Dr. Dougbeh Nyan may still be basking in the glow of his appointment as Director General of the National Public Health Institute of Liberia (NPHIL).
But in a few weeks, he will come to terms with the political and economic challenges that impeded his predecessors' efforts to conduct cutting-edge public health and biomedical research to inform Liberia's health policies.
"No public health institute can work for the good of the public if it is underfunded--and with NPHIL, this has been the challenge since its founding in 2017," says Dr. Abdul-Rahman Fayiah Bah, a Chair of the Department of Public Health at the African Methodist Episcopal University.
Dr. Bah noted that while NPHIL has made some progress in responding to outbreaks and monitoring diseases with epidemic potential, it has largely failed in its scientific function, relying on outside research to inform government policy and guidelines on public health -- contrary to its mandate.
Public health, Dr. Bah says, is "continuously busy" and heavily reliant on research to provide factual and evidence-based results to guide government healthcare policy formulation and implementation, intending to address health disparities.
"This is the core function of a public health institute, but in Liberia, this has not been the case; I have not heard or read any scientific paper published by NPHIL, including research into the rich phytopharmaceuticals of the country," Dr. Bah noted. "It is not that none of the three former Directors General of NPHIL were capable, but government support has largely been limited to salaries and goods and services, while scientific advancements have been left to donors--crippling NPHIL's research ability in the process."
Dr. Bah, like many experts, argued that while Dr. Nyan's education and expertise make him the right fit for the job, he may struggle to overcome the problems at NPHIL due to the "deep-rooted politicization of the entity over the years."
A graduate of Humboldt University Berlin, Germany, Dr. Nyan holds a degree in human medicine (infectious diseases) and completed his post-doctoral fellowship as a biomedical scientist at the National Institutes of Health (NIH), USA, and the University of Pennsylvania, USA.
Over the last 25 years, he has worked in the U.S., African, and global public health systems--making him one of Africa's foremost infectious and biomedical scientists with accumulated experience in medicine, biomedical research, and academia.
He takes over NPHIL at a time when the agency has been plagued internally by attrition and low morale while externally struggling with politicization, a weak surveillance system, inadequate laboratory and diagnostic capacity, and weak health information and research systems, among others.
According to Dr. S. Mohammed Sheriff, a former administrator of the JFK Hospital, the biggest challenge facing Dr. Nyan is not just about ending the politicization of NPHIL or restoring trust and credibility but solving the issues of lack of sustainable and innovative financing mechanisms for public health.
Over the last six years, NPHIL has had a fluctuating budget with small increases in some years and cuts in others--making it quite difficult for the agency to advance a scientific-based public health agenda that would strengthen the health security of the country. In the fiscal year 2024, the budget for NPHIL is US$3.1 million, and in the next three years, up to 2026, it remains small with very little increase.
Nearly all of NPHIL's budget of $3 million is allocated for salaries, with the rest for goods and services, leaving little for investment in research or laboratory diagnostic capacity.
This, experts say, leaves little room for Dr. Nyan to make public health a reality in people's lives and to implement whatever scientific vision he has for the good of the country.
"Dr. Nyan's appointment excites the public health community, but he is in a very hot seat as he has been a critical voice against the shortcomings of NPHIL over the years--so the pressure is on him to transform the agency in the shortest possible time, or he may lose the public's trust," says Dr. Sheriff, who is also a lawyer.
However, Dr. Sheriff noted that despite the odds against Dr. Nyan, his experience working at one of the highest levels in the U.S. federal government health system as an infectious disease and biomedical scientist equips him with the understanding of how to make a public health institute work for the public and secure funding.
Dr. Sheriff says his only skepticism about Dr. Nyan's appointment is that he has never worked in Liberia's challenging health environment as a political appointee, so it is unclear whether he can transform NPHIL to the level where it can "conduct research to address the country's growing health disparities."
"Working in America is not the same as working in Liberia. So, the challenge for Dr. Nyan at NPHIL is not an easy one. NPHIL has had great and well-educated leaders before, but they struggled to make a real impact due to the challenging economic environment, which means they lacked the budgetary support to perform their tasks effectively.
"However, he is one of Liberia's and Africa's top researchers and inventors, with experience working in large and complex public health organizations that serve the public," Dr. Sheriff added.
While Dr. Nyan has yet to unveil his vision for NPHIL, sources close to him say his agenda is expected to promote innovative approaches in health financing, enhance robust governance structures, cultivate technical expertise, and develop stronger partnerships, with a vision of fostering Africa's reliance on local resources and homegrown solutions.
Key components of this vision, sources say, include elevating NPHIL to the level where it will engage in biomolecular, public health, and phytopharmaceuticals research -- "to ensure that Liberia takes control of its health security through strong local leadership and innovation."
"He is aware of the challenge and has developed a roadmap to change the narrative," sources closest to Dr. Nyan say. "As one of Africa's foremost infectious and biomedical scientists, Dr. Nyan is aware that if he fails to elevate and strengthen NPHIL's research capacity, he has failed as a professional. So, the Liberian people should expect a change."
As for Dr. Bah, he says even though the NPHIL job is challenging, he expects the new Director General to enjoy the opportunity despite the intense scrutiny and, in the process, earn the trust of the Liberian people.
He advises Dr. Nyan to carry an open mindset at NPHIL to cultivate a productive work culture, as well as to effectively articulate his decision-making and policies to the political decision-makers and the public "to lift the morale and culture of an agency that's been badly bruised."
"I have heard a lot of positive things about him and how he loves challenges and has been handling such challenges all his life. So, like many in public health, I am eager to see how he handles this challenge of a lifetime as Director General of NPHIL," Dr. Bah says.
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Dr. Nyan, as the Chief Medical and Scientific Officer of Shufflex Biomed, a biotech start-up company that operates in the USA, Liberia, and Rwanda, is an inventor with four patents, his most groundbreaking invention being the Nyan rapid diagnostic test that detects Ebola, HIV, Zika, Plasmodium (Malaria), Yellow Fever virus, Dengue virus, Hepatitis B, C, and E, and West Nile virus.
The test can detect three to seven infections simultaneously in 10 to 40 minutes.
In his acceptance speech on August 19 at NPHIL headquarters, Dr. Nyan echoed close aides' views about being aware of the challenges and unveiled what is expected to be his vision, which could go beyond disease surveillance and deeper into science.
He says his mission is to transform NPHIL into a hub for biomedical science and innovation, where transparency and collaboration with international partners flourish.
"I am deeply honored by the confidence placed in me to lead this institution," says Dr. Nyan. "We stand at a critical juncture in our nation's public health history, and we must rejuvenate NPHIL as a center of excellence for public health and biomedical sciences. Together, we will work tirelessly to ensure that NPHIL not only identifies and responds to public health threats but also drives innovation in public health, science, and technology."
"We want to build an institution that attracts top talent and provides opportunities for public health students to engage in internships that will foster the next generation of public health professionals," he added.
Editor's note: Joeraisee I.P. Joe contributed to this article.
