they are not clustered together, and that might also be helping us to manage the spread of this disease. I mean, we tend to keep our older people at home so they are spread out. But with respect to young people, i would say be cautious. We cant really assume anything. But you know that 60 of urban dwellers in africa live in very overcrowded neighbourhoods and the continent has a very heavy disease burden. And so now there are really worried voices saying that the knock on effects of coronavirus is actually going to have an impact on other illnesses. So, for example, Winnie Byanyima who is the head of unaids says that half a Million People could die of aids related illnesses without efforts to overcome disruptions to Health Services and supplies. So whilst focusing on coronavirus, you cant lose sight of other illnesses, tb and all the rest. I absolutely agree with that. I think winnie is correct. And we can even see it with respect to things like immunisation, vaccinations. As the head of gavi, we are seeing that many parents are not taking their children for their usual course of vaccination. And 13. 5 million children have not had their vaccinations in all the countries we are working, including countries in africa. So, diseases, other Infectious Diseases like measles are rearing their head and, if we are not careful, more people might die from measles or hiv aids or other diseases than from covid. So that is absolutely right. We have got to keep our eye on the ball. The second thing i want to say is that there is now community spread. You mentioned the heavy clusters of People Living in poorurban areas, and i think it is true that this is one of the most worrying things we have to look at. In our informal dwellings and communities, the spread can be quite rapid. All right but i mean one other layer of difficulties for africa is of course that Health Systems across the continent are really quite fragile. So, for example, the World Health Organization says that there are only about 2000 ventilators across 41 countries of the 5a in africa. That there are only 5000 intensive care beds in 43 of its 5a countries. So, the picture is really dire. I mean, when people fall ill, there arent the facilities to treat them. Well, zeinab, that is correct what you say. But i just want you to also take note that the Health Systems of developed countries were also vulnerable and overwhelmed. So, really, nobody was prepared for this pandemic and, if the Health Systems in rich countries could not cope and they didnt have enough icu beds, they didnt have enough personal protective equipment, how much more our own Health Systems which you know are already fragile . However, what i can tell you is that the African Union is acting in concert under a plan to make more equipment available to other countries, and the platform has been developed where countries can go and purchase equipment. So hopefully, this will help but absolutely we have to be very careful because our Health Systems are fragile. I mean, i accept what you say that its a challenge for countries everywhere nevertheless in per capita terms, the rest of the world spends ten times more on health care than in africa. And you know that way back in 2001, the declaration said that african countries, and they all signed up to it, should spend 15 of their gdp on health. And in 2017, the World Bank Says the average is about 5 with some countries spending as little as 2 3 of their National Budgets on health. So, african countries, governments, are to blame themselves for this woeful lack of supplies and services in their health care systems. I think its a little bit harsh to say they are to blame because, as i said, countries all over the world have not really been able to cope, except a few who have managed to contain the pandemic very early, but it is also true that many countries are not spending up to the 15 of their budget declaration. Actually, the situation has improved over the years and many more countries are spending more than the 5 you talked about, and i think there will be an improvement in that. But i do accept the fact that, yes, we are not spending enough. I think the issue, zeinab, is the issue of fiscal space. Do we have what it takes in order to spend on health and all the other sectors that support health . And now the situation from any kind of spending looks pretty dire because the pandemic of course is threatening social and economic progress in africa. Its facing the worst global recession than its own recession in 25 years, and so where is that money going to come from . I actually think that this is one of the very difficult situations we face. As you said, the continent is projected to contract by about 3 in per capita terms, per capita gdp is supposed to contract by about 5 according to imf figures. Throwing us back a decade. The biggest problem here, zeinab, is we are losing the gains that the continent made over this past 1. 5 decades. And there is not enough fiscal space meaning that when we countries have to service debt and take up the other needs, there is not enough to deal with the present situation of the pandemic, both the health and economic aspects. So, this needs to be done in a way that brings solidarity. I want to make one or two quick points on that. First, i am quite proud of what the continent is doing in terms of solidarity. The African Union has come together, resources have been put together, 63 million out of the 350 needed to support the africa cdc which again is doing a very good job. The countries have all tried to put in fiscal measures to cope with the situation. But whereas developed countries are implementing 8 10 of gdp fiscal stimulus, we are only able to do 0. 