A journey of selflessness and dedication to humanity: Mr Ishmael Nyasulu, WHO Malawi foot soldier

One of the things that had heavily impacted on TB programming in Malawi then was the high TB/HIV co-infection rate that was around 70%. The public health approach ART provision had only started and coverage was still low. The emergence of drug-resistant tuberculosis (TB) raised new challenges for existing TB control programs and supposedly contributed to early mortality, particularly in high HIV co-infection settings such as Malawi. Therefore, the coming up of the 2004 WHO interim policy document on TB/HIV collaborative activities could not have come at a better time. We worked with national authorities to structure activities under three distinct objectives: establishing and strengthening mechanisms for integrated delivery of TB and HIV services; reducing the burden of TB among people living with HIV and initiating early antiretroviral therapy; and reducing the burden of HIV among people with presumptive TB (that is, people with signs and symptoms of TB or with suspected TB) and diagnosed TB.

The WHO 3 by 5 Initiative to provide antiretroviral treatment to patients with HIV/AIDS in low and middle-income countries, facilitated the recruitment on an international technical officer to support MOH to roll out ART using the public health approach. Following the winding out of the initiative, the position could not be sustained. Consequently, I was requested to take up the additional responsibility of HIV around 2010. Then viral hepatitis became an issue and again, the responsibility fell on me.

The reassignment of the malaria NPO to Botswana around 2020/2021, necessitated that I take over his responsibilities for malaria, neglected tropical diseases and essential medicines. So, my responsibilities and scope of work increased over time. While the multi-tasking was an opportunity to learn what other areas of work are all about, there were too many competing priorities to efficiently manage them all.

I cherish the support I received from the other levels of the organization when requested. A big shout out to Dr Wilfred Nkhoma, Dr Farai Mavhunga, Dr Fabian Ndenzako (did the first Viral Hepatitis assessment and put together the first Viral Hepatitis Strategic Plan), Dr Jean-Louis Abena, Dr Nirina Razakasoa, Dr Daniel Low-Beer, Dr Rachel Baggaley, Dr Meg Doherty, Dr Lana Saidi, Dr Michelle Rodolf, Dr Frank Lule and Dr Jean de Dieu Iragena.

I have fond memories of the four-day visit to Malawi by Dr Lous Sambo the then Regional Director for the African Region (2005-2015) and Dr. Jorge Sampaio, UN’s Special Envoy to Stop Tuberculosis in March 2007 during which they attended the launch of the declaration of Tuberculosis as an emergency by the Republic of Malawi as well as the national TB Strategic Plan 2007-2011.

I also look back with lots of satisfaction the many TB/HIV external progamme reviews where I was part of the review teams: Zambia, Zimbabwe, Eswatini and South Africa, as well as Regional Greelight Committee drug resistant TB monitoring missions in Zambia, Zimbabwe and Mozambique. Additionally, the organization and resource mobilization of two Malawi joint TB/HV programme reviews in 2019 and 2023.

I am encouraged by the contribution I made to the health sector in Malawi through provision of technical support in the development of different disease specific strategic plans such as TB, HIV and Viral Hepatitis as well as resource mobilization including Global Fund requests for funding.

Chairing the WCO Staff Association and the role of The Ombudsman was as exciting as it was challenging. I may not have listened impartially to all those seeking assistance but one thing I can say with lots of confidence is that where advice was provided, it was independent and impartial.

It is encouraging that I am leaving behind a great team of experts in their own fields. I enjoyed working with each one of them and learnt a lot in the process and I can only wish them well as they continue serving humanity.
I was privileged to have worked under the leadership of four WRs during my time with WCO-Malawi. Dr Matshidiso Rebecca Moeti who had served as the WHO Country Representative in Malawi from 2005 until 2007, Dr Felicitas Zawaira from 2008-2013, Dr Eugene Appiah Nyarko, from 2014-2017, Dr Nonhlanhla Dlamini from 2019-2021 and Dr Neema Kimambo, incumbent WHO Representative at the time of my separation (30 June 2024). Diverse backgrounds and different leadership styles but all very wonderful people. I learnt a lot from all of them and to them all, I say thank you.