When Ebola hit West Africa in 2014, Médecins Sans Frontières (MSF), under the leadership of Joanne Liu, MDCM, MSF's International President, spoke out early and forcefully pressed for a stronger response from the WHO and the world. Now, as the world watches the WHO director-general election process unfold, the 6 candidates for the WHO’s director-general election will present their leadership vision to member states and answer questions on their candidacy in a closed forum. As the world contemplates the candidates and the future of the organization, Dr. Liu shared some qualities that MSF is searching for in the WHO’s new leadership in a Q&A with GHN’s Dayna Kerecman Myers.
What do you think is at stake in the WHO director-general elections?
What we’ve been missing from WHO leadership is an ability to rise up to meet challenges—as seen with Ebola, and then this past summer with yellow fever. Approaching the job with the mindset of civil servant has its limits and often one will end up being ping-pong ball between member states—being led rather than leading. We need a director-general who is going to lead the WHO, with a clear vision for health in the broader sense for all countries.
At the end of the day it’s about life, and with the response to Ebola and yellow fever, MSF spoke out mainly on the delayed response, the inability to fast track procedure and scaling up in a timely fashion. We cannot prevent outbreaks but we can prevent a pandemic if we get our acts together. So it is a pity that we are not able to overcome bureaucratic procedures in times of emergencies.
What obstacles to reform would MSF like to see the new director-general tackle?
The WHO convenes people and offers a valuable supranational forum—one we should try to safeguard in times of a more polarized landscape. But it needs to put lives before politics. That said, we can’t be naïve; we know we need political support to get things moving, but domestic political interests cannot be the sole drivers for emergency response. One of the lessons learned from Ebola, cholera, yellow fever, etc. is that political courage and political will are what really matter. In the end, responding to West Africa’s Ebola crisis late into the epidemic proved collectively much more costly. The WHO needs to be able to act at the right time, and we need to find a way to incentivize countries to declare outbreaks and reach out if they don’t have surge capacity to respond. Without that, we’ll most likely always be late.
Somehow, Ebola created a crisis of confidence in the WHO. The WHO struggles with funding, while the Global Fund and Gavi fundraise on and reach targets. The failure of governments to invest is the WHO’s biggest problem—it’s being bought out by philanthropy. I believe that health is a public good and a public responsibility. The government needs to be responsible for the health of people, and accountable to citizens. The big philanthropies are not accountable for the health of citizens—and thus they should not drive the agenda.
What qualities do you think will be most important for the new director-general? Are you comfortable with the field of candidates?
For me, the driving question is competence. I believe that there are some good, competent individuals in the WHO today, but in some areas the organization’s competence is being questioned.
Many would like a candidate who understands the health imperatives, who is prepared to do their best and confront the political powers, when necessary for health of the people.
We need someone at the helm who will restore trust, and inspire us. I hope the candidates we have will step up to the plate and inspire; that is what will encourage people to invest. We’re starving for good leadership.
Do you feel that the process is transparent enough; do you have any concerns about how it is unfolding?
Many are worked up over the fact that the director-general elections will take place by secret ballot, leading to questions about transparency. But the flip side is that a small country might find it difficult to openly vote against a country that it depends on, so MSF is neutral on that process.
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