Presentation to the Executive Board
Mr Chairman, Members of the Executive Board, ladies and gentlemen,
It is an honour to be here today to present to you why I am seeking election as the next Director-General of this great organization. You must be very tired today after listening to all these presentations. But I am sure I can maintain your attention in the next half an hour.
I have worked for WHO for 20 years. And I am proud of it. I started in Fiji, working to control leprosy. It was a rewarding and a humbling experience. I was a young doctor, working and travelling alongside more experienced, wiser and older national physicians. But because I came from WHO, they always put up with me. Their understanding and good humour helped shape my career in public health. Since leaving them, I have worked at the Western Pacific Regional Office for 7 years and for nine years at headquarters. But it was the experience of working with doctors, patients, and public health officials in the field that has always been my reference point. These people have brought me here today.
As you know well, when WHO was established in 1948, we were given this mission statement: “The attainment by all of the highest possible level of health”.
Nearly 55 years later, we are still a long way from achieving this lofty goal. Millions of people continue to suffer and die unnecessarily, and billions lack the basic health necessary to raise themselves from abject poverty.
But this is not a reason to become disheartened. These noble goals we have set ourselves must not be abandoned. Setting apparently impossible goals drove us to eliminate smallpox and will soon rid the world of polio. These are the ideals which will drive the entire global health community to ever greater achievements.
In this presentation, I will answer three fundamental questions. WHAT needs to be done to fulfil our mission. HOW can we do it, and WHY I am the right person to make it happen.
Let me begin with the question of “WHAT” needs to be done.
Today, we have another set of ambitious goals that build on the WHO constitution and the aspiration of health for all, expressed in the Alma Ata declaration 25 years ago. These are the Millennium Development Goals agreed at the Millennium Summit by the members of the United Nations in September 2000. We must now focus our work on these global commitments to sustaining development and eliminating poverty.
The eight Millennium Development Goals have clear targets and indicators. Six of the goals, and many of the targets, are specifically related to health. What we now need is a massive and rapid scale up of action and resources to meet these targets. WHO will have a crucial role in facilitating this scaling up.
As we all know, many parts of the world, especially Africa, are experiencing the devastating impact of the HIV/AIDS epidemic. HIV/AIDS threatens many areas of human social life in highly impacted countries. There is no question that the new Director-General will have to make it an extremely high priority. Together with UNAIDS and the Global Fund, I will forge a powerful and effective alliance to address this pandemic.
There are no easy answers to this problem, but in leading vaccine and TB programmes, I have learned much about organizing and delivering complex public health interventions in resource poor settings. We will have to use all the lessons of past interventions, and invent many new ones. Our generation will be defined by what we do in response to HIV/AIDS. While we can't allow it to overshadow other critical programmes, successful measures to combat HIV/AIDS could have extremely positive effects on all aspects of health systems.
We come now to “HOW”.
I have five priority areas for WHO that will turn commitment into measurable outcomes:
- Total commitment to achieving the Millennium Development Goals;
- Decentralizing WHO and its work;
- Enhancing WHO's efficiency;
- Improving WHO's accountability;
- Making WHO an even better place for people to work.
If I am elected, my first and over-riding priority as Director-General will be to meet the health-related Millennium Development Goals. I will advocate for a substantial increase in investment - both national and international - in public health systems and services.
The new resources flowing through the Global Fund to Fight AIDS, Tuberculosis and Malaria will make a substantial difference, and are most welcome. WHO will continue to work with the Global Fund Board and its Secretariat to ensure that the GFATM can manage existing resources well and disburse them rapidly. But we must also continue to make it clear that the financial commitments made so far are nowhere near enough, and do not adequately address the wider needs for scaling up AIDS, TB, and malaria control.
Despite the generosity of our supporters inside this room and elsewhere, WHO will never have resources to do everything that we want it to do. We must therefore focus our work on the things we do best - on setting high quality norms and standards in health, directing and coordinating international public health, on advocating for better resources and more efficient delivery, and on always providing the evidence to back up what we say.
I will focus on helping Member States to address the serious human resource problems that many currently face. I will therefore work with countries:
- to mobilize investment to increase their capacity for basic training of health workers;
- to develop sustainable reward systems for health workers;
- to improve long-term human resource planning in rich and poor countries to help alleviate the brain drain from the south;
- and to develop a mentoring system in WHO. This would involve recruiting and training young health professionals who would gain valuable experience by working alongside more senior colleagues in WHO for a 2 year period before returning to their home countries.
I will promote specific health interventions that have clear impact on reducing both morbidity and mortality, particularly for the most vulnerable. Improving maternal health, child immunization, DOTS to cure TB, are some of the examples here. Having directed the campaign against polio for eight years, first at WPRO and later from headquarters, I will ensure that polio is eradicated during my tenure. In focusing on the Millennium Development Goals, I want to make it clear that this will not be at the cost of WHO’s broad scope and mandate. Our definition of health is a wide-ranging one. Our work must continue to encompass other priority areas, such as noncommunicable diseases, reproductive health, tobacco control, health systems, human rights, gender, violence, and mental health. We must continue to demonstrate leadership in all these areas.
