WHO’s New Management Staff Is A Combined Bag Of Political Appointees And Specialists

Almost a yr after his appointment to a second time period as WHO’s Director Basic, Tedros Adhanom Ghebreyesus has completed a revamp of his senior management staff –  retaining key loyalists in place, whereas including new faces which might be a transparent nod to highly effective member states akin to China, France and Japan.

However the brand new staff members include a blended bag of expertise – and a few have hardly any expertise in any respect within the areas to which they’ve been appointed, WHO insiders had been fast to say in response to the brand new appointments.

The brand new appointees embrace Dr Ailan Li, a Chinese national and head of WHO’s Cambodia officeas Assistant Director-Basic for WHO’s ‘More healthy Populations’ cluster which covers the more and more vital areas of local weather change, air pollution, wholesome life and vitamin.

Dr Yukiko Nakatani, currently deputy director in Japan’s Ministry of Health, wsick change into Assistant Director-Basic for Entry to Medicines and Well being Merchandise – a politically charged space of labor marked by oft-highly charged battles between pharma corporations and medicines entry teams over medication prices and IP rights.

One other new appointment is Dr Jérôme Salomon, a French nationalas Assistant Director-Basic for Common Well being Protection, Communicable and Non-communicable Ailments.  Of the three, Salomon has probably the most intensive international public well being expertise, together with stints on a WHO Emergencies Committee; as a director at Institut Pasteur in Paris, and as a  full professor on the Simone Veil Medical College, Paris.

Aylward, trusted advisor, will get new function

In the meantime, Bruce Aylward, a longtime Tedros senior advisor, was appointed Assistant Director-Basic of the Common Well being Protection, Life Course Division – the place he’ll “drive the group’s agenda to remodel major well being care as central to common well being protection, in addition to overseeing WHO’s work on well being programs, immunization and reproductive, maternal and baby well being,” in line with a WHO press release Monday asserting the brand new staff.

Aylward had beforehand led the DG’s “Transformation” initiative which sought to revamp the group’s inner construction till the COVID pandemic shifted his consideration to well being emergencies, the place he participated within the first go to by senior WHO leaders to China on the outset of the pandemic in February 2020, and later led WHO’s work on the multi-agency Entry to COVID-19 Instruments Accelerator (ACT-A) Hub, together with the creation of the COVAX vaccine facility.

“In his new function, Dr Aylward will drive the Group’s agenda to remodel major well being care as central to common well being protection, in addition to overseeing WHO’s work on well being programs, immunization and reproductive, maternal and baby well being,” stated Tedros’ announcement Dr Aylward holds a medical diploma and a grasp’s diploma in public well being.

Beforehand introduced additions to the senior administration staff embrace Jeremy Farrar, former head of Wellcome Belief as new WHO Chief Scientist. Farrar, a famous epidemiologist who additionally performed a key management function within the international public well being response to COVID might be probably the most excessive profile public well being character to affix the WHO senior staff. He replaces Indian nationwide Soumya Swaminathan.

Disappointment in more healthy inhabitants cluster

There was, in the meantime, disappointment in WHO’s inner ranks over the appointment of Li to the More healthy Populations cluster.  With a background primarily in emergencies and rising infectious illnesses, it’s an space of labor that can be solely new to her professionally.

“Clearly she has no expertise on this space of labor in any respect,” stated one WHO employees member. One other insider who beforehand labored together with her within the Western Pacific area described Li as a “micromanager” who had carried out a primarily political function till now – as head of the Cambodia WHO workplace.

Whereas it is not uncommon for the DG to present influential WHO member states, akin to China, a seat across the management desk, earlier Chinese language appointees, such as Ren Minghui additionally had important public health careers alongside their political assignments – and gained vast respect throughout their time in Geneva.  Minghui, a former ADG of WHO’s Common Well being Protection cluster till not too long ago, is now a director general at the Chinese Ministry of Health.

