Nearly a year after his appointment to a second term as the World Health Organisation’s director general, Tedros Adhanom Ghebreyesus has finished a revamp of his senior leadership team, keeping key loyalists in place, while adding new faces that are a clear nod to powerful member states such as China, France and Japan.
But Health Policy Watch reports that new members come with a mixed bag of experience – and some have hardly any experience at all in the areas to which they have been appointed, according to WHO insiders.
The new appointees include Dr Ailan Li, a Chinese national and head of WHO’s Cambodia office, as assistant director-general for the agency’s ‘Healthier Populations’ cluster, which covers the increasingly critical areas of climate change, pollution, healthy lifestyles and nutrition.
Dr Yukiko Nakatani, currently deputy director in Japan’s Ministry of Health, will become assistant DG for Access to Medicines and Health Products, a politically charged area of work marked by oft-highly charged battles between pharma companies and medicines access groups over drugs costs and IP rights.
Dr Jérôme Salomon, a French national has been named as assistant DG for Universal Health Coverage, Communicable and Non-communicable Diseases. Of the three, Salomon has the most extensive global public health experience, including stints on the WHO Emergencies Committee; as a director at Institut Pasteur in Paris, and as a full professor at the Simone Veil Medical School, Paris.
Long-time Tedros senior adviser Bruce Aylward was appointed assistant DG of the Universal Health Coverage, Life Course Division – to “drive the organisation’s agenda to transform primary health care as central to universal health coverage, and oversee work on health systems, immunisation and reproductive, maternal and child health”.
Aylward previously led the DG’s “Transformation” initiative which sought to revamp the organisation’s internal structure until the pandemic shifted his attention to health emergencies
Previously announced additions to the senior management team include noted epidemiologist Jeremy Farrar, former head of Wellcome Trust, as new chief scientist and probably the most high-profile public health personality to join the team. He replaces Indian national Soumya Swaminathan.
There was, meanwhile, disappointment in WHO’s internal ranks over the appointment of Li to the Healthier Populations cluster. With a background primarily in emergencies and emerging infectious diseases, it is an area of work that will be entirely new to her professionally.
While it is common for the DG to give influential WHO member states a seat around the leadership table, previous Chinese appointees, such as Ren Minghui, also had significant public health careers alongside their political assignments and gained wide respect during their time in Geneva.
Minghui, a former ADG of WHO’s Universal Health Coverage cluster until recently, is now a director general at the Chinese Ministry of Health.
Appointments of trusted associates
Only a handful of senior officials who served in the first five years of Tedros tenure remain in the new leadership team. Those include Dr Hanan Balkhy, a Saudi Arabian national, as assistant DG for Antimicrobial Resistance (AMR), where she leads a multi-sectoral collaboration with the Food and Agriculture Organisation, the World Organisation for Animal Health, and the United Nations Environment Programme, to enhance prevention of AMR through better management of animal and environmental drivers.
Other long-serving staff include Mike Ryan, executive director of Health Emergencies, and Samira Asma, head of Data, Analytics and Delivery for Impact (DDI).
Ryan, a respected emergencies specialist, was the public WHO face of the global COVID response. But he also demonstrated intense loyalty to Tedros echoing his statements on controversial WHO positions, such as opposition to public masking in the early days of the pandemic.
Disappointment
There was some disappointment that none of the senior WHO staff who had been serving as interim assistant DGs received final appointments to Tedros management team, apart from Aylward.
Influential member states like the United States had earlier expressed some hopes that the promotion of more senior WHO staff through the ranks to senior leadership positions could help convey a stronger sense of professionalism and accountability within the ranks.
Instead, four senior staff who had briefly served as interim ADG’s were dismissed by Tedros with little more than a “thank you” conveyed via an internal note sent out to WHO staff.
Observed one WHO scientist: “I think our organisation needs a very clear and honest agenda first of all. We need strong technical competency, less political mumbo jumbo, and honesty and accountability; this is what we have lost over time.”
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