Nishtar has an important civil society background which she hopes will help her build partnerships as WHO’s Director General
Sania Nishtar is the candidate of Pakistan to become the next director general of the World Health Organization (WHO).
A cardiologist trained to work in complex healthcare settings, the only female candidate in the race also has extensive experience working in civil society institutions. She is the founder of the NGO think tank Heartfile – described as a health policy voice and catalyst for health reform in Pakistan.
She has also served as federal minister in the 2013 Pakistan Caretaker Government.
Recently, she shared some of her ideas about how WHO can be reformed.
According to her, the world’s expectations do not match WHO’s capacity and resources. WHO is primarily an organization that sets norms and standards, speaks to matters of global, nationals and local public health, and provides technical advice to governments on matters of public health and health related issues. It has not been an organization that deploys a “white helmet” army to respond to major health emergencies, she said.
Sania says the world wants a WHO that can mobilize partners and provide strategic direction where needed to the response to outbreaks and emergencies with health consequences. To this end, the World Health Assembly, comprising the member states of WHO, agreed on the course for reform of WHO’s emergency capacity in May of 2016. “Implementation of those reforms is ongoing and will be a priority for the organization moving forward under my leadership.”
Responding to the issue of WHO’s limited resources, and her plan to ensure WHO has sufficient, sustainable funding in the future, the Pakistan candidate said:
“We need to rethink WHO’s financing model. As reliance on voluntary contribution increases, WHO erodes it capacity to fulfill its own agenda. As the world’s only multilateral agency in health with exclusive mandates, WHO has a critical role. Its strategic plans relevant to its core mandates must be adequately funded.”
Nishtar said she is focusing on four compacts to address the funding issue. The first is “financing consensus compact” to address the current imbalance between assessed and voluntary contributions, which is currently skewed towards the latter. “Over the last decade, we have seen increases in WHO budgets, but not assessed contributions. Assessed contributions reflect confidence in the multilateral character of WHO. An increase will enable more strategic and predictable use of resources and better investments for capacity building to respond to emergencies.”
I also propose a “value for money compact,” Sania added. “WHO must institutionalize the culture and systems to ”buy results” of the desired quality at the lowest price. Next I propose a “solidarity financing framework” for example providing organizations with details on ways to charge and channel voluntary micro-levies to support WHO’s assessed contributions.”
And finally, an “emergencies financing compact” the Pakistan candidate proposed. “The idea is to consolidate funding instruments and mobilize full financing for the Contingency Fund for Emergencies.”
Should WHO be concerned about climate change and what role would the organization take under her leadership to tackle climate change?
Sania said a range of environmental threats affect health, and addressing environmental challenges can also protect and promote health, asserting that the scale of the problem is quite clear.
Policies to increase resilience of populations to climate change, such as by enhancing food security and access to safe water yield benefits to health, she said. “Many health issues are directly linked to climate change, such as shifts in the distribution of tropical diseases and disease outbreaks.”
“Over two years, 2014-15, I served on the Planetary Health Commission and contributed to a report, which highlighted existing evidence to show how the health and well-being of future generations is being jeopardized by the unprecedented degradation of the planet’s natural systems,” Nishtar added.
Droughts, floods, other extreme climate events (hurricanes, typhoons), and changes in disease vector distribution can also wreak havoc in many other countries. WHO must facilitate access of vulnerable countries to the climate mitigation and adaptation funds.
On the likelihood of countries reaching sustainable goal of universal health coverage, Nishtar said the Universal Health Coverage (UHC) is the central pillar in the health SDGs, promoting healthy life expectancy, reducing poverty, and protecting household incomes. “Under my leadership, WHO will promote UHC as a health policy goal for all countries, and will help ministries of health galvanize commitment at every level of government.”
Sania believes that the success of UHC hinges on effective health systems. “This will involve tailoring country-specific approaches to combat corruption, promoting collaboration between public and private sectors, developing innovative strategies for health and human resources, and setting priorities that integrate a strong health prevention and promotion approach – to combat both infectious and non-communicable diseases as well as to manage the population health needs of changing and ageing populations.”