Thank you so much for joining us, and thank you to all our RDs.
Good morning, good afternoon and good evening to all our staff, all over the world.
Thank you for joining us for this important announcement, and thank you for your patience. We know you have been eagerly awaiting this moment – and so have we.
WHO has been part of my life since I was a child.
I remember walking through the streets of Asmara with my mother as a small boy, and seeing posters about a disease called smallpox. I remember hearing about an organization called the World Health Organization that was ridding the world of this terrifying disease, one vaccination at a time.
When I leave the office, when I see the statue, it reminds me of my walk with my mother in the streets. For me it’s not just a statue, it’s something I’ve seen in real life.
Later in life, I received a scholarship from WHO to do my Masters degree at the London School of Hygiene and Tropical Medicine. I wonder if the person who awarded me that scholarship could have imagined where it would lead.
It set me on a path that enabled me to serve my country Ethiopia at the highest level, and which has now given me the opportunity to serve the world.
At that time, somebody who later started working for WHO nominated me for that scholarship. He used to work for malaria here. I remember that. I competed for a scholarship.
So for me it’s also a day to say thank you to WHO.
Because of the vision and mission of WHO, I am proud to serve WHO. It’s such a great honour and privilege for me to serve this great organization.
My dear colleagues,
We work for a great organization.
You know that already.
I have known it most of my life
But in the past 20 months, it has become crystal clear.
I have seen just how much the world needs WHO. Not Tedros as a child, but now as an adult, I realise the needs of the world for an organization like WHO.
I have seen the incredible work you do every day to promote health, keep the world safe and serve the vulnerable.
I believe we can do even more and be even better.
I believe we should not put any limits on ourselves as we strive to deliver a measurable impact in the lives of the people we serve.
We must work with unrelenting vigour and unrestricted belief that anything is possible.
If we imagine it, we want to do it, we can do it.
I would like to express my sincere thanks to each of the Regional Directors – my colleagues and friends – for their support, their ideas and their leadership over the past 20 months.
Together, we have visited every region and met thousands of staff in many countries.
We have met the people you serve, and seen the difference you make to individuals, families, communities and nations.
We have seen and heard your commitment, your passion and your pride.
We have also heard your ideas for how we can make WHO even better.
We have heard your frustration at the limits the Organization has sometimes put on you.
We have heard your desire for a more modern WHO; a more open WHO; a transformed WHO; a fair WHO.
Through consultations, the staff survey, open door meetings and the Values Jam, you have told us the kind of WHO you want.
We are grateful to all of you who have contributed your ideas and energy to this process.
What will be announced today will be the result of your ideas.
I would like to say a special thanks to Bruce Aylward and the transformation team. For the past 18 months, they have been relentless in conducting a root-and-branch examination of what we do, why we do it, and how we can do it better.
We would also like to thank the Change Network, who have been the link between staff and the transformation team here at headquarters. You have given us great ideas, valuable insights and honest feedback.
We have heard from the Change Network that staff are impatient for change. So are we. We know that you want clarity so that you can make an even greater impact. That’s what we want too.
Our plan today is to give you that clarity.
I want to emphasise that transformation is not about downsizing, or cutting jobs.
It’s about new ideas.
It’s about new ways of working.
It’s about empowering people and unlocking their potential.
It’s about refreshing and modernising the organization.
We have to be clear on that. It’s how change can be successful. It’s a mindset issue. I have led changes and transformation in many organizations. I was lucky. I truly believe in what I said.
This is a historic moment for WHO. For the first time, the heads of the 7 major offices have worked together to identify the changes we need to make at all three levels of WHO – headquarters, regional offices and country offices – to transform this great organization and make us more effective and efficient.
Transformation is actually a journey we have been on for 20 months. We have already come a long way. And we still have a long way to go.
Our vision remains the same as it was when we were founded in 1948: the highest attainable standard of health for all people.
But the world has changed, which is why we have articulated a new mission to reflect what our world needs us to do now – to promote health, keep the world safe and serve the vulnerable.
Through the Values Jam we have also identified a new values charter, which defines the kind of organization we aspire to be.
To support the mission we accelerated the General Programme of Work, our strategic plan for the next five years.
At its core are the “triple billion” targets, to make a measurable impact on the health of the world’s people, and to support countries in reaching the Sustainable Development Goals.
Transformation is about asking how we must change to achieve those targets.
Today we will announce our new structure, but it’s not the structure that will make the difference.
Transformation is much more profound. It’s about changing the DNA of the organization to deliver impact.
We asked questions like, why do we do things the way we do? Is that the best way of doing them? How can we do better?
What we discovered is that we needed to overhaul all our major processes.
We were advised not to redesign more than two or three major processes at once. But we are ambitious and impatient. We ended up starting the redesign of 13 processes.
We identified 11 processes for radical redesign – planning, resource mobilization, external and internal communications, recruitment, supply chain, performance management, norms and standards, research, data and technical cooperation.
To be ahead of the curve and relevant in all countries, we needed two completely new processes, for innovation and strategic policy dialogue.
The first process we chose for redesign was planning. We realised that to truly deliver impact in countries, we need a robust, integrated process, from country offices to headquarters, to identify what technical products countries need, so we can prioritise the timely development of those products.
