Address to WHO staff
Colleagues in our 147 country offices, six Regional Offices, here in Headquarters, and elsewhere,
Twenty years ago, almost to the day, I started working for WHO. Over two decades, I have had the privilege of witnessing many of our Organization’s accomplishments. You, WHO staff, made these achievements happen.
Diversity of skills and backgrounds make WHO’s strength. We bring together the wisdom of experience and the energy and enthusiasm of youth. The youngest of our colleagues were born not long before I entered the Organization. For example, Deepti Adlakha, who works in the library of the South-East Asia Regional Office in New Delhi, was one-year old when I began working for WHO in Fiji.
Youthful commitment can become a lifelong vocation. Joseph Ockana, an Administrative Officer in the African Regional Office in Brazzaville, joined WHO in 1964, when he was only 21 years old. He has now served this Organization for nearly 39 years.
These two colleagues represent the range of experience and some of the many skills on which WHO depends. Veterans and newcomers, administrative, professional and maintenance staff: without all of your individual contributions, WHO’s work could not progress.
Today we begin a new chapter in WHO’s history. We will continue the work already underway. And we will make changes where these are needed to meet the test - results in countries.
Global health work must be guided by an ethical vision. WHO’s Constitution articulates our vision. At its heart is a commitment to respect for all human beings. That commitment sustains every part of our work.
The concept of Health for All reflects the quest for social justice and health equity expressed in WHO’s Constitution. The Alma-Ata Declaration still inspires us - because it puts the people at the centre of health and development. This May’s World Health Assembly resolutions and the activism of many health workers and communities around the world show that the Health for All ideal is alive. Slogans come and go. But the objective of Health for All will always be central to WHO’s work.
Our work together in the coming years will be guided by three principles.
We must do the right things.
We must do them in the right places.
And we must do them the right way.
First, doing the right things.
Today, as the HIV/AIDS pandemic enters its third decade, fresh political will and new technologies have created an opportunity to turn the tide of this global killer. The international community must act now. We must scale up an integrated global HIV/AIDS strategy linking prevention, care and treatment, prioritizing poor and underserved areas. I am, therefore, constituting an HIV/AIDS leadership team to ensure that WHO, working with local, national and international partners, will be at the forefront of this effort.
The Global Fund and bilateral programmes have pledged increased resources to the AIDS fight. But, in order for these resources to bring results, countries are requesting technical cooperation in the design and implementation of comprehensive HIV/AIDS programmes. I will focus WHO’s resources on supporting countries on the forefront of the pandemic.
In May, the World Health Assembly took note of the goal of providing three million people in developing countries with antiretroviral therapy by the end of 2005. The “three by five” goal presents a great technical and political challenge. By 1 December this year, World AIDS Day, WHO’s HIV/AIDS Department, working with partners, will produce a global plan for reaching the “three by five” target. Together with partners such as UNAIDS, WHO will use all available tools of advocacy to mobilize the political will and the additional resources needed to put this plan into action.
We will use the provision of AIDS treatment to strengthen HIV prevention and to build up health systems. Resistance to antiretroviral medicines must be closely monitored. I will work with WHO’s partners to establish a global network to monitor patterns of resistance to AIDS medicines.
In 2001, the Stop TB Partnership launched the Global Drug Facility and Green Light Committee to make quality TB medicines available at reduced prices. These facilities have promoted the standardization of TB treatment, paving the way for programme scaling-up and helping control drug resistance. Later this year, WHO will launch similar initiatives for malaria and HIV/AIDS.
To promote synergies in our work on major infectious diseases, the WHO departments working on HIV/AIDS, tuberculosis and malaria will be brought together in one cluster. This grouping will facilitate our work internally. It will also streamline our cooperative relationship with countries and partners such as the Global Fund.
Partnering with countries towards the Millennium Development Goals in health will be a key WHO objective in the years ahead. We see the Millennium Goals as milestones on the road towards health for all. Until now, WHO’s contribution to the Millennium Development Goals has largely focused on measurement. We will continue to emphasize reliable data and to cooperate in building country-level health measurement capacity. But, we will also strengthen technical cooperation with countries in designing and implementing national plans to reach the targets.
Threats to maternal health and child health demand intensified action. More than 500,000 women die each year during pregnancy and childbirth; millions more become ill or disabled. This year, more than ten million children in low-and middle-income countries will die before reaching their fifth birthday. Seven out of ten of these deaths are due to five preventable and treatable conditions: pneumonia, diarrhoea, malaria, measles and malnutrition. We can reduce this toll substantially by working with countries to ensure that health delivery systems incorporate strategies such as Making Pregnancy Safer and Integrated Management of Childhood Illnesses.
Noncommunicable diseases and injuries account for a growing share – now about 60% - of the burden of disease worldwide. We will develop and implement a comprehensive plan for fighting noncommunicable diseases.
