RESULT's Interview

“I had a voice that no one could stifle”: a World Immunization Week interview with Joan Awunyo-Akaba

This week, I was fortunate to reconnect with someone who has inspired me: Joan Awunyo-Akaba. Joan is a registered nurse, a passionate advocate for health, a civil society representative on the GAVI Alliance Board, and the Founder and Executive Director of Future Generations International, a Ghanaian NGO focused on health promotion and development. As we chatted, it struck me that she could be the Ghanaian Sheryl Sandberg—leaning in fearlessly and unapologetically to her work on behalf of Ghana’s children. Here are excerpts from our conversation:

You’re a registered nurse by profession—what made you want to get into advocacy work?
I’ve come a very long way. After studying health visiting in England, I came back to Ghana and went to work in the maternal and child health sector. That was back in the ‘70s, when so many children were dying from measles. At that time, vaccines were there in Ghana, but many were wasted as they expired or were not delivered to the children who needed them. We were not reaching the children. And that was frustrating.

So I went back to school, and got my masters in community health and my PhD in medical sociology. Then, I worked for the government in the Ministry of Health; I was at the height of my career, but in 1994, I resigned from the public sector to start my own NGO. I wanted to be a louder voice for the children who were not being reached.

How did you know when you had found your voice as an advocate?
In 2004, my organization, FUGI, Was supported to undertake a project called Community Action for Health that worked in 10 communities. We were going out to villages to talk to leaders about health promotion within their communities, and it was considered tradition to bring alcoholic beverages to each village chief as a welcome greeting. Well, I told my team that when we went, we not going to bring the chiefs drinks because I wanted the message to be clear: I was there to do them a favor, not the other way around. And sure enough, when we went to the first chief, I told him, “I’m not coming with a drink, because I am one of you. I’m not a visitor—I’ve come so we can see how we can help move the health of your people forward together.”

That was a bold move! What was his reaction?
[Laughing] He was shocked, but pleasantly surprised. Now, we don’t go to any chiefs with any drinks. And from that day forward, I learned that I don’t owe allegiance to anyone. I saw what power I had: that I had a voice that no one could stifle.

Tell me about someone in Ghana who has inspired you.
I have a friend who is now in her 60s. She had one daughter who, at the age of two, died of measles infection. Still to this day, she cries when she talks about her daughter. Hers is a story that motivates me. The death of children is just a statistic to the public, but to a mother—someone who has carried her daughter for nine months, held her in her arms, nursed her, looked after her for years—that death is not a statistic. No one should lose their child to a preventable disease. So that is a negative story, but it drives me forward positively in my work.

What are you most proud of about Ghana’s immunization work? What are some of the biggest remaining challenges?
Ghana is toasted as doing so well in terms of development; indeed it’s true. It was the first country to roll out pneumococcal and rota virus vaccines at the same time, and it’s now implementing the HPV vaccine. Our political leaders in Ghana are committed to seeing all children vaccinated, and President Mahama is a GAVI champion.

But Ghana is divided into two: some districts are doing well, but others are really struggling. When you don’t disaggregate the data, it gives a rosy picture. We need more support for civil society to help reach children in all the most remote areas. And I’m pushing that we need a stronger sustainability plan in place for immunization financing. GAVI support will not be around forever. If we graduate from GAVI support in a few years and we don’t have the plans and the clear budget lines in place to say how we will finance these vaccines on our own, we will lose some of the gains we’ve made.

What’s your elevator pitch, in 5 sentences or less, on GAVI?
It has the right mission and the best interventions to save the lives of children. It has helped countries to introduce new vaccines at a pace and a price that would have never been possible otherwise. And it has helped bring awareness to governments that the child is important, and worthy of our investment.

What message would you deliver to ONE members and to advocates around the world working in support of GAVI?
For those of us like me who interact with mothers who are happy because they have healthy children—thank you, we are grateful to your work. GAVI must not lose sight of the children and communities they are serving. With 22 million children unimmunized every year, there are still too many out there dying unnecessarily from preventable diseases. We must be mindful of them, and always hear their voices.

Special thanks to our friends at RESULTS for facilitating this interview with Joan.

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