We looked internally at our own best practices and experience, but also benchmarked ourselves against many other agencies to identify best practices.
In March last year, the Regional Directors and I signed off on the new Programme Budget process and asked all our country representatives to do a prioritization exercise with their counterparts in government.
The results of that exercise fed into Country Support Plans and in turn into our radical new programme budget, which replaces our old siloed approach to budgeting with a new systems-oriented approach.
In the coming months we will be rolling out our other new processes.
Today the Regional Directors and I will describe the decisions we have made together and the strategic changes we are making, in 10 major areas.
Later in this presentation, I will describe the new headquarters structure. Our new senior leadership team will be announced in a memo to all staff immediately following this presentation. We will press the button as soon as we finish so you know who the leaders are.
To start us off, I’d like to hand over to Dr Tshidi Moeti, the Regional Director for Africa.
Strengthening our core business
Thank you, Dr Tedros, and good afternoon from Brazzaville.
For 70 years, WHO has been trusted as the world’s standard-setter for health. From our treatment guidelines to our Essential Medicines List, to the International Classification of Diseases, we set the standards on which billions of people rely.
We are a unique organization with a unique role.
Transformation is about strengthening that role by making sure our norms and standards are based on the best evidence, are driven by what our Member States need, and translate into making a real impact in the health of people.
Science is changing at a rapid pace. WHO must not just keep up; we must be ahead of the curve, setting the agenda, driving research and innovation, and ensuring it works for people.
To ensure we are set up to harness the power of science and innovation in a systematic way, we are creating a new Division of the Chief Scientist.
This office will perform two essential functions. First, it will ensure WHO anticipates and stays on top of the latest scientific developments, and that we identify new opportunities to harness those developments to improve global health.
For example, the development of gene editing technologies has raised important scientific, ethical, social and legal questions.
To address those questions, we recently established an expert panel on gene editing, bringing together the best minds from across the globe to help us define the boundaries between the potential opportunities and harms of this frontier technology.
That’s the kind of thing we must be doing all the time in a more deliberate and systematic way. We must also be doing it faster and with more foresight.
The second key role of the Division of the Chief Scientist will be to ensure the excellence, relevance and efficiency of our core technical functions, including norms and standards and research. In short – giving our Member States better products, faster.
The task of developing individual norms and standards will remain with technical departments, who have the relevant expertise in their respective areas.
The Division of the Chief Scientist will support them by ensuring norms and standards are produced to a consistently high standard, in a timely way, and are designed and delivered for impact.
Finally, to invest in science, we must invest in scientists.
We are a science-based organization, but too often, the only opportunity for scientists to progress in their careers at WHO is to move into managerial positions.
We’re changing that. By the end of this year, we will begin piloting a new career path for technical staff who want to remain in technical areas, to give them the opportunity to move into progressively more senior positions that make the most of their scientific expertise, without adding managerial responsibilities.
To do that we will expand the P6 and other categories, and also create a new P7 category for top scientific experts. This will act as an incentive for existing staff and help us to attract talented experts.
This will also ensure we have more people working in technical roles because they are able to grow and excel in those roles instead of moving into management.
Of course, those who want to move into management will still be able to do that, with the right experience and training.
One key area of the Chief Scientist’s work will be to keep WHO ahead of the curve by overseeing our work on digital health and innovation.
To tell you more about how we plan to do that, I’d like to hand over to Dr Takeshi Kasai, Regional Director for the Western Pacific.
Harnessing the power of digital health and innovation
Thank you, Dr Moeti, and greetings from the Western Pacific Region, where we are actually in the middle of an all-staff retreat, bringing together more than 600 staff, across 6 time zones, and in 11 different country sites.
DG, you may be surprised to know I have visited 10 different countries today … virtually of course.
An event of this nature in our Region today is only possible because of technology and innovation.
Colleagues, we all know that the future of health is digital.
Around the world, artificial intelligence and digital health are changing the way health care is delivered right across the continuum of care, for promotion, prevention, treatment, rehabilitation and palliative care. There are many opportunities to take, challenges to overcome and policy decisions to make, to maximize the incredible opportunity of digital tools for health.
WHO has a unique role to play in advising countries on how to maximize the opportunities of digital technologies, while avoiding the pitfalls with appropriate regulation.
We already do cutting-edge and inspiring work in digital health.
For instance, tens of millions of children have been protected against polio because we have worked with partners to push out mass text messages with information about where parents can take their children to be vaccinated.
We’re also working on software to monitor blood pressure using a smartphone camera.
Since 2013 we have worked with the International Telecommunications Union on the “Be Healthy, Be Mobile initiative” which works in 11 countries, using mobile technologies to raise awareness about cervical cancer, tobacco cessation and more.
Last year, we began a new collaboration with Google, in which they adopted our technical standards on physical activity in the Google Fit smartphone application.
And just last week we launched two new applications for mobile devices: one that enables people to check their hearing, and another to prevent medication errors.
These are all great initiatives, but they are not sufficiently connected or coordinated.
We have different people in different parts of the organization working on different digital health projects.
We need a stronger, more systematic way of leveraging digital technologies for both WHO and countries helping our Member States to leverage digital health to support their national priorities.
