Partnerships with the drug industry would be constructive

BMJ 2003; 326 doi: (Published 18 January 2003) Cite this as: BMJ 2003;326:123

Karam Karam is minister of tourism and a former health minister in the Lebanon

On 27–28 January, the World Health Organization executive board picks its new director general elect. The BMJ asked all eight candidates what they would do if they got the job. We print extracts from the replies on the next four pages. Full answers are available on

What will be your priorities on taking office?

Emphasis must be placed on public health programmes—tackling such issues as nutrition, access to essential health needs, access to medicines in developing nations, maternal and child care, and access to primary health care. We must also place emphasis on cost effective public health programmes such as immunisation and the development of safe and effective new vaccines for diseases of poverty. Moreover, in addition to the recent epidemics of AIDS and other resurgent infections, chronic endemic diseases such as cardiovascular diseases, cancer, and arthritis need to be addressed through innovative approaches.

What will you do to champion the needs of the developing world?

During the last few years international agencies, including WHO, have emphasised the role of health as the basis of sustainable development. Strengthening of national and global capacities to address the problems in developing countries is best advocated through close collaboration between various health institutions. In developed and developing countries, WHO collaborating centres should have a leading role in this respect. I would also aim to strengthen national health research institutions and would advocate that social and public health scientists should contribute to the setting of national as well as global health research policy.

What will you do to change the culture of WHO so that there is greater openness, communication, and internal debate?

We need to focus on the development of a healthy, stable, and productive working environment, with a team approach across various levels, as well as across the organisation. I feel that there is a need to improve staff morale across WHO. This can be achieved by developing a more secure organisational structure and a sound human resource policy with proper attention given to staff recruitment and retention policies, staff performance appraisal systems, and career development.

What new ideas do you have for funding WHO's core activities?

Specific public health projects needing funding should be presented to major grant giving countries. Any cooperation stemming from this effort would benefit global health and should be a major concern for potential donor countries. Monitoring and evaluation of such programmes should be an essential part of the implementation process.

What rules or policies should there be to govern WHO's partnerships?

The basis of partnership should be the recognition of WHO's role as the world's health conscience, the leading agency for global health, and an organisation with a fixed vision of attainment of health for all. Partnerships with the research based pharmaceutical industry to improve public health would be constructive. Some renewed attention to the problem of access to medicines, the quality of accessible medicines, and innovation in new therapeutic and preventive technologies is needed.

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