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A conversation with Laurie Garrett about the road ahead for the WHO

Outgoing Director-General of the World Health Organization China's Margaret Chan, left, reacts next to Tedros Adhanom Ghebreyesus from Ethiopia, right, newly elected as Director-General in Geneva, May 23, 2017. (KEYSTONE/Valentin Flauraud)

The 70th World Health Assembly in Geneva just elected a new director-general of the World Health Organization (WHO) on Tuesday. But underfunded and over strapped, what does the road ahead look like for the WHO?

Laurie Garrett

To answer that question for us in today’s Humanosphere podcast, we caught up with Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations. Garrett is also an award-winning journalist – Pulitzer, Peabody and Polk! – and the author of two best-selling books, The Coming Plague: Newly Emerging Diseases in a World Out of Balance and Betrayal of Trust: The Collapse of Global Public Health.

Garrett is currently in Geneva where she just witnessed an election that she described as “unprecedented in every single way.” But first we start with the basics: What is the WHO? Why do we need it? And what does it do?

The fundamental purpose of the WHO comes from a historical understanding that diseases cross borders, and no one country can effectively stop a contagion, outbreaks or even pollutants by itself. As the world becomes increasingly connected through travel and trade, a coordinated global – or at the very least, regional – response to health needs is crucial.

However, the problem today is that as the WHO’s range of mandates has broadened over the years – to include sanitation, noncommunicable diseases and other issues – the budget is just “not up-to-snuff.” According to Garrett, 80 percent of the WHO’s budget is now voluntary, and over the last 15 years or so, the agency has become increasingly dependent on just three donors: the U.S., the U.K. and the Bill and Melinda Gates Foundation.

With Trump’s proposed budget cuts and the U.K. facing Brexit, will the Gates Foundation – already the single largest donor as of this year – be the only thing keeping the WHO afloat?

That will be a major question for Tedros Adhanom Ghebreyesus, the newly elected director-general, who prefers to just go by “Dr. Tedros.” After a controversy-filled campaign – with “tension, spirit and hallway maneuvering” that felt more like a U.S. political campaign than anything Garrett had ever seen in global health – Tedros, a malaria expert, defeated the U.K.’s David Nabarro and Pakistan’s Sania Nishtar.

His victory is an emotional one, particularly for the African Union, as the first African to lead the WHO. In fact, he is the first person from the global south to do so. He is also the first director-general who is not a medical doctor (he holds a Ph.D. in community health) and the first to “come from an orientation to health that is very rooted in practical accomplishments at the community level,” according to Garrett.

Although some people have raised concerns about his connection to Ethiopia’s politics and human rights record as the nation’s former foreign minister, his accomplishments in public health are promising for the WHO.

But before we get into all that, our producer Imana Gunawan and I talk about some of this week’s news highlights in the Humanosphere, starting with concerns that India’s sanitation campaign is not a successful as Bill Gates says it is. Also concerning is a new study, reported on by our correspondent Tom Murphy, which found that the number of refugees arriving in the U.S. has dramatically declined since October, despite Trump’s executive order being stuck in court.

Another study this week found that out of 30 low- and middle-income countries that ratified a U.N. convention against discrimination, not a single one has provided indigenous and rural women legal protections to own and manage property. But according to Lisa Nikolau’s story, it’s not just a rights issue, it’s affecting agricultural production as well.

Finally, we segue into our WHO talk by discussing the outgoing Director-General Margaret Chan’s parting words, in which she makes the case for the agency’s continued relevance.

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About Author

Joanne Lu

Joanne Lu is a South Carolina-based writer and editor dedicated to global development, poverty alleviation and social justice. After a year in Rwanda, she now covers the Asia-Pacific and economics. Find her on Twitter @joannelu or email