This is something countries have asked us to do. At the World Health Assembly last year, Member States passed a resolution asking WHO to develop a comprehensive digital health strategy.
To spearhead our digital work, WHO is creating a new Department of Digital Health, in the Division of the Chief Scientist.
This department will enhance our role in assessing digital technologies, and support countries to make decisions about how to prioritise, integrate and regulate them.
Of course, innovation extends well beyond digital technologies. Innovation is not an end in itself – it is only of value if it delivers impact in countries and accelerates progress towards the SDGs. A key bottleneck for innovation is scale and sustainability. That’s where WHO can play a key role. Our global reach and mandate give us the opportunity to scale health innovations like nobody else.
For this reason, we are taking a new approach to innovation that promotes and provides a clear entry point for innovations, from both inside and outside WHO.
To do this, we established the WHO Innovation Hub at the end of last year, with two main aims.
Internally, we want the Innovation Hub to foster a culture of innovation at WHO through training, programmes and special events.
Externally, the Hub will work to identify and match with country needs innovations that have the potential to improve the health of millions, but which face bottlenecks in being taken to scale.
Through WHO’s new innovation process, the iHub will ensure clear, fast, pathways for innovative products and services to be considered and, if appropriate, recommended by WHO.
As a trusted advisor to governments, and to leverage our country and regional offices, we will then work with countries to scale and sustain evidence-based innovations. Our aim is to address gaps in UHC, health emergencies and healthier populations.
We are currently in talks with UNITAID about hosting the Innovation Hub at UNITAID’s headquarters to leverage its networks and expertise in innovative financing across WHO’s strategic priorities.
Although it will be based in Geneva, the Innovation Hub is not intended to be a headquarters-only initiative. AFRO already has its own Innovation Challenge, and EMRO is appointing a focal point for innovation. We will link and harmonise these various initiatives.
I have only been RD for one month, but I am already thinking about how we can better organise ourselves to support innovation. This is an area I feel very strongly about – and has been the subject of a lot of exciting discussion here at our Western Pacific Region retreat this week.
We’ve talked about strengthening science and stepping up work on digital health and innovation. But ultimately, the point of both those initiatives is to make an impact in countries.
To tell you more about that, I’d like to hand over to Dr Poonam Khetrapal Singh, Regional Director for South-East Asia.
Engaging with all countries
Many thanks Dr Kasai, and good evening from New Delhi.
Colleagues, we are the World Health Organization. Our mandate is to improve the health of all people in all countries, rich and poor. But in practice, we only work in some countries.
The SDGs are about addressing inequality wherever it exists.
All countries have people who are left behind. No health system is perfect. Health trends are constantly evolving, and health systems must evolve with them.
That doesn’t mean we will operate in high-income nations the same way we do in low-income countries. We’re not about to open country offices in Stockholm, Singapore or Sydney.
But it does mean we need a radical new approach to the way we engage with countries.
That is why we have created an entirely new process for strategic policy dialogue with countries, that uses evidence and information strategically to drive change.
What is strategic policy dialogue? Let me give you an example.
In several countries, we have demonstrated that treating people with hepatitis C with modern, curative drugs not only saves lives, it also saves money and results in long-term economic benefits.
This modelling and analysis led to negotiations that lowered the price of medicines, dramatically expanded access and improved the health of millions of people.
That’s WHO at its best. Our new strategic policy dialogue process is designed to ensure we can deliver our best more consistently, and in all countries.
Critically, we will do this in all countries, although, it will be less regular in some countries than in others.
This is a major shift for WHO.
We have modelled this new process on the International Monetary Fund’s “Article IV” consultation.
Our starting point will be to develop profiles for each country, based on robust data. In doing so, we will identify the weak points in national health systems, and identify opportunities for change.
To illustrate how policy changes can result in significant improvements in public health and contribute to inclusive economic growth, we will develop tailored models to show countries where they’re headed on current trends, and how they can change course.
These models will be more than just spreadsheets and charts. They will transform our ability to engage in strategic and effective dialogue with all sectors of government.
To operate in this way, we need much stronger information and analytics.
Effective policy dialogue must be underpinned by robust, reliable data, generated in countries.
But many countries lack the health information systems they need to accurately monitor health trends and inform decision making.
At the same time, we are not giving countries the best support because our data systems are fragmented and we lack adequate analytical capacity to fully support strategic policy dialogue. We lack common standards, common processes and common access to data.
So we have redesigned an end-to-end data process to reorient and strengthen our data and analytics functions across the entire value chain, from country information systems to modelling and analytics that underpin strategic policy dialogue to drive impact.
Our aim is to make data work harder to improve health. We’ll do this in several ways.
First, we will continue to work with countries to strengthen their health information systems and generate better data.
Second, we will build a modern data “backbone” in WHO that allows sharing and analysis of data between the three levels of the organization and countries.
Third, we will make investments to strengthen our analytical capacity, to identify trends and make projections.
Fourth, at headquarters we will implement a new “hub and spoke” model, by which all of the data work conducted in the technical departments will be supported by a central data and analytics division.
Of course, none of this happens without you, our people. We cannot achieve anything without a dynamic and diverse workforce. To talk more about that, I’d like to hand over to Dr Carissa Etienne, Regional Director for the Americas.
