on Wednesday, 21 June 2017.

Dear Colleagues,

Here is our topic for June,2017.

The 70th World Health Assembly ended nearly one month ago and left me feeling good for a number of reasons.

The first was the election of Dr. Tedros Adhanom Ghebreyesus of Ethiopia as the first African Director General of WHO. This was achieved in a closed session where three candidates vied for the votes of all member states by secret ballot unlike in the past years when the Executive Board of WHO submitted one name for endorsement by the WHA. Dr. Tedros, as the new Director General is generally known, won easily in three rounds of voting and is an excellent choice. Dr. Tedros has first-hand experience in running a national health system as a very successful Health Minister in Ethiopia.

As health minister, he was very popular among the global health initiatives where he served as chair on the Boards of these organizations such as Roil Back Malaria, and the Global Fund. His current job has been Foreign Minister of Ethiopia which has further exposed him to the world of global diplomacy. I have personally worked with Dr. Tedros in my days as Executive Director of GHWA where Ethiopia was a grantee as one of the 8 global Pathfinder countries on HRH development and later I was a Senior Adviser to the five-year Ministerial Leadership Initiative for Global Health where Ethiopia was one of the five project countries. From this experience I can describe Dr. Tedros as human, caring and visionary. The WHO and the global community should look forward to the future of global health with hope and I wish Dr. Tedros every success. Should Africa expect anything special?

Another reason I came back feeling good from the 70WHA is that I witnessed time and again the return of the discussions to the days following the 1978 Alma Atta Declaration where the focus was on Integrated Primary health Care involving the active participation of the people themselves. Whenever I had an opportunity to speak at the WHA, I applauded this approach to health systems strengthening and prayed that we will not depart from it again as we did in the past if we are committed to the SDGs and the goal of Universal Health Coverage (UHC). How will countries and partners protect this welcome return to the Health for All days and direction?

The third encouraging experience was to participate at the Side Event when the government of the Republic of Zambia launched their National Surgical, Obstetric, and Anaesthesia Strategic Plan (2017 – 2021). The Republic of Zambia has shown exceptional leadership in this field having been a sponsor of the WHA resolution 68.1 in 2015 that recognized that essential surgery and anaesthesia are critical components of Universal Health Coverage thus setting the stage for placing surgery, obstetrics and anaesthesia as key components of Integrated Primary Health Care strategy for achieving UHC that leaves no one behind. Congratulations to Zambia. Can we hear more stories of other similar efforts?

My organization, ACHEST also participated at pre-meetings of CSOs where the entire agenda of the 70WHA was dissected in detail over a two day meeting asking the question in all cases ‘Where are the people in this agenda item?’ Last year the 69WHA adopted a resolution on Framework of Engagement with non-State Actors (FENSA) allowing these to participate at the WHA and the work of the WHO. There are three major categories of non-state actors namely, (i) not for profit civil society organizations (CSOs), (ii) for profit industry and commercial organizations and (iii) philanthropic organizations. The CSOs see themselves as watchdogs making sure that the public interest is safeguarded at all times in the work of the WHO. These CSOs have established an office in Geneva under the name Geneva Global Health Hub (G2H2) as a watch tower for observing and responding to what is going on at this global health capital. I hope country level CSOs can operate similar watch towers. There are several effective ones in many countries.

Finally there was the networking which is extremely valuable as a source of learning and an enabler in forging partnerships and connections for carrying forward the work generated by and that follows the WHA.

I am looking forward to a future of effective health action that actually leaves no one behind.

Three Cheers to Dr. Tedros and UHC.


Comments (12)

  • OKELLO, David O.

    OKELLO, David O.

