Should WHO chief save face or save lives?
By SIMON LEE
Hong Kong _ Yesterday was the closing date for candidates to lead the World Health Organisation. Let's hope that when elections are held in November, they find someone with the character to tackle both new transnational health threats such as avian flu, and persistent killers such as diarrhoea, TB, malaria and Aids. Unfortunately, at least one candidate has already shown signs that she might not have what it takes.
One of the favourites to replace the late Dr Lee Jong Wook, who died suddenly in May, is China's candidate Margaret Chan. Currently in charge of the WHO's response to avian flu, she was also director of health in Hong Kong from 1994 to 2003, a period that coincided with the emergence of both avian flu and severe acute respiratory syndrome or Sars.
As avian flu marches up the global political agenda, her experience in these two roles should make her a shoo-in. After all, the World Bank has just announced that Indonesia's economy has already been affected by bird flu and the WHO is the only agency with the skills and mandate to coordinate the response to this kind of pandemic health threat. What could be better than a leader who already has a track record of dealing with them?
The problem is Dr Chan's past actions show her to be more concerned with saving face than saving lives, an unsuitable candidate for a position that requires honesty, accountability and genuine leadership.
Take the Sars outbreak of 2003. Dr Chan was then chief health adviser to the Hong Kong government and responsible for determining strategy. Although the outbreak came to an end fairly swiftly, it killed a total of 298 people in Hong Kong.
A subsequent enquiry by the Hong Kong legislature concluded that Dr Chan's response to the Sars outbreak was unsatisfactory, condemning her for not attaching sufficient importance to soft intelligence on the epidemic and not taking account of the heavy passenger flow between Guangdong and Hong Kong.
If Dr Chan had announced the epidemic in Guangdong in the two months before the outbreak arrived in Hong Kong, hospitals would have had time to prepare. Instead, Hong Kong's hospitals acted like an incubator for the disease before it spread out into the community.
More egregiously, Dr Chan spent the vital early days of the outbreak wrangling with the WHO over its choice of the name for the disease: Sars.
This choice was coincidentally similar to the official abbreviation for Hong Kong, the Special Administrative Region (SAR). Instead of immediately setting in train the necessary procedures to tackle the outbreak, Dr Chan wasted time trying to save China's face by protesting against the name Sars.
Without this delay many lives could have been saved.
Dr Chan's handling of avian flu in Hong Kong was equally inept. When the H5N1 virus was first identified in 1997, nobody knew if it could spread to humans. Dr Chan sought to reassure a jittery public by declaring, ''I eat chicken every day.''
However, as it emerged that poultry were dying in great quantities, the Department of Food Hygiene decided to intervene before a crisis developed. Even though Dr Chan had famously told everyone to carry on eating chicken, the Hong Kong government slaughtered approximately 1.6 million and banned all chicken imports.
So it was actually the head of the Department of Food Hygiene who took the tough decision that risked embarrassing Beijing. Dr Chan, meanwhile, was more concerned about saving her boss's face than with protecting public health.
China is at the centre of a number of emerging health threats. In addition to avian flu, for which honesty and openness from China will be absolutely vital if a devastating global pandemic is to be prevented, China has a burgeoning Aids problem which threatens millions of people. However, censorship and the restriction of free speech has meant that these two diseases have either been underplayed or officially disavowed in China, denying people the knowledge needed to protect themselves.
If Dr Chan held the top job at the WHO, China would effectively have carte blanche to continue the deceptions and ignorance on which infectious diseases such as HIV/Aids and avian flu thrive.
Avian flu is perhaps the biggest communicable disease threat facing the world. To defeat it and to defeat the many other existing diseases and emerging threats will require accountability and honesty from the WHO, the only agency that has the ability to coordinate action on a global scale.
Dr Chan's past actions in dealing with avian flu have shown her to be more concerned with politics than public health. WHO member states could save face now by electing someone else.
