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Following a promise made at the beginning of his tenure to meet with the press regularly, World Health Organization Director General Tedros Adhanom Ghebreyesus (Dr Tedros) held a press conference today to paint a picture of what has been done under his leadership for the last seven months. He highlighted the establishment of the WHO General Programme of Work for 2019-2023, the quest for a new resource mobilisation strategy, measures taken on emergencies, and the push for universal health coverage. He also answered questions about the WHO nomination of President Mugabe that was cut short, and an appointment in his leadership team.

Move faster, go for big change and keep the quality of WHO’s work. These have been the founding principles of the changes envisioned by Dr Tedros and his team since he took office in July 2017.

The General Programme of Work, produced by his team one year ahead of schedule, and endorsed by the Executive Board last month, is very ambitious, he said. It implies a paradigm shift and a change of business model of the organisation, and WHO will need to look for a new resource mobilisation strategy with innovative ideas for raising funds and expand its revenue sources, he said (IPW, WHO, 29 January 2018).

Dr Tedros also underlined his efforts to put together a high-level leadership team, which is both gender- and geographically balanced. For the first time in the history of the WHO, the leadership team is composed of over 60 percent of women and each of the 6 WHO regions are represented, he said.

He highlighted the importance of universal health coverage, with many countries committing to achieve it. “It is not only a slogan or a pipe dream,” he said, but something that is achievable.

The WHO is on constant alert for health security and emergencies, he said, with daily briefings on the global situation.

He also underlined the WHO’s efforts in building partnerships with different partners, including with the other United Nations agencies, civil society, governments, and the private sector.

Plague: A Rising Worry

According to Dr Tedros, the latest pneumonic plague outbreak in Madagascar is a subject of “serious concern.” The plague this year “behaved in a very different way,” he said. It started earlier than the normal season when plague cases are expected to show up, and it affected a larger perimeter than usual. The latest outbreak is of higher magnitude and the new characteristics of the outbreak lead to presumptions that because of factors such as lack of vector control, bacteria remain in the environment. An aggravating factor is the growing resistance of the fleas to insecticide.

Dr Tedros underlined his recent visit to Madagascar to discuss the issue. He warned that the next outbreak could be graver, and the perimeter larger, spilling over to neighbouring countries and beyond.

A question came up about the issue of yellow fever vaccine shortages. A Brazilian journalist mentioned that only four producers are accredited by WHO to manufacture vaccines. Following an outbreak in Brazil, the country was asked to proceed to massive yellow fever vaccination, potentially impeding its capacity to produce the vaccine for other countries.

Dr Tedros recognised the issue of shortages, which he said needs to be addressed, and on which the WHO is working to find short-term and long-term solutions.

Delicate Questions

Journalists at the press briefing today had diverse questions on issues not commented upon yet by the WHO.

For example, Dr Tedros was asked about the tension between the WHO and its agency, the International Agency for Research on Cancer (IARC). The WHO had seemed reluctant to follow the findings of its agency on reports such as the one linking a high consumption of red meat and cancer.

Dr Tedros replied it is a very important question and that as soon as he took office, he examined the relationship between the WHO and IARC. He called a meeting in which it was agreed that science would be the base of discussions, and IARC agreed to engage staff from the headquarters from the early stages of research so that “there is no complication, there is clarity and transparency,” so as to address differences. “That does not mean that there will be no difference in the future,” he said. “There will be,” but the important part is how differences are managed.

Responding on the appointment of Tereza Kasaeva, director of the WHO Global TB Programme, which had raised questions about influence by the Russian government, Dr Tedros said “I can’t really understand the criticism.” All previous directors were appointed directly, he said. He defended the skills and competency of Kasaeva. “Direct appointments have never been an issue before me,” he said. “I have done nothing different,” he added, underlining his progress compared to previous leadership teams in terms of gender and geographical balance (IPW, WHO, 9 January 2018).

On the potential appointment of former Zimbabwean President Robert Mugabe as a WHO goodwill ambassador for non-communicable diseases in Africa, he said the appointment was done in good faith, adding that some countries had suggested Mugabe’s appointment would be helpful, in particular in sub-Saharan Africa. So the appointment was not global, Dr Tedros explained, and was only put forward for a formal vetting.

The appointment of Mugabe is “an unfortunate situation,” which reflected badly on the WHO, he acknowledged, adding that other progress at WHO should not be tainted by the one episode. But he defended the idea of being able to take at-times uncomfortable decisions if needed if, as in the case of Mugabe, there might be competencies that are useful.

”I prefer to build bridges, even with the more difficult ones,” he said.

“I am truly worried where we are heading,” he added. “We see more conflicts than ever before. Do we address them by breaking bridges?” he asked. He called for understanding one another even in disagreement, repeating, “We have to be prepared to build bridges” between areas of disagreement.