“We don’t need faster horses, we need a new model of global health,” says Professor Helen Rees, who received the World Health Organization’s (WHO) 2025 Dr Lee Jong-wook Memorial Prize on Friday for her “outstanding contribution to public health”.

“If there isn’t going to be money, we shouldn’t be trying to run the same things on a third of a budget.

“We have to restructure, focusing on what is going to give us the best return on investment –  things like immunisation, and maternal and child health,” she told the award ceremony last Friday, hosted by the Korea Foundation for International Healthcare (KOFIH) and the Geneva Graduate Institute. 

Rees has spent her entire distinguished career finding solutions to some of the most pressing global health problems, including malnutrition, HIV, cervical cancer, tuberculosis, and access to medicines for low- and middle-income countries (LMICs). 

Although the University of the Witwatersrand in Johannesburg, where she has been based for three decades, faces enormous funding cuts following the immediate withdrawal of US funds, her instinct is to seek solutions.

“The sudden withdrawal of funds is really tough because we’re dealing with patients facing the withdrawal of services; with participants on studies that have suddenly stopped; with people losing their jobs in large numbers who were providing unique services around things like HIV and TB,” Rees told Health Policy Watch before her award ceremony last Friday.

“But the point is now, we have to sit up and say: What is the reset dial? “We need to innovate, prioritise and use digital and AI solutions.”

Leapfrogging to most effective technology

Rees is urging a “rethink of global health” encompassing “global governance, financing, health services, research and [how to] leapfrog to the most effective technology”, she told the award ceremony. 

First, governments and regions need to take more responsibility for the health of their citizens, she says. Back in 2001, African leaders adopted the Abuja Declaration in which they pledged to spend at least 15% of their budgets on health, yet a quarter of a century later, only Rwanda, Botswana, and Cabo Verde has consistently done so.

“Country budgets need to be redirected to health services, and the ‘sin taxes’ [on tobacco, alcohol and sugary drinks] can also be considered. But debt relief needs to come into this. Over 50% of low-income countries are at risk of a debt crisis and the development banks and multilateral organisations also need to rethink what is their model.”

She warns that if there is a substantial rise in HIV infections as a result of the withdrawal of US funding, this will “create a huge reservoir of immunocompromised individuals” that will “facilitate the emergence of new pathogens”.

Wealthier countries need to persist with official development assistance (ODA) to the poorest countries, even if only to protect themselves.

Joining Rees on a panel after her award, Dr Jerome Kim, director-general of the International Vaccine Institute, agreed on the need for a global restructuring, and urged “end-to-end thinking”.

“We can’t just have a vaccine. We have to have a plan to use it. We have to know that it’s going to be cost-effective. We’re not just developing vaccines for the companies. We’re developing them to be used and to have impact,” said Kim.

“The rotavirus vaccine was approved in the US in 2006. It was approved by WHO and recommended in 2009. Now, in 2025, 60% of the world’s children still don’t receive all the doses of rotavirus vaccine,” Kim pointed out.

Innovative financing

Rees cites MedAccess, which she chairs, as an organisation that is looking at getting health products needed by LMICs “through innovative financing, health and volume guarantees”.

We need “better, smarter technologies, that make health services easier to administer, medicines easier to store and transport.

To address the worldwide shortage of health workers, resulting in crowded clinics and overloaded nurses, Rees wants technology “to enable patient-responsible care”, such as tools to self-monitor chronic conditions.

There needs to be facility-level digitisation to manage clinic appointments, ensure patients are collecting medication and identify outbreaks.

Then, says Rees, “we need to make the products we deliver easier for patients”. A key example is long-acting lenacapavir, an antiretroviral medicine that prevents HIV via two annual injections.

Finding solutions for the most vulnerable 

British-born, Rees has spent her career based in southern Africa finding solutions to health problems of people living in poor settings in roles ranging from paediatrician to researcher, academic, policy-maker, drug regulator and international adviser.

