Seeing and becoming: Q&A with Gbenga Ogedegbe, MD, MPH
March/April 2025 | Volume 24 Number 2
Photo courtesy of Dr. Gbenga OgedegbeDr. Gbenga Ogedegbe
Dr. Gbenga Ogedegbe is the Adolf and Margaret Berger professor of medicine at New York University Grossman School of Medicine and director of NYU Langone Health Institute for Excellence in Health Equity. A principal investigator on numerous NIH projects, his work focuses on implementation of evidence-based interventions for cardiovascular risk reduction in the U.S. and strengthening research capacity and reducing cardiovascular disease burden in Africa. He has authored or co-authored more than 500 publications; is a member of the National Academy of Medicine; and has served on scientific panels for the CDC, WHO, the European Union Research Council and on Fogarty’s advisory board.
Why did you want to become a doctor?
I grew up in Nigeria and, when I was about 8 years old, I fell on a broken bottle. I had a huge gash on the sole of my right foot, so my mom took me to the teaching hospital in Lagos. I was sitting in the general waiting room in pain, petrified, and my mom was upset, too. Then this guy walks in and calls my name. He wore glasses and a white coat—he looked really sharp—and I was just…in awe! My mom had to say, “Let's go, you're being called!”
I wanted to be a doctor from then on. There's an old saying that goes, “you can't be what you don't see.” That was my moment of seeing.
What was your earliest Fogarty project?
My first encounter with Fogarty was in 2006. I was at Columbia then, I'd left Nigeria 15 years prior. It really gnaws at you all the time that you're not giving back to where you come from. At that time, if you had an existing R01 grant, you could apply for a FIRCA (Fogarty International Research Collaborating Award) supplement to build research capacity in a low-income country. I applied with my colleagues at the Lagos State University College of Medicine (LASUCOM) and received funding to build research capacity for management of hypertension in Nigeria.
For my FIRCA project, I trained three postdoctoral fellows and graduate students along with five medical residents at LASUCOM and we conducted a study of 140 hypertension patients. We asked them:
What are your beliefs about the causes, consequences, and treatment of high blood pressure? We found all kinds of beliefs that were not concordant with traditional biomedical beliefs. Our second question was:
Do patients’ beliefs affect how well they take their medications? We measured medication adherence by using electronic pill bottles, which track when they’ve been opened, and found that non-concordant beliefs led to poor medication adherence. It was a very impactful
study.
What is the value of international collaboration?
It’s very important to bring different perspectives of care together. In most international collaborations within the global health space, information flows pretty much one-way: from the global north to the global south. Such collaboration is not sustainable because context matters and it’s not always possible to translate evidence generated in a high-resource setting like the U.S. to a low-resource setting like Ghana and Nigeria. When we collaborate on the continent, we often bring what we do here over there… and often it doesn’t work!
For example, about 50% of the Nigerian economy is an informal economy and most of that is driven by transactions in urban markets, which are a major staple of African life. Market vendors spend 11-14 hours a day in the market. I know and lived this because my mother, a trader and businesswoman without formal education, was a market vendor. So when you tell people to go to a primary health center for an asymptomatic disease like hypertension that means they have to leave the market and go to a health center, where they’ll wait three hours, maybe spend the whole day before they’re seen by the doctor. Given this rather high opportunity cost, folks would rather just wait till they’re really sick before seeing a doctor, at which time it may be too late.
We need to reimagine primary care in Africa. And, to do that, we have to reimagine collaboration with our colleagues on the continent and adopt innovative strategies not used here in the U.S. For example, we have a National Heart, Lung, and Blood Institute (NHLBI) proposal designed to leverage urban markets as a site for healthcare delivery.
How do researchers bring lessons learned in Africa back to the U.S.?
In a successful reverse innovation, Dr. Antoinette Schoenthaler, one of my colleagues here at NYU Langone Health Institute for Excellence in Health Equity, adopted a task-shifting strategy, where nurses partnered with community health workers to improve medication adherence among Hispanic patients with uncontrolled hypertension in community health centers. That first study, which was funded by NHLBI, was published in 2021 and now she's implementing the task-shifting intervention across 10 primary health centers. That's classic reverse innovation—something we took from work done in Ghana and incorporated into team-based care here in the U.S.
Why do you study noncommunicable diseases?
Several reasons. The first is that hypertension and stroke is a lived experience for me; my mother died of a massive stroke, so she had hypertension for a very long time. When I finished med school, I often helped in her treatment. My uncle died at age 44 from chronic kidney failure while I was an intern here in the U.S. I remember, vividly, that we couldn't find a dialysis center in Lagos to treat him. Another reason has to do with the fact that the burden of hypertension in Africa is troubling. In Nigeria, for example, prevalence of hypertension in 1994 was only 5% and by 2012 it was about 30%. I don't know of any nation that saw the burden of hypertension increase so rapidly in roughly 20 years, and in a relatively young population with a median age between 20 to 25 years.
Do you have advice for other global health researchers?
I always say,
If a research question is not relevant to the population you're studying, then why ask that question? We can do all these complex basic science studies—and Africa has been the site for quite a good number of those—they're fascinating scientifically, but if it's not pragmatic and it's not simple enough, then who benefits from them? If it doesn't improve the health of people, then, frankly, what’s the purpose?
If we’re going to do true implementation science, we’ve got to do away with the frameworks that we designed, because every framework is really a construct of the context it comes from. The next generation of implementation scientists need to develop models and conceptual frameworks that are focused on the African way of life because that is the only way we will have sustainable improvements and increase the gains made in healthcare delivery.
Chinua Achebe, a well-known Nigerian writer, often said,
Do not enter your house through another man's gate. In other words, you've got to own what belongs to you. You've got to understand your own context and its importance in implementing evidence-based interventions.
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Updated April 21, 2025
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