The World’s Doctor

At the end of May the nations of the world will meet in Geneva to elect the next Director General of the World Health Organisation. It is no exaggeration to say that the fate of millions rests on the decision. That is why the United Kingdom is supporting the candidacy of Dr David Nabarro.

The WHO has not avoided criticism during the eight year mandate of Dr Margaret Chan, the remarkable current DG. But that criticism has been the result of a reality that has dawned on world leaders over the last few years. The reality that the WHO is the frontline of humanity’s defence against one of the most terrible by-products of globalisation: the possibility of a devastating pandemic, spread by the very agents of the modern world, mass air travel, and the unprecedented movement of people.

The WHO has faced an escalating series of health emergencies over the last decade. H1N1 represented a highly infectious and mobile airborne pathogen. Global air transport was nearly shut down, and billions of dollars were spent developing and manufacturing a vaccine, before it became clear that this was not the deadly strain the world had been fearing since the Avian Flu emergency. More recently, Ebola represented a much more deadly pathogen, but one that was not airborne and so less infectious and mobile.

In the first case the WHO was accused of overreacting, in the second, of reacting too late. What nobody disagreed about was the WHO’s essential role in ringing the alarm bell for the world, and in providing the scientific framework for a global response.

We have to accept, and prepare for, the possibility that in the next few years we may face a much worse scenario: a pathogen with the transmission rate of H1N1 and the morbidity of Ebola.

That is one reason why who we choose in May matters.

There are many others. The WHO is the global agency that sets the standards and defines the methodologies for health professionals. These are literally a matter of life and death in countless clinics is some of the most remote places in the world. They provide the instruction manual for the world’s health ministries, and underpin the health programmes of development agencies like DFID. In partnership with its member states, and through its regional organisations and country offices, the WHO plays the leading role in strengthening health systems across the world.

The WHO is also the agency that has methodically acted over decades to eradicate some of the world’s greatest killers, from Smallpox – eradicated in 1980 – to Polio, which has been beaten back to pockets in Nigeria and Pakistan by the WHO’s efforts.

And the WHO is at the centre of an effort that can only be led globally, and in alliance with the world’s nations: the battle to reverse the growing resistance of many of the world’s worst diseases to the antibiotics that have transformed life expectancy around the world in the last fifty years. Lord O’Neill’s recent review of Anti-Microbial Resistance estimated that on current trends AMR will be killing 10 million people a year by 2050 – more than currently die from cancer – and costing the world $100 trillion.

These are enormous challenges. To succeed the next leader of the WHO will need to be someone who can build on the reforms and legacy of Dr Chan and win the trust of its member states, global health professionals, the organisation’s regional leadership, and its staff. Someone with the experience both to understand the needs of the world’s least developed countries, and to raise billions in funding from its most developed ones. Someone with the political skills to build consensus among the WHO’s 194 members; with the management skills to lead a highly complex and decentralised international organisation; with the tested integrity to do so on the basis of merit, probity and transparency; and with the global relationships to rally the international system behind the WHO in times of need.

That is why the United Kingdom is delighted that last week Dr David Nabarro was selected, from a strong field of six candidates, to join the short list of three that will face election in May. His record as a doctor and an international public health official over the last four decades speaks for itself. From working as a volunteer doctor in Nepal to acting as the UN Special Representative on Ebola, Dr Nabarro has literally been preparing for the job of leading the WHO his whole life.

Dr Nabarro’s job over the next few months will be to convince the world that he is indeed the exceptional leader the WHO needs at this time of unprecedented challenges. In that endeavour, he will have the full support of the United Kingdom.