81 . So, it means we need resources in a solitary fashion from outside also to help us meet these costs. That is not going to come though, is it . Im just going to give you one example, you mentioned debt, and when you were finance minister in nigeria, you are very deeply involved in trying to get Debt Forgiveness for countries in africa. But as david malpass, the president of the world bank has just said, he is so disappointed that the appeal made to g20 countries who account for about 80 of global gdp saying, look, african countries that are heavily indebted are spending more on servicing that debt than they are on their own health spending, and countries have not stepped up to the plate in the more advanced economies, they havent helped. I agree completely with that. We dont see the kind of concerted world action and response in a solidarity fashion that we did in the 2008 2009 financial and food crisis where the world came together to really try to solve the problem as a whole, as a community. That is not happening now, that is a problem. I totally agree that on the issue of two things, on the issue of debt relief, we are asking from the african side, there are envoys working on this, we are asking for a debt standstill, and that will give us time to assess the debt situation of each country, and it would also put about 41; billion, if its across all types of debt, into the hands of african countries which to try and deal with the economic and the health situation. We also need fresh resources. It cant be that we dont have any debt relief, and we also dont have enough fresh resources. So weve estimated that the continent needs about 100 billion a year for the next three years to be able to weather the crisis. Do you think there is a double standard operating here . Because the finance minister in ghana, one of many african politicians to complain that, as he put it, while richer countries have taken massive and unorthodox measures to stave off economic collapse, african countries are expected by creditors to stick by the rules. We have seen trillions of dollars being assigned for spending in developed economies, yet, africa is held to sticking to the rules. Let me put it this way. This is a pandemic such as no one has ever seen, and i think we cannot have business as usual. In an unusual environment, i mean, ratings agencies are carrying on with businesses as usual, so countries are really even afraid to avail themselves of whatever Debt Service Relief at that g20 had initially set. You will see this weekend what happened with the g20 meeting. Many countries are not even stepping forward because they are afraid of losing their rating stance. So this is business as usual. Secondly, you are absolutely right that african countries are not able to come forward with the kinds of stimulus that you see in developed countries. They are helping the businesses in these countries with liquidity, the Central Banks are putting out liquidity and businesses have access, households have access. We dont have that. And i think the world really needs to step back and think about it, do you really want to leave developing countries and the african continent behind . No one will be safe until everyone is safe. No country is going to be safe until our countries are safe from this pandemic. So i think this is the time to act together to act as a community, not alone. Well the plummet in incomes especially in the Informal Sector in africa is really threatening peoples livelihoods in a very very dramatic way, and as you say, they dont have the safety nets in these countries to help people along. So the sudanese philanthropist and the co founder of the Kofi Annan Foundation have said this, that the pandemic will cause widespread social distress and possibly political upheaval in africa, especially amongst young people who lack work and opportunity more than ever. Do you agree that we could actually see a political crisis of upheaval in a very extreme fashion . I agree that that could happen, i think the african governments themselves from what we can see we are doing everything they can to try and make sure this does not happen, but without the solidarity and support needed from abroad, yes, there could be dislocations because, as you say, many people work in the Informal Sector on the continent. 70 80 in our urban areas and Informal Sector. Which means they earn on a daily basis. If you have lockdowns, you have the kind of hit on our economies where the contraction is severe, then it means people cannot earn, and when they cannot earn, they cannot eat. They have no jobs. This is really, really a very difficult situation. So one cannot rule this out. Its not what we want, but it cant be ruled out. And i think this is what calls for the solidarity that we are talking about. So you are appealing for Global Solidarity antonio gutierrez, secretary general of the United Nations has in the past few days said this, he told the bbc that, if the developed countries try to solve their own problems and forget about the rest, in the end, they will pay a terrible price. Do you agree with him and what might that terrible price be . Well, i agree completely with the un secretary general that this is not a time to look at the National Well being alone, its a time to look at communities, approach it from a communal and solidarity point, because thats price might be that would be in your own country thinking you solved the problems and that you are safe, but the interconnectedness of the world today with globalisation means that that is not true and you can have this spread again from different parts of the world if you dont come together to help. You can have the social dislocation we talked about. People will move if they dont have the economic wherewithal to survive where they are. But what can you do about it . What can you do about it . You are chair of gavi, the Global Alliance of the public and private sector on vaccines and immunisations. What are you doing to combat what people are describing as vaccine nationalism, whereby, countries put r d research and development and dig pharmaceutical committees and say come a yes, we are going to strike a deal, that if the vaccine is found or any kind of treatment is going to come to us first, what are you doing to combat this . Well, first, let me say something, that actually gavi provides an example of what the world should be doing. The world came together onjune 11th to do the gavi replenishment, contribute the money needed to make sure that for the next five years, gavi has what it needs to combat and carry on immunisation programmes for our children in the 73 developing countries we work in. And that is the kind of approach we need. The world also came together to contribute money to fight covid. That is also a good thing to do. But we need that to continue to be wider. So gavi provides a good example. 