Dr. Carissa Etienne, who led COVID-19 response in Latin America and Caribbean, is dead

Dr. Carissa Etienne, the medical doctor and public health trailblazer whose calm demeanor and resolve helped steer Latin America and the Caribbean through the COVID-19 pandemic, has died. She was 71.

Her death was confirmed by the Pan American Health Organization, which she recently retired from after 10 years as its director. The organization, which is the Americas office of the World Health Organization, did not give a cause of death. Caribbean media reports say Etienne died in the early hours of Friday after collapsing at her home in Maryland.

“Carissa was a dear friend and colleague, and under her steadfast leadership and guidance, PAHO achieved significant milestones for the region of the Americas while facing one of our greatest public health challenges with COVID-19,” said Dr. Jarbas Barbosa, who replaced Etienne as PAHO director. “I am very saddened by her passing, and my thoughts are with her family, friends and all of us at PAHO who cared deeply for her.”

In a statement, the Organization of Eastern Caribbean States said Etienne’s legacy and illustrious career as a highly-respected leader in the field of public health will continue to inspire the region.

“Her contributions to strengthening health systems, promoting infectious disease control, and addressing health inequities have left an indelible mark on the region,” the regional bloc said. “Her passion for improving the lives of others was evident in her dedication to serving the most vulnerable populations, having also made significant strides in addressing noncommunicable diseases (NCDs) and mental health in the Americas.”

Barbados Prime Minister Mia Mottley said she was “shocked and deeply saddened” to learn about Etienne’s untimely death. The two spoke less than a month ago.

“Whether at midnight or midday, she was one of the few people who was most there for our country and our people when we most needed it,” Mottley wrote on X, formerly Twitter. “It was for this reason that the Government awarded her the Honorary Freedom of Barbados in 2022.”

By the time COVID-19 arrived, Etienne, a longtime advocate of universal health coverage, had already distinguished herself as regional director for the Americas of the World Health Organization.

Week after week in video press conferences, she updated journalists on the latest deaths and hospitalizations as she called on Caribbean and Latin American governments to do more. Though she sympathized with governments about the pandemic’s devastating effects on their fragile economies, she also challenged them to take hard decisions by considering its threat to indigenous and poor communities.

“It’s difficult to ever imagine a pandemic of this magnitude,” Etienne told the Miami Herald in a wide-ranging 2021 interview in which she offered a glimpse into her daily life as both a wife and mother of three.

Morning prayer before dawn, followed by a long succession of back-to-back meetings and caring for her elderly mother in between.

READ MORE: ‘Baptism of fire’: Tested Caribbean trailblazer leads COVID response in the Americas

Building a legacy

Born in Dominica in the Eastern Caribbean, Carissa Faustina Etienne would rise to international prominence during her efforts to rebuild her island homeland’s health care system after a devastating Hurricane David in 1979. One of the most destructive storms at the time, David’s 150 miles-per-hour winds and rains wiped out crops and destroyed most of Dominica’s healthcare facilities while leaving more than three dozen dead and 60,000 homeless.

At the time, Etienne was six weeks into her internal medicine postgraduate studies in Jamaica, where she earned degrees in medicine and surgery from the University of the West Indies at Mona. After deciding to return to Dominica, she would lead the health system’s rebuilding as medical officer at the Princess Margaret Hospital in Dominica, demonstrating her leadership abilities and setting her off on a distinguished career.

That career would include various prominent roles in her native Dominica, including as director of primary health care services, coordinator of the National AIDS Program, disaster coordinator for the Ministry of Health, and chair of the National Advisory Council for HIV/AIDS. Between 2003 and 2008, she served as assistant director of the Pan American Sanitary Bureau where she led five technical areas: health systems and services; technology, health care, and research; health surveillance and disease management; family and community health; and sustainable development and environmental health.

She would earn a reputation as a primary health care crusader who championed universal health care. She would spearhead policies to reduce health inequalities, increasing people-centered care and integrating health into broader public policies.

“We have lost a great public health champion,” Dr. Barbosa said. “Dr. Etienne’s invaluable experience will be sorely missed in global health discussions to improve the lives of people and to ensure better preparedness for global health emergencies.”

In 2012, while serving as assistant director general for health systems and services at the WHO in Geneva, Switzerland, she went after PAHO’s top post with the support of her country’s prime minister Roosevelt Skerrit. He led an aggressive campaign to rally support within the 15-member Caribbean Community to secure her victory.

“She came up against candidates from Costa Rica and Ecuador,” Skeritt said at the time. “This is no doubt a very proud moment for her family, herself and indeed all Dominicans and CARICOM citizens because we were able to get the support of CARICOM in that regard.”

He credited Etienne’s accomplishment as a testament of what the Caribbean had to offer and of its advances in the foreign policy realm. In addition to her degrees from the University of the West Indies, Etienne held a Master of Science Degree in Community Health in Developing Countries from the London School of Hygiene and Tropical Medicine, University of London.

“There is no way that 10, 15 or even 20 years ago that a Dominican could even think of wanting to be a candidate, far more to be a candidate and far more to be elected as the Director of PAHO,” the prime minister said.

In a statement, PAHO noted that during her tenure, Etienne not only led the response to the unprecedented COVID-19 pandemic in the region of the Americas, but also efforts to control Zika and chikungunya epidemics and cholera and yellow fever outbreaks in Haiti and Brazil, while significantly improving the organization’s response to emergencies and disasters within 48 hours.

In September of last year, she was named director-emeritus of the organization.

“Under her leadership, the Americas eliminated the endemic transmission of measles, rubella, and congenital rubella syndrome, and made considerable strides in the prevention and control of chronic non-communicable diseases,” PAHO said. “Legislative and regulatory mechanisms gained traction, as countries enacted legislation on the labeling of food products and introduced taxes on sugar-sweetened beverages.”

Advances were also made in strengthening national health systems and in progress toward universal health. In the last five years of her mandate, PAHO said deliveries by skilled birth attendants increased from 95% to nearly 100% and, for the first time, the region of the Americas reached the recommended target of 25 physicians and nurses per 10,000 people