Investing in a diverse workforce
Thank you, Dr Singh, and good morning from Washington, DC.
We always say that WHO’s best asset is its staff.
And as Dr Tedros said, this transformation is not about downsizing. On the contrary, we want to invest in our staff, unlock your potential and empower you to excel.
We want to make sure that WHO attracts, motivates, incentivizes and retains the best people.
We know some of the challenges you sometimes face – too little certainty, too little support, too little respect.
We’re committed to changing that. Our aim is to transform WHO into a career organization with compelling opportunities, powered by a dynamic and diverse workforce.
To do that, we are taking several important steps.
First, we have achieved some “quick wins” to increase gender parity and geographic diversity. Already we are seeing signs that they’re working.
Second, we will start testing a new recruitment process at headquarters to cut the average hiring time for fixed-term positions in half, from more than 5 months to 80 days.
We plan to expand that process to the whole organization.
This new, transparent approach will leverage the best modern technologies and practices to identify and recruit talent, and reduce the administrative workload.
Third, we have already announced the career track we are creating for scientific staff.
But fourth, we also want to invest in managers. At present, we don’t have a standardized professional development system for managers, or a standard approach to management.
So across WHO we will be rolling out a new Global Leadership and Management training initiative, which has been developed and is being piloted in the African Region. This will include best practices like 360-degree reviews and mentoring.
Fifth, we’re establishing the new WHO Academy, a major initiative to substantially increase professional development opportunities for WHO staff, and to revolutionize health learning globally.
Our vision is a state-of-the-art school to deliver high-quality, multi-lingual learning, both on-line and in-person, alongside a cutting-edge simulation centre for health emergencies.
Our aim is to build one of the world’s largest and most innovative digital learning platforms to enhance the competencies of a large number of health professionals every year.
By drawing on the expertise of more than 700 WHO Collaborating Centres and our unrivalled networks of specialists, the WHO Academy will bring together the world’s leading health experts to deliver unique learning opportunities.
The Academy will be a powerful professional development tool for all WHO staff, but will also help to strengthen the capacity of Member States by “training the trainers” in how to implement WHO’s norms and standards at country level.
The WHO Academy will be based in Lyon, France, but with hubs in each of the six regions. We will partner with the best institutions in each region. So it will be dual certification.
We are now developing detailed business and implementation plans, a full costing and financing plan, and building a network of partners including MIT, Nanyang Technological University Singapore and the CGFNS International.*
You will be hearing more about this exciting development in the coming weeks and months.
A sixth measure is that we are offering new opportunities for National Professional Officers. After their first two years working as NPOs, subsequent years will count as international experience, opening up new opportunities to apply for international positions in WHO. This offers talented people a career path at WHO, and ensures we retain the best young talent. We have to start treating our NPOs fairly.
Seventh, as you know, we have already announced that we have completely revamped our internship programme.
We’ve already provided health insurance and lunch vouchers for interns, and starting next year we will also pay a stipend. This is a vital investment in diversity, in equity and in the health leaders of the future.
And finally, we are taking steps to enhance diversity and inclusion.
Our commitment to diversity is not about ticking a box, it’s about improving the quality and impact of everything we do, by drawing on the richness of experience we all bring. The diversity of our workforce is not just an incredible asset that we must utilize more fully, it’s essential to achieving our mission.
In the next six months we will develop a diversity and inclusion strategy with clear targets to which we will hold ourselves accountable.
One of the key tools for driving diversity will be the Mobility programme, which will ensure that people are constantly gaining new experience in new places, and that the organization benefits from that experience. Mobility will become a key criterion for career progression. We plan to finalize our new mobility policy by the middle of the year and start implementing late in the last quarter, when the first people will start to move.
Colleagues, in our new strategic plan we have made bold commitments and set ambitious targets.
To tell you more about how we will keep ourselves accountable for meeting those commitments, I’d like to hand over to Dr Ahmed Al Mandhari, Regional Director for the Eastern Mediterranean.
Keeping ourselves accountable
Thank you, Dr Etienne, and greetings from Cairo to our colleagues all over the world.
As Dr Tedros said at the beginning, transformation is all about impact – changing our organization so we can make measurable improvements to the health of the world’s people
That is our commitment, and the people we serve will hold us accountable for keeping it.
But we do not want to rely on others to keep us accountable. We must keep ourselves accountable.
That applies to all of us – not just the Director-General and the Regional Directors, but to everyone who works for WHO.
Each one of us is responsible for playing our part in delivering the “triple billion” targets.
To do that, we must align the work of every employee to our strategy and goals.
This is a major shift. In the staff survey we did in 2017, only 47% of you said that you can link your day-to-day work with our overall strategy.
Through Goals Week last month, we asked all staff to explicitly identify how their work supports the triple billion targets. This is the first time we have asked all staff members to link their personal objectives to the organization’s strategic objectives.
Many staff have expressed strong approval for this change.
Our new approach to planning integrates our strategy into the daily business of every employee, and ensures we are working together towards shared goals, instead of in a more splintered way.
This will also allow us to reshape our approach to performance management as a compact between staff members and their supervisors, so that all our work links to specific outputs and targets from the GPW. By mapping individual work to concrete outcomes, performance management becomes more meaningful, more fair, and more effective.