We will sustain and intensify our work in areas including tobacco control; nutrition; violence and injuries; and mental health. The nutritional transitions now affecting all but the very poorest communities pose major challenges. Working with all stakeholders, we must develop integrated approaches that will respond to the critical needs of the malnourished, while avoiding the adverse health consequences of inappropriate diets. World Health Day 2004 will focus on traffic injuries, which are responsible for over one million deaths every year, the vast majority in developing countries. Most are preventable on the basis of existing knowledge and experience.
We will eradicate polio. A difficult struggle lies ahead. But with determination we can complete the global health community’s long effort to end this scourge.
We must also be ready for new threats. The SARS crisis illustrated WHO’s essential role in coordinating the international response to infectious disease outbreaks. SARS also revealed weaknesses in global disease surveillance. We will work with our partners in the Global Outbreak Alert and Response Network, and with bilateral and multilateral donors, to reinforce national and regional surveillance systems. We will strengthen the support and coordination functions of the Global Network. And we will revise the International Health Regulations to improve disease control.
Doing the right things is only part of the job. We must also focus our action in the right places.
That means putting countries at the centre. This idea is as old as the Organization itself. What has changed is the urgency of our commitment, and the determination to back this commitment with resources. We are putting countries where they should be - at the heart of WHO’s work.
In the coming months and years, we will strengthen WHO’s presence and impact at the country level. Working with Member States, Regional Directors and WHO country staff, we will ensure that our country offices have the resources and the authority they need. We will empower WHO country offices to work more effectively and accountably with countries in responding to national and local health needs.
In recent years, WHO’s resources have become increasingly concentrated in Geneva. Concentration has enabled much excellent work at headquarters. Yet there has been a gradual drift away from programmes based on countries’ needs toward programmes driven by headquarters priorities.
I am asking all Assistant Directors-General to analyse the work of their respective clusters and to propose specific steps for moving resources from headquarters to regions and countries. I will begin deploying additional resources to priority country offices for building up capacity in HIV/AIDS control and health systems. These resources should be available by early 2004 to support the rapid scaling-up of HIV/AIDS technical cooperation and other top priorities.
Countries have expressed their desire for greater cooperation in health systems development. This will be the core mission of WHO’s Evidence and Information for Policy cluster.EIP’s new leadership will implement a strategic planning process to achieve this mission.
Health information is the glue that holds a health system together. In most countries stronger, more integrated information systems are required. One example is vital registration systems - the ability to count births and deaths. These systems are still missing for most of the countries' population, especially in countries with high disease burdens. To make people count, we first need to be able to count people. To address this problem, I will develop WHO’s health information partnership with Member States and international organizations including the Gates Foundation, the World Bank and UNICEF. We will put in place a health metrics network to support countries in fullfilling critical health information gaps.
Many countries face a human resources crisis in the health sector. The shortage of skilled health personnel slows progress toward health goals such as “three by five” and the Millennium target on maternal mortality. Our cooperation with countries on this issue must intensify. Together, we must build the health work force using innovative methods of training, deployment and supervision of allied and community health workers. Community mobilization is a key to success. WHO’s engagement with civil society and communities must develop - both in international forums and on the ground at country level.
At the international level, WHO can contribute in direct ways to strengthening human resources for health. In early 2004, I will launch the Health Leadership Service programme. This initiative will recruit promising young health professionals from around the world and will provide them with the opportunity to work and learn for two years within WHO - in countries, regional offices and at headquarters. Mentored by senior WHO staff, these young professionals will form part of the next generation of international health leaders.
Global forces influence countries’ ability to build and maintain health systems that meet people’s needs. Putting countries at the centre of our work requires critical reflection on the factors influencing sustainable development and on the health consequences of development policies. As the world’s health advocate, WHO will be a strong voice in international debates on all issues that affect health. We will continue our analysis and advocacy on the health effects of global trade policies, intellectual property rights, environmental change, migration, conflict, and other institutions and processes related to development.
As we work to do the right things in the right places, we must also do things the right way. This means a new way of working together.
To serve Member States more effectively, we need to modify our human resources policies. I want to enable WHO people to perform better, with greater job satisfaction. I will initiate an Organization-wide talent review, to be completed later this year. The goal is to ensure that people’s skills and experience are being used effectively to reach our shared goal of improved results in countries.
I am instituting a new system of staff mobility, giving WHO staff the opportunity to work in different geographical and functional areas. The programme will enhance staff development, encourage the exchange of knowledge, and strengthen connections between countries, regions and headquarters. Within the next few weeks, I will discuss with all Directors and Regional Offices the preparation of plans for rotation and mobility with their staff.
Our staff appraisal mechanism is not always effective in helping people improve their work performance. We will base appraisal on a constructive dialogue, leading to a clear development plan for each staff member. I will commit increased resources to staff development. I am reviewing our recruitment and contracting processes to fulfil our commitment to equity and geographic and gender balance.
Along with specific policies, our overall organizational culture must evolve. Such a change cannot be imposed, but it can be modelled and supported at all levels, from country offices to Geneva. The climate within WHO must become more open and collaborative. We must work more closely together, in an atmosphere of trust and mutual respect. Decision making will become more participatory. Information sharing across clusters and departmental boundaries will intensify.