    21 June 2017 at 11:53 |
    Dear Professor Omaswa
    Thank you for sharing your observations on the outcome of 70WHA. The election of Dr. Tedros seems like the unique climax of this year's WHA. Your probing question on whether Africa should expect anything special is interesting. Personally, I think we should all help him do his global health work - he is DG for the global work of WHO. Any specific benefit to Africa should come in the context of the global work. We wish him good luck.
    Thank you.
    Dr David Okello
  • Prof. Nelson Sewankambo

    Prof. Nelson Sewankambo

    21 June 2017 at 12:43 |
    Dear David and Francis,

    I do agree entirely with Dr. David Okello otherwise he is perceived by others as Africa's DG and that ma have its potential negative impact on his leadership. Hi David!

    nelson Sewankambo
  • KELLEY, Edward Talbott

    KELLEY, Edward Talbott

    21 June 2017 at 13:19 |
    I could not agree more with your summary and highlights! The momentum behind the return to Health for All principles is exhilarating. As lead on primary care for WHO, though, I want to understand why previous efforts to revive this effort became mired in technical issues or missed proper political attention? Perhaps you have thoughts on that!

    Glad to talk whenever we can get a chance. All the best.

    Dr. Edward Kelley
    Service Delivery and Safety
    World Health Organization
  • Marian Jacobs

    Marian Jacobs

    21 June 2017 at 13:37 |
    Dear Nelson, Francis and David

    Great piece on the WHA and the future of WHO under new leadership.

    That we finally have an African DG is cause for much celebration and presents a real opportunity for all of us to support his tenure for success. He is head of world health and I have no doubt that there is much speculation behind closed doors. Some of the evidence of such speculation was publicly visible in the run up; others may be more covert.......

    Whatever happens, I am ready to do anything to support him: no recognition, no remuneration, no per diem needed...

    Warmest regards –and many thanks to Francis and ACHEST for continuing to stimulate dialogue

  • Francis Omaswa

    Francis Omaswa

    22 June 2017 at 10:32 |
    Dear Dr Kelley,

    Thank you for your contribution to this discussion and it was good to be in same meetings and share some of these experiences with you during the 70WHA.

    With respect to your question on why previous efforts to implement the Health for All agenda in the past did not succeed, I can assure you that a lot of soul searching took place and I do remember Halfdan Mahler him self lamenting several times. In brief these are some of the factors as I see them:

    1. Impatience and the yearning for "quick wins and magic bullets". Integrated PHC with participation of the population calls for patience, persuasion, demonstration leading to results ownership, accountability and sustainability.

    2. Low Resource base in LMICs compounded by political instability and economic crisis after Alama Atta. Donors and Development Partners were under pressure to show quick results in the face of weak country governments.

    3. Low Knowledge base on how to deliver Integrated PHC.

    Today all these factors have been largely mitigated and I can elaborate on each of them but we are in a much better position now. The global climate of opinion is supportive and and knowledge base s stronger.

    I suggest yo organize a Bellagio Retreat to answer the question that you asked and let us hear from others too on this forum.

  • Adamson S. Muula

    Adamson S. Muula

    22 June 2017 at 10:36 |
    Dear Prof Sewankambo,

    Thank you for your contribution. I had raised a similar issue on:

    On 21 June 2017 at 14:02, Prof. Nelson Sewankambo wrote:
    Dear David and Francis,

    I do agree entirely with Dr. David Okello otherwise he is perceived by others as Africa's DG and that ma have its potential negative impact on his leadership. Hi David!

    nelson Sewankambo
  • David Sanders

    David Sanders

    22 June 2017 at 10:40 |
    Dear Francis and colleagues

    Thanks Francis for your reflections. It was indeed exhilarating that Tedros was elected by such a large margin.
    You may be interested in a piece in The Conversation on his election and its meaning, potential and challenges.

    While I agree that there is a sentiment in support of comprehensive PHC, there are also strong contending pressures - not least the continuing underfunding of WHO. The resolution to increase assessed contributions (financial contributions from Member States) by 10% was severely amended to a paltry 3%. Tedros will have to somehow succeed in gaining more funding from rich countries if setting of the global health agenda is to return to countries - rather than donors.
    Best regards

  • DG


    22 June 2017 at 10:52 |
    Dear David

    I thought the appraisal published in Global Health Watch 3 provides us with some insights. I recommend that we reflect on some of the issues raised as they are still relevant to the discussion today as they were then. An honest reflection on what progress has been made and we're problems have been experienced and the Lancet series on PHC. David this is your product which I consider a useful reference.
  • Prof Lovemore Gwanzura

