What has the most powerful woman in global health learned over the last decade at the helm of the World Health Organization (WHO)?
Director-General of WHO since 2007, Dr. Margaret Chan’s tenure coincided with major public health challenges including refugees fleeing Syria and other war-torn countries, pandemics like Ebola and Zika, and a strain on health systems due to larger aging populations.
Chan, speaking at the tenth anniversary of the University of Washington’s Department of Global Health, shared a range of lessons she’s learned from her work in an ever-changing political landscape.
Her experience yields insights our global health community can heed as we look ahead to more complex challenges amid resource constraints.
1. Health delivery can’t exist in silos, but programs can
“It’s ok to look at programs in silos, but not from the delivery perspective.”
Chan argued for continued research in the verticals of communicable disease like HIV and tuberculosis and non-communicable disease like cancer and diabetes, but said that when it comes to providing health services to a patient, “it’s incomprehensible for the health care worker to think of the person as a collection of organs; ‘today I treat the heart, tomorrow I deal with the lung.’ ”
The delivery of health has to cut across silos, “it’s the delivery systems that has the capacity to prevent, detect and respond to a health crisis.”
2. Return to a focus on prevention
“We need a resilient, functional health care system with the right health care workers, infrastructure, and access to essential medicines. We need prevention. How can the world, no matter how wealthy you are, pay its way out of these diseases? We need to go back to prevention—the importance of vaccines. We know the importance of biomedical research, but let’s not forget delivery research and linking it to policy.”
She called for researchers to include policymakers right from the start of a program to shorten the amount of time it takes to implement.
Citing one example, Chan said, “During Ebola, WHO brought industry, regulators and civil society together to look at what vaccines we could develop.” Guinea provided space and people for the clinical trial and, “now we have a one hundred percent effective Ebola vaccine.”
The experimental Ebola vaccine was developed in two years which The New York Times deemed a “scientific triumph.” (McNeil, 2016)
3. What gets measured, gets done.
Joining Chan onstage, UW Global Health Department Chair Dr. Judy Wasserheit commented, “We all know about the importance of evidence-based programs and policies, but the reality is that most programs have limited resources for research and evaluation.” Turning to Chan she asked, “How do we do better on that?”
“There’s no replacement of results and impact to convince governments and development partners to support programs. That’s why the work Chris [Murray of the Institute for Health Metrics and Evaluation] does is so important,” Chan replied.
She encouraged the audience of global health practitioners to not give up, but instead take a different approach. “Research money is never enough. One [approach] is don’t work in silos…which is easier said than done.”
4. The needle moves through collaboration and alliances
Chan left us with this food for thought:
“We like to be the “discoverer” but the day of superman and superwoman is gone, it’s all about alliances, teamwork and collaboration going forward…partnership.”
At WGHA, we couldn’t agree more.
Global health leaders in Seattle alongside Chan
In likely her final visit to Seattle as acting Director-General of WHO, Chan shared the platform with global health luminaries including: Dr. Bernice Dahn (Minister of Health, Republic of Liberia), Dr. Patty Garcia (Minister of Health, Peru), Dr. Peter Piot (Director, London School of Hygiene and Tropical Medicine, co-discoverer of the Ebola virus), Dr. Ala Alwan (Regional Director, Eastern Mediterranean, WHO), Dr. Chris Elias (President, Global Development, Bill & Melinda Gates Foundation) and Dr. Judy Wasserheit (Chair, UW, Department of Global Health).
Chan challenged the audience of global health practitioners to daily tackle inequality, collect quality information, stimulate innovation and show impeccable integrity.
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Header photo credit: Tara Brown Photography