0n the vaccines issues, as we speak, there is an International Effort called the tools accelerator, which is an International Effort between who and several governments to make available an accelerated effort to find vaccines, therapeutics or diagnostics to help countries deal with this pandemic. That effort is going quite well. Is it really . I mean, is it really going well . For example, in the last six months, nearly 50 countries in the world have export restrictions on medical supplies. We have had a former World Health Organization official, David Salisbury saying, there is no Global Authority that has the money and the influence to direct with the private sector, the pharmaceutical industry will do. You can have as many sentiments of altruism, but the question is, how do you translate that into reality . I mean, the efforts you speak about are not going to amount to very much, are they . No, there is a specific effort to actually try and deal with this. Within the tools accelerator, gavi and another organisation along with the who are developing what is called the covax facility. This facility is meant to assure that developing countries, poorer countries in the world, get access to vaccines and do not stand behind the queue when it comes to availability of vaccines. The idea is to get 2 billion doses of vaccines, which would be enough to make sure our poorer countries get access. There are now 77 countries who are we call them self financing countries who want to join this effort. If we can put together a bundle where the self financing countries and poor countries who cannot self finance completely come together to pay for the vaccines, to bring down the price and make it. All right, but is the United States on board . Is the United States on board, this initiative, for example . Well, many countries are coming together, the United States is not there yet, but there is not any ruling out that it could join, because the United States supported gavi during the replenishment, and in fact give it 16 more resources than it had in the past. So there is hope that they willjoin. Its an International Effort, its the kind of effort we need to make sure poor countries get vaccines at the same time. But i was just giving you the example that a powerful rich country like the United States has kept away, and indeed, President Donald Trump has said hes going to withdraw the United States from the who. May not happen if he doesnt win the election, but nevertheless, you have critics coming out, david miliband, former British Foreign secretary saying that the american governments argument with the World Health Organization is interfering with an Effective Response to the disease. I mean, what do you make of fact, the fact that the United States is attacking a Key Organisation involved in the fight against covid 19 . It cant be something you welcome. I think there are many countries supporting the who. This effort that i spoke about with respect to the vaccines is also an International Effort, and we should hold out the hope that the United States willjoin. I know that the scientists are continuing to work with other scientists in who and elsewhere to try to find answers to this vaccine issue. So, we should work to persuade and so that they can join, many countries are joining. So im always an optimist with respect to international cooperation, and im not going to give up that they wontjoin this effort. All right, finally, we know that the wto rules to protect lower Income Countries, you are one of the candidates to become one of the new director generals of the wto, but critics say, look, you are great on finance, but where is your experience in trade . What makes you think you are the right person to lead the wto . I remember answering this question a few days ago. Im a Development Economist by training. You cannot be that without having knowledge, experience in trade. At the world bank, i worked on trade policy reforms along with other economic reforms. As finance minister, i had the Customs Service of nigeria reporting to me for the seven years that i was finance minister, that is all about trade facilitation. Im also known as a reformer, i have the credentials to prove it. And i think the wto at this time is not about the technical qualifications or technical negotiating skills. If that is what they needed, they would have solved the problem long ago because they are are many skilled negotiators. They need something different. It cannot be business as usual for the wto. They need to reach for someone who can break through the impasse, someone willing to do the reforms and lead. Leading with the members. Thank you. Ngozi 0konjo iweala thank you very much indeed for coming on hardtalk. Thank you, zeinab. Hello. Well, for some of us, the skies have remained clear but overall a very cloudy picture on the way, at least for the northern half of the uk during the course of wednesday, and on top of that, weve got some patchy rain as well. And you can see where the clouds coming from, off the atlantic as it often does. Its spreading across Northern Ireland and into scotland. Eventually, it will engulf northern england, too. To the south of that, however, i think some sunshine in the morning and in fact, it will end up being a pretty decent day for the channel counties, certainly for london perhaps east anglia, too. Temperatures could get up into the mid 20s in one or two spots but for northern england, scotland, and Northern Ireland at times overcast, and there will be a little bit of rain, too. And temperatures will be mostly in the mid or the high teens. Now, this is the following night, so early hours of thursday, and you can see that cloudy theme continues. If anything, further patchy rain streams in on a south westerly breeze off the atlantic. And its going to be mild early on thursday morning, around 13, 1a, 15 degrees. Now, this is thursdays weather map and quite a complicated structure of weather fronts sitting on top of the uk. That basically means a lot of cloud and outbreaks of rain. And you can see dumfries and galloway, the lake district, the north west of england, certainly wales getting some rain, too. Now later in the day on thursday, it does look as though it will brighten up across parts of scotland and Northern Ireland and there might even be some sunshine there across the south east in the afternoon, too. That was thursday, this is friday. And on friday, we are actually in between weather systems. So, one moves away towards the east. Another one waiting in the wings here and approaching ireland during the afternoon with the bulk of the uk during the course of friday actually enjoying a pretty bright if not in places sunny day with temperatures into the low 20s. Now, heres the weekend. At this stage, it is looking unsettled. You cant miss that low pressure with weather fronts moving across the uk, quite a few splodges of blue here moving across the uk and increasing breeze as well, so a pretty unsettled start to the weekend for many of us on saturday. And those temperatures a little lower than the average for the time of the year, especially in the south of the uk. Now, there is a possibility things will brighten up at least a little bit by the time we get to sunday but on the whole, an unsettled weekend on the way. This is bbc news. Im Maryam Moshiri with the latest headlines for viewers in the uk and around the world a change in tack as President Trump brings his daily virus briefings back. 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