We believe that performance management should be used to support staff, not to punish them – to encourage them to improve and excel, to identify training opportunities and to increase their productivity.
When supervisors write a review twice a year, they are typically too generic, and are skewed by the immediately preceding period, rather than reflecting work over the entire six months. This means reviews can be unspecific, incomplete or unfair.
More regular feedback can help identify problems as they arise and resolve them more quickly.
Under our new performance management process, supervisors will document the performance of their staff every month and provide feedback. Those monthly reports will help to make six-monthly reviews more complete and objective.
The heart of transformation is to make a measurable impact on the health of the people we serve, by changing our organization to deliver the “triple billion” targets and the health-related SDGs.
To keep us focused and accountable for delivering the GPW and the “triple billion” targets, we are creating a new Division of Data Analytics and Delivery for Impact, reporting to the Director-General.
This division will drive our redesigned data and analytics function, which Dr Singh described earlier.
Within this division, the new Department of Delivery will focus on WHO’s work at all levels and across pillars to optimize our impact at country level. It will drive delivery of our workplans in three important ways:
First is tracking. The Department of Delivery will connect our planning and data work by building a set of metrics and dashboard to link concrete work outputs of the secretariat with achievement of the “triple billion” targets. This builds on the work we are already doing in the Programme Budget on output measurement, the WHO Impact Framework, and country case studies.
Second is problem solving. Based on the results of our tracking work, the department will work with managers at all levels and across pillars to identify and overcome roadblocks that hinder progress through regular stocktakes on the “triple billion” targets.
Third is learning and capacity building. Based on the stocktakes, the delivery department will work with the country cooperation and strategy department, as well as the talent management at HQ and regional levels, to continuously strengthen the capacity of leaders at all levels, in particular our country representatives and their teams, by sharing lessons learned and best practices.
Taken together, these functions will drive a relentless focus on impact to ensure WHO plays its role alongside partners to support Member States in achieving the triple billion targets, and ultimately the SDGs.
By combining data and analytics, and delivery we will create a new powerhouse for country-focused health information that makes a difference for people.
Colleagues, you have heard about the changes we are making to strengthen our core business, to stay ahead of the curve, be relevant in all countries, invest in our people and keep ourselves accountable.
Now, to tell you about the structural changes that will support these strategic shifts, I’d like to hand over to Dr Zsuzsanna Jakab, the Regional Director for Europe.
Aligning as one
Many thanks, Dr Al Mandhari. Good afternoon to everyone in every part of the organization.
Dear colleagues, if we had to sum up transformation in three words, it would be: aligning for impact.
Our aim is to create one strong, coherent WHO with clear goals, roles and a consistent structure that is mirrored across all the three levels, and which reflects the “triple billion” targets.
This is a major change in the way we are set up, and the way we work. Instead of 7 different organizations, working with different set-ups, we have agreed on a single, streamlined structure for the entire organization.
That structure is built on four pillars. Two will be responsible for delivering the technical work of the organization, in line with the “triple billion” targets: Programmes and Emergencies.
The other two will be responsible for providing the corporate functions: External Relations and Governance; and Business Operations.
These four pillars will extend right through the organization, and will help us to operate in a more consistent, seamless way.
Within the pillars, there will be some variation between major offices, reflecting the different needs of different regions.
As Dr Tedros said at the beginning, transformation is about much more than structure.
It’s the combination of roles, skills, functions, processes and structures, but it also includes the “software” – how we work together across the organization to get things done. It’s about making sure we have the right people with the right skills in the right places to succeed.
For the first time, our new operating model articulates more clearly-defined roles for country offices, regional offices and headquarters.
Country offices are our front line. Their primary role is to engage with governments in strategic policy dialogue, based on country needs and priorities, to translate our normative work into policy, and to work with UN Country teams to deliver shared goals.
This has long been the role of our country offices, but it needs to be strengthened. The current UN reforms give us a unique opportunity to amplify the impact of our normative work.
To take advantage of that opportunity, we are taking significant steps to reinvent our country offices, so we can support them better and increase their impact. In some countries that may mean more people. In others it may mean adjusting the mix of skills. In all countries, it will mean providing training so that we are continually improving our work.
The role of Regional Offices and Headquarters is to support country offices with the technical know-how and corporate muscle to truly deliver impact.
We have paid particular attention to eliminating duplication and inefficiencies in some of the overlapping roles and work of Regional Offices and HQ.
The essential role of Regional Offices is to lead our technical cooperation, ensuring our normative work is driven by the needs of countries and translates into impact in countries. They do that by synthesising inputs from countries into our new country support plans. They will also focus on being the primary provider of technical support, such as giving countries subject-matter experts on specific topics.
Headquarters will focus much more clearly on producing the “global goods” countries need – including norms and standards, research, data products, and the tools to apply them. Headquarters will also provide specialised technical support and surge capacity as needed.
An important change we are making is that headquarters will get out of the business of providing day-to-day technical support, which is the core business of regions and countries.
But defining our roles is only one part. We must also change the way we work, to break the silos and work in a more seamless, agile way that fosters much greater collaboration both vertically and horizontally.
An agile organization is one that can rapidly adjust the way it works to meet the needs of the people it serves.
