By John Lauerman
Sept. 6 (Bloomberg) -- The next World Health Organization leader, charged with leading the fight against bird flu, must navigate a complex political landscape of emerging private assistance foundations, powerful regional agencies and governmental self-interest to do so, experts said.
The first step toward filling that job may come today when the agency may list as many as 12 nominees, some with strong political overtones. The announcement comes in a year when the WHO's visibility couldn't be higher as it pushes global programs against smoking, AIDS, obesity, heart disease, malaria and the headline-grabbing H5N1 avian flu.
Interest in the next leader has ``never been quite like this,'' said David Nabarro, the senior United Nations system coordinator for avian and pandemic influenza, in a telephone interview yesterday. ``The significance of the World Health Organization's work has become much more evident to all.''
The new leader replaces Lee Jong-Wook of South Korea, who died in May of complications following a blood clot on his brain. While Lee dedicated himself to the agency's ``3 by 5'' initiative to get treatment for 3 million HIV and AIDS patients by 2005, his tenure will likely be noted more for the agency's wide-ranging response to the spread of H5N1.
The virus, found in Asia, Africa, the Middle East and Europe, has killed millions of poultry. More significant, it has also spread from birds to at least 241 people, killing 141. The fear is that the virus could mutate into a form that spreads easily between people, sparking a deadly human pandemic.
Gathering Support
The Geneva-based World Health Organization, which plays a leading role in tracking the virus, has also been involved in gathering support for anti-flu measures in developing nations that sometimes can't afford them, and in getting drugmakers such as GlaxoSmithKline Plc, Sanofi-Aventis SA, Novartis AG to develop antiviral drugs and vaccines.
``The threat of an influenza pandemic has made everyone realize that the WHO has a huge role to play in getting people to prepare,'' said William Steiger, a U.S. Department of Health and Human Services international affairs specialist, in a telephone interview yesterday. ``That has certainly raised the profile of the institution worldwide, exposing both its weaknesses and strengths.''
One key bureaucratic issue for the new chief, Steiger said, is getting regional offices of the WHO, that elect their own leadership, to work with the central office on health programs. Also, with an annual budget of just $1.7 billion, small given the scope of the targeted diseases, the agency can't really afford to manage large, interventional health programs on the ground, he said.
Large Donors
As a result, the WHO's next leader will have to balance some of the agency's needs against the desires of large donor organizations, such as the Bill & Melinda Gates Foundation, said Christopher Murray, a former WHO official who is now director of Harvard University's Global Initiative for Public Health.
The Gates foundation is the biggest of about 70 health initiatives that the WHO has to work with in combating global diseases, he said. Founded by the chairman of the Microsoft Corp., it has an endowment of about $29 billion.
``It used to be that WHO was it, they had the mandate and the role of convening the world's governments, bringing the scientific community to bear and helping to set policy,'' Murray said. Now there are many more players, he said, ``and how WHO responds to that is an important aspect of what the new director general has to deal with.''
`Social and Economic Havoc'
``New diseases spread faster and wreak more social and economic havoc in today's highly mobile and closely interdependent world, and these consequences have made health issues matter at the highest levels of government,'' said Margaret Chan, 59, WHO's avian influenza coordinator and assistant director-general for communicable diseases, in an e- mail distributed by the Hong Kong government yesterday.
Chan's nomination by China for the top job two months after Lee's death is cited by Harvard's Murray and others as a prime example of how nationalism is also, increasingly, becoming an issue for the global agency.
In pushing Chan, who led Hong Kong's battle against the 2003 epidemic of severe acute respiratory syndrome, or SARS, China violated an unwritten rule among the UN's Security Council nations, Murray said. Security Council member nations normally don't nominate officials to become UN agency heads, said Murray, who worked at the WHO until 2003.
China has been criticized for its responses to both SARS and avian flu, and may have nominated Chan because of the prominence of the issue, Murray said.
`Countrymen'
``Having one of their countrymen for the head of the agency may be very helpful, along with the status that goes with it,'' he said yesterday in a telephone interview.
