First there was HIV and Ebola, now Matshidiso Moeti faces down Covid-19

South Africa-born Dr Matshidiso Moeti has seen her fair share of epidemics and pandemics over the course of her decades-long career in public health, and is now the face of the World Health Organisation (WHO) in Africa, bringing information to billions as Covid-19 sweeps across the continent.

As a young doctor working in public health in Botswana, Moeti was tasked with one of the two biggest challenges in her career. One was the HIV/Aids pandemic which at that stage faced massive challenges, not just in terms of access to treatment but also with the stigma attached to the disease.

“In those very early days when it [HIV] was very stigmatised, you had to keep absolutely secret who was infected,” she told Business Day in an interview. 

 “I remember the register of who was infected in Botswana used to be kept under lock and key in a drawer in my desk in the office that I had as a programme manager [for HIV in Botswana],” she said. 

In those days, the reality was that people she would see at an HIV/Aids conference who visibly had the infection would just not be there when the next conference was held.  

Decades later Moeti faced her second notable public health challenge, in part as the then new and first female regional director of the WHO in Africa.

The deadly Ebola epidemic hit countries in West and Central Africa hardest and saw violence break out in reaction to attempts to combat the virus, which notably required people having to change one of their most sacred rituals — burying the dead. 

This year has added another public health-care crisis to her tally as the novel coronavirus has done the unthinkable. It has brought the global economy to a halt as people stay confined to their homes.

While the spread in Africa, which has more than 47,000 cases, has been far less rapid than in Europe, the US and China, where it originated, the continent faces extreme challenges in its response. Even developed economies have taken a beating as they tried to contain and mitigate the devastation caused by the spread of the disease. In addition, the politics involved in public health at this scale is also no small challenge. 

When asked about the response to Covid-19, the 66-year-old Moeti says she often tells her colleagues she has not worked this hard since she was the programme manager for HIV in Botswana. 

Maybe, she says, this is just the result of her being older.

“But I feel the intensity more than I did when I was 40 years old. It has really, really been relentlessly intense, and it’s meant that I have stopped virtually everything else, which is a worry at the back of my head.

“There’s things that should not stop. You are running an institution that does more than outbreak control,” Moeti says.

She says she relies heavily on her team to ensure the rest of what the WHO in Africa has to do gets done while the world comes to grips with the reality of Covid-19.

Early life

While public health has consumed her adult life, it was “by accident” that she ended up working in it. As a young high school girl she wanted to be a physicist, then ended up studying medicine and dreaming of specialising as a paediatrician.

Her decision to go into public health was in no small measure influenced by her parents, who both worked in the sector, most notably in Botswana, which became their home after the family left Springs in Gauteng when she was 11. The decision to move countries was in part to get away from the apartheid security forces but also to ensure the children received a better education than what was available under Bantu education in SA, Moeti says.  

On how her country of birth is dealing with the outbreak, Moeti says the approach taken by the government, which includes data-based interventions and economic and social support packages to help mitigate the effects of the pandemic, is a “strong combination”  the WHO in Africa would recommend other countries adopt in their own context.

With five years left on her term as director of the WHO in Africa, it can be assumed that Moeti will continue at the coalface of public health on the continent as the world thinks about how to come to terms with life after Covid-19.

The dream of what comes after these five years is a bit more whimsical than her unending workdays.  

“I want to rear ostriches and grow olives in Botswana,” she says, adding that the climate would be ideal for it. 

But for now, dreams of farming, attending jazz festivals and spending time with her family are a far cry from reality. There is, after all, an invisible enemy on the loose, and she is helping to  call the shots in Africa’s first line of defence.