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BMJ No 7124 Volume 316
News Saturday 3 January 1998
WHO Special Report
WHO leadership candidate: Dr Nafis Sadik
BMJ analysis
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Dr Nafis Sadik (68) from Pakistan has been the executive director of the United Nations Population Fund since 1987, where she has championed the needs of women and their involvement in policy making at all levels. She has been a strong advocate for human rights and individual empowerment and has argued for an integrated approach to social development as the only sustainable route to universal health. |
Replies to BMJ questions
What do you see as the major health challenges of the next five
years, and how should the WHO address them?
Overall, one of the key challenges will be to ensure that health
is clearly seen as the cornerstone of all efforts towards social
and economic development. More specifically the WHO has a key
role in each of the following:
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Setting standards: the WHO should be prepared to offer leadership
towards new goals for health in the 21st century, together with
standards and "best practices" for reaching them; |
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Health monitoring, surveillance, and reporting: the WHO's responsibility
is to ensure that monitoring and surveillance extend to all health
related matters. Analysis and reporting on trends will offer important
guideposts for health related policy; |
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Control of communicable diseases and emerging threats to health:
the WHO is responsible in cooperation with its partners for providing
accurate and timely information and promoting appropriate responses
in all matters relating to health; |
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Health policy as part of development: the WHO must take the lead
internationally in demonstrating the importance of the goal of
the Health for All initiative, and in calling attention to the
development policy implications of changing health needs; |
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Civil emergencies, war and natural disasters: the WHO, with its
partners, should be prepared to respond to civil emergencies,
war, and natural disasters. |
Should the WHO be addressing the effects of socioeconomic factors
on health, and if so, how?
The WHO must position itself as the global leader not merely in
fighting disease but in promoting a proactive concept of personal
and public health. In so doing, it must promote the concept of
health as a key element of overall development and give attention
to the effects of socioeconomic factors on health. The rapid pace
of economic and social change calls for constant attention to
its effects on all matters related to health. Smoking and tobacco
related diseases and drug misuse are a growing threat to health
in many developing countries. The WHO should be prepared to mobilise
global efforts to adapt to the emerging challenges brought on
by these trends.
How should the WHO's activities best reflect the long term needs
of individual countries rather than the short term interests of
donors?
The WHO's programme must be based on an in depth and objective
assessment of needs at global, regional, and country levels, and
it must match these with the capacities that constitute the specific
comparative advantage of the WHO. The only way any organisation
can meet the enormous needs of both developing and developed countries
is through focusing its programme areas on those areas where it
has the excellence but calling on others to perform the roles
in areas where they are stronger. Provided that the WHO inspires
the confidence of all its partners, it can have a key role in
promoting these strategic alliances. All proposals should be examined
in the open, in a transparent and professional manner.
Do you think constitutional reform of the WHO is needed, and what
would you like to see changed?
An important review process of the constitution is under way,
and I will be guided by some of this work. Issues that require
attention relate to the allocation of resources, the relations
between the headquarters and the regional offices, and representation
at country level. The review of the constitution must also look
into issues that relate to the position and role of the WHO in
the present day context, given that there are today so many other
groups that are also active in health.
How should the WHO respond to the current domination of international
health by the World Bank?
Today many other organisations, in addition to the WHO, are active
and influential in the health field. Therefore, it is essential
that close cooperation is established among all these entities,
including the World Bank. The WHO should itself be in the position
of a respected international leader on all matters related to
health, giving policy advice and being proactive on health as
a development question. The WHO can provide the forum for bringing
together a large number of groups from within and outside the
United Nations, to discuss issues of common concern.
Over the past 10 years, the WHO has suffered a collapse of international
prestige and internal morale. How would you restore faith in the
WHO?
The process of reform within WHO has already started and can be
further encouraged and used to promote a culture of cooperation,
which will in turn lead to greater cohesion and integration. It
is the role of the director general to cultivate throughout the
organisation a sense of purpose and commitment towards the goal
of the Health for All initiative and to ensure that organisational
priorities and managerial policy reflect this goal. Recruitment
should be based on suitability, and promotion on performance.
Personal integrity and commitment to the organisation's goals
as much as technical expertise will be the hallmark of an effective
staff member.
Why are you the best person for the job?
I am uniquely trained and prepared for these challenges. I understand
from personal experience the reality of building better health
in the context of a developing country and what is required in
terms of global leadership. I have been widely acclaimed for my
effectiveness as a strong leader, in the United Nations system.
I have a long experience of the WHO's operations, yet I am not
identified with its structure or management style. I have worked
closely and at the highest levels with the government and institutions
most closely concerned with the future of the WHO.
I have demonstrated outstanding fundraising capacity and the skills
to build consensus and partnerships even on issues of a most complex
and sensitive nature. I have brought together groups and individuals
from the most diverse origins and representing all possible views,
and in the end, through effective facilitation, coordination,
and leadership, together we have agreed on new international agreements
that all groups and countries can be truly proud of. The WHO's
long term aim is to be an effective part of the structure of international
cooperation to build peaceful development. I am in a unique position
to make a critical difference in this process.
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