US Supports WHO Reforms, Backs Director General Chan

The United States fully supports the programme of reforms proposed by the World Health Organization Director General Margaret Chan, the US health minister said today.

Kathleen Sebelius, the US Secretary of Health and Human Services (HHS), gave a press briefing today on the side of the 64th World Health Assembly (WHA). The WHA is taking place from 16-24 May.

Sebelius quickly expressed her support for Chan’s work to date, and signalled US support for her candidacy for election as head of the WHO next year.

“I would start with saying the United States fully supports the leadership of Dr. Chan, feels that she has been a creative and innovative leader at a time where the issues of global health could not be more important,” Sebelius said.

Chan, who is from Hong Kong, has not yet been formally put forward as a candidate by China. Members at this week’s Assembly will discuss rules for the next election.

A US mission spokesperson clarified after the event that “the call for nominations for director general of the World Health Organization will not take place until the summer of 2011 and no candidates have yet been announced. The United States has been impressed with Dr. Chan’s service and would certainly be pleased to see her as a candidate for a second term,” according to a US Mission spokesperson afterward.

Nils Daulaire, director of the HHS Office of Global Affairs, and the US representative to the WHO Executive Board, said at the briefing that global health security depends on the objectivity and independence of WHO, and the US strongly supports Chan in her effort to look broadly at reforms of the organisation in the context of financial challenge. The director general’s reforms look at engaging a broader range of stakeholders, he said.

Sebelius cited two major issues for the US: the eradication of polio, as concerns remain in countries where the disease is endemic, such as Afghanistan, India, Nigeria, and Pakistan, with outbreaks in other nations, and maintaining the stocks of smallpox virus, which has already been eradicated.

The US introduced a resolution to the WHA yesterday to retain virus stocks in the two official repositories, in the United States and Russia, as there is no certainty that there are no other stocks of the virus that could be released unintentionally or used as a bio-weapon.

The US proposes to conduct research for an appropriate vaccine for smallpox and anti-retrovirals. Research results would be widely available, Sebelius said. The US remains committed to the ultimate destruction of the virus, she added.

In answer to a question about two vaccines already being studied, Daulaire said the issue was not simply to have preliminary products but rather effective products that have been developed, tested, certified, and licensed for use. “If we do not go all the way, we have an uncertain and unfinished product,” he said.

Influence of Donors on WHO; Transparency Needed

On a question about the possibility of undue influence on WHO strategy of some donors, such as the Bill and Melinda Gates Foundation, Sebelius said there is no question that independence and the ability to strategically determine global health plans are critical components of the WHO.

“The absence of influence by industry groups or political pressure is critical” so that WHO is regarded not only as an effective world leader, but has a transparent operation.

The fact that the organisation is drawing on partnerships, some in the public sector and some in the private sector, is beneficial, Sebelius said. Regarding the suspicion that can arise when financial help is taken from certain groups, that those groups will dictate or influence the work of the organisation or the outcome of research, she said transparency is a good safeguard. Scientific evidence should determine the best outcomes.

Another question was about advance purchase schemes that are sometimes considered as anti-competitive, and as subsidies for companies. In advance purchase schemes, donors commit money to guarantee a certain price for vaccines so that it creates an incentive for companies.

Daulaire said advance purchase commitments are only one of a variety of experiments aimed at ensuring availability of essential new commodities like vaccines. The US is looking to see how effective current schemes, such as the Global Alliance for Vaccines and Immunisation, are over the long term at providing drugs at lower price, he said.