Just before WHA79, IHP editor Kristof Decoster spoke with Jocalyn Clark, international editor of The BMJ, for her new article on the campaign for next Director-General of WHO, which has just kicked off. They had a broader discussion than was able to be included in the BMJ article. Here, we publish a fuller Q&A between these two editors who discussed the qualities needed to lead the organisation in this moment of geopolitical disorder, strained finances, and future planetary health challenges. The interview has been condensed and edited for clarity.
JC: Thank you for your time and for sharing your observations about the new WHO DG race. Amidst the current challenges for WHO – calls for reform, health crises, and also what we’ve seen in terms of leadership challenges over a monumental last decade, including the COVID pandemic – what kind of qualities are needed next in the director general?
KD: What I think we probably need most now is somebody with moral authority, a kind of global role model. At this point in time, I think we definitely need somebody with very strong ethics and somebody that we can look up to. And in addition, somebody who understands what the millions of ordinary people in the world want and puts them first in everything he or she does. And in that sense, I think he or she should be able to come up with, or at least add to a narrative for our new times that can inspire millions of people. Because for the moment, I don’t think global health is really able to do that.
JC: Yes, a visionary and a global role model. Others have called for that leader to have a large and diverse mix of technical, public health, diplomatic, and communication skills – someone described as a “unicorn” – do you agree?
KC: The director-general has to be a good manager, a good networker, and have good skills at navigating the geopolitical environment. That’s obviously going to be very important now even more so, and he/she needs to be in sync with the paradigm shifts for global health that are taking place now.
JC: Yes, the world is changing so rapidly and there are many threats to and changes debated in the so-called global health architecture. In terms of health focus, what do you think their next priorities will need to be?
He or she should have a good eye on what’s needed post 2030, because that’s coming fast now. And I think that also means that the DG will need to have a bigger focus on the political and commercial determinants of health. Also they should go much further in terms of the analysis of the planetary emergency, and what it requires, because for the moment, it mainly seems to be about a health and climate intersection but we need more than that. Also – AI and the governance of AI, which is going to be a massive challenge.
JC: Your experience as a political scientist provides a valuable perspective. The geopolitical environment now is highly destabilising and will require what sort of political skills?
KD: I think it’s fairly unavoidable that there’s going to be a much more transactional environment. And not just with the United States. The same thing could be said about the European Union, and China was already like that in the past. So people will probably agree the DG should be good at navigating that. But I don’t think you can go too far: diplomacy and navigating are good, but the moral authority is actually crucial in the current situation, which is a darkening world.
JC: Add to the mix of challenges the financial crisis facing WHO – how will this figure in the DG campaign and in how we assess the candidates’ suitability?
KD: I’ve said several times that the global health community should reach out much more to the global tax justice movement. And this also applies for the next DG. And by global tax justice, I see that as broadly defined – solidarity levies, windfall profits, wealth tax, and so on. Trying to raise more funds via assessed contributions, while a good thing, isn’t going to work alone. Even this latest WHO investment round I was less convinced of. I think instead the next DG should really go all out for global tax justice because I also think that’s where the political momentum is potentially both on the left and the right.
JC: It’s an interesting strategy for mobilising support and needed funds for WHO. Is it feasible?
KD: I understand that for a member state driven organisation, which is part of the UN system, this approach may not seem obvious for WHO. But if the DG can put out his strong rhetoric on things like vaccine apartheid, I don’t see why he or she shouldn’t be able to do the same on global tax justice. For me, that’s a big part of the new narrative I’m looking for now – a new narrative to boost global investment for global public goods, including for health, and part of that should go to WHO.
JC: You have highlighted how there is more attention needed to planetary health, which seems to be missing from our global health debates on reform.
KD: Yes, and I think the link between global health and planetary health should also be emphasised much more in terms of financing. We have to start thinking about – how do you get to an economy that actually works within planetary boundaries? And I don’t think WHO has done that enough so far. For me when you think about global public goods and financing for global public goods the links with planetary health become very obvious. For example, fossil subsidies that have to be removed, taxing billionaires flying to space, frequent fliers & private jets, … among others. I think there’s a lot of potential there to actually make a more convincing narrative. I’m not sure that the WHO DG should take the lead in that, but he or she definitely shouldn’t refrain from putting it in these terms.
JC: One other question I wanted to ask was your thoughts on the ways that WHO could be more engaged with civil society.
KD: Yes, I definitely don’t have the feeling that civil society or the younger generation are as important stakeholders for WHO as, say, philanthropic foundations or some of the global health initiatives that they have helped inspire like CEPI, and so on. There’s definitely some imbalance there and I hope that the next DG is going to try to do something about it. For youth, in particular I hope in the campaign they will try to do something special. Because at the moment youth definitely don’t have enough impact on the global health post 2030 agenda. And many of them are feeling fairly desperate about how the world is currently evolving. So I think the candidates and the next DG definitely have to find a way to bring them much more structurally into all these forums and debates we have on global health reform.
JC: Thank you for your time and interesting perspective. Let’s see how the race unfolds and whether the candidates can address the new narratives and approaches you are advancing.
KD: You’re welcome, I look forward to reading your article.