WHO launches new leadership, new priorities

The Lancet
Oct 14, 2017 Volume 390 Number 10104 p1715-1810   e25-e26
http://www.thelancet.com/journals/lancet/issue/current

WHO launches new leadership, new priorities
The Lancet
Published: 14 October 2017
WHO’s Director-General, Dr Tedros, last week launched his new cabinet to widespread acclaim. His mix of deputy and assistant director-generals is made up of nine women (two-thirds of his leadership team) with a geographical spread across 14 countries. India, Brazil, Saudi Arabia, South Africa, and Barbados are all newly represented. The announcement also translated Tedros’s verbal promises into structural commitments. New priorities include Universal Health Coverage, climate change, and access to medicines. His cabinet is diverse, talented, and experienced. Now it’s all about WHO’s actions. A special session of the Executive Board will be convened in November to agree a future global programme of work for the agency.

There are important questions to resolve. How will the new team in Geneva work with regional directors and regional offices? Will the expanded number of priorities and larger executive team create more silos within an organisation that is already partly paralysed by inefficiency? Will the optimism engendered by Dr Tedros’s election be backed by donor investment to a chronically impoverished WHO? Internally, the director-general has signalled to staff that he wants urgent and profound organisational change. Reports suggest that he is likely to appoint a transformation czar and hire McKinsey consultants to manage the change.

Dr Tedros is said to be obsessed by impact, which is welcome. WHO is at its best when it amplifies its voice and reach by establishing radical and innovative initiatives led by internationally recognised technical or political leaders. This was the lesson of Gro Harlem Brundtland’s term as director-general. The goal of transformational change is good. But it might be more practical for WHO to deliver on a limited number of tangible and feasible objectives rather than speaking in terms of broad generalities and aspirations. Dr Tedros and his team will be judged on specific and measurable successes—such as pandemic protection and stronger health systems.

The announcement last week has brought additional and valuable momentum to the renewal of WHO. The agency must now raise its political game.