For governments with powerful pharmaceutical industries, trade issues also spur an interest in health.
William Aldis, the WHO's representative to Thailand, wrote an editorial in the Bangkok Post newspaper in January encouraging the Southeast Asian nation to think carefully about a proposed free trade agreement with the U.S.
Aldis said the ``restrictive intellectual property rights'' being pursued by U.S. negotiators would prevent Thailand from using locally produced affordable generic drugs, and that the price of newer-generation drugs for the 600,000 Thais living with HIV/AIDS ``will remain exorbitantly expensive.''
Two months later, Aldis was transferred to a research position in New Delhi. He had served less than 16 months in what is usually a posting of at least four years.
U.S. Clout
Aldis's case is an example of the U.S. government using its political clout to advance its interests in developing countries, U.S. Representative Jim McDermott of Seattle told the House on June 20.
``The United States government is helping the pharmaceutical industry squeeze the Third World,'' McDermott said in a transcript posted on the lawmaker's Web site.
The new director general needs to ``be very tough minded and unafraid of upsetting politicians who guard the industry interests,'' Richard Fielding, a clinical psychologist in the University of Hong Kong's department of community medicine.
Others nominated include: Shigeru Omi, the WHO's regional director of the Western Pacific, by Japan; Pekka Puska, Finland's top public health official, by that country; Kazem Behbehani, an agency assistant director general of external relations and government bodies, by Kuwait; Tomris Turmen, a WHO family and community health specialist, by Turkey; and Julio Frenk, Mexico's health minister, that country.
As many as six more nominations may be announced when the WHO releases its full list, Murray said.
One round of voting by the WHO's executive board will reduce the field of candidates to five, Murray said. The subsequent rounds will eliminate low vote-getters one by one, he said.
To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net .
Last Updated: September 6, 2006 07:47 EDT
http://www.bloomberg.com/apps/news?pid=20601082&sid=ay4zFaF4H4Nw&refer=canada
Sept. 6 (Bloomberg) -- The next World Health Organization leader, charged with leading the fight against bird flu, must navigate a complex political landscape of emerging private assistance foundations, powerful regional agencies and governmental self-interest to do so, experts said.
The first step toward filling that job may come today when the agency may list as many as 12 nominees, some with strong political overtones. The announcement comes in a year when the WHO's visibility couldn't be higher as it pushes global programs against smoking, AIDS, obesity, heart disease, malaria and the headline-grabbing H5N1 avian flu.
Interest in the next leader has ``never been quite like this,'' said David Nabarro, the senior United Nations system coordinator for avian and pandemic influenza, in a telephone interview yesterday. ``The significance of the World Health Organization's work has become much more evident to all.''
The new leader replaces Lee Jong-Wook of South Korea, who died in May of complications following a blood clot on his brain. While Lee dedicated himself to the agency's ``3 by 5'' initiative to get treatment for 3 million HIV and AIDS patients by 2005, his tenure will likely be noted more for the agency's wide-ranging response to the spread of H5N1.
The virus, found in Asia, Africa, the Middle East and Europe, has killed millions of poultry. More significant, it has also spread from birds to at least 241 people, killing 141. The fear is that the virus could mutate into a form that spreads easily between people, sparking a deadly human pandemic.
Gathering Support
The Geneva-based World Health Organization, which plays a leading role in tracking the virus, has also been involved in gathering support for anti-flu measures in developing nations that sometimes can't afford them, and in getting drugmakers such as GlaxoSmithKline Plc, Sanofi-Aventis SA, Novartis AG to develop antiviral drugs and vaccines.
``The threat of an influenza pandemic has made everyone realize that the WHO has a huge role to play in getting people to prepare,'' said William Steiger, a U.S. Department of Health and Human Services international affairs specialist, in a telephone interview yesterday. ``That has certainly raised the profile of the institution worldwide, exposing both its weaknesses and strengths.''
