World Health Organization to Elect a New Leader
STEVE INSKEEP, host:
Well, the World Health Organization is electing a new director general. That person will be in charge, to the extent that anybody is, of safeguarding the world's health. Health experts worry that political considerations and the promise of favors may count more than merit in this election.
NPR's Brenda Wilson reports.
BRENDA WILSON: The position of director general of the World Health Organization is becoming increasingly important. Not only is there the HIV/AIDS pandemic but also a growing threat from an almost untreatable form of tuberculosis. And Laurie Garrett, senior fellow with the Council of Foreign Relations, says dealing with those diseases is complicated by growing disparities in healthcare between poor and rich countries and a potential flu pandemic that will affect everyone.
Ms. LAURIE GARRETT (Senior Fellow for Global Health, Council on Foreign Relations): And if WHO isn't the agency that can handle the problem, we're in deep trouble because there is no agency that has free access to every corner of the world and is respected by all the nations of the world.
WILSON: And they all have a say in who is director general. Right now there are 11 candidates from all over the world. Nils Daulaire of the Global Health Council, an international organization of health workers, says more than anything the WHO needs someone who can lead.
Dr. NILS DAULAIRE (President and CEO, Global Health Council): I think WHO, in order to gain in the full respect that it would warrant, has to show itself to be a premiere technical agency that makes decisions not on a political basis, not on the basis of source and force and patronage, but rather on the best available scientific evidence. And nobody else can serve that role.
WILSON: Daulaire says WHO is a highly political organization. Its campaigns have historically been intense and the outcomes often unpredictable.
Dr. DAULAIRE: The process by which the WHO director general gets picked is opaque in the extreme. There are so many ways in the process and in the vote that favors can be earned or bought. It's very possible that somebody with terrific credentials could wind up not even on the shortlist.
WILSON: That said, three of the candidates are considered frontrunners: Drs. Julio Frenk of Mexico, Margaret Chan of China and Shigeru Omi of Japan.
Dr. Jim Kim, the director of Social Medicine at Brigham and Women's Hospital and Harvard Medical School, worked at WHO and knows all three of them.
Dr. JIM KIM (Director, Division of Social Medicine and Health Inequalities, Brigham and Women's Hospital): Dr. Chan is a brilliant person who did really tremendous work in fighting the SARS epidemic in Hong Kong.
Dr. Omi has long experience in the World Health Organization and also played a strong leadership role in the SARS response.
WILSON: All have worked for WHO, but only Dr. Frenk has administered a large health system as Mexico's minister of health.
Dr. KIM: His record on both expanding access to health insurance and declaring universal access to HIV/AIDS care, which he's now still trying to put into action, has given him a very unique set of experiences and he, too, is a very brilliant man and I think would be a great director general.
WILSON: The new director is going to have to change WHO to accommodate new players on the global health front, players with a lot of money like the Gates Foundation and the Global Fund to Fight AIDS, TB and Malaria.
Laurie Garrett of the Council on Foreign Relations says voters will have to ask themselves...
Ms. GARRETT: Should we move towards a less internal bureaucratic, shall we say, sometimes problematic institution, be more open and embrace a different kind of management? And I think that there will be a split among the voters and that there are some countries, some representatives that will feel very, very threatened by the idea of bringing in really strong, sweeping reform.
WILSON: In addition to continuing the reform undertaken by the previous director, Dr. J.W. Lee, the new director general will have to stand up to powerful interests, including pharmaceutical companies, the tobacco industry and countries like the United States and Japan.
Brenda Wilson, NPR News.
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