In the meantime, Nakatani, appointed ADG within the Entry to Medicines cluster, is thought to be a largely unknown amount by Geneva observers of the complicated set of points circling round that subject – which vary from the excessive value of most cancers medication to points across the transparency of medical trial knowledge and costs paid by international locations for bulk medicines purchases.

A paediatrician by coaching, Nakatani has labored on subjects akin to medical device reimbursement and price-setting regimes throughout her time at Japan’s Ministry of Well being – typically defending  insurance policies that raised the ire of trade.

Throughout her two years as a WHO technical officer she additionally co-authored plenty of papers on assistive technologies.  However she seems to lack the rich policy background of her predecessor, the Brazilian Dr Mariângela Simon within the space of medicines entry. Previous to arriving at WHO, Simon was a senior official at UNAIDs and in Brazil’s Ministry of Well being, the place she led profitable negotiations with pharma corporations to decrease the value of HIV medicines.

Appointments of trusted associates a Tedros hallmark

Solely a handful of senior officers that served within the first 5 years of Tedros tenure, stay within the new management staff. These embrace  Dr Hanan Balkhy, a Saudi Arabian nationwide, as Assistant Director-Basic for Antimicrobial Resistance (AMR), the place she is main a multi-sectoral collaboration with the Meals and Agriculture Group, the World Group for Animal Well being, and the United Nations Setting Programme, to reinforce prevention of AMR by means of higher administration of animal and environmental drivers. Previous to becoming a member of WHO, Dr Balkhy, a paediatrician, was Government Director for An infection Prevention and Management at Saudi Arabia’s Ministry of Nationwide Guard.

Different long-serving employees embrace Mike Ryan, Government Director of Well being Emergencies and Samira Asma, head of Data, Analytics and Delivery for Impact (DDI).

Ryan, a revered emergencies specialist, was the general public WHO face of the worldwide COVID response. However he additionally demonstrated intense loyalty to Tedros echoing his statements on controversial WHO positions, akin to opposition to public masking within the early days of the pandemic.

Asma is taken into account an in depth Tedros confidante. Her administration of DDI has been controversial internally insofar as she lacks the well being statistics, measurement and monitoring of her predecessor, Ties Boerma, now a professor on the College of Manitoba.

Triple Billion targets – a movable goalpost

Asma can be tasked with displaying progress on WHO’s ‘Triple Billion’ targets for reaching entry to common well being protection, improved well being emergencies response, and more healthy life and environments for 3 billion people worldwide by 2023.

The Triple Billion targets had been the centerpiece of Tedros’ strategic course in his first 5 years of workplace.

In Monday’s announcement, the DG recalled them as soon as extra, saying that the reformed senior management staff goals to: “speed up progress on implementation of WHO’s thirteenth Basic Programme of Work (GPW13), and achievement of its “triple billion” targets and the health-related Sustainable Improvement Objectives.”

However critics say that the targets are a moveable goalpost – a helpful public relations instrument however targets for which it’s just about unimaginable to exhibit concrete, measurable progress, within the methods outlined by WHO’s 13th Programme of Work (2019-2023).

Disappointment amongst senior civil servants

There was additionally some disappointment that not one of the senior WHO employees that had been serving as interim Assistant Director Generals obtained last appointments to Tedros administration staff, except for Aylward.

Influential member states, like america, had earlier expressed some hopes that promotion of extra senior WHO employees by means of the ranks to senior management positions may assist convey a stronger sense of professionalism and accountability throughout the group’s ranks.

As an alternative, 4 senior employees who had briefly served as interim ADG’s had been summarily dismissed by Tedros with little greater than a ‘thanks’ conveyed by way of an inner notice despatched out to WHO employees concurrently to Monday’s bulletins.

Noticed one WHO scientist, “I believe our group wants a really clear and sincere agenda to begin with. We want robust technical competency, much less political mumbo jumbo, and honesty and accountability; that is what now we have misplaced over time.”

Picture Credit: Guilhem Vellut, DFID, WHO, Japan MoH, WHO.