What's Ahead For Global Health

In 2012, our WE health team managed the news room and global communications for the 15th World Conference on Tobacco or Health (WCTOH) in Singapore. I remember seeing Dr Margaret Chan, the then Director-General of the World Health Organisation (WHO), deliver her keynote address attacking big tobacco to a standing-room only auditorium. Her words were powerful and inspiring.

Last week, Dr Chan delivered a speech of a different kind – her final address to the World Health Assembly looking back at 10 years of leadership. She acknowledged both mistakes and achievements while emphasising the continued importance of the WHO in setting the agenda for global health. Once again, her words inspired, but also reminded the next generation of health leaders of the heavy lift ahead. In her characteristic frankness, she said: “We falter sometimes, but we never give up.”

The WHO’s new Director-General, Dr Tedros Adhanom Ghebreyesus, who takes office this July, is the first African elected to the post. A former health and foreign minister of Ethiopia, his persona is not without controversy, but he brings the unique qualification of having worked in one of the most challenging environments for public health.

Such experiences will serve Dr Tedros well as he inherits an embattled agency, criticised for its mishandling of the Ebola crisis, questioned about its relevance in a changing world and most recently under media scrutiny for allegedly spending more on business class travel than on public health.

Dr Tedros has already acknowledged to the press that the WHO needs to change on a number of fronts. Below are three areas that may dominate the global health agenda in the coming years:

1) Universal Health Coverage

Dr Tedros has said that all roads should lead to universal health coverage. We can expect a strong push towards insurance coverage even in the poorest countries. The WHO will work with member nations to strengthen health systems and build financing structures. It will encourage investments in primary care, essential drugs and devices. Discussions will aim to go beyond the pill or device and build partnerships that drive the funding, management and delivery of health solutions to the communities that need them most.

2) Access to Medicines

Closely tied to the idea of universal health coverage is access to medicines. The new Director-General has spoken of his experience growing up in a poor country and refuses to accept that poor people have to go without new and innovative medicines. In her concluding speech, Dr Chan talked about a pilot project for prequalifying biosimilar medicines to make expensive cancer treatments more widely available. She said the WHO is also working with partners on a model for the fair pricing of pharmaceuticals. Expect more lobbying to make medicines affordable and a greater emphasis on transparency around how new treatments are priced.

3) Pandemic Preparedness

The WHO acknowledged that it had stumbled on the emergency response to Ebola but applied many of those lessons to its handling of Zika. The new leadership will push for the full implementation of the International Health Regulations, which came into effect post-SARS. These regulations help the global community prevent and respond to public health risks that could cross borders and destabilise health security worldwide. The regulations require countries to report certain disease outbreaks and public health events to the WHO. The idea is to enable faster convening of the emergency response committee and early deployment of guidelines and communications for a coordinated response to any pandemic threat.

Despite its problems, the WHO remains an influential agency that the world looks to for leadership on global health security and equity of access to care. Consider this point made by Dr Chan in her final address: “It took nearly a decade to get the prices for antiretroviral treatments for HIV down. In contrast, thanks to teamwork and collaboration, prices for the new drugs that cure hepatitis C plummeted within two years,” she said.

WE will be watching closely to see how the new WHO leadership implements its agenda and the effects that trickle down to the health industry in Asia Pacific.