Aurelia Nguyen: the COVAX chief aiming to lead us out of the pandemic
As the lead of an initiative aimed at leaving no-one behind in accessing COVID-19 vaccines, Nguyen has had a busy two years. With over 1.3 billion doses now delivered to 144 territories around the world, the months of hard work are now paying off.
- 8 March 2022
- 6 min read
- by Priya Joi
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In February 2021, a year into the COVID-19 pandemic, Time magazine published its ‘TIME100 Next’ list of 100 leaders shaping the future. The entry for Gavi’s head of the COVAX Facility, set up to ensure equitable access to COVID-19 vaccines in underserved populations said: “The health of the world lies in the hands of Aurélia Nguyen.”
That seems like a lot of pressure to put on one person, but Nguyen, who has been at Gavi for over a decade, points out that she’s “not alone in feeling the stress that comes with delivering on COVAX, and while the recognition may have been personal, the work in making COVAX a reality has been done by hundreds and thousands of people”.
“I think we will remember both our moments of triumph, the speed of vaccine development, the massive multilateral response, and also our moments of failures, the vaccine nationalism and hoarding, export bans, the lack of upfront funding, and we will ensure the memory of these translates into actions that will continue past this current pandemic.”
When the pandemic hit in early 2020, Nguyen was Gavi’s Managing Director of Vaccines and Sustainability, in charge of vaccine supply and demand. She was instrumental in setting up COVAX even before she officially took the helm in October that year. “It was a really steep learning curve as very little was known about the virus, there were a lot of new manufacturers we hadn’t dealt with and so it was difficult and chaotic,” she says.
The start of 2020 was also a time of personal crisis for millions around the world, under lockdown, unable to see friends or family, and no idea of how the pandemic would unfold or whether they would be alive at the end of it. How did she balance her home life with working on something as monumental as COVAX?
“The truth is my work-life balance was fairly poor,” she says. “It’s important to dispel the Wonder Woman myth that women can somehow magically balance the worries of their home life, particularly during a pandemic, with their work responsibilities. I think it’s simply not true.” With two young children, Nguyen and her husband worked in shifts, with the days getting longer and sleep ever-diminishing.
“What kept me going was telling myself that the sooner COVAX was up and running, and reaching the objectives on fair and equitable access, the sooner we could hope to have an end to the pandemic, and return to a sense of normality.”
Nguyen has one of the biggest jobs in public health, but she says that even in 2022 being a senior woman in public health can mean making “a conscious effort to not let myself get talked over by a man in a high-level meeting.
“When I interact with more junior women, I feel a sense of responsibility to show that they can be leaders but still be true to themselves. And that’s also why having other senior women around really matters both in supporting each other, but also to show that women leaders can bring diversity to traditional leadership styles.”
Public health officials are criticised both for seeming too sure of the way out of a crisis and for hedging their bets. For Nguyen, the answer is to be confident but acknowledge that scientists don’t always have all the answers. Despite being extremely experienced in multilateral initiatives, bringing vaccines to market, and having years of technical expertise, she is candid in admitting that she often “doubts herself, sometimes several times a day”. But as a good friend told her at the height of the pandemic: “the entire world is out of its depth”.
Self-doubt can be, she says, a reminder of the value of collective action: “Looking for the best solutions can be a strong driving force for effecting change. Being willing to tap into the expertise, knowledge and experience of others is important in tackling something as monumental as a pandemic.”
Collaboration has been key to running COVAX in the virtual workplace, but like many working on the initiative, Nguyen has been working on Gavi’s most far-reaching global initiative through a computer screen at home, without travelling to any of the countries where COVAX is having the biggest impact.
“I’ve missed experiencing the reality of the work we do,” she says. “It’s difficult to only think rationally about the impact of Gavi – we also need the emotional connection you get from seeing the work first-hand and seeing everything come to life.” It was only when stories from friends and families started to come in from around the world that the impact of the work really hit home.
Nguyen is incredibly proud of COVAX’s achievements so far – it has helped deliver 1.3 billion doses to 144 countries. While it’s too early to be looking at lessons learned, the importance of communication when working with so many stakeholders is clear. “It sounds trite, but there cannot be enough communication when there are so many players, and sometimes it's a false economy in saving time to plough forward with decisions if everyone hasn’t been consulted, because ultimately, for COVAX to deliver you need all of the different instruments to be playing in unison.”
There is still no time to relax. Nguyen can see several challenges ahead for 2022. She is keen to ensure that people in humanitarian settings have access to the vaccine. Another issue is around supporting countries in improving coverage. “Some countries have reached high coverage rates, which is great. The question is whether they will have immunised their at-risk population because ultimately that's the true measure of success. And then, on the other hand, you still have countries who are struggling to increase their coverage rates. So what will it take to get their coverage to go up?”
To help increase coverage, Gavi provides funding to support delivery and is also fundraising to support countries throughout the process, whether that’s technical assistance, planning, increasing their outreach, or boosting community acceptance to make sure that the vaccines are well understood and well accepted by populations.
She adds that it’s important “to make sure we're not caught short if we get a new variant that the current vaccines are not well suited for. I think we can hope that the emergence of Omicron as a milder variant is a sign of the pandemic abating. But I don't think we can assume that.”
As Gavi’s CEO Dr Seth Berkley has said, it’s inevitable we will have another pandemic. So knowing what we know now, how do we prepare for it?
“I think we will remember both our moments of triumph, the speed of vaccine development, the massive multilateral response, and also our moments of failures, the vaccine nationalism and hoarding, export bans, the lack of upfront funding, and we will ensure the memory of these translates into actions that will continue past this current pandemic,” she says.
Knowing how to tackle a pandemic once doesn’t guarantee you can do it again. “It’s more like learning a foreign language. You have to keep practising it to be fluent the next time you're in a foreign country.”