Declan Butler, reporter This is the personal blog of Declan Butler, a senior reporter at Nature. All views expressed here are mine, and not those of Nature. Contact me at

November 15, 2006

Article on WHO’s new DG — Margaret Chan

Filed under: avian influenza,Uncategorized — admin @ 10:26 pm

With the death penalty trial in Libya and the Nature supplement on Islam & Science, I’ve had to put avian flu and the World Health Organization (WHO) on the backburner over the past few weeks.

In this week’s Nature, though I take at look at Margaret Chan’s election as director general of WHO, and what this might mean for global health.

As with any new international appointment, Chan deserves the right to a honeymoon period to show what she is made of, without prejudging her.

That said, the political election for the WHO director general remains, as always, an anachronism, that makes the Cold War seem modern. It is a nefast relic of the horsetrading of the ination state system, and where talent and competence are far down the criteria for election.

The election process, secret ballots behind closed doors by the member states of the executive board, is an anathema to transparency and democracy. It’s far removed from the merit-based search to find the best candidate to best advance global health, that we might expect in today’s modern society, and open Internet world.

Chan’s landslide victory shows at the least, for whatever that is worth for the world’s sick, that she knows how to play the existing political status quo. People who have worked with her speak highly of here though. For further information, I’d recommend The Lancet’s special as one of the best sources of coverage of the election within the existing political context.

History is always interesting though; to see how the new head of WHO handled SARS, see these archive videos here and here of her reactions to the SARS outbreak.

Here are a few excerpts from the article:

The WHO faces a crisis of identity and purpose. The organization used to be the only global-health show in town, but the past decade has seen a series of new players emerge. The Global Fund to Fight AIDS, Tuberculosis and Malaria has a bigger budget than the WHO’s US$1.7 billion, and the Bill & Melinda Gates Foundation spent almost $1 billion last year supporting global health. And nearly 100 public–private health partnerships have sprung up, for example to develop drugs and vaccines for malaria and leishmaniasis.


In her manifesto, Chan endorsed such a shift in the WHO’s focus. She is also apparently open to change: she recently led a review panel that concluded that the Tropical Disease Research programme sponsored by the WHO, the United Nations and the World Bank needs to be rethought. Yet Chan’s victory surprised even some of her colleagues, who say that her track record, latterly with the WHO’s programmes on communicable diseases and pandemic influenza, is more as a diplomat than a leader.

Chan campaigned on her “outstanding leadership” as director of health in Hong Kong during the H5N1 avian flu outbreaks in 1997 and the 2003 SARS outbreak. But in 2004, a Hong Kong government inquiry sanctioned Chan for “unsatisfactory performance” in her handling of the SARS outbreak. And Hong Kong’s cull of all chickens in late 1997 to stop the spread of H5N1 happened seven months after the first human H5N1 cases were reported.


Most observers are giving Chan the benefit of the doubt. “She has travelled the rocky road of H5N1 and SARS and is well equipped to head the WHO in the many challenges and opportunities that lie ahead,” says Ken Shortridge, a veteran of infectious-disease research in China, now retired in New Zealand.


For Ellen t’Hoen, who leads Médecins Sans Frontières’ campaign for access to essential medicines, Chan’s priority must be to put health above national and business interests. For months, under US pressure, the WHO has sat on an advisory document on using trade rules to negotiate cheaper drugs. Chan would demonstrate her independence by publishing the document, says t’Hoen.

And here is a para that I didn’t have space for:

SARS and avian flu may have forged a new Chan, says another observer. In 1997, Chan made the classic mistake of declaring ”I eat chicken every day,” in a naive bid to reassure consumers and prop up Hong Kong’s poultry industry in the face of the spread of H5N1. She has since, however, been converted to complete transparency as the best way to deal with public confidence in health agencies, says the source, and has become a force for this within a reluctant WHO.

And here is a summary of Margaret Chan’s CV

International experience
2006 Elected director general of WHO
2005 Nominated representative of the WHO Director-General for Pandemic Influenza and Assistant Director-General for Communicable Diseases.
2003 – 2005 Director, Department of Protection of the Human Environment, World Health Organization

National experience
1994 – 2003 Director of the Hong Kong Department of Health
1989 – 1994 Senior positions at the Department of Health, Hong Kong
1985 – 1989 Middle management positions, Department of Health, Hong Kong

1984 – 1985 MSc in public health from Singapore National University
1978 – 1985 Medical Officer, Maternal & Child Health Services, Department of Health, Hong Kong
1977 – 1978 Internship, Victoria Hospital, London, Ontario, Canada
1973 BA from the University of Western Ontario, Canada
1947 Born in Hong Kong

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