WHO Director General race

As promised, we have the full slate (13) of those running for Director General of the World Health Organization:

Dr. Kazem Behbehani (Kuwait); Dr. Margaret Chan (China); Dr. Julio Frenk (Mexico); David Gunnarsson (Iceland); Dr. Nay Htun (Myanmar); Dr. Karam Karam (Syria); Dr. Bernard Kouchner (France); Dr. Pascoal Manuel Mocumbi (Mozambique); Dr. Shigeru Omi (Japan); Dr. Alfredo Palacio (Ecuador); Pekka Puska (proposed by Finland); Elena Salgado (Spain) and Dr. Tomris Turmen (Turkey). (Canadian Press)

The CP story (no byline but likely Helen Branswell) also tells us the Executive Board (see yesterday's post) will narrow the list to five or so in the days before the November 9 World Health Assembly meeting in Geneva and in secret balloting pick one to be confirmed by the WHA by November 8.

An excellent story by Bloomberg's John Lauerman (emerging as one of the better flu reporters) gives more background:

The race for the director-general's job, open since May, comes as the WHO has increased its visibility in battling smoking, AIDS, obesity, heart disease, malaria and the headline- grabbing H5N1 avian flu, among other deadly diseases.

The position will also offer unique challenges, experts say. The new leader will be forced to navigate a complex political landscape of emerging private assistance foundations, powerful regional agencies and governmental self-interest in continuing to expand the agency's influence as it works to limit the effects of the growing bird flu pandemic.

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.'' (Bloomberg)

Lauerman's story has an interesting piece of protocol I was unaware of. Permanent members of the Security Council do not, by custom, nominate candidates. In this case, China has gone against custom and is pushing hard for their candidate, Dr. Margaret Chan. Chan previously was health director in Hong Kong during the SARS outbreak, and her record at that time has been controversial, with some saying she was very effective while others say she failed to handle the situation. Subsequently she moved to WHO where she headed the agency's pandemic flu effort. Speculation that China is championing Chan's candidacy as a way to neutralize their sorry record on covering up the SARS outbreak seems somewhat odd, as it would seem more likely to call attention to it.

There is more at stake in the WHO position than response to bird flu. In June we brought you the story of how the US was interfering with WHO for political and commercial purposes. Here is a brief summary, as given by Lauerman as part of the context to the DG election:

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.

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.

This is one of several reasons why US support or endorsement of a candidate would be a strong negative in our view. We feel the same about China.

The list is now complete. We invite readers to comment on the candidates, and especially if they have useful information for the rest of us (anti-WHO rants are discouraged!). For starters, we note that the French candidate, Bernard Kouchner, is a 66 year old gastroenterologist who was UN Kosovo chief, former French health minister and Socialist member of the European Parliament, and most notably, co-founder of Doctors without Borders (Medecins sans Frontieres). Last year he was an unsuccessful candidate for UN Refugee Commissioner (AFP). He has good credentials, but that doesn't mean he'd be a good DG. Further insights from knowledgeable sources solicited. Again, rants are discouraged.

Addendum: Helen Branswell (Canadian Press) has a characteristically informative piece this morning on the intricacies of this election. Essentially reading for those interested in the topic.