This upcoming May marks a pivotal transition in the World Health Organization (WHO): its 26th election for a new director. Whoever will serve as the new director of the WHO will make decisions that affect millions of lives around the world. In the past, the director was typically selected by the major nations, but now every member nation of the WHO can vote, which means that a vote from the United States has the same weight as a vote from Uganda.

The WHO is suffering from an existential crisis. Many critics chide the organization as just “another lumbering United Nations agency paying tax-free salaries to technocrats to live in Switzerland and churn out reports”[1]. In the past, we have seen that the WHO’s functions are severely limited by its heavy bureaucratic structure. It consists of 194 member states that can stifle progress due to conflict of interests. Vertical bureaucracy within the WHO, with “150 local offices and six regional ones, run by officials with local political connections”, hinders smooth communication between the headquarters and the regional staff [1]. Anthony Banbury, a former United Nations Assistant Secretary-General for Field Support, shared an anecdote with the New York Times that detailed the WHO’s failure to respond quickly to Ebola epidemic. When he was in dire need for qualified staff to show up at Accra, Ghana, they could not travel from nearby South Sudan “until she received a new medical clearance.” Expressing his disappointment with the WHO, he wrote, “We were fighting a disease that killed many thousands and risked spinning out of control and yet we spent weeks waiting for a healthy colleague to get her forms processed” [2].   

Complicated procedures and a bulky hierarchical system are not the only issues plaguing the WHO right now – WHO is also functioning on a low budget. With only $2.2 million to spend annually, this international organization that oversees global health has a budget half that of the New York- Presbyterian Hospital  [1]. Moreover, only 30% of the budget is from member’s dues; the majority is supported by wealthy donors such as the United States, Britain, the Bill & Melinda Gates Foundation, Rotary International, Norway, and big pharmaceutical companies. However, there is no such thing as a free lunch. WHO initiatives face constraints set by these donors. For instance, pharmaceutical companies give out low-cost drugs but protect profitable patents, thus limiting developing countries’ access to patented drugs  [1].

Facing much external criticism and internal conflict, the elected director must navigate the WHO to overcome its hardships. The three candidates all have extensive experiences in public health initiatives, leading health campaigns, and understanding the role of politics in health. The first candidate is Tedros Adhanom Ghebreyesus, age 52, an expert in malaria and a former Ethiopian health minister. He is backed by both the United States, which supported his effort in fighting regional Malaria, and the African Union. Nevertheless, Dr. Tedros is known for his suppression of dissents while being a governor in Ethiopia, raising crucial questions about his stance on human rights  [1]. The second promising candidate is Dr. David Nabarro, 67, a British candidate who experienced in leading United Nations response to multiple disease outbreaks. As a candidate, he pleaded to focus on “people-centerd” health policies and improve upon how the organization response to outbreaks and emergencies  [1]. Last but not least is Sania Nishtar, 54, a cardiologist and a former Pakistani government minister. More of a person of knowledge than of experience, Nishtar envisions WHO as a “knowledge lighthouse,” emphasizing that the job of WHO is more about setting medical practices [1].

One of these contenders will restore and magnify WHO as the world’s leading health agency. “The WHO needs to make the case for greater investment in public health and be fearless in calling out countries that fail to play their part,” stated Dr. Jeremy Farrar, director of the Wellcome Trust, highlighting the need for a successful leadership under the future director [3].

Though its efficiency diminished due to the broken bureaucratic system, the WHO is still the one agency that gives the first emergency response (or declares a health emergency), sets global medical standards, mobilize funding, and lends assistance to poor countries. The world looks to the WHO for leadership in global health. We hope that the new director will bring back the organization’s vitality. We need it, desperately.

Update on May 24, 2017: With 186 member-state-votes, Dr. Tedros Adhanom Ghebreyesus from Ethiopia will serve as the next director general of the World Health Organization (WHO). In his speech, Dr. Ghebreyesus envisions that “All roads should lead to universal health coverage” and promises that he “ will not rest until [the world] have met this”. Congratulation to Dr. Tedros Adhanom Ghebreyesus! [4]

 

 

References

McNeil, G., Donald (2017, April 3). The Campaign to Lead the World Health Organization. The New York Times. Retrieved from
https://www.nytimes.com/2017/04/03/health/the-campaign-to-lead-the-world-health-organization.html?rref=collection%2Fcolumn%2Fglobal-health&action=click&contentCollection=science&region=stream&module=stream_unit&version=latest&contentPlacement=3&pgtype=collection&_r=0

Banbury, Anthony (2016, March 28). I love the U.N., but It is Failing. The New York Times. Retrieved from
https://www.nytimes.com/2016/03/20/opinion/sunday/i-love-the-un-but-it-is-failing.html?mtrref=undefined&assetType=opinion&_r=0

Branswell, Helen (2017, January 25) World Health Organization Names Nominees to Lead Global Agency. Retrieved from: https://www.statnews.com/2017/01/25/who-director-general-finalists/

BBC (2017, May 23). Tedros Adhanom Ghebreyesus: Ethiopian wins top WHO job. Retrieved from:
http://www.bbc.com/news/health-40010522

Posted by Linh Tran

Linh is a sophomore studying Biomedical Engineering and Applied Mathematics and Statistics. Together with members of Global Health member, we are conneting Hopkins students with current health issues around the world.On campus, Linh is an Event Commitee Chair of JHU Visionaries, Agency Chair for Project Prevent, memmber of Women Pre-Health Leadership Society and a volunteer at the Adult Emergency Department. Linh’s hobbies consist of a wide range from cooking to water coloring.

Leave a reply

Your email address will not be published. Required fields are marked *