The Framework Convention on Tobacco Control is a case in point. Signing of this important treaty is just a start, and its effectiveness must be carefully monitored over the coming months and years. My second and third key priorities are interlinked - decentralization and efficiency. I will devote more of WHO's resources to the countries and regions where they can have the most direct impact. Today, the numbers of staff, long-term and short-term, at HQ are increasing steadily. In the 2004 and 2005 budget, 36% of the total are allocated to HQ. I will shift this HQ proportion to 25% by 2005 and 20% by 2008. Shifting the HQ budget to the regions and countries will stop and reverse the trend of ever increasing number of HQ staff.
I will implement what I call “forward deployment” of specific technical programmes to the regions where they can have the biggest impact. For example, the Leprosy programme will be moved to the South-East Asia Regional Office, the Guinea Worm programme to the Eastern Mediterranean Regional Office, and the Traditional Medicine programme to the Western Pacific Regional Office. This “forward deployment” of programmes should not be interpreted as ‘regionalization’ of specific diseases. Rather, WHO's technical experts will benefit from the rich local knowledge, as well as delivering programmes more directly to the people most likely to benefit from them. It will also produce cost savings. Together, we have to change both the way our work is done and the places where it is done.
We have to move to high technology. I will continue to invest in information technology and specifically in the communication infrastructure that links country offices with the regions and headquarters. Increased use of video conferencing will replace some meetings and duty travel.
We have to outsource whenever possible. Can't we utilize our hundreds of collaborating centres around world more effectively?
Some people do not believe that our regional and country offices can deliver. Their scepticism has contributed to the centralization of resources we see today. I strongly disagree with this assessment.
Country offices, regional offices, and headquarters are the three organizational pillars of WHO. Taking advantage of my personal experience in each of these three pillars, I will oversee a more effective distribution of resources among them.
Together with Regional Directors, I will undertake management reforms and capacity building in regional and country offices. With greater capacity and more resources, regional and country offices can take more responsibility for country support. The focus of work at Headquarters will be on setting, directing, monitoring and coordinating strategic directions on global health issues, and on the normative functions that support communities and countries as they strive to reach their health goals.
These changes will be an extension of what Dr Brundtland started 5 years ago. I will introduce these changes through close consultation with you, the Members of our Board, with the Regional Committee and Regional Directors, and Member States.
Fourth, under my leadership, WHO will be more accountable and more transparent. We receive and spend large amount of public money. Even the poorest taxpayers in the poorest country contribute financially to the work of WHO. As Director-General, I will introduce a continuous process of programmatic and fiscal evaluation. I will always remember that the Member States are the reason for WHO's existence.
The final priority I want to talk about today is the people who work for WHO - but by no means they are my last priority. None of the things I have talked about can be done without a fully engaged and committed staff. I am committed to making WHO a great place to work. I will do this by building clear career path, by investing in in-service training, and by delegating authority to the skilled professionals who work here. Our people are the most valuable asset we have. Maintaining high morale and keeping them focused and committed is not a simple task. I want to attract the best people. I want to provide the best possible working atmosphere for them. I want them to grow professionally during their time here.
Mr Chairman, Members of the Board, I would now like to turn to the key role of partnerships. WHO, essentially, is itself a specialized partnership of sovereign Member States.
For the past two years, I have been in charge of rebuilding Stop TB. During that time, the Stop TB partnership has grown into a complex and effective coalition of more than 250 international partners that includes WHO Member States, donors, NGOs, industry and foundations. We have developed innovative ways of purchasing and delivering much-needed drugs through the Global Drug Facility. We have brought global attention to a woefully neglected problem and we have made major measurable progress towards the goals of better detection and treatment of TB.
This is real progress. It was brought about by serious commitment to partnership. In all that we do, we must find ways to work beyond WHO. Building successful inclusive partnership cannot be an extra to our core work. It must be the core. However, any partnership in which WHO plays a part must earn our participation. If anyone worries about dilution of WHO's leading role through partnership, I like to remind you that partners need WHO as much as we need them.
As you nominate the next Director-General of WHO, I ask that you consider three facts.
First I know this organization - probably better than most. I know the people who work here. I know our strengths and our weaknesses. As a Senior Adviser to the Director-General, I was closely involved in the reform process over the past years. That experience will be a vital asset in the coming months and years, as we build on the achievements of WHO in the past 55 years.
Second, I understand the opportunities and problems faced by many countries, both developed and developing. I grew up in what was then an extremely poor country. The Republic of Korea today has become an industrial and economic power house, but during my early life, Korea faced the problems of a developing country. I have not forgotten that experience.
Third, I deliver results. Over the past nine years, I have had the privilege of leading two key programmes, the immunization programme, including the polio programme, and Stop TB. The key element for both is their impact in countries. The numbers of children immunized and protected from vaccine preventable diseases. The number of people cured of TB. Both programmes have shown substantial improvements in performance, and a significant increase in resources under my leadership.
I know this organization. I understand the opportunities and problems faced by many countries. And I deliver results. This is what I offer to you today.
Thank you very much.