WHO Challenge: Thoughts for the new Director-General

As WHO considers who will be it's new Director-General, Warren Feek, Director of The Communication Initiative highlights 5 major challenges, from a communication perspective, that the succesful candidate will need to address:

1. A better balance in WHO between specific disease control and addressing the underlying factors that significantly contribute to all major heath issues: at present WHO is still very individual disease focussed but
   
   1. many of those diseases have similar antecedents
   2. the same people on-the-ground as health officers and their staff address all of the diseases
   3. conditions of poverty, general lifetstyle choices, stigma and discrimination [ eg against women], and
   4. social trends such as urbanisation are major contributary factors to health status. WHO needs to get a grip on these.




2. The recent WHO report - click here for summary - highlights the rise of non-communicable diseases as significant health risks - from obesity and tobacco to alcohol and accidents. These pose a real challenge for an organisation that has mainly been medical science focussed with corresponding capacities. Non-communicable diseases require a much stronger social science and communication analysis, approach and capacity. This is a big concern in terms of both the WHO organisation culture and it's priority orientation.





3. WHO neeeds to reassert it's role as the global normative arbiter in health - something made both more complicated and necessary by 1 and 2 above. WHO appears to be losing the almost unchallenged credibility that used to reside in it's 'pronouncements'. That is because the health ground has shifted away from 'objective' medical scientific evidence to guide interventions to the murkier issues of values, norms, behaviours, social trends, policies and their impact on health [as described above]. A big challenge for the new WHO DG will be taking the WHO normative role and appplying it to the new health scene.





4. Engaging people in acting on their own health is now a priority. As health issues move to more of a social analysis and action perspective it will be increasingly important that WHO finds ways to both engage and support people taking action on their own health issues. This was the case for example in the very succesful effort against drucunculiasis - a key component of which was community monitoring. People acting on their own health is a central focus of the anti-genital mutilation movement. The most succesful HIV/AIDS initiatives have involved People Living With [or Affected by] HIV at the core of the effort, The Treatment Action Group campiagn against the Pharmaceuticals led directly to wider drug access at cheaper prices. There are many other examples.





5. The new person will have a very difficult high wire act with regard to WHO's relationship to Ministries of Health. They will remain both WHO's "bosses" and WHO's main constituency. WHO can do nothing in countries unless it is through Ministries of Health. But increasingly we realise that the impacts on health status are well beyond Ministry of Health mandates. Issues of trade, gender, formal education, communication trends, cultural change, urbanisation and others directly contribute to both health status issues and opportunities for effective action to improve health status. So, how can the new DG maintain and improve the base - Health Ministries - whilst ensuring the major perspectives issues and opportunities outside the formal health system are engaged and mobilised for better health?

Warren Feek

Director

The Communication Initiative

1-250-658-6372 - ph

1-250-658-1728 - fx

wfeek@comminit.com

The Communication Initiative site