In May 2020, Dr. Joanne Liu appeared on Quebec’s popular Sunday-night talk show, Tout le monde en parle. As the former head of the humanitarian aid organization Médecins sans frontières (MSF, a.k.a. Doctors Without Borders) and an expert in health emergencies, she had been invited to provide insight—and, arguably, reassurance—into the COVID-19 pandemic to the roughly one million viewers watching at home.
Other than crew members, the only other people on set were the show’s two co-hosts and Prime Minister Justin Trudeau. When asked if she had been worried, prior to COVID, about Canada’s state of pandemic preparedness, Liu paused briefly, with a slight smile, before glancing over at Trudeau. “I can feel our prime minister’s eyes on me,” she said, before acknowledging that, yes, she was worried.
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“Epidemics and pandemics are without pity,” she continued. “If there are weak links, they will break.” Watching her, it was clear that after years spent working in conflict zones and providing medical assistance during natural disasters and epidemics, dropping truth bombs on her head of government wasn’t particularly intimidating.
Since that appearance, the 57-year-old has found a new way to help Canada—and the world—prepare for the Next Big Bad. In 2021, she joined the faculty of McGill University’s School of Population and Global Health and set up, with the school’s director, Dr. Timothy Evans, the Pandemic and Emergency Readiness Lab (PERL). Focused on learning from the various global responses to COVID, the lab’s mission includes identifying best practices around pandemic response, training the next generation of emergency leaders and—its foremost priority—identifying gaps in vaccine equity.
Ensuring that everyone has access to vaccines, no matter where they live, has been a failure. “The first casualty in pandemics is solidarity,” Liu says now. “Of course a leader will protect their citizens first. But, once that is done, what else can you do?” A whole lot, it turns out. PERL is working to improve the effectiveness of vaccine distribution, particularly in Africa, which includes building alliances with affected communities, so that recommendations are culturally sensitive and locally informed. If the past three years have proven anything, it’s that our collective health depends on everyone else being healthy, too.
Liu and I first meet last year, on a brisk November afternoon on the 12th floor of a glass office building on the McGill campus in downtown Montreal. That same week, in response to rising cases of respiratory syncytial virus (RSV), Quebec’s College of Physicians recommended, once again, masking in public spaces. Of the dozen or so people I cross paths with in the building, Liu and I are the only ones masked.
Liu is coming off a shift at Sainte-Justine, the children’s hospital where she works as an emergency-department pediatrician—her other full-time job. We settle in a boardroom with a front-row view of Mount Royal, a favourite running spot of hers. “Something nice to look at, plus it’s not as cramped here as in my office,” she says matter-of-factly. Everything about Liu is straightforward, including her unflinching eye contact. She exudes confidence, calm and competence—the precise qualities of a person you’d look to in an emergency.
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“Taking action in the moment is so important,” says Evans, who was determined to bring Liu on board after her term with MSF ended in 2019. “She’s remarkably resourceful and is always carrying on multiple conversations on multiple fronts to move important agendas forward.” But what makes Liu even more exceptional in his eyes is her ability to recognize when things aren’t working—without losing her sense of humour. “In our work, we are always running into all kinds of barriers and problematic power structures. So, she’ll tease me about being a privileged white guy who speaks French like an Anglophone, and I’ll tease her for being a quintessential Quebecoise. We’re joking all the time. She doesn’t take herself too seriously, even though she’s dead serious about what she wants to do.”
The child of Chinese immigrants, Liu was born in Quebec City in 1965. Growing up in an almost exclusively white city, she was constantly reminded of how she was different—starting with a punch to the face by another kid on her first day of school. Her father owned and operated a busy 250-seat Chinese restaurant. It’s there, working the cash on evenings and weekends, that Liu learned two foundational life lessons: how to remain calm in the midst of chaos, and the importance of always treating people with dignity.
“We would have customers coming in to the restaurant who were unhoused and couldn’t afford a meal,” says Liu. “The waitress would take their order, bring them food and hand them the bill. They would then bring that bill to the cash, but we knew they shouldn’t be made to pay.” Her father’s generosity never came up; all parties would act as if this practice were completely normal.
Those exchanges stayed with Liu throughout her years as an aid worker. “I’ve seen people deal with so much misery, hardship and violence. Most of the time, they accept those things because they have no other choice. But the thing people don’t accept is not being treated with dignity. That’s an unbreakable rule.”
By the age of six or seven, she couldn’t wait to leave Quebec City. At 13, her escape plan began to take shape when she read Et la paix, docteur?, a book by French physician Jean-Pierre Willem recounting his work with MSF. Around the same time, she picked up The Plague by Albert Camus and became fascinated by the character of Dr. Rieux, who is driven to help his patients, even though they are doomed and he does not believe in God. When asked why he persists, he says that it’s because he never got used to death. “That’s when I promised myself that I would never trivialize death and that I would always fight for life,” says Liu.
Liu was 18 years old and in West Africa for a three-month volunteer stint when she saw abject poverty for the first time, affirming her goal of working with MSF.
Medical school at McGill—where she found an apartment in Chinatown and a vibrant Chinese community—was followed by a pediatrics specialty at Sainte-Justine. Wanting to prepare for the dizzying pace and violence of conflict zones, Liu did a subspecialty in pediatric emergency care at Bellevue Hospital in New York, the oldest public hospital in the United States.
