http://www.iht.com/articles/2007/01/05/news/profile.php
At WHO, a chief cut from Hong Kong cloth
Job could put her at odds with Beijing
By Elisabeth Rosenthal,Published: January 5, 2007
NEW YORK: She was nominated by the People's Republic of China to be
chief of the World Health Organization and has been repeatedly
dubbed "the Chinese candidate." But there is little in terms of
style or history that links Dr. Margaret Chan, who took office this
week as the agency's new director general, to the country she still
calls "mainland China."
Raised in the British colony of Hong Kong and trained as a doctor
in Canada, Chan was Hong Kong's chief public health official from
1994 to 2003, an extraordinary decade that spanned not only the
territory's return to China, but also two public health crises: the
first outbreak of H5N1 avian influenza, or bird flu, in 1997, and
the 2003 epidemic of severe acute respiratory syndrome, or SARS,
which killed 800 people worldwide, nearly a third of them in Hong
Kong.
Weathering each crisis with a direct, outspoken approach, Chan
proved to be more of a no-nonsense British civil servant than a
Chinese Communist Party bureaucrat.
Throughout her tenure, Chan was best known for her differences with
Chinese officials over how to handle health issues, from
counterfeit medicines to infectious diseases. During the SARS and
bird flu outbreaks, the Hong Kong government published painstaking
daily updates on illness and death, while China the place that
many scientists believe both viruses originated worked hard to
cover up the problems, allowing the diseases to spread.
At home in Cantonese and English, Chan admits that her Mandarin
the official language in China is slightly ragged. And Chinese
officials must cringe a bit when she refers to "mainland China," a
term regarded as something of an aberration in Beijing, where
language is chosen carefully to avoid lending credence to the
concept of a separate, independent Taiwan.
At Beijing's urging, the WHO has repeatedly voted to reject
Taiwan's requests to attend the organization's yearly meeting as an
observer. In a news conference Thursday, Chan said that this would
not change, but that Taiwanese scientists would be able to attend
WHO meetings as technical experts, in accordance with a policy
established in 2005.
Chan, 59, said that she was surprised when officials in Beijing
called last fall to tell her they wanted to nominate her to lead
the United Nation's health agency.
Before she accepted, "I said, 'I really need to understand why
China wants to nominate me,'" said Chan, a chatty woman who wore a
fashionable black pantsuit at a recent interview near the United
Nations.
Subsequent discussions convinced her that China was ready to become
a more active and open participant in global health matters. "I
said: 'Good, all right, if you're really interested I'm happy to
take on this challenge. But don't think I'm going to let you off
the hook.'"
Still, during the highly politicized campaign for WHO leadership
last year, many experts objected that Chan lacked the clout and
experience for the job and to stand up to China. Since then, some
detractors have softened these views.
Chan's new position could quickly put her at odds with Beijing.
International scientists complain that China is still playing down
its bird flu problem and has been slow to share virus samples that
would allow them to develop better vaccines.
"It is a huge step, moving from managing a health department of a
British colony to managing a global health system, but I'm less
worried about that now," said Dr. Richard Horton, editor of The
Lancet, a medical journal, who had previously questioned Chan's
qualifications.
"In her speeches so far, she's sent strong signals about her
intentions to focus on Africa and women. And I think that should
be applauded."
Some doctors who worked with Chan when she was in Hong Kong, who
spoke on the condition of anonymity, regard her vault to power as
unwise, even surreal, "like making a colonel head of the armed
forces."
Chan knows that she faces enormous challenges. Last year, WHO
announced that it would take a more active role in ensuring that
expensive medicines were available to poor people in the developing
world. With the rapid spread of bird flu, the agency has become the
de facto coordinator for preparedness against pandemics.
Chan, who has been WHO's chief communicable disease official for
the past two years, will have to show "much stronger engagement" in
confronting drug companies in patent disputes so that poor people
can get medicines for HIV and malaria, said Tido Von Schoen
Angerer, of Doctors Without Borders' Campaign for Essential
Medicines.
To promote women's health, she will have to champion improved
access to contraception and abortion, said Horton, moves that are
opposed by the U.S. government.
Chan says that she believes in "coming together rather than
confrontation" and hopes that her "access" in Beijing will help to
improve collaboration on bird flu, for example.
But she insists she will not compromise on things like the need to
share viral samples and will fight, if required.
Born in Hong Kong in 1947, Chan had planned to become a teacher.
Instead, she followed the man she would later marry, David Chan, to
medical school in Canada. "I gave up my teaching career to study
medicine with him," she said. "Now he says it's his turn to retire
early to join me in Geneva."
Returning home, she rose steadily through the bureaucratic ranks of
the Hong Kong health department, becoming director in 1994. Despite
pressure from Beijing, she banned imports of substandard foods and
medicines from across the border in China. "I also banned ice cream
from the U.S.," she says, with a smile.
But bird flu and SARS were Chan's trial by fire, catapulting her
into the international limelight. On Dec. 29, 1997, to combat the
first recognized outbreak of H5N1 avian influenza in people four
had died in Hong Kong Chan ordered all 1.2 million chickens and
ducks in the city killed and closed down live poultry markets. That
draconian strategy has become a model for controlling the disease
in outbreaks taking place elsewhere.
After the SARS outbreak in 2003, a Hong Kong legislative panel
concluded that Chan had failed to respond quickly enough, ignoring
rumors that the deadly pneumonia was killing people in neighboring
Guangdong Province.
But many experts say that the real culprits were the Chinese
officials who refused to share data. Chan told the panel that the
Guangdong health department had failed to respond to her numerous
inquiries, regarding infectious disease as a state secret.
Once SARS was confirmed in Hong Kong, Chan organized daily
briefings, displaying a candidness that displeased some Chinese
officials, who were convinced that the term SARS had been created
by the World Health Organization "to discredit Hong Kong," she
said. (The Chinese territory is officially known as the Hong Kong
Special Administrative Region, or Hong Kong SAR.)
"The leadership in mainland China has moved a long way since then,"
she said.
"Hong Kong demanded transparency. They know what kind of person I
am."