Too often we work in narrow pigeon holes that confine people to one area of work.
But the people we serve cannot be put in pigeon holes. And the health issues they face are complex and multi-faceted. So must we be.
Every issue demands that we work together, and deliver together, across the three levels of the organization.
And every issue needs input from other teams and departments with relevant expertise.
Fundamentally, this requires a change of mindset. But it also requires changes of behaviour.
It requires changing the way we manage staff and budgets, and the way we arrange teams.
So although we will still have departments and units dedicated to specific health issues, we are also creating teams that cut across the horizontal and vertical silos, to bring together all the expertise we need on a given issue to deliver results.
This will happen in three ways.
First, to drive progress towards the triple billion targets, we will establish 3-level delivery teams, combining staff from headquarters, Regional Offices and Country Offices in a team with a joint goal and joint accountability for the results they achieve.
For example, we expect to create a 3-level delivery team programme for our new “High Burden, High Impact” initiative on malaria, with staff from across WHO.
Second, for some initiatives that require expertise from multiple departments, we will build cross-cutting teams with joint accountability for specific projects.
Primary health care and antimicrobial resistance are good examples of issues that will require the input of many different parts of WHO, which we can deliver with agile cross-cutting teams.
And third, for short-term projects that require expertise from multiple disciplines to develop a specific product, we will create agile product delivery teams with fully seconded and co-located staff who work together intensively to deliver that product.
For example, if a new guideline is needed in a short period of time, a dedicated product delivery team will be brought together, under a leader with a budget for that project.
You’ve heard about many of the changes we are making. Now let’s look at what that means for how we are structured.
To explain that, I’d like to hand back to the Director-General, Dr Tedros.
Moving to one structure
Thank you, Zsuzsanna.
The Regional Directors will announce the details of their own structures in the coming weeks. I’d like to take a few minutes to explain the structure here at HQ.
As you heard, it consists of four major pillars.
The Programmes pillar will be responsible for two “triple billions” targets on UHC and healthier populations.
Let’s start with UHC, which is WHO’s top priority, and is central to everything we do.
This work will be supported by two divisions.
The first, called UHC & Life Course will include eight departments, spanning the traditional health systems “building blocks”, as well as services that are key features of every health system, regardless of a country’s epidemiological profile: Life Course & Ageing, and Immunization, Vaccines and Biologicals. This division will also lead our cross-cutting work on primary health care, which is the bedrock of UHC. We will test our agile structure with primary health care.
I cannot overstate the central importance of this work to the achievement of our strategy and the SDGs. Strong health systems based on people-centred primary health care are foundational not just for improving health in all countries, but for protecting them from the impact of health emergencies.
For those reasons, I have agreed with the Deputy Director-General, Dr Zsuzsanna Jakab, that the Executive Director of this division will have dual reporting, to the Deputy Director-General and myself.
The second division, called UHC & Communicable & NCDs will include six departments dealing with disease-specific programmes: HIV & Hepatitis; Malaria; Tuberculosis; Neglected Tropical Diseases; Noncommunicable Diseases; and Mental Health.
The third division, Healthier Populations, will support our work towards seeing 1 billion more people enjoying better health and well-being. This division will have four departments: Climate Change, Health and Environment; Social Determinants of Health; Nutrition and Food Safety, and Health Promotion. This division will also address issues related to migration.
Our existing Essential Medicines Department will be split in two. The policy work will remain with the Access to Medicines Department under the UHC & Life Course division, while our prequalification services will be split off to become a standalone entity under the Programmes pillar. We will also explore options for relocating this unit to another city with better connections and lower costs than Geneva, to achieve greater value for money.
Antimicrobial resistance is one of the most urgent health threats of our time, and WHO has a central role to play in leading the global movement to address it. In our role as the secretariat for the Inter-Agency Coordination Group on AMR, we are preparing a report to be submitted to the Secretary-General in June, and are preparing for the future based on its recommendations.
Accordingly, we are appointing a new Assistant Director-General for antimicrobial resistance, with oversight of the twin arms of this work – strong technical competency and strong partnerships.
As you have heard, the Division of the Chief Scientist will support and quality-assure the development of norms and standards, and will also lead our work on research and knowledge and digital strategy, and will provisionally host the Innovation Hub. This office will also manage our relationships with research partnerships including TDR, the Alliance for Health Policy and Systems Research and the Human Reproduction Programme, and technical links with IARC.
The Emergencies Pillar will be responsible for the “triple billion” target that relates to keeping the world safe.
Over the past few years, the response arm of our work on emergencies has become much stronger. You know what it has delivered, and how it has changed the image of WHO.
But the preparedness arm remains weaker. We have already taken some steps to strengthen it. With the World Bank we established the Global Preparedness Monitoring Board last year, an independent panel of experts to identify gaps in the world’s defences.
But it is vital that we strengthen it further, to support countries not just in responding to emergencies, but in preparing for and preventing them. Fighting fires is important. But preventing them is even better.
For that reason, we are appointing a new Assistant Director-General for Emergency Preparedness, to work with countries to strengthen their preparedness, including implementing the International Health Regulations aggressively.
We will also create strong links between our work on emergency preparedness and our work on health systems and UHC. As you know, health systems and health security are two sides of the same coin.