In some cases, the physical arrangement of our workspaces will change to facilitate new ways of working. For example, the Director-General’s Office here at headquarters will be set up on an open plan. My desk will be among other people’s. This is not just a symbolic gesture. It is a way of ensuring that the lines of communication stay open, and that I stay in touch.
As we work more collaboratively, we will also work more efficiently.
I will review and rationalize our administrative processes. Our Management Support Units can be streamlined. We will combine units so that each MSU supports two clusters.
I will foster efficiency by making better use of information technology. IT is an important catalyst for reaching WHO’s goals - in particular, closer organizational, integration and greater country-level impact. Currently, WHO’s talented IT professionals are hampered by insufficient resources and the lack of an overall institutional technology strategy. Later this year, I will release a comprehensive plan for knowledge management and information technology across the Organization. We will develop a clear, rational team structure for the IT department itself. We will streamline management functions through the Global Management System. We will develop flexible, “customer-driven” IT solutions that will facilitate collaborative work. For example, today I have introduced a pilot wireless network in the Director-General’s Office. We will strengthen information management in country offices and enhance the connectivity between headquarters, countries, and regions. We will find solutions to facilitate data management and use at the point of collection.
Over the last few years, we have shifted the emphasis in planning from resources to results. This shift must also occur in our evaluation and audit functions. I am strengthening our audit capacity. I am also appointing a technical ombudsman.
I am proud to say we have been able to recruit an exceptional group of women and men to join us and help guide the work ahead. Your have already read their names in the e-mail message I sent out last week.
I would like to introduce the team of Assistant Directors-General:
Denis Aitken (United Kingdom), formerly Chef de Cabinet, will be Director of the Office of the Director-General.
Liu Peilong (China), formerly Director-General, Department of International Cooperation, Ministry of Health, will be Adviser to the Director-General.
Anarfi Asamoa-Baah (Ghana), currently Executive Director for Health Technology and Pharmaceuticals, will head the Communicable Diseases cluster.
Kazem Behbehani (Kuwait), most recently DGO Eastern Mediterranean Liaison, will lead the External Relations and Governing Bodies cluster.
Jack Chow (USA) served most recently as Ambassador and Deputy Assistant Secretary for Health and Science, US State Department. He will head the new HIV/AIDS, TB and Malaria cluster.
Tim Evans (Canada), Director of Health Equity at the Rockefeller Foundation in New York, will take leadership of the Evidence and Information for Policy Cluster.
Catherine Le Gales-Camus (France), Scientific Adviser to the Director-General of Health, France, will lead the Noncommunicable Diseases and Mental Health cluster.
Kerstin Leitner (Germany), UN Resident Coordinator and UNDP Resident Representative in China, will have responsibility for the Sustainable Development and Healthy Environments cluster.
Vladimir Lepakhin (Russian Federation), most recently Head of the Department of General and Clinical Pharmacology at the Russian University of People’s Friendship, will lead the Health Technology and Pharmaceuticals cluster.
Anders Nordström (Sweden), Head of the Health Division, SIDA, will take charge of the General Management cluster.
Joy Phumaphi (Botswana), currently Minister of Health of the Republic of Botswana, will lead the Family and Community Health cluster.
Now I invite Joy Phumaphi to take the oath on behalf of the Assistant Directors-General.
I have asked four outstanding colleagues, who have completed their tenure as Cabinet Members with Dr Brundtland, to undertake important tasks.
I have named David Heymann to lead our work in Polio Eradication. I have charged Dr David Nabarro to lead our Health Action in Crises. Tomris Türmen will lead a team to assess the health implications of intellectual property rights structures and develop clear policy recommendations in this area. I have appointed Dr Derek Yach to design a comprehensive plan for strengthening WHO’s response to noncommunicable diseases.
I am also appointing the following directors:
Robert Beaglehole (New Zealand) to Evidence and Information for Policy; Margaret Chan (China) for Protection of the Human Environment; Graeme Clugston (Australia) as Technical Ombudsman; Marie Andree Diouf (Senegal/France) to Cooperation and Country Focus; Hiroyoshi Endo (Japan) to Communicable Disease Prevention, Control and Eradication; Mario Raviglione (Italy) to Stop TB in the new HIV/AIDS, TB and Malaria cluster; Bernhard Schwartlander (Germany) to Strategic Information for HIV/AIDS, TB and Malaria; Ambi Sundaram (Sri Lanka) to Support Services, Procurement and Travel; Paulo Teixeira (Brazil) to HIV/AIDS, TB and Malaria.
The team members I have just introduced will be catalysts in moving our work forward. But, to meet the goals I have outlined, we need the commitment of all WHO’s staff, the support of Member States, and the efforts of our national and international partners.
With humility and determination we will carry on our work in the months and years ahead. WHO’s founding vision, its achievements, its partners and, above all, its people create a solid foundation. We will put countries at the heart of our efforts. Guided by our principles of loyalty, transparency and commitment to excellence, we will move forward towards the goal of Health for All. Together, learning from the past, we can change the future of global public health.
Thank you very much.