WHO ponders future without Lee

After director-general?s unexpected death, the UN health agency may hasten search for a replacement

By | May 24, 2006

The untimely death this week of the World Health Organization's chief, Lee Jong-Wook, leaves the United Nations health body with some difficult decisions to make about how to find his successor. "It's come at the worst possible time for WHO" in light of issues such as avian influenza, said Zsuzsanna Jakab, director of the European Centre for Disease Prevention and Control. "You need leadership, and this leadership is now gone." This week, WHO announced it was appointing Anders Nordström, now assistant director-general for general management, as acting director-general. Meanwhile, representatives of member countries in Geneva for the ongoing World Health Assembly are now pondering how to appoint the next permanent director-general. The process will begin in earnest next week when the WHO executive board comes together for a scheduled meeting. At that meeting, the 32 members of the board, all appointed by WHO member states, will consider a range of options for how to proceed, said Christine McNab, spokeswoman from the WHO director-general's office. One of those options could be to open a call for nominations to the post as early as next week, McNab told The Scientist. Under normal procedures when electing a new director general, the board would not meet to consider the nominations until January 2007, and would then make a recommendation that would be put to the next World Health Assembly in May that year for ratification. But given that Lee's death leaves WHO without an appointed leader, the board could chose to make a selection earlier, and even call an extraordinary World Health Assembly to ratify the new appointment quickly, she said. The board is likely to move quickly, said Mohga Kamal, health advisor for the international charity Oxfam and a close observer of the WHO, who thinks a candidate could be chosen and ratified well before the end of the year. "What is very important is to get a really good leader; one who is visionary and can really inspire his staff to go with him," she said. "We also need a good manager -- one who can combine a focus on diseases with attention on health systems. The onus is now on member states to find somebody with those attributes." Jakab added that Nordström was a good choice as the interim head, but a year without a full director-general would be hard on WHO. Jakab herself previously spent 12 years in senior roles at WHO in Europe. Lee was director-general of the WHO since 2003. He died Monday morning (May 22) at the age of 61, after surgery to remove a blood clot in his brain. Lee's ambitious goals for WHO included the "3 by 5" plan that aimed to provide three million people with HIV/AIDS in poor countries with access to treatment by the end of 2005. "I think that will be his greatest legacy," said Oxfam's Kamal. She noted that Oxfam considers the 3 by 5 program a success because of the way it improved access to antiretroviral drugs, even though its ambitious targets had not been met. Lee's tenure was also characterized by a strong push to decentralize WHO, including moving staff out of the headquarters and into country and regional offices. "He really started a serious decentralization in WHO toward the regions and the countries," Jakab said. "He said, 'let's put our resources in the places where our priorities lie.'" His loss will be deeply felt by the organization, she added. "He really was a global leader in public health. He took up the battle to make sure that priority was given to countries that had the greatest need," she told The Scientist. Stephen Pincock stephenpincock@the-scientist.com Links within this article I. Ganguli, "WHO head dies," The Scientist, May 23, 2006. http://www.the-scientist.com/news/display/23475/ World Health Organization http://www.who.int/en/ S. Pincock, " And if bird flu hits Africa?" The Scientist, January 23, 2006 http://www.the-scientist.com/news/display/22989/ European Centre for Disease Prevention and Control http://www.ecdc.eu.int "Dr Anders Nordström becomes Acting Director-General of the World Health Organization," WHO, May 22, 2006. http://www.who.int/mediacentre/news/statements/2006/s08/en/ Oxfam http://www.oxfam.org.uk "A tribute to Dr. Lee Jong-Wook, director-general of the World Health Organization," WHO, May 22, 2006. http://www.who.int/dg/lee/tribute/en/

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