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Issues in World Health Care I

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Opinion: My vision for the WHO

By David Nabarro 27 March 2017



Dr. David Nabarro, candidate in the race for World Health Organization director-general. Photo by: Simon Ruf / UNMEER / CC BY-ND

We live in a world that is constantly changing. It has changed more in the past 100 years than it did in the previous thousand. An uneven climate, novel diets and new ways of communicating all impact on our lifestyles. Amid these changes, our health is a precious asset and we must preserve it carefully. For many people — especially those who are poor, vulnerable and living amid conflict — maintaining good health is a constant challenge.

For these and many other reasons, the World Health Organization is vitally important to all of us.

We need the WHO as we try to understand risks to our health. We need the WHO to help us respond to threats of disease when they appear. We need the WHO’s advice when deciding how best to make sure that those who need health care can get it. Because patterns of sickness and disease vary from place to place, the WHO has to be nimble when deciding which issues need its attention. That calls for effective leadership — and it is needed now more than ever.

If elected as director-general of the WHO, I will prioritize the building of capacity within countries: Poor countries will receive the support they need to protect their people and to keep them safe. I will ensure that the worldwide response system will function well, responding impartially to people’s needs, with dependable support systems in each region.

I will upgrade its response to disease outbreaks, as a matter of urgency. I know what is required after leading international responses to malaria, avian influenza, Ebola and cholera. The WHO was criticized for a delayed response to the 2014 outbreak of Ebola disease. Yet as the premier health body of our world — owned by all countries and serving the needs of all people — it must strive both to be relevant and effective, at all times. I have set out what needs to be modified in the wake of the Ebola response. I know what is needed and am ready to make it happen.

A relevant and effective WHO will help close the health gap by identifying inequalities in people’s health experiences and ensuring they are overcome. I have seen the impact of unequal access to health care with my own eyes because I have treated the sick in many countries. Most people in today’s world get sick and die because they get diseases that are linked to the ways they live. The WHO’s principle role is to show how diet, exercise, water, sanitation, education, conflict, the environment and human rights all influence how long people live and how healthy they are. That is why I work for public health through primary health care, leaving no one behind.

Often many health challenges people face can be prevented by ensuring early access to the factors that determine well-being. Why should anyone have to die of an illness that can easily be treated? Why should people anywhere be sick when prevention is inexpensive? In September 2015 our world agreed to a plan to ensure the well-being of all people and nurturing of the planet. If that plan — the 2030 Agenda for Sustainable Development — is fully implemented, people everywhere will enjoy good health.

I want the WHO to be at the heart of efforts to implement the 2030 Agenda, supporting the many governments across our world who are working to put the plan into action: making people’s health and well-being a central objective.

When I worked in communities as a young doctor, I always depended on WHO guidance on how best to treat those with tuberculosis, to mend broken bones, to tackle complicated deliveries or to manage malnutrition in childhood. Governments also turn to the WHO for advice and that is why the organization must be well-managed, properly financed, credible and trustworthy.

I want the WHO to be closely connected to its member countries and those people working on the frontlines — helping them analyze needs, draw on evidence of what works (and what does not), engage different specialists and pursue cost-effective solutions. It is urgent work: our changing world does not wait for anyone.

I want the WHO to evolve as the undisputed lead agency for health, showing what needs to be done in response to malaria, HIV/AIDS, and tuberculosis, to chronic diseases and to the needs of women, children and adolescents. When I led the WHO’s malaria effort in 1999, my intention was for WHO expertise to catalyze a global effort; it actually resulted in a halving of malaria deaths in Africa over the past 15 years. This is a massive reduction in suffering and death and an achievement of which many should justifiably be proud.

I want the WHO now to catalyze reductions in widespread suffering caused by lifestyle diseases such as cancer, obesity and diabetes. In 1985 I was involved in research that led Tanzanian scientists to find high levels of diabetes in the adult population. In 2015 I was a commissioner tasked with finding better ways to prevent obesity in childhood and reduce the risk of diabetes in later life. Advancing this work needs powerful and unrelenting advocacy by the WHO.

If elected, I will ensure that the WHO is transformed with a scaled-up and catalytic response to outbreaks of infectious disease, as well as to noncommunicable illnesses. The WHO will set the standards and ensure they are implemented by working through governments, NGOs and other actors.

I want the WHO to demonstrate results and show that it offers value for money. I want the  WHO to be trusted by people, governments and partners everywhere — contributing to improved standards of health and health care.

There is a simple mandate that sits at the heart of the WHO. It means enabling all people, everywhere, regardless of gender, status or nationality, can attain the highest possible standard of health. I want the WHO at all times to demonstrate how its work links directly to improving people’s health.

My career has taken me from treating patients as a clinician, to teaching medical students, all the way to being an international senior leader. I have worked on global health issues in more than 50 countries for over 40 years. I know I am the best qualified person to be the director-general of the WHO and ensure that it is a WHO that is fit for the future.

This op-ed is one in a series from all three WHO candidates. You can read our full coverage and analysis on the election of the next WHO director-general in May 2017.

Devex does not endorse any particular candidate.

About the author

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David Nabarro

Dr. David Nabarro is a special adviser to the United Nations secretary-general on the 2030 Agenda for Sustainable Development and Climate Change and a candidate in the race for WHO director-general. In the past 12 years, successive secretaries-general of the United Nations have entrusted David to lead collective action on some of the most pressing and complex challenges — responding to avian and pandemic influenza, promoting food security, ending malnutrition, combating Ebola, promoting the 2030 Agenda for Sustainable Development and advancing efforts relating to climate change.


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