Tuberculosis: criteria for global leadership?

In December, WHO Director-General Dr Tedros received a letter from a respected list of individuals and organisations urging him to implement “a competitive, open process…to identify an experienced, change-oriented leader…to drive forward evidence-based guidance and advance human rights in this pivotal moment on TB”. The objective of such a transparent selection process was in part “to solicit the input of various stakeholders, including civil society”. WHO rejected their request.

Tedros has identified gender disparity among WHO Directors as one of his most important organisational challenges. He has already made several Director appointments to address the gender and geographical imbalances in leadership within the agency. But in the case of Kasaeva, activists have raised questions about her international expertise and experience. They are frustrated that she was named without any external call for candidates and that there was no consultation with the broader TB community.

An additional anxiety is that Russia has a poor record on TB and HIV. Her appointment may be regarded as rewarding a country that does not deserve to be rewarded. As one WHO Director told The Lancet, “Will [she] have credibility or a mandate? Does this politicise the technical side of the organisation?” By contrast, others, such as Lucica Ditiu who leads the Stop TB Partnership, praised Kasaeva's appointment.

WHO's reputation—indeed, its political leverage—depends on the agency's technical credibility. The sharp divisions that Kasaeva's appointment has created bode ill for efforts to align the TB community during a year when the disease will receive unprecedented attention at a high-level meeting to be held during the 2018 UN General Assembly. It will now be important for Kasaeva to reach out to a sceptical TB community to reassure them of her commitment to engage and build a powerful movement for action on this still neglected disease.

Source: The Lancet