World Health Organization: The World’s Doctor
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SUSAN DENTZER: Dr. Gro Harlem Brundtland is the new director-general of the World Health Organization. That’s the United Nations agency that aims to control and eradicate disease and improve the quality of life worldwide. Brundtland is the former prime minister of Norway and a Harvard-trained physician. She took over at WHO earlier this year on the eve of the agency’s 50th anniversary.
Founded in 1948, and headquartered in Geneva, Switzerland, WHO has 4,500 employees around the world and an annual budget of roughly one billion dollars. It does not provide health services directly, but rather offers advice, research, training, and funding to help mostly developing countries fight disease. The agency has played a major role in such achievements as the virtual eradication of smallpox around the globe.
Despite the dedication of the many public health professionals who work for it, the WHO has had a reputation of being one of the United Nation’s most bloated and worst-run institutions. And so, after a decade of what was widely deemed uninspired leadership under her predecessor, Brundtland has begun an overhaul. She has brought in an almost entirely new senior staff and refocused WHO’s mission. In particular, she wants to strengthen WHO’s partnerships with member countries, non-profit groups and even private-sector businesses to increase the agency’s effectiveness. I asked Brundtland why she took on the challenge after stepping down as prime minister.
DR. GRO H. BRUNDTLAD, Director General, World Health Organization: My former health minister came to me and said, Gro, you have to take this challenge, and I said, you know that I was planning to have some free time. But as my conscience then started working, my background as a doctor and public health worker, you know, I had to take it seriously.
SUSAN DENTZER: The first World Health Assembly in June 1948 listed its top priorities as fighting malaria, improving maternal and child health, fighting tuberculosis, sexually transmitted diseases, and nutrition, and environmental sanitation. What’s changed in the past 50 years?
DR. GRO H. BRUNDTLAND: Those basic ideas and challenges are still with us. We could nearly list them today the same. At the same time a lot has been achieved. We have eradicated smallpox, which no one would have envisaged in 1948. We are trying now and about to eradicate polio, although we have emerging infection, and new threats, they are still with us, and we can never be thinking that we have solved those problems.
SUSAN DENTZER: In an address you gave this week to the Americas region of the world you had particularly strong words about the need to stamp out use of tobacco.
DR. GRO H. BRUNDTLAND: Because tobacco is a killer. And tobacco leads to non-communicable diseases. The other major area of concern, which creates a double burden of disease, in poor countries, in developing countries, the tobacco habit is spreading, consumption is increasing, we know that the 3 million deaths a day globally, which are related to tobacco, in 2010 will be 10 million deaths. So this is really an epidemic going on around the world. A child of ten or twelve influenced by society and by their peers will make choices in life that can be with them long, you know, into adult years and premature death from cancers, heart disease, which is related to their tobacco habit. So this, I feel, we as society and we as parents cannot look upon it as a kind of free choice problem.
SUSAN DENTZER: How will you be working more effectively with other organizations, outside the WHO?
DR. GRO H. BRUNDTLAND: We are, first of all, reaching our two other partners, making an alliance for roll-back malaria, 3,000 children dying every day from malaria. I am going to take direct contact with the leaders of African countries with the World Bank, with UNICEF, with UNDP, there is a large challenge there, especially in Africa, where you have to break the circle of the way that that disease spreads in communities, in the homes, impregnated bed nets for children. You have around the bed a net, which is set with insecticides, but in a way that doesn’t put damage on the child or the home, which will avoid biting while you are sleeping, which is one of the main channels of spreading the disease. That’s one example. But it’s a broad effort. You must go into the homes and communities around in African countries and have a sustained long-term effort. It’s not something, a quick fix you can do overnight or in a few months.
SUSAN DENTZER: An international Congress on Obesity recently noted an epidemic of obesity throughout the world. What will WHO do to reduce weight?
DR. GRO H. BRUNDTLAND: This is also part of the lifestyle changes. Maybe the most important thing is that we have stopped moving. People sit; they don’t walk; they don’t work the way we did. But we continue eating with the eating habits of our childhood. And so that’s exercise, lifestyle pattern changes is one of the important aspects to it. It does lead to non-communicable diseases. Heart disease, even cancer – so it is a challenge, and it’s part of the effort in non-communicable diseases that we need to improve and increase.
SUSAN DENTZER: There’s a growing gap between the rich and the poor around the world, and this is particularly evident in health care. What can the WHO do about this?
DR. GRO H. BRUNDTLAND: WHO has a special role because we know the links between health, disease, and poverty. Not only does poverty create ill health and disease, but if you invest in health, if you make improvement, in health care and in spreading the message of how to improve health, then you will increase productivity and increase economic output.
SUSAN DENTZER: Eleven people a minute around the world die of AIDS and AIDS-related disease. And as the late Jonathan Mann noted, he died, of course, in the Swissair crash recently, but he was formerly the head of the global program on AIDS for WHO, he noted that community and political commitment to AIDS is plateauing or even declining, even as the numbers of those affected grow, and the disparity between rich and poor within and between nations grows ever larger.
DR. GRO H. BRUNDTLAND: We will be looking at how we can narrow the gap that Jonathan Mann was talking about. Also, with regard to trying to bring drugs to poor countries, the treatment should be made gradually available to all countries. That’s a major problem and a major, I think, solidarity concern.
SUSAN DENTZER: Tens of billions of dollars is what it would cost to bring those drugs to those countries in an effort to eliminate this disparity where AIDS patients in wealthy countries now can live a great deal longer, those in poor countries are given an immediate death sentence.
DR. GRO H. BRUNDTLAND: What is happening now is that in certain countries and for mothers, pregnant mothers, the drugs are made available, so that we try in cooperation with other partners and AIDS of course is in the lead in this, working at least to make product to start using the drugs, and then we will hope that we can stimulate research, so that even less expensive drugs will come, and so that we can make gradually a major effort. I think there is an obligation morally to work towards narrowing this gap.
SUSAN DENTZER: What have you learned in your experience as a politician and as a physician that you will bring to this job?
DR. GRO H. BRUNDTLAND: You can use your knowledge to make a difference by having an influence on political decision-making, and world health is not an issue for any nation, because disease is spread and we are in the same boat, and that’s all the background and experience that I bring to the job. This is not a question only for health ministers. Presidents, prime ministers, and finance ministers are, indeed, health ministers, themselves, and they should know, and we will help them know.
SUSAN DENTZER: Dr. Brundtland, thank you very much.
DR. GRO H. BRUNDTLAND: Thank you.