WHO NEWS
WHO Regional Director dismisses "bleak picture" of his work in Africa
The director of WHO's Regional Office for Africa, Ebrahim Samba, dismissed a scathing critique published in the Lancet on 7 August of his work.
Dr Samba, who has been regional director for 10 years, argued that despite widespread poverty and instability in the region his office had achieved unprecedented success.
In a response published on 11 August, Dr Samba rejected the Lancet's central charge that appointments of WHO country representatives and senior staff were "often paybacks for political or other favours", or that his successor would be selected on a political basis.
He said that to suggest as much was a misunderstanding of WHO's role and that as an international organization it was inevitably close to the 192 governments it represents.
"The Lancet painted a bleak picture of the work of WHO in the African Region, giving the impression that WHO is not recording any successes there. In fact, despite the challenges and ongoing instability, the opposite is true," Dr Samba said.
He gave polio eradication, as well as fighting leprosy and guinea worm, and helping to rebuild health systems in post-conflict Liberia and Sierra Leone as examples of those successes.
In an editorial (2004;364;9433) entitled: WHO's African regional office must evolve or die, the Lancet called for more transparency from WHO and public debate over the nomination of a successor to Dr Samba, who retires in January.
The Lancet said WHO's African office had an "ineffective and self-serving central management" leaving staff "demoralized and unsupported", and that the root cause was mistakenly acting like a "political rather than technical agency".
The weekly journal said that despite having the world's highest disease burden and lowest level of economic development, and the constraints of "corruption, poor governance, political instability, and civil strife" in Africa, WHO's Regional Office for Africa could do better.
"Indeed many commentators are privately and scathingly critical of its composition and working practices", the Lancet said.
Dr Samba said that all staff were recruited "strictly on the basis of qualification, experience, proven track record and competence" and that a current review of WHO policy on selection, placement and rotation of WHO representatives would address some of the Lancet's concerns as well as other issues.
On 1 September, each of the five candidates for the post was due to be interviewed for an hour by the African Regional Committee which comprises health ministers from 46 countries that belong to the African Region. Then they will vote on the nomination.
The candidates are Dr Deogratias Barakamfitiye of Burundi, Dr Phetsile Kholekile Dlamini of Swaziland, Dr Evaristo Njelesani of Zambia, Dr Francis Gervase Omaswa of Uganda and Dr Luis Gomes Sambo of Angola. The result of the vote will be announced on 2 September.
Dr Samba, who comes from the Gambia, accepted the Lancet's concerns that some programmes were driven by donors. He said this was true of "some important programmes" and had been the subject of considerable internal discussion.
Dr Samba added that far from being "limited" extra-budgetary resources had grown from a combined budget of 90 million dollars for 1994 and 1995, when he first took office, to 350 million dollars for 2002 and 2003, which he viewed as a "vote of confidence".
The Lancet recommended that WHO should loosen political ties between its Regional Office for Africa and African governments, re-orient its core function toward technical expertise and make appointments based on competence and qualification.
It said the African office should decentralize into four or five sub-regions a scheme Dr Samba said had been tried before without success. 