HEALTH: WHO Needs Urgent Reforms, says UNFPA Boss

By Thalif Deen Reprint | | Print |

Thalif Deen

UNITED NATIONS, Jan 20 1998 (IPS) - The World Health Organisation (WHO) urgently needs to be restructured and reformed, says Nafis Sadik, head of the U.N. Population Fund (UNFPA)who is among the front runners for the job of running WHO.

“WHO is not seen as a leader in the field of health,” Sadik told reporters Tuesday. If elected, she said, she not only will ensure that health is recognised as a development issue, but also will re-establish WHO’s role in a changing environment where many organisations are competing on health issues.

“WHO is very far, far from achieving its goals,” Sadik said, adding that even its current health strategy is “vague.”

The 32-member WHO Executive Board met in private session Monday to approve a shortlist of five candidates for the post of Director-General at WHO to succeed the outgoing head, Hiroshi Nakajima of Japan.

Besides Sadik, the Pakistani-born Executive Director of UNFPA, other candidates are Gro Harlem Brundtland, former Prime Minister of Norway, George Alleyne of Barbados, Ebrahim Malick Samba of Gambia and Uton Rafei of Indonesia. All five are medical physicians with strong credentials in public health.

Samba is WHO’s regional director for Africa, Alleyne is director of the Pan American Health Organisation (PAHO) in Washington and Rafei, head of the WHO’s regional office for Southeast Asia based in New Delhi. Two other names that featured in early speculation to lead WHO – Arif Batayneh, a former Minister of Health for Jordan – and Fernando Antezana of Brazil quit the race last year.

Asked how she would stack up against her competitors, Sadik said the absence of the Jordanian would be to her advantage because “we were both competing for the same votes.” “He comes from the same region as Pakistan,” she said.

“I believe I have a reasonable chance” of being chosen, Sadik said, but added she thought Brundtland “probably has the best chance.”

“My experience with the U.N. system gives me an advantage. I know the system, and can go to WHO with all my knowledge running, so to speak,” she said.

The Executive Board will meet again in private session Jan 26 to interview each of the five candidates. Under new rules, candidates will make a presentation before the Board and be subjected to questioning.

On Jan 27, the Board will assemble again to vote on their choice. After the name of the successful candidate is announced, it will go before the World Health Assembly, the governing body of the WHO, for ratification in May.

An editorial last September in the Lancet, the influential British medical magazine, said that many people inside and outside WHO saw the impending change of leader as an opportunity to renew their commitment to “an organisation that has lost much respect and authority in recent years.”

“With such diverse multilateral involvement, there has never been a more im portant moment for strong moral and technical leadership in world health,” the Lancet said.

The British Medical Journal stated that changes in the world since WHO was founded nearly 50 years ago had put enormous pressure on WHO for greater change.

But the World Health Organisation failed to meet these challenges, primarily because of its “narrow, top down, service- oriented approach to health and its centralised, hierarchical bureaucracy,” the journal opined.

“Much of this can be blamed on WHO’s lack of leadership and inadequate commitment from member states,” the magazine said. “In trying to please all its political constituents, WHO has spread itself too thin and lost its direction.’ ‘

Following consultations in 1997 between a group of health experts, NGOs and former U.N. officials, the Dag Hammarskjold Foundation of Sweden released a study that spelled out in detail the weaknesses of WHO and the need for reform.

The study recognised the accomplishments of WHO during the last five decades, including the eradication of small pox and the organisation’s successes in global health policy, epidemiological information, health care standards and medical ethics.

“During the last decade, however, WHO has been openly criticised and does not seem to have the necessary preparedness for the 21st century with its new challenges,” the survey said. It added that the question of reform is largely a question of political will among the 190 WHO member states.

At an international seminar on health , held in Rome last November, Evelyn Wong of the Penang-based Third World Network traced WHO’s failures mostly to mismanagement and inept leadership.

“We would like to see a new WHO with a vision and a commitment for the new millennium,” she said. “That is why the election of a new director-general is so important to Third World nations,” she added.

Wong pointed out that WHO’s failings had prompted other U.N. bodies to hijack its mandate. The U.N. Population Fund had taken the leadership role in reproductive health; the U.N. Children’s Fund (UNICEF) in child health and breast feeding and the International Labour Organisation (ILO) led the way in occupational health, she said.

Wong also predicted that human rights in the health field is expected to be taken over by the U.N. High Commissioner for Human Rights. “So, what is left for WHO?,” she asked.