One key bureaucratic issue for the new chief, Steiger said, is getting regional offices of the WHO, that elect their own leadership, to work with the central office on health programs. Also, with an annual budget of just $1.7 billion, small given the scope of the targeted diseases, the agency can't really afford to manage large, interventional health programs on the ground, he said.
Large Donors
As a result, the WHO's next leader will have to balance some of the agency's needs against the desires of large donor organizations, such as the Bill & Melinda Gates Foundation, said Christopher Murray, a former WHO official who is now director of Harvard University's Global Initiative for Public Health.
The Gates foundation is the biggest of about 70 health initiatives that the WHO has to work with in combating global diseases, he said. Founded by the chairman of the Microsoft Corp., it has an endowment of about $29 billion.
``It used to be that WHO was it, they had the mandate and the role of convening the world's governments, bringing the scientific community to bear and helping to set policy,'' Murray said. Now there are many more players, he said, ``and how WHO responds to that is an important aspect of what the new director general has to deal with.''
`Social and Economic Havoc'
``New diseases spread faster and wreak more social and economic havoc in today's highly mobile and closely interdependent world, and these consequences have made health issues matter at the highest levels of government,'' said Margaret Chan, 59, WHO's avian influenza coordinator and assistant director-general for communicable diseases, in an e- mail distributed by the Hong Kong government yesterday.
Chan's nomination by China for the top job two months after Lee's death is cited by Harvard's Murray and others as a prime example of how nationalism is also, increasingly, becoming an issue for the global agency.
In pushing Chan, who led Hong Kong's battle against the 2003 epidemic of severe acute respiratory syndrome, or SARS, China violated an unwritten rule among the UN's Security Council nations, Murray said. Security Council member nations normally don't nominate officials to become UN agency heads, said Murray, who worked at the WHO until 2003.
China has been criticized for its responses to both SARS and avian flu, and may have nominated Chan because of the prominence of the issue, Murray said.
`Countrymen'
``Having one of their countrymen for the head of the agency may be very helpful, along with the status that goes with it,'' he said yesterday in a telephone interview.
For governments with powerful pharmaceutical industries, trade issues also spur an interest in health.
William Aldis, the WHO's representative to Thailand, wrote an editorial in the Bangkok Post newspaper in January encouraging the Southeast Asian nation to think carefully about a proposed free trade agreement with the U.S.
Aldis said the ``restrictive intellectual property rights'' being pursued by U.S. negotiators would prevent Thailand from using locally produced affordable generic drugs, and that the price of newer-generation drugs for the 600,000 Thais living with HIV/AIDS ``will remain exorbitantly expensive.''
Two months later, Aldis was transferred to a research position in New Delhi. He had served less than 16 months in what is usually a posting of at least four years.
U.S. Clout
Aldis's case is an example of the U.S. government using its political clout to advance its interests in developing countries, U.S. Representative Jim McDermott of Seattle told the House on June 20.
``The United States government is helping the pharmaceutical industry squeeze the Third World,'' McDermott said in a transcript posted on the lawmaker's Web site.
The new director general needs to ``be very tough minded and unafraid of upsetting politicians who guard the industry interests,'' Richard Fielding, a clinical psychologist in the University of Hong Kong's department of community medicine.
Others nominated include: Shigeru Omi, the WHO's regional director of the Western Pacific, by Japan; Pekka Puska, Finland's top public health official, by that country; Kazem Behbehani, an agency assistant director general of external relations and government bodies, by Kuwait; Tomris Turmen, a WHO family and community health specialist, by Turkey; and Julio Frenk, Mexico's health minister, that country.
As many as six more nominations may be announced when the WHO releases its full list, Murray said.
One round of voting by the WHO's executive board will reduce the field of candidates to five, Murray said. The subsequent rounds will eliminate low vote-getters one by one, he said.
To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net .
Last Updated: September 6, 2006 07:47 EDT
http://www.bloomberg.com/apps/news?pid=20601082&sid=ay4zFaF4H4Nw&refer=canada
