Will the new Director-General of the WHO meet the needs of the global health challenges?
The World Health Organization has a new leader: as the first African ever, Dr. Tedros Adhanom Ghebreyesus, will be the new Director-General of the UN-organization. Promising words have been said. Aletha Wallace, G3W-volunteer, was present in Geneva during the election, and gives an analysis from a civil society perspective.
Three candidates were shortlisted for the position of Director-General (DG) of the WHO at the Executive Board Meeting in January 2017: Dr. Tedros Adhanom Ghebreyesus, Dr. David Nabarro, and Dr. Sania Nishtar. Finally, Dr. Tedros emerged as the new leader of the UN-organisation after the election on Tuesday May 23, 2017.
The DG-elect Dr. Tedros was elected through a secret ballot and will lead the WHO for the next five years. Dr. Tedros was elected in a landslide victory with 133 votes. It must be mentioned that for the first time in the history of the organization, many countries participated in the election. Given the huge vote margin, many believe that Dr. Tedros is the candidate to lead the WHO at this crucial stage in the history of the organization when it is under immense pressure to restore its credibility, legitimacy, and capacity to play the leading role in global health governance.
“The WHO we want and the leadership WHO needs”
Ahead of this year's crucial World Health Assembly with the election of the DG, civil society organizations sent out a strong message about “the WHO we want and the leadership WHO needs”. Civil society organizations, including the People's Health Movement, have refrained from publicly endorsing any candidates. Civil society does not have any direct role in the election of the DG. However, the organizations voiced their concerns about the state of the WHO and hoped to see the transition to a WHO that is independent of the influence of private sector actors and see it restored to its constitutional mandate as the leading global health authority.
Civil society wants a WHO with a robust and credible leadership in global health, which takes a human rights-based approach, and promotes comprehensive primary care. Social organizations call on the WHO to take a bold pro-public health approach independent of philanthrocapitalism. They also urged that WHO set its priorities from a global public health perspective, rather than being guided by individual donor interests and preferences. Member states must fully support the WHO work through assessed contributions to protect the organization from influences of private actors and ensure that the WHO can work efficiently as a fundamental norm setting organization. As a public health champion, the DG must defend public health goals against conflicts of interest with corporate entities. Lastly, the DG must ensure that more attention is given to the political, social, economic and environmental determinants of health.
Which promises were given by Dr. Tedros?
When addressing the WHO Assembly after his election, Dr. Tedros said he understood, given his life history and his background as an African and Ethiopian, what it means to be poor and live in survival mode. He vowed to work towards reducing health inequality and inequity, improving health systems, and committed himself to improving people’s lives. He promised to deliver on Universal Health Coverage, to provide a robust response to health emergencies, to strengthen the WHO health workforce, and to improve WHO’s image as a world-class organization. Shortly, his priorities will be to deliver health to all people by promoting access to quality care and access to medicines.
Meeting the health goals means addressing the social and economic determinants of health, which required political and innovative leadership. On this matter, Dr. Tedros pledged to focus on health promotion and disease prevention and to design and implement a comprehensive health system to meet the sustainable development goals. He pledges to address the challenges of mental health, non communicable diseases and nutrition, which he described as the silent killer. Furthermore, he pledged for a geographic and gender-sensible representation in the WHO-workforce and to place accountability and transparency at the core of WHO’s work to earn confidence through results.
Dr. Tedros emphasized that he had seen first-hand what it means to lift individuals from despair to hope and that he has the political and technical leadership to lead WHO. To end, he said it is about people and not whether we live in the developed or the developing world and that “he is ready to serve”.
Civil society hopes that Dr Tedros delivers on his campaign promises and that he and the WHO take the outgoing DG's call to "listen to civil society" seriously.
Background analysis by the People's Health Movement:
The elections this year was the first occasion when the entire Assembly voted through a secret ballot – earlier only the Executive Board would select the new DG. The massive margin for Tedros indicates that, in all probability, the entire South voted for him – a virtual tricontinental alliance. The massive margin had not been anticipated and possibly marks a silent vote against big power machinations in the WHO.
The WHO faces possibly its biggest crisis since it was set up in 1948. Its finances are in shambles and it faces a USD 500 million deficit this year – potentially meaning many work programs will not go forward and staff might be laid off. For years now the WHO has been dependent on donor funds (mainly from rich countries and Foundations like the Bill and Melinda Gates Foundation) rather than through secured funding from countries. As a result, currently, 80% of WHO’s funding is tied to programs that donors cherry pick. Work programs that are vital to WHO’s mandate as a norm setting organization remain underfunded as they clash with the interests of big donors – especially rich countries of the North. Consequently WHO’s role as a leader in global health has been supplanted by other intergovernmental bodies such as the World Bank, and increasingly by big foundations like the foundation. The organizations effectivity has come under question, especially after its lack luster role in containing the Ebola epidemic of 2014 in West Africa.
These are the challenges that Tedros faces after his election. While it appears that the South has voted against the domination of big powers, often through back room manoeuvres, it is yet to be seen if this unity will be maintained when the WHO debates different issues where the North and the South are often arrayed against each other.