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Los Angeles Times Interview

Gro Harlem Brundtland

A Reformer Hopes to Heal a Troubled World Health Body

September 20, 1998|Craig Turner | Craig Turner is United Nations bureau chief for The Times

GENEVA — Former Norwegian Prime Minister Gro Harlem Brundtland has swept into office as the new chief of the prestigious but troubled World Health Organization like a bracing wind out of the north. She was elected on a promise to reform and reenergize the Geneva-headquartered public-health arm of the United Nations, which declined precipitously under the uninspired leadership of Hiroshi Nakajima of Japan.

Brundtland lost no time making good on her pledge. Her first day on the job, in July, Brundtland imposed a new administrative structure on the WHO, staffed mainly by newcomers from outside the agency; issued a tough new set of ethical guidelines for the staff; and identified a clear set of priorities for the organization. She also pledged to forge new links to foundations, private health organizations and business, and shrewdly, given the increasingly large role business plays in the world, pointed out the links between health conditions in developing countries and their attractiveness to investors.

Brundtland and her backers, including the United States, want to return the WHO to the days when it was a model U.N. agency rather than an egregious example of what's wrong with the world body. The organization, which has 3,700 employees, regional offices in six countries and an annual budget of more than $840 million, does not directly provide health services to individuals. Instead, it offers training, guidelines, research, funding and expertise to national health ministries, mainly in poor countries.

In the past, the WHO has been credited with stamping out smallpox, curtailing polio, funding immunization programs for hundreds of millions of children and alerting the globe to the worldwide threat of AIDS. Under Nakajima's 10-year reign, however, it suffered from administrative drift, bureaucratic bloat and political infighting.

Brundtland's supporters say few others are as well equipped for this job. Brundtland, 59, said she was inspired to go into medicine by her father, a physician who specialized in rehabilitation medicine. She grew up in Norway, the United States and Egypt, where her father did a stint with the U.N. After graduating from medical school at the University of Oslo and receiving a master's from the Harvard School of Public Health, Brundtland combined a career in public health with a passion for politics. A member of the left-leaning Labor Party, she moved steadily up the political ladder, winning her first Cabinet job--as minister of the environment in 1974. Seven years later she became her country's first woman prime minister, a post she held for 10 of the next 15 years.

After her retirement from politics in 1996, Brundtland was immediately rumored to be a candidate for high positions at the United Nations. Sources there say she turned down the post of deputy secretary general--the second-highest position. Instead, Brundtland campaigned for a five-year term as WHO director general and easily won election by the organization's executive board in January.


Question: In your early speeches, you've identified three priorities for world health protection: curtailing use of tobacco products, rolling back the spread of malaria and fighting AIDS. Can we talk about those one at a time? Let's start with tobacco.

Answer: When you analyze the burden of disease and, even more, when you calculate the future burden of disease 20 years from now, tobacco is a major killer. . . . It's a global issue, and we can add to what is being done today around the world. . . . It's an issue where increased awareness and increased knowledge lead to action. . . . Tobacco marketing activities in developing countries have been increasing and are . . . really having an effect--especially on young people and children. This is really dangerous. It should be prevented, and we should help.


Q: And what about malaria, a disease many Americans think of as contained to isolated, tropical regions of the world?

A: Over the years, the world came to believe that the new pesticides, such as DDT, could wipe out malaria, [but] it turned out it was really not that easy. For the last 15 years, people have stopped talking about eradicating malaria and, to the contrary, we have seen it increasing in many places. . . . It also has become resistant to some of the drugs that usually took care of the disease. . . . Malaria is in no way over, and it is now a threat to Americans and Europeans and whoever . . . visits other parts of the world. . . .

The World Bank, by the way, also is active in this--because it really has a lot of consequence for economic development in a lot of countries. The burden that malaria brings is not only mortality. . . . More than anything, the number of sick days in a year is immensely increased by a malaria epidemic. There's a lot of loss of productivity.

There are African countries where I'm sure that their potential and their ability to attract investment they need for economic development is really hampered by malaria. . . .

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