WHO’s New Regional Appointments Are Historic – and Controversial
WHO Director-General Dr Tedros Adhanom Ghebreyesus with Hanan Balkhy of Saudi Arabia, taking the oath as the new WHO Eastern Mediterranean Regional Director.

The World Health Organization’s (WHO) executive board confirmed the appointment of three new regional directors on Tuesday, which are both controversial and historic.

The election of Saima Wazed,  the daughter of Bangladesh’s prime minister, to lead the South-East Asia region has already been mired in allegations of nepotism.

Tonga’s Dr Saia Ma’u Piukala steps into his role as the head of the Western Pacific office, following his predecessor’s dismissal for alleged racism. He has his work cut out in the region with many small-island nations weathering climate impacts, and the added pressure to restore trust among the staff in the regional offices.

The Eastern Mediterranean has its first female leader in Hanan Balkhy of Saudi Arabia. Balkhy takes charge as the region is experiencing a staggering humanitarian crisis in Gaza which has left over 25,000 dead, and in Sudan where an estimated 11 million people are in need of urgent healthcare.

The three regions are home to around 60% of the world’s population and face a range of health challenges from climate change to infectious disease as well as conflict, making the appointments critical in the delivery of healthcare.

WHO Director-General Tedros Dr Tedros Adhanom Ghebreyesus remarked that it was the first time a high-profile post was being transferred from one woman to another, as Wazed took over from India’s Poonam Khetrapal, who was the first woman in the post of South-East Asia’s Regional Director.

“The success of this organization depends on close collaboration, co-operation, co-ordination, and trust between headquarters and the regional offices and country offices,” Tedros said, assuring the new directors all the support they needed from him as well as the colleagues in the WHO offices.

While the elections for the regional directors were conducted last year, the appointments were confirmed at the ongoing 154th executive board meeting of the world health body that will continue until Saturday.

The new appointees spell out priority areas

All three appointees spelt out their priority areas for their region reflecting the health challenges the countries in their region face, as they took charge.

Balkhy said her region had a large number of displaced populations, with both strong and fragile economies. “We aim to enhance end-to-end supply chains, ensuring essential medicines and supplies reach all populations, not an easy task for many in the region. Additionally, we will foster collaborations to build skilled and sufficient health workforce to serve diverse populations across the regions,” she said.

Wazed highlighted improving mental health awareness and services as one of her key priority areas, along with women and children. “I look forward to devising and implementing specific interventions for women and children, including pregnant women. This will be created with education, empowerment and prevention in mind, structured with the life course approach,” she said.

In his emotional speech, Piukala said that his journey from a small island to his current role showed that everyone can have something to contribute. He listed strengthening primary healthcare as a key priority area as well as bringing more people in the region under the ambit of universal healthcare.

“In recent years, our region accounted for 80% of the total global new displacement related to disasters, becoming the world’s most climate-vulnerable region. Critically, every person deserves access to basic preventive care,” he said.

Dr Tedros with Dr Saia Ma’u Piukala, the new Western Pacific Regional Director. Piukala is the first Pacific Islander to be appointed to the post.

Conflict of interest

The WHO election in South-East Asia region has been mired in controversy, with Bangladesh allegedly using its political clout to get Wazed elected. Unlike in other regions, she only had one other competitor, Shambhu Prasad Acharya, a WHO and public health veteran.

Wazed is now tasked with providing WHO policy advice to her mother’s government, but the WHO has not addressed the potential conflict of interest.

Within the public health community concerns were raised about the lack of transparency in the elections and there have been a call for reforms. Medical journal The Lancet also carried an editorial on the need to protect the integrity of WHO’s regional offices.

New South-East Asia Regional Director Saima Wazed and WHO. Director-General Tedros Dr Tedros Adhanom Ghebreyesus.

In her first speech on appointment, Wazed paid tribute to her mother. “I’d like to express my big thanks to Prime Minister Sheikh Hasina, not only for the leadership she has demonstrated over the decades of governance in our country and in our region, but also as my mother for teaching me how to lead with compassion and care,” she said.

Image Credits: WHO, WHO, WHO.

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