After New York, Liu headed to Paris to work for MSF. From there, she returned to Montreal and took a job at Sainte-Justine, using her time off for MSF postings. Liu was in Indonesia after the tsunami and Haiti after the earthquake. She was also part of a team that spearheaded a comprehensive response to sexual violence during the civil war in the Republic of the Congo. Providing survivors with the morning-after pill, medication to prevent STIs (including HIV) and psychological support is now common practice in conflict zones, but Liu considers helping to set up this program—the first of its kind for MSF—among her most important work. “It was one of those rare moments where I thought, ‘I’ve contributed to something.’”
Underplaying her contributions is par for the course with Liu. She agreed to participate in this piece under one condition: “Don’t make me sound like a hero. It’s not right when the people I am working beside are struggling for their lives.” For Liu, the work—and the people it helps—is the focus, always.
After being elected president of MSF in 2013, Liu quickly made an impression. In September 2014, she urged the UN to take notice of the Ebola epidemic in West Africa, an issue MSF had been raising alarms about for six months already. (When MSF called the Ebola outbreak “unprecedented” in March of that year, a spokesperson for the World Health Organization took to Twitter to say, “Don’t exaggerate.”) Coordinating MSF’s fight against Ebola in Guinea, Liberia and Sierra Leone landed Liu on Time’s 2015 list of the 100 Most Influential People (in which she sounded like, yes, a hero). Ebola also gave her unparalleled insight into how to deal with COVID—something many people picked up on, just not her own government.
Not putting Liu in charge of Quebec’s pandemic response, especially when she reached out to provincial leadership to offer help, was considered a major misstep on the part of Premier Francois Legault. (He was criticized for benching the medical equivalent of Wayne Gretzky.) Liu is even-keeled about the slight now, but she recalls remarking at the time how Quebec’s “alpha males” spoke with such authority. “I thought, ‘They will never again speak with such assertiveness.’ In the face of emerging infectious disease, the only thing I am certain about are my uncertainties. You need to build the evidence.”
Liu isn’t immune to anger, but she refuses to be paralyzed by it. And she doesn’t hesitate to unleash it on those who deserve it, no matter their rank. She made international headlines in 2015 for curtly dismissing President Barack Obama’s apology when a U.S. air strike on an MSF trauma hospital in Kunduz, Afghanistan, killed 42 patients and staff. Two years later, she spoke out about the horrific treatment in detention centres in Libya, where asylum seekers and migrants were being imprisoned to keep them from reaching European shores. Witnessing the effects of starvation, sexual violence and humiliation on people who just want a better future affected Liu profoundly. “I remember being so sad when I got home. I called one of my friends and said, ‘I need to see beauty to believe in human beings again.’ He brought me on a hike, we went to some hot springs, we listened to opera. And later I got psychological support.”
Liu has a partner whom she’s been with for 20 years, but she speaks sparingly of him. When pressed, she says he’s an engineer, older than her. One condition of their relationship, on his request: He stays out of the media. She does say she would have loved to have kids, but didn’t settle down with her partner until it was too late. When asked if the nature of MSF’s work would have made parenthood impossible, she concedes that perhaps she would not have gone to “the very dodgy places.” However, as she takes pains to point out, MSF has had a number of women in leadership roles who have also been mothers.
When we speak again in February, Liu is preparing to leave for a meeting at the Rockefeller Foundation’s Bellagio Center in Italy, focused on rethinking the production and distribution of vaccines in emergency situations.
Throughout her career, Liu has witnessed just how different life can be for those who don’t have access to resources. For PERL’s inaugural project, she developed a vaccine tracker in collaboration with a South African NGO that looks at the factors that can impede delivery once vaccines have arrived in a country—anything from refrigeration issues to rebel blockades. “Joanne wanted to get to work right away,” says Evans. “Rather than spend six months developing a strategy, she immediately came up with something very reasonable and relevant.” The ultimate goal is to position the lab as a resource for governments and to provide focused, tangible assessments—ones that leaders at all levels will listen to.
Humans aren’t all that good at anticipating problems or dealing with them head-on when they do arise, says Liu. And that’s never clearer than when evaluating how the world is dealing with a looming health crisis—or one that is already upon us.
“The next pandemic is already here: antimicrobial resistance [AMR],” says Liu. “By 2050, it’s estimated that 10 million people could die from it globally each year.” Millions of people are already dying from AMR, she notes, and we haven’t changed our behaviour. She equates the pressing nature of AMR and our collective attempt to ostrich our way through it with climate change. “C’est fini là, we have enough evidence. We are going to hit a wall, so let’s get our shit together.”
Back in November 2022, a few days before we met, a young woman approached Liu at a conference. Years earlier, the woman had seen Liu on television and turned to her mother to say, “Mommy, one day I’m going to marry the president of MSF.” Her mother suggested she should become a doctor herself instead. Fast-forward a decade or so, and that same girl was graduating from medical school. Highly entertained by the story, Liu took a photo with the young woman for her to send to her mother.
While she has no interest in being a hero, Liu has accepted, tentatively, the mantle of public role model. She understands that she is in a unique position, as a woman of colour, to inspire and motivate. It’s a responsibility encouraged by one of her mentors: Louise Arbour, the former UN High Commissioner for Human Rights and a former Justice of the Supreme Court of Canada. “Louise told me I had to share my experiences with younger generations,” says Liu. “And as we joke in my house, ‘If Louise says it, you have to do it.’” Whether it’s by building PERL, working with MSF or appearing in the pages of this magazine, Liu will continue to step up, speak out and take action—and encourage others to do the same. “People are just starting to understand what it means to be so interconnected,” she says. “Nobody’s safe until everybody’s safe.”