The common thread in all these roles is her desire to improve the lives of those most vulnerable – social justice values she gets from a family of Welsh coalminers, trade unionists, teachers and preachers.

Rees and her South African husband, Dr Fazel Randera, met when they were medical students in the UK and, on graduating, they went to newly independent Zimbabwe to apply their skills.

Rees was a paediatrician, and her malnourished little patients inspired her and colleagues to encourage parents to fortify the maize meal they were weaning their children on by adding locally grown nuts. 

Looking at the bigger picture to find population-level solutions was a no-brainer for Rees from the start.

Solving problems with research and technology

“It is really about identifying the problem, prioritising a research agenda, and then looking for appropriate technology, then looking at implementation, science, policy, governance, finance, access and community and trust,” Rees told the award ceremony of her professional approach.

Understanding this essential chain “took a while”, and has come through many years of experience.

In 1980, she and Randera left Zimbabwe for South Africa, where they were quickly drawn into trying to address the effects of apartheid from Alexandra Clinic, a donor-funded health oasis in a densely crowded Black-designated township in Johannesburg.

“The townships were on fire,” says Rees. “The first grant I ever got was to set up an emergency services group for youth in townships who were being shot, were being frightened and persecuted. We trained them in emergency first aid, and we gave emergency equipment.”

By the time South Africa overcame apartheid in 1994, HIV was emerging as a major challenge – particularly for young women.

Rees started the Wits Reproductive Health and HIV Institute (Wits RHI) at the University of the Witwatersrand, which has become one of the country’s most important research institutions.

The institute is based at Hillbrow Clinic, an inner-city slum in Johannesburg, where a collection of derelict buildings was transformed.

“Where I have physically worked has always integrated the needs of underserved communities with research and clinical services,” Rees explains.

Several key trials have been run from the clinic, which also provides healthcare to the community, particularly to mothers and children.

Building a new country

“How do you jump from clinical to research and then into policy and governance?” Rees asks, then answers by saying that South Africa was “looking towards a new country” in the late 1980s.

She was drawn into this quest, first assisting in writing a new health policy for the government-in-waiting, then working on several clinical trials that guided policy, including pioneering research on human papillomavirus (HPV) vaccines and operational research on infectious disease control strategies in the most vulnerable settings.

Then she jumped into governance when appointed to chair of the board of South Africa’s medicines regulator, the Medicines Control Council (MCC).

One of the unexpected challenges she encountered as a regulator was when former President Thabo Mbeki denied that HIV causes AIDS, and pressured the regulator not to approve nevirapine for prevention of mother-to-child HIV infection.

She and the Registrar of Medicines, Precious Matsoso, who recent co-chaired the WHO pandemic agreement negotiations, registered nevirapine anyway – and cemented the principle of science over politics.

Rees still chairs the board of the South African Health Products Regulatory Authority, the successor of the MCC. 

More recently, she has assisted African countries with the Ebola, COVID-19, and monkeypox epidemics on several groups, including as chair of WHO’s African Regional Technical Advisory Group on Immunization and a member of the WHO African Regional Emergency Preparedness and Response Technical Advisory Group.

She also chairs and participates in several global WHO expert scientific committees on global vaccine policy and health emergency preparedness, and served on the WHO Strategic Advisory Group of Experts on Immunization (SAGE) for several years.

Back home, Wits RHI is leading a vaccine trial for TB vaccine (funded by the Gates Foundation and Wellcome Trust), and researching how to roll out lenacapavir, the long-acting antiretroviral for pre-exposure prophylaxis.

In recognition of her immense contributions to science and public health, she has received numerous prestigious awards, including the Order of the Baobab of the Republic of South Africa, the Gold Medal of the South African Academy of Science and an Officer of the Order of the British Empire (OBE).

But Rees said that her greatest achievement is her family. She has three children – raised with “benign neglect”, she laughs – and four grandchildren.

Image Credits: ARD.