Having served as Ethiopia’s Minister of Health and its Minister of Foreign Affairs, Tedros Adhanom Ghebreyesus brings unique qualifications to the race to be the next Director-General of WHO. Tedros cites his leadership in reforming Ethiopia’s health system “in an environment that was resource-constrained with a heavy disease burden” as a key indicator of his ability to achieve results. He promises to bring a “fresh perspective” to WHO.
Considered by many to be the front runner in the race, Tedros has the support of the African Union yet has also been called out by critics of his country’s human rights record.
In this 4-part Q&A with GHN, Tedros discusses his background, the greatest global health threats, the changes that he will bring to WHO, the idea that the next DG should be from a low- or middle-income country, as well as his country’s record on human rights.
For the first installment, Tedros makes his case for being DG and explains how he would improve the WHO.
Why should countries select you as the next DG?
Countries should vote for me because I am the only candidate who has the technical, political, diplomatic and operational experience to lead the WHO into the future. For the past 30 years, I have worked tirelessly to improve health outcomes both in my home country, Ethiopia, and around the world. As Minister of Health for 8 years, I oversaw a reform effort that transformed Ethiopia’s health system, positively improving the lives of millions by bringing health care closer to communities, promoting prevention and engaging communities in their own health. The fact that we did this in an environment that was resource-constrained with a heavy disease burden would bring fresh perspective to WHO. Later as board chair of the Global Fund, a complex partnership between country governments, the private sector and civil society, I too led a reform effort, starting from a point in which donor confidence was low and culminating in raising $12 billion in 2013, the highest funding level the organization had hit at that time. And finally, as Minister of Foreign Affairs in Ethiopia for four years, I led successful, complex negotiations including peace treaties in countries facing decades long conflicts, as well as the Addis Ababa Action Agenda, a global partnership among 193 countries to achieve and finance the Sustainable Development Goals. The WHO needs a decisive leader who understands deeply the challenges that Ministers of Health face, has a local and global track record of reforming complex organizations and systems and can bring diverse groups to the table. That is what I would bring to the WHO.
What would you change about WHO?
As DG I would first work tirelessly to build WHO into a more effective, transparent and accountable agency that is independent, science and innovation-based, results-focused and responsive to member states. This work will have to start with working to regain the world’s confidence in WHO. While there are many elements to this, one that we saw work very well at the Global Fund was instituting an internal and external review panel of representatives who knew Global Fund but were independent and could share their concerns. They helped ensure we were honest about the organization’s strengths and weaknesses, and their work helped to rebuild confidence because we were willing to make ourselves vulnerable to get to the root of the challenges. Additionally, to make WHO more efficient and effective, we need to ensure it has access to more flexible and a broader set of funding sources, as its current funding limits how responsive it can be. This will include increasing the amount of funding – as well as changing the type of funding it receives. Finally, regarding where we focus our efforts, as we saw with Ebola, we need to improve WHO’s ability to respond to health emergencies. To do this, I would urgently implement the reforms the WHO has already started because we don’t know when or where the next emergency will occur. Additionally, I would make achieving universal health coverage my top priority. When we look at all the health challenges facing our world today – from health emergencies to preventing and treating NCDs to achieving the sustainable development goals – all roads lead back to strong health systems and universal coverage. The WHO must be a strong advocate and partner in countries’ efforts to achieve this goal.
What would you do to improve WHO’s funding situation to secure the WHO budget?
The key challenges with WHO’s budget today are that the bulk of its funding comes from just a few sources and the majority are earmarked, which results in a situation in which it is overfunded in some areas and underfunded in others. To address this, we must diversify the sources of funding, as well persuade those providing voluntary contributions to shift from earmarking contributions to instead pooling resources into basket funds that could be used across key priorities. We also must be more strategic with what money has already been committed and focus on value for money, dedicating our resources where they can have the largest impact. Finally, we need to strengthen WHO’s internal funding unit ensuring it has the capabilities and capacity to conduct the fundraising necessary to support WHO’s work. As part of this, I also believe there is an opportunity for WHO to pursue more innovative financing mechanisms to support its work. With actions like these and if we can demonstrate results from WHO programs and progress toward the SDGs, I’m confident we will be able to rebuild confidence in WHO and mobilize new resources.
This interview has been edited for clarity and length.
Read other installments of Global Health NOW’s Q&A with Tedros.
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