The Emergencies pillar will be led by an Executive Director.
Now let’s turn to the two corporate pillars.
External Relations and Governance will include five departments: Governing Bodies, Communications, Resource Mobilization, Health & Multilateral Partnerships, and our offices at the EU in Brussels.
Our New York office will be led by a member of the senior management team who is fully empowered to represent WHO at the UN and to coordinate our efforts on UN reform.
Business Operations will be responsible for the seamless day-to-day running of WHO and organization-wide planning. This division will include seven departments: Planning, Budget and Monitoring; Finance; Talent; Supply Chain; IT; the Global Service Centre; and Operations Services. It will also have a special unit to ensure fast-track business processes for emergencies and other time-sensitive priorities.
The big change we are making here is to centralize several corporate functions that are currently fragmented and delivered inconsistently.
Much of the fragmentation we see in our work is driven by fragmentation in the way corporate services such as resource mobilization, communications and human resources are set up and delivered. You know the problems we’re facing because of this decentralization and fragmentation.
For instance, many departments do their own fundraising, with little coordination at the corporate level.
As a result, WHO manages more than 3000 grants, some for very small amounts, as little as US $100,000. Many are tightly earmarked and not aligned with our strategic priorities. It also results in donors receiving multiple requests from multiple parts of WHO. This puts a huge administrative burden on the organization, stresses our systems to breaking point and makes it harder to steer organization strategically, and leads to utter confusion.
That’s why we have decided that at headquarters, we will make a smooth transition to a centralized resource mobilization department, to bring greater coherence to our fundraising work. That will bring not only more money, but quality money.
The same applies to communications. Currently, many headquarters departments have their own communications staff who report to their departmental director instead of the corporate Director of Communications. That weakens our ability to speak with one voice.
In the new headquarters structure, all communications will be centralized in the Department of Communications, and we have hired a new director.
We will take a similar approach to some core management functions, such as human resources, which leads to lack of uniformity and some of the grievances and complaints that some of our staff have. In the new structure, we will continue to provide tailored HR support to the pillars and divisions, but HR functions will be centralized in a way that is fully aligned with corporate policy. That will also help us to ensure diversity, which is one of the major challenges we’re facing.
These changes are important for two reasons: first, they will free up our technical departments in Programmes and Emergencies to focus on their core work; and second, it will reduce fragmentation and strengthen our corporate fundraising and communications.
That’s the path to build one WHO.
As Dr Singh mentioned earlier, we are making significant changes to the way we use data at WHO.
The technical work to bolster the quality of data that countries generate will remain with the Department of Health Information Systems Strengthening, under the UHC and Life Course division.
But we will create a new Division of Data, Analytics and Delivery for Impact, reporting to the Director-General. This division will perform two major functions: Data Management, Governance and Analytics; and delivery, which Dr Al Mandhari described earlier.
The Programmes pillar will be led by the Deputy Director-General, who will also have an overall mandate to support me.
The Chef de Cabinet will continue to support me in the day-to-day running of WHO.
As we enter the final push to eradicate polio, we decided it was important to elevate the Global Polio Programme to the Office of the Director-General, to give it the attention and support it needs for this crucial final stage.
We will also appoint a DG’s Envoy for Multilateral Affairs, to strengthen our role in international political fora like the G7, G20 and multilateral negotiations that we were not really exploiting.
Another important change is that we are moving the Department of Gender, Equity and Rights into the Director-General’s Office to support the mainstreaming of these functions in all our work.
Mobilizing resources in new ways
As I mentioned, we are consolidating our resource mobilization under one roof. But this structural change is just one part of a much bigger shift in the way we generate resources, to diversify our funding base and make us less reliant on a handful of major donors.
First, we launched WHO’s first Investment Case last year, which estimated the resources we need to support countries in achieving the “triple billion” targets.
Second, we have developed a new resource mobilization strategy, which lays out our vision for how WHO will be financed in future, and how we plan to realize that vision.
Third, we are establishing the WHO Foundation and developing innovative financing mechanisms to generate resources from previously untapped sources.
And fourth, in April we will hold the first WHO Partners Forum in Sweden, to build momentum for more flexible, predictable and multi-year funding. We plan to hold this event every year.
As I said at the beginning, structure is just one part of our transformation.
What’s more important than the “hardware” of our structure is the “software” – our mindset.
Living up to our values
We won’t achieve our vision, mission and goals just by changing the lines and boxes. It comes from changing our mindset – the way we think and behave.
That’s why we decided that in addition to a new mission, strategy, processes and structure, we needed to formalize the values that define who we are.
Last year’s Values Jam was a great example of how we can use digital tools to engage thousands of staff from multiple offices in a virtual conversation about the kind of organization we need to be.
The result is the Values Charter, which defines five values to which we are committed:
Trusted to serve public health at all times;
Professionals committed to excellence in health;
Persons of integrity;
Collaborative colleagues and partners;
And people caring about people.
To translate these values into practice, we must create a much more open organization, in which people can communicate more freely. Too often the layers of hierarchy impede the flow of information. This holds us back and slows progress.
We have great people, with great energy and great ideas. Our systems and structures must empower people, and enable ideas, not stifle them.
We must make openness and transparency the hallmark of our organization, both internally and externally.
