Taking South Africa’s health to heart
WHEN we were medical students, our teachers would ask: “What kind of a doctor do you want to be?”
That is usually a signal to explain the specialisation you want to follow: plastic surgery, cardiology, psychiatry, endocrinology: there are many possibilities.
At the time I would respond that I wanted to be in a position to serve those who get sick, whoever they were, wherever they lived.
Most of all I wanted to serve those who are most in need, who – without help – would suffer greatly or die. I wanted to be a good doctor, one who brought good quality care to those in need: who would help them keep healthy and avoid debilitating illness.
I have worked in South Africa several times throughout my career across a range of issues including strengthening health systems – the very core of how we maintain happy, healthy lives. It will not come as a surprise to say, like in many countries, I saw disparities between rural and urban populations in South Africa and it is vital we do not allow these gaps to widen. Progress is indeed encouraging and I have been privileged to work with health department director-general Precious Matsoso, who, working closely with Health Minister Aaron Motsoaledi, has ensured South Africans are accessing the services they need, and promote public health.
When governments are not able, or not properly resourced, to spark change or respond to health emergencies, they look to the World Health Organisation (WHO).
The WHO helps countries work out how best to organise health services for their people, and helps them to respond to infectious disease outbreaks, which is not an easy task, given every country has very different needs. So why am I the right person for the job?
The director-general is responsible for directing the WHO as it undertakes actions that impact on the health and wellbeing of billions of people.
It is perhaps one of the most important jobs in the world.
This deep ambition to help people and to improve their wellbeing drove me to work in South Africa, in Nepal, Iraq, Bangladesh, and right across Africa – indeed in more than 50 countries so far.
That was my ambition then, and it is my ambition now more than ever today.
Perhaps that is the underlying reason why I am pleased to be nominated, by the UK, as a candidate to be the next director-general of WHO.
It is the role that I have been training for my entire life: I am motivated to do it by every patient I’ve ever treated, and by every community that I have served – including my time spent in Cape Town, Joburg and Pretoria.
Whoever runs the WHO must have proven experience in responding to disease outbreaks and emergencies, working in different national settings, and commanding the respect of international health professionals from the full range of government and non-government organisations.
The director-general must also command the respect of many thousands of hard-working and dedicated health professionals, including midwives, nurses, pharmacists, laboratory workers, first responders and all kinds of doctors.
This is especially important for those who fight for people’s lives on the front line.
Preventing sickness means working with multiple partners inside and outside the government, including science, civil society, faith groups and business, and making sure they work in synergy to deliver results. The director-general must be able to work with everyone – whoever they are, wherever they live, whatever their needs.
Success only happens if WHO is seen as attractive for investment – and not just by governments. The director-general must be able to generate investments and show they are well used. Working for health requires gender-sensitive strategies and a feminist perspective, with full involvement of women at all levels – especially as decision-makers. The incumbent must commit to the realisation of all human rights. I want to see equal numbers of men and women decision-makers at all levels of WHO, within five years.
The person needs the scientific background, the connections and the organisational ability to ensure that polio is eradicated, to advance efforts against HIV/Aids, tuberculosis and malaria, to face up to chronic diseases and to tackle the emergence of super-bugs that are resistant to antibiotics (the problem of anti-microbial resistance).
In addition, the DG must have experience of working with world leaders, politicians and funders and be familiar with the intricacies of the UN system. I have successfully served under several UN secretaries-general working on Ebola, food security and nutrition as well as avian influenza.
The WHO director-general is a challenging and important role. It is huge, and it matters to everyone throughout our world, including those in South Africa. All of the 50 countries where I have been fortunate enough to work in have helped shape who I am today, and I want to be there to help to shape the South Africa of the future, and the health of its people, especially women and children.
Whether it is improving health security or reducing the spread of infectious diseases, WHO has much to offer South Africa.
Like many countries South Africa is also grappling with an increasing number of non-communicable, or so called “lifestyle” diseases, conditions like heart disease, cancer and diabetes.
Doing more to address these challenges is one of my top three priorities should I become director-general. The WHO is a vital organisation for a healthy world and I am passionate about ensuring it delivers for the people of South Africa.
Nabarro is one of three final candidates for the position of director-general of the World Health Organisation. He has worked as a doctor, educator and international public servant in global health for over 40 years, across more than 50 countries.