How will the next leader of WHO tackle future health emergencies?

In The BMJ, Devi Sridhar and colleagues outline the key questions on epidemic preparedness for prospective candidates.

Their analysis is based on each of their involvement in three of the major reports reviewing the global response to Ebola, including the Harvard-London School of Hygiene & Tropical Medicine independent panel, the WHO interim assessment panel, and the National Academy of Medicine panel.

They say their aim is to clarify the candidates' position on what policies and procedures need to be in place before the next health crisis occurs and how they see the leadership challenges ahead of them.

For example, they question WHO's role in any future health emergency and outbreak response and how this should be financed, following deep budget cuts to its outbreak response capacity.

And after concerns that the director general declared a public health emergency too late with Ebola, they ask if there is a need to change this procedure for future emergencies.

They include questions about health security concerns, WHO's operational role in any future health emergency response, and whether WHO should engage in research to better prepare for outbreaks.

The authors argue that an effective global system for preventing and responding to outbreaks "needs well coordinated and appropriately resourced organisations to fulfil clearly defined roles and responsibilities and to hold each other accountable for doing so."

They ask candidates to reflect on how the WHO could achieve this, and how WHO should engage with private sector foundations and communities, especially during a public health emergency.

The authors say that the relationship between the WHO director general and the UN secretary general should be strengthened, and ask how better links could be made as well as the establishment of new health security mechanisms.

Finally, the authors point to accountability mechanisms, asking candidates to reflect on how accountability be strengthened in relation to health and emergency and outbreak response, including the creation of a freedom of information policy and an inspector general at the WHO.

"Our primary goal is to convince political leaders worldwide to reflect hard on the type of director general they want to lead the WHO," write the authors.

They say their questions "show the different facets of leadership that are required to ensure that WHO has a key role in the coming years and decades and that an Ebola-like crisis never happens again." And they conclude: "Business as usual cannot continue; transformative leadership is called for."