That’s why when I started, we put out a call for bold new ideas from across the organization.
And that’s why every Thursday I’m in Geneva, my door is open for any staff member to make an appointment to talk to me about any issue they want. To be honest, Open Hour is the thing I look forward to the most every single week, because I learn from it. It doesn’t just help our staff, it helps me to learn from you.
Another tool we’re adopting to help us become more open is a new internal communications platform – Workplace by Facebook.
About 2000 staff have already started using it, and we plan to roll it out for all staff between now and the World Health Assembly.
For those of you familiar with Facebook, it works much the same way. But there is an important difference: unlike the public version, Facebook will not own the data.
I encourage all staff to use this new tool, and I look forward to using it myself.
We need an open organization. Please, talk to whoever you want, without conditions.
I have already told all the leadership that they should have open hour.
Forging a new mindset for partnerships
Finally, becoming a more open organization means changing the way we engage with partners.
WHO cannot do everything. Partnerships have always been vital, and are even more vital in the SDG era.
But historically, we have been too afraid of partnerships. We have developed a culture of control and risk-aversity that means we miss out on opportunities that could really help us achieve our goals.
We need to change that. We must be much more bold and creative in finding and cultivating new partnerships to accelerate progress.
No other organization has a mandate as unique and powerful as ours. No organization on earth has a mandate as broad as WHO. That puts us in a position to leverage the enormous capacities of our global health partners. The success of the Global Fund, Gavi, UNITAID and others is our success. Since we have the broadest mandate, the only option we have to release our energy and potential is to share it with others. If we want to be stronger, give it away. That’s the principle. We don’t need to be paranoid and risk-averse. Let’s learn to work with civil society, the private sector and others.
One important way we are harnessing the combined strength of the global health community is the Global Action Plan on Healthy Lives and Well-Being. Our Member States have asked us to play a leading role in bringing together 12 of our partners – and counting – to develop a cohesive and coherent plan to progress towards SDG 3, based on three principles: to align, accelerate and account.
We must also explore deeper partnerships with technical partners in academia, think tanks and research networks who have greater expertise than we do. Our role – a role only we can do – is to amplify the capacities and expertise of others for the health of all people.
Civil society groups and NGOs are also key partners. For instance, when we were developing new guidelines on drug-resistant TB last year, we actively engaged civil society groups representing TB patients. The result was a much stronger guideline that was much better suited to the communities we need to reach.
Last year, the Civil Society Task Team gave us a set of recommendations on how we can engage more constructively in several areas. We are now developing an engagement strategy to implement many of those recommendations.
And we must also engage more proactively with private sector companies, who have the products and services the world needs, and who can teach us a lot about innovation for success.
Of course, we will not be naïve. We will continue to keep a close eye on conflicts of interest and interference from groups who do not share our vision, mission, goals and values. But FENSA is not a wall to keep out the private sector; it’s a guardrail to facilitate collaboration within appropriate boundaries.
But we must approach partnerships with a can-do mindset. We must focus on our objectives, pursue bold partnerships, and manage the risks, rather than avoiding risks at all costs, and foregoing opportunities as a result. To exploit opportunities, we have to be able to take risks and understand the risks we can manage.
Next steps
So, what happens now?
Our new HQ structure will take effect on the 15th of March, which is also when our new senior leadership team will begin their new roles. But the process of fully implementing the new operating model will take more time. Later this afternoon, the new senior leadership team and I will meet with our directors to map out the next steps.
All directors will meet with their departments over the next few days to discuss how to set up teams and processes to reshape your department in line with the new operating model and processes.
The next step will be to ensure every department and function here at HQ has designed a new structure and staffing plan that is aligned with these new roles and functions.
We will then finalize the new department-level structures and begin realigning staff within and across departments in line with the new operating model.
Our overall goal is to ensure that we will be well on the way to implementing these changes by mid-May.
We will fully engage staff throughout this process.
I hope today that we have answered some of your questions. I know you will still have many more. Please submit them through the Events App. In the coming weeks we will also arrange in-person Q&A sessions in each major office.
As we move forward, our transformation team will help coordinate this work until the end of this year. That unit will then itself be transformed into a continuous improvement unit to identify new problems, opportunities, solutions and ideas. I like to call it the “brain of the organization”.
But change doesn’t belong to just one unit. Change is everyone’s business.
We must all continue to ask why we do things the way we do, and how we can do them better. Even as we serve, we must think, learn and change continuously.
So this new unit will continue to gather new ideas from across WHO and will continue to propose improvements to the way we work to make us more effective.
Colleagues,
I want to end by saying thank you.
Thank you for your commitment to serving humanity.
Thank you for making this organization great.
Thank you for the ideas that you have contributed to make it even greater.
And thank you for your tireless efforts to promote health, keep the world safe, and serve the vulnerable.
When I said I have a special relationship with WHO, it’s not just the organization. It’s you. I’m proud to be one of you. We will make big changes to help the people we serve.
Merci beaucoup. Shukraan jazeelan. Xie xie. Spasiba. Muchas gracias.
* Corrigendum On 08 March 2019, names of universities were corrected to read "Nanyang Technological University Singapore and the CGFNS International" from "the National University of Singapore and IMD in Lausanne".