NZMJ 1446.Indd

LETTER

New Zealand’s voice at the World Health Organization (WHO) Frank Houghton

Many eyes are currently focused on the Under the new rules governing the US, where Hillary Clinton and Donald Trump election process, up to fi ve of these candi- have begun the fi rst in a series of live tele- dates may be shortlisted for interview by vised debates in the presidential race there. the Executive Board of the WHO in January However, it is important not to overlook 2017. Three of these candidates will then be other elections with real potential to impact chosen to go forward for a deciding vote by global health. The most important of these is the World Health Assembly. Interestingly, at undoubtedly the post of the Director-General that point all 194 nations will have an equal of the World Health Organization (WHO). vote, albeit a secret equal vote. Therefore The (second) term of the current incumbent, this process “gives Niue, population of 1,612, Dr Margaret Chan, expires on June 30 2017, an equal vote with China, population of and jockeying for the prime position is 1.4 billion—and Lichtenstein, equal voting already underway. Historically there have power with India, population 1.25 billion”.1 been many accusations and assumptions So where does New Zealand stand in of bribery and corruption in the process, this process? New Zealand is fortunate in although there is, to date at least, very little being just one of thirty-four nations repre- 1 evidence to support such claims. sented on the Executive Board of the WHO. In the past the World Health Assembly This Board will in effect whittle the fi eld was simply presented with one candidate of six initial candidates down to three. to endorse.2 This rubber-stamping exercise New Zealand is represented there by Dr however, has now been replaced with a new Stewart Jessamine, a Scotsman by birth. Dr system which rather bizarrely manages to Jessamine is Director of Public Health at combine infl uence and democracy, as well the New Zealand Ministry of Health, and a as transparency and secrecy. What is clear member of the Executive Leadership Team in the process is that, in the fi nal round at there.3 least, the decision as to who will become Voting on traditional geo-political and Director-General of the WHO will be decided cultural lines would presumably result in 2 by a vote of all 194 WHO member nations. New Zealand supporting the UK’s candidate, Following the deadline for proposed Dr David Nabarro. However, it must be candidates in September 2016, there are acknowledged that Dr Nabarro is in fact a now six nominees for the position of Direc- highly experienced candidate with a wealth tor-General (see Table 1 for details). of relevant expertise and experience.4 It

Table 1: Candidates for the WHO Director-General post.2

The Government of Ethiopia has submitted the nomination of Dr Tedros Adhanom Ghebreyesus. The Government of Italy has submitted the nomination of Dr Flavia Bustreo. The Government of France has submitted the nomination of Professor Philippe Douste-Blazy. The Government of the United Kingdom of Great Britain and Northern Ireland has submitted the nomination of Dr David Nabarro. The Government of Pakistan has submitted the nomination of Dr Sania Nishtar. The Government of Hungary has submitted the nomination of Dr Miklós Szócska.

NZMJ 2 December 2016, Vol 129 No 1446 ISSN 1175-8716 © NZMA 109 www.nzma.org.nz/journal LETTER

might also be said perhaps that this once Hopefully these ‘baby steps’ towards full dogmatic allegiance is not as strong as it transparency in the electoral process once was.5–6 should help restore conﬁ dence in both the Readers are undoubtedly familiar with process and the institution. In line with political and ideological voting blocs, this therefore, health professionals in New perhaps most notably at the UN,7 but also Zealand should put prescriptive political possibly within the European theatre.8–9 geography aside and explore for themselves It is vitally important however, that the the relative merits of all of the candidates skills, knowledge and experience, including for the Director-General position. Based political adroitness of course, determine the on their appraisal they should make their next Director-General of the WHO, rather preferred choice known to the Ministry of than rampant geo-political cronyism. Health (the Ministry operates a simple email address formula: Firstname_Lastname@ The WHO is suffering ﬁ nancially and polit- moh.gov.nz). ically from a lack of popular global support.1

Competing interests: Nil. Author information: Frank Houghton, Public Health & Administration, Eastern Washington University, US. Corresponding author: Dr Frank Houghton, Public Health & Administration, Eastern Washington University, 668 N. Riverpoint Blvd, Spokane, Washington State, US. [email protected] URL: http://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2016/vol-129-no-1446- 2-december-2016/7092

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