Margaret Chan’s Farewell

GENEVA – Blowing kisses, bowing deeply, and giving a final salute, Margaret Chan ended a farewell address Monday that acknowledged WHO’s shortcomings but also argued vigorously for the organization’s contributions to health during her decade as WHO Director-General.

Speaking to a packed World Health Assembly with 3,500 delegates (including US Health and Human Services Secretary Tom Price), Chan directly challenged “the frequent criticism that WHO has lost its relevance.”

Early in her speech, however, she addressed WHO’s much-criticized response to West Africa’s 2014–2016 Ebola outbreak.

“WHO was too slow to recognize that the virus, during its first appearance in West Africa, would behave very differently than during past outbreaks in central Africa, where the virus was rare but familiar and containment measures were well-rehearsed,” Chan said. “This happened on my watch, and I am personally accountable.”

Sounding chastened, Chan added, “I saw it as my duty, as your Director-General, to do everything possible to ensure that a tragedy on this scale will not happen again.”

She detailed the positive “spill-over effects” from the Ebola outbreak. Realizing the need to speed up research, WHO and partners established an R&D blueprint in 2016 that created “collaborative models, standardized protocols for clinical trials, and pathways for accelerated regulatory approval in advance.” Chan says the blueprint meant the time for candidate products has been reduced from years to months.

Also born from Ebola’s lessons learned was the Coalition for Epidemic Preparedness Innovations, launched in January nearly $500 million in initial funding. CEPI is developing a new system for affordable vaccines against priority pathogens to jumpstart response to upcoming outbreaks, Chan said. The new WHO Health Emergencies Programme http://www.who.int/about/who_reform/emergency-capacities/emergency-programme/en/ is another legacy of the Ebola response.

Chan also exhorted countries to develop core capacities to detect unexplained deaths earlier. “This is critical for improving global health security to protect our common vulnerability,” she said.

Beyond Ebola and its aftermath, Chan made the case for WHO’s relevancy by citing the organization’s role health successes. She credited WHO’s changes in technical strategies as turning points in the HIV, TB and malaria epidemics. She noted WHO’s seal of approval on a vaccine triggers efforts by Gavi, the Vaccine Alliance, to scale up distribution. She celebrated the free treatments for neglected diseases that were distributed to 1 billion people (“among the poorest in the world”) in 2015 by WHO and its global partners.

Chan also trumpeted other WHO contributions including 2013’s comprehensive mental health action plan, the new global antibiotic research and development partnership launched with Drugs for Neglected Diseases initiative, and the 2010 World Health Report on health systems financing and universal coverage.

She couldn’t resist sharing some advice for those shaping the future of the WHO (no doubt speaking to the next Director-General who will be chosen today):

• Prioritize vital records
• Protect scientific evidence
• Respond to the issue of vaccine refusals
• Innovate in order to reach health targets in the Sustainable Development Goals
• Listen to civil society
• Remember the people

Chan’s 27-minute farewell drew a standing ovation by the delegates from 194 countries. After the applause faded, Chan returned to her seat on the dais. The Assembly resumed its scheduled business, but one sentence from Chan’s speech still resonated:

“We falter sometimes, but we never give up.”

Ed. Note: See all of GHN’s #WHA70 coverage here.

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