The Lancet  
Jan 14, 2012  Volume 379  Number 9811 p93 – 192  e5 – 11
http://www.thelancet.com/journals/lancet/issue/current

Editorial
WHO and Margaret Chan: the next 5 years
The Lancet

WHO is in the process of appointing a Director-General whose tenure will run from June, 2012, to June, 2017. Margaret Chan, the current incumbent, is the only candidate standing. WHO’s Executive Board will consider her appointment when they meet later this month, and the World Health Assembly will ratify the Board’s decision in May. It is certain that Dr Chan will win a second term.

Her renewed appointment comes at a perilous moment for WHO. As a letter we publish online this week from Oxfam reveals, WHO is in crisis. Rescue is needed. But is this predicament a fair reflection of the Director-General’s performance? No, it is not.  When Dr Chan was elected she made a promise—namely, that she wanted her term to be judged by progress on health for Africa and for women. WHO’s leadership of Every Woman, Every Child, the UN Secretary-General’s Global Strategy on Women’s and Children’s Health, has been her great success these past 5 years. Add to that the remarkable achievement in September, 2011, of a political declaration on non-communicable diseases, together with her refashioning of a failing health systems agenda around universal coverage, and you have a record that is a surprising success for an agency in the vortex of a financial emergency.

One cannot judge Dr Chan’s legacy without recalling that her first priority 5 years ago was to deliver the initiatives begun by her predecessor, Dr Lee Jong-wook, who tragically died during his first term as Director-General. The most important project left unfinished was the Commission on Social Determinants of Health. Initially sceptical, Dr Chan not only saw this important report through to completion, but also became a significant champion of the social determinants agenda. Also recall that Dr Chan deftly led communications with the media and public during the 2009 influenza A H1N1 pandemic.

None of this is to say that there have not been disappointments. Her leadership team has not been a success. Only recently have the right people been selected for crucial portfolios. Several regional offices of WHO remain lacklustre backwaters. And sometimes one wishes for a sharper message, a stronger articulation of what WHO is for in the 21st century. These matters can be addressed during a second term. But that term will depend on proper financing of WHO by its donors. And here Dr Chan faces her greatest test of all.

Online First
Correspondence
Jan 13, 2012
Action to preserve WHO’s core functions cannot wait for organisational reform
Mohga M Kamal-Yanni

Preview
While WHO undergoes a wide-ranging reform sparked by a US$300 million budget shortfall, the agency is facing an exodus of qualified staff that is affecting its ability to work.1 The Executive Board is due to meet on Jan 16 to agree long-term principles and priorities for the organisation; it must ensure, in particular, that core functions are accorded the priority they merit. Oxfam is especially concerned that inadequate funding will severely diminish the WHO Essential Medicines Department, which for more than three decades has had an indispensable role in enabling developing countries to access affordable medicines.