WHO harnessing science
Dr Jeremy Farrar during a discussion on the highest attainable standard of health for persons with disabilities and behavioural sciences for better health, during the 76th World Health Assembly in Geneva, Switzerland, on 29 May 2023.
Science is about seeking, generating, translating and sharing knowledge, the same tenets on which the World Health Organization was built. So, it is only fitting that WHO, like science, evolves to keep pace with the complex and shifting contexts of society.
Enshrined in the WHO Constitution as a core function of the Organization, 76 years on the world still looks to WHO to promote science for health, to shape global health research agendas and to provide evidence-based guidance to governments and health providers and professionals. The new Science Division, led by the Chief Scientist – a new executive position introduced in 2019 as part of WHO transformation – has a mandate to bring order to the multitude of research agendas across the Organization, ensuring a more systematic approach to research prioritization.
Dr Jeremy Farrar, Chief Scientist of WHO, explains that both WHO and global health have traditionally been vertically organized, yet we live in an increasingly horizontal world. Considering the multiple health challenges of climate change, demographic shifts and pandemics, Dr Farrer says, “We need to move away from vertical structures, and I think the Science Division, when it is functional and at its best, will be something of a glue that brings people together.”
Established just before COVID-19 hit, WHO’s Science Division represented a key shift in enabling the Organization to harness the power of science and innovation to face the pandemic. Charged with driving research and innovation to set the global health agenda, the Science Division helps WHO stay ahead of the curve while building trust and transparency in an era of scrutiny of health-related science. The pandemic made it clear that the bedrock of health, economy and national security must be a strong science base at country and regional levels.
“I think everybody now understands that science is part of our culture; it’s part of our way of life,” observes Dr Farrar. “Suddenly society is interested in science, and that comes with challenges. I think that is to be welcomed; science is not in an ivory tower.”
The increased expectation of accountability, transparency and clear communication from WHO necessitates the strengthening of its core capacities. From country offices and regional hubs to headquarters in Geneva, WHO possesses a wealth of knowledge and expertise. With the support of Member States, and collaborations with partners and key public health stakeholders, this combined experience is vital in keeping the world safe from existing and emerging health threats. Creating the Science Division has been essential to consolidate and strengthen this core.
“All organizations, whether they are a factory making widgets or a UN technical agency, have to be good at the core jobs,” says Dr Farrar. “And if you strip away everything, what is the core of WHO? Scientific advice, technical guidance and support for countries, and that core is critical, and science is critical to that.”
The Science Division is composed of three departments: Digital Health and Innovation, Research for Health, and Quality Assurance for Norms and Standards. It facilitates the world’s leading public health library, a remarkable resource which links with over 11 000 institutions, achieving more than 80 million downloads a year. The Science Division also hosts three important partnerships: the Alliance for Health Policy and Systems Research, the Special Programme for Research and Training in Tropical Diseases, and the Human Reproduction Programme.
Working with these partnerships, the Science Division helps WHO to give advice and provide service of the highest standard, to ensure the latest science can be incorporated into government policy and implemented by Member States, and to predict trends and work with a focus on the future.
“I think that will be an increasing role of ours: to anticipate what science is coming next year, 5 years from now, 10 years from now,” says Dr Farrar. “So that we don’t build in inequity from the start, but that we anticipate what’s coming and we encourage and help all countries to access the best science.”
Like the overarching transformation of WHO, the Science Division is a work in progress, with the team members learning and course-correcting as they go. Transformations are two-phased, with structural changes being followed by cultural change, which is, according to Dr Farrar, where the real results will start to show.
The reality is the hard work starts there. You can change structures whenever you want, but you can’t change culture overnight.
Barriers such as internal resistance and resource constraints inevitably remain, but the Science Division is central to moving WHO away from a competitive and vertical structure towards a more corporate mindset. The Division will continue to focus on increasing capacities at country and regional levels and ensuring continuous improvement because, as Dr Farrar puts it, “you should never just sit back and accept where you are as good, it can always get better.”