Simon Lee is a Hong Kong-based analyst and a columnist for ''Apple Daily''.
http://www.bangkokpost.com/News/13Sep2006_news28.php
By SIMON LEE
Hong Kong _ Yesterday was the closing date for candidates to lead the World Health Organisation. Let's hope that when elections are held in November, they find someone with the character to tackle both new transnational health threats such as avian flu, and persistent killers such as diarrhoea, TB, malaria and Aids. Unfortunately, at least one candidate has already shown signs that she might not have what it takes.
One of the favourites to replace the late Dr Lee Jong Wook, who died suddenly in May, is China's candidate Margaret Chan. Currently in charge of the WHO's response to avian flu, she was also director of health in Hong Kong from 1994 to 2003, a period that coincided with the emergence of both avian flu and severe acute respiratory syndrome or Sars.
As avian flu marches up the global political agenda, her experience in these two roles should make her a shoo-in. After all, the World Bank has just announced that Indonesia's economy has already been affected by bird flu and the WHO is the only agency with the skills and mandate to coordinate the response to this kind of pandemic health threat. What could be better than a leader who already has a track record of dealing with them?
The problem is Dr Chan's past actions show her to be more concerned with saving face than saving lives, an unsuitable candidate for a position that requires honesty, accountability and genuine leadership.
Take the Sars outbreak of 2003. Dr Chan was then chief health adviser to the Hong Kong government and responsible for determining strategy. Although the outbreak came to an end fairly swiftly, it killed a total of 298 people in Hong Kong.
A subsequent enquiry by the Hong Kong legislature concluded that Dr Chan's response to the Sars outbreak was unsatisfactory, condemning her for not attaching sufficient importance to soft intelligence on the epidemic and not taking account of the heavy passenger flow between Guangdong and Hong Kong.
If Dr Chan had announced the epidemic in Guangdong in the two months before the outbreak arrived in Hong Kong, hospitals would have had time to prepare. Instead, Hong Kong's hospitals acted like an incubator for the disease before it spread out into the community.
More egregiously, Dr Chan spent the vital early days of the outbreak wrangling with the WHO over its choice of the name for the disease: Sars.
This choice was coincidentally similar to the official abbreviation for Hong Kong, the Special Administrative Region (SAR). Instead of immediately setting in train the necessary procedures to tackle the outbreak, Dr Chan wasted time trying to save China's face by protesting against the name Sars.
Without this delay many lives could have been saved.
Dr Chan's handling of avian flu in Hong Kong was equally inept. When the H5N1 virus was first identified in 1997, nobody knew if it could spread to humans. Dr Chan sought to reassure a jittery public by declaring, ''I eat chicken every day.''
However, as it emerged that poultry were dying in great quantities, the Department of Food Hygiene decided to intervene before a crisis developed. Even though Dr Chan had famously told everyone to carry on eating chicken, the Hong Kong government slaughtered approximately 1.6 million and banned all chicken imports.
So it was actually the head of the Department of Food Hygiene who took the tough decision that risked embarrassing Beijing. Dr Chan, meanwhile, was more concerned about saving her boss's face than with protecting public health.
China is at the centre of a number of emerging health threats. In addition to avian flu, for which honesty and openness from China will be absolutely vital if a devastating global pandemic is to be prevented, China has a burgeoning Aids problem which threatens millions of people. However, censorship and the restriction of free speech has meant that these two diseases have either been underplayed or officially disavowed in China, denying people the knowledge needed to protect themselves.
If Dr Chan held the top job at the WHO, China would effectively have carte blanche to continue the deceptions and ignorance on which infectious diseases such as HIV/Aids and avian flu thrive.
Avian flu is perhaps the biggest communicable disease threat facing the world. To defeat it and to defeat the many other existing diseases and emerging threats will require accountability and honesty from the WHO, the only agency that has the ability to coordinate action on a global scale.
Dr Chan's past actions in dealing with avian flu have shown her to be more concerned with politics than public health. WHO member states could save face now by electing someone else.
Simon Lee is a Hong Kong-based analyst and a columnist for ''Apple Daily''.
http://www.bangkokpost.com/News/13Sep2006_news28.php