    Prof Lovemore Gwanzura

    22 June 2017 at 10:55 |
    Hi ALL!

    Indeed Cheers to Dr. Tedros for being appointed first African WHO DIRECTOR General.
    A first for Africa and of course Africa does look forward for something SPECIAL without fear
    or favor. Others who have been on the reign have left evidence inclined to their continent
    so somehow he must reorient whatever to AFRICA as well. LET US CALL SPADE SPADE..
    I am sure there is reason for the rotations.. so we do expect a good administration and orientation
    that recognize AFRICAN Health needs too

    Lovemore Gwanzura Bsc. Mphil MD . Mmedclinepi. PHD. ZAS fellow
    Professor CHSC,University of Zimbabwe
    Lab Director BRTI
  • PTessie Catsambas

    PTessie Catsambas

    22 June 2017 at 11:02 |
    Dear Francis and Colleagues,

    Let me add my humble voice to the celebration for this new beginning. I had the honor of supporting the Ministerial Leadership Initiative working with you, Francis, and then Health Minister Tedros along with health leaders from other countries. In my role in evaluation and learning from the Initiative, I learned a lot from Minister Tedros' open and embracing approach to new ideas, his bold testing of the Balanced Scorecard for creating alignment in the health system, and his strength as a great communicator of strategy. I look forward to his leadership in the years to come, and am ready to join you all to amplify and support his vision.

    Echoing your cheers for Dr. Tedros!

    Tessie Catsambas
  • Miriam Were

    Miriam Were

    22 June 2017 at 11:04 |
    Dear Professor Omaswa & Colleagues,

    Thank you, Francis, for sharing your reflections following the 2017 WHA, I rejoice in the choice of Dr. Tedros as the incoming DG of WHO not only because he is an African but also because he has such an impressive record of success in the health sector at the national and global levels. May this trend for successful leadership continue for the next five years; and indeed for the next ten years!

    You hit the nail on the head when you bring up the issue of the world facing up to PHC in this era of the SDGs. Your additional comments in response to the question raised by Dr. Kelly were useful. I would like to add another factor that held back the PHC in the past. And this is the opinion of health workers--especially Medical doctors and Nurses-- in many countries that somehow, the Health For all Approach was "second class care". I hope that the global success stories of Community Health Workers (CHWs) has somewhat addressed this problem. But specifically for Africa, ACHEST needs to work with Tedros in convening or using the meetings of specialized group of Surgeons, Physicians, Obs &Gyn etc to continue to make the case for PHC and articulation by each of these group of how each group is to contribute to this movement and what they will need to do. Maybe Dr. Kelly department in WHO can work with ACHEST on this for Africa under the leadership of Dr. Tedros. I specifically say Africa because this continent is still in the greatest need for making health care available and accessible to all.

    David Sanders, thank you for the links you have provided.

    With kind regards and best wishes,
    Miriam K. Were
  • Fikru Tessema

    Fikru Tessema

    26 June 2017 at 07:12 |
    Dear Colleagues,

    I agree more with the summary and highlights of Prof Francis regarding the election of Dr. Tedros Adhanom Ghebreyesus of Ethiopia as the first African Director General of WHO and his thought on those strategies of WHO for effective health action, like Primary Health Care, Health for All, Universal Coverage, the MDGs and SDGs, etc.

    These strategies are ways to a better health for everyone everywhere everyday. In my view, these strategies at least help each WHO member countries to graduate for basic health services and in place essential services for their citizens and striving with universal coverage and beyond. My worry is that still there are some countries behind and they are becoming pocket for harboring emerging health problems that become a threat for the world, like Ebola.

    So that, one of the priorities of Dr Tedros, "Transforming WHO" means, for me, "Ending to talk about such pocket countries to become a place of harboring emerging health problems that become a threat for the world. We have to advocate for Transforming WHO with a capacity to go beyond and ending dealing with basic health services, because each and every WHO member country should gradate for basic health services and build capacity not to be a place for harboring emerging health problems that becoming a threat for the world.

    Sincerely yours,
    Fikru Tessema (MSc, MBA, BSc)

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