With new WHO director appointments, women outnumber men in senior leadership

MANILA — Just before the year ended, World Health Organization Director-General Tedros Adhanom Ghebreyesus announced another set of officials to join his leadership team; nearly all of them women. The list of eight new appointees — which was not made available to the media but was seen by Devex earlier this week — include directors for some of the agency’s biggest and newest programs.

Elizabeth Iro was already announced at the WHO Western Pacific regional meeting in October as WHO’s chief nursing officer. The others on the list are Shenaaz El-Halabi from Botswana, and Min Whee Kang from South Korea, who will both be taking the role of director in the Office of the Director-General; Dr. Tereza Kasaeva from Russia, as the new director of the WHO’s Global Tuberculosis Program; and Diah Saminarsih from Indonesia, as advisor on gender and youth in the Office of the Director-General.

Tedros also announced the directors of newly formed clusters at WHO: Dominique Hyde from Canada is the director for strategic engagement in the new External Relations cluster; Dr. Samira Asma from the United States is the director in the new Metrics and Measurement cluster; and Dr. Hama Boureima Sambo from Nigeria is the director in the new Climate and Other Determinants of Health cluster. Sambo is the only male in the latest appointment announcement. He is currently WHO’s representative in Gabon.

In an email about the announcement, which was sent to staff and seen by Devex, Tedros again emphasized his commitment to gender equality and geographic diversity in WHO’s senior leadership.

“Despite setting a target of achieving 50% gender equity in 1997, WHO has not lived up to that goal. Two decades later, only 28% of the directors are women,” he said in the email. “As you’ve seen, we’ve started to change that, first when I appointed nine extraordinary women in October to the senior management team. For the first time in WHO history, women outnumber men in the senior leadership.”

But he acknowledged there is still much work ahead, and he told staff that his office is “already working with experts on refining the recruitment process to tackle some unconscious biases that have created gender and geographic inequalities — and to ensure we can more quickly and efficiently bring in diverse talent where we have gaps.”

Yes to women — but yes to process too?

As before, Tedros’ appointments have received praise in the health community, particularly among gender advocates who have been pushing for more women in senior leadership roles in global health institutions.

Women in Global Health Executive Director and Co-Founder Roopa Dhatt said she is “thrilled” to see the WHO aid chief’s continued commitment to gender equality in WHO’s leadership, and she hopes the wider global health community and its leaders follow suit.

“We also are aware this shift of power and culture is challenging long-standing norms,” Dhatt told Devex. “But shifting power from the ‘old boys club of privilege and influence’ is no easy task. Feathers will be ruffled and we may see a backlash against the DG, the women leaders, and groups working on gender equality.”

She added: “Let’s hope global health stops being gender blind and ‘walks the talk’ much better than it did at the UHCForum2017 or in Hong Kong.” The gender champion was referring to photos that recently circulated on social media of global health leaders, including Tedros and World Bank President Jim Yong Kim, participating in mostly male panels.

But the latest announcement also raised some questions on transparency. Just before the WHO chief made the announcement, over 100 civil society organizations and individuals from around the world published an open letter to Tedros, dated Dec. 11, asking him for a “competitive, open process” to identify the next director of the WHO’s Global Tuberculosis Program after Dr. Mario Raviglione, the previous program director, retired at the end of November.

“We believe that a competitive, open process is needed to identify an experienced, change-oriented leader that is needed to drive forward evidence-based guidance and advance human rights in this pivotal moment on TB. In your curriculum vitae as a candidate for Director-General of the WHO you mentioned your strong track record ‘championing open and transparent communications to ensure everyone’s voice is heard.’ As such, we urge you to lead a transparent process that gives full consideration to a range of candidates from diverse backgrounds and perspectives, to identify the best leader for WHO’s work with a range of constituents to end TB,” according to the letter.

The request included giving different stakeholders — civil society included — an opportunity to provide input in the selection process. Four days later, on Dec. 15, Tedros responded to the letter, expressing his appreciation for civil society’s support and commitment in working together to end TB, and that, rest assured, he will continue to listen and engage with all stakeholders.

But Tedros also said WHO already selected Raviglione’s successor in Dr. Tereza Kasaeva — who is currently the director of the Department of Medical Care in Russia’s Ministry of Health — as well as the other new senior officials he announced that afternoon.

“You and some of your colleagues suggest that the TB Director should be selected in the same manner as has been done in past years,” Tedros said. “But with WHO facing urgent challenges — and unique opportunities such as the High-Level UN Meeting on TB — I felt strongly that we need to fill these new director positions with high-quality individuals who could hit the ground running urgently, without waiting for the unusually long recruitment process. And I am confident that we have found the right person to lead the TB program at WHO — Dr. Tereza Kasaeva.”

He said Kasaeva has 25 years of public health experience and has been working on the “perfection of technologies” for outpatient TB treatment. She will be working closely with him and WHO’s deputy director-general in charge of programs, Dr. Soumya Swaminathan, who is also known for her work on TB.

Devex reached out to Blessina Kumar, CEO of the Global Coalition of TB Activists and one of the signatories in the letter addressed to WHO director-general, regarding the appointment and what civil society meant when they sent the letter to Tedros.

“You obviously saw the open letter and the response. You see the decision has already been made and the announcement has been made,” she said. “I think for us now, what we want to see, is that moving forward we will have someone who is sensitive to civil society and communities, and is open to having a relationship that is positive and constructive.”

She said the letter was written because “there was a sense that perhaps the process wasn't open and transparent.”

Those in the TB community engaged with WHO knew that Raviglione was set to retire this year. In fact, he was set to retire earlier in November, but was asked to stay on up until the WHO Ministerial Conference on TB in Moscow. “So the natural process would have been for a call for applications, which is why the letter. But I think by then there was a decision that’s already been made by the leadership of WHO,” Kumar said.

“But he said in his response very clearly why it happened the way it did,” she said. “We will be watching and keeping a close watch on how things proceed. And the first signs of any tension, we’ll reach out to him again. The civil society will hold people accountable definitely.”

But the TB activists global coalition chief said she’s “encouraged” by Tedros’ openness to civil society, even calling on six members of civil society groups to advise him on issues concerning them. “He's also made it very clear that we have direct access to him if we have any concerns,” she said.

Kumar said she met the new WHO global TB program director on two occasions during the year, one in New Delhi during the ministerial meeting on TB in Southeast Asia in March, and the other during the WHO Global Ministerial Conference on TB in November in Moscow.

“At that time we didn't know that there was a possibility that she will be the next director, so we didn't have any conversations regarding that, but she seemed pleasant enough. But now we will be taking the conversations to more specifically civil society engagement,” she said.

Read more Devex coverage on the World Health Organization.