Senior WHO appointments are praised but raise questions

The Lancet

Tedros, in unveiling his 15-strong top leadership team in October, declared “The team represents 14 countries, including all WHO regions, and is more than 60% women, reflecting my deep-held belief that we need top talent, gender equity and a geographically diverse set of perspectives to fulfil our mission.” This was the first time since the establishment of WHO in 1948 that women outnumbered men in senior management positions.

The appointments—well received by the global health community—included Indian Soumya Swaminathan as deputy director-general for Programmes; Brazilian Mariângela Batista Galvão Simão as assistant director-general for Drug Access, Vaccines and Pharmaceuticals; and French Ambassador Michèle Boccoz as assistant director-general for External Relations. Swaminathan had recently served as secretary of the Department of Health Research in India and as director-general of the Indian Council of Medical Research. Simão had previously been director of Community Support, Social Justice and Inclusion at UNAIDS, and had spent more than 30 years working in the Brazilian public health system. Boccoz, a top health diplomat, had been serving as the French Government’s Ambassador for the fight against HIV/AIDS and communicable diseases since 2016.

Sarah Russell, acting WHO director of Communications, told The Lancet that WHO was “the first UN agency to have more women than men in its top ranks…”

“It’s a positive move,” Mohga M Kamal-Yanni, senior health policy adviser at Oxfam, told The Lancet. “Some women are from developing countries such as India, Brazil…it brings a diversity of views, knowledge, [and] experience at a country-wide level, [which] can only be a plus for WHO.”

Among the directors appointed to head WHO agencies since Tedros started, “seven [of] eight…are women, a 40% increase in the number of women at director level at headquarters”, Russell said.

These appointments included registered nurse and Cook Islands’ current Secretary of Health Elizabeth Iro as chief nursing officer. Patrizia Carlevaro, board director at the Florence Nightingale International Foundation, said she welcomed WHO giving a higher visibility to nursing. “We need more focus on nursing in public policy not only in developing countries but also in developed countries”, she said.

Samira Asma from the USA, formerly with the US Centers for Disease Control and Prevention, was appointed director of the new cluster for Metrics and Measurement, and Nigerien Hama Boureima Sambo and WHO Representative in Gabon to the new cluster for Climate and Other Determinants of Health.

Russian Tereza Kasaeva, former deputy director of the Department of Medical Care in the Russian Ministry of Health, was appointed director of the Global Tuberculosis Programme. Mario Raviglione, who retired on Nov 30, 2017, told The Lancet that “in the field of [tuberculosis], [Kasaeva] had provided leadership in dealing with the problem in Russia, and had been open to innovation and the recommendations of WHO”.

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