Diplomacy, Disease & Donald: The challenges facing the new WHO Chief
The World Health Organisation's new Director-General will have to face up to a fast changing world, says Dods Monitoring political consultant Bruce Reilly.
The World Health Organisation (WHO) has elected Dr Tedros Adhanom Ghebreyesus as its new Director-General, at a time when the UN agency faces unique challenges and doubts about its role in improving global public health.
Dr Tedros defeated his two rivals, British candidate Dr David Nabarro and Pakistan's Dr Sania Nishtar in three rounds of voting. A former health and foreign affairs minister in his native Ethiopia, Tedros is a well-known and well-respected figure in global public health. Of course, his credentials were rock-solid but, as ever, geo-politics played a role in his election; there has never been a Director-General from Africa.
The use of elections to choose the next WHO chief meant that candidates had to openly campaign and outline their plans for office. Tedros pledged to prioritise universal healthcare and more resilient health systems in developing countries. He has also acknowledged some of the problems WHO faces and plans to improve transparency and governance, no easy task for an organisation with 194 members often dealing with global health emergencies.
It is WHO's response to such situations that means Tedros' election comes at a difficult time. The organisation was roundly criticised for its delayed response to the West African Ebola crisis and its flaws were laid bare. With thousands of staff across regional offices and the need to placate demands from member states more decisive leadership is needed if WHO is to avoid being caught on the back foot again.
The new Director-General cannot ignore the accounting either, and there is no doubt that WHO has been underfunded in recent years. The United States remains the largest donor, but President Trump's plans to cut American aid spending only adds to budgetary worries. The UK has also made half of its funding conditional on agreed reform "objectives".
Some argue that WHO is too reliant on voluntary donations from organisations such as the Bill and Melinda Gates Foundation. Much of this funding is earmarked for specific programmes, meaning WHO has less flexibility in determining its own priorities.
Tedros has already pledged to broaden WHO's donor base, but that’s perhaps easier said than done when he's barely out of campaign mode and yet to officially take up his new post. It will require all his political nous to persuade donor countries to raise their levels of compulsory funding.
All these of these problems have exacerbated doubts over WHO's future role in global public health. Other partners, including the Global Fund to Fight HIV and AIDS, Tuberculosis and Malaria, the Vaccines Alliance and the World Bank have shown what effective health interventions can look like. There is debate as to how much time and funds WHO can devote to responding to health emergencies whilst also improving health systems in developing countries.
On the bright side, Tedros can count on the potential eradication of polio in the next few years, but rising rates of anti-microbial resistance, growing prevalence of non-communicable diseases and the emerging health effects of global warming are becoming etched into his to-do list. He will have to work with political leaders, NGOs and pharmaceutical firms alike to ensure WHO can craft long-term solutions to these problems.
The democratic nature of Tedro's election marked a new chapter for WHO, and if he can begin to cure its problems as well as he's diagnosed them, there's certainly hope for the billions across the globe who rely on its support.
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