Opinion is divided on whether UNICEF's current leader, Ann Veneman, should be given a second term—or be replaced with a new candidate, likely, by convention, to be hand-picked by US president Barack Obama. Lancet Editor Dr Richard Horton explores the reasons why Veneman is popular with some observers and less so with others in a Comment in this week's edition of the Lancet.
The Lancet' s own opinion is also divided—on the one hand, the journal is highly appreciative of the renaissance in child survival Veneman embraced after the publication of the journal's first child survival Series in 2003. But Dr Horton adds: "We were concerned by the irritation and displeasure [expressed by UNICEF] when the Institute for Health Metrics and Evaluation began publishing technical analyses of child mortality and results-based financing in The Lancet. UNICEF did not like what it saw as competition."
In preparing the Comment, Dr Horton sought views from within UNICEF itself. Again, these views were mixed. One perspective held that Veneman had clearly prioritised child survival—with budget, staff time, public advocacy, strengthening of technical teams, and strengthening of country logistics. Veneman's supporters also highlighted major increases in insecticide treated bednet coverage, progress in measles mortality reduction and elimination of maternal-neonatal tetanus, increases in antimalarial treatment, antiretroviral therapy, and access to new vaccines, in addition to a "major push" on severe acute malnutrition.
Criticisms from some of her staff included her diminishing the importance of field, institutional, and leadership experience at UNICEF. Success on bednets, measles, malaria treatment, and preventing mother-to-child transmission of HIV was not hers alone. These programmes began before her tenure. She continued their work, but did not raise their profile or UNICEF's commitment substantially. Others claimed her lack of experience in the field meant she took too long to get up to speed when starting the position, and said that she had poor diplomatic and public speaking skills.
Other UN agencies and the World Bank also had a mixture of views. Veneman's greater attention to reproductive health, gender-based violence, and water and sanitation were praised; her record on nutrition was highlighted as a failing by several different UN agency contacts. The academic sector, those working in donor countries, and NGOs had similarly divided opinions.
One long-term, loyal UNICEF staff member told The Lancet: "UNICEF could benefit from, and deserves, a more committed leader willing to travel as often and wherever necessary in the interest of the organization. Someone who understands and recognizes the history of the organization and the strength of its staff; one who can speak from the heart and from personal knowledge. UNICEF current and retired staff want to see a leader they would be proud of for her or his personal accomplishments and commitment to children. The Obama administration has an opportunity to nominate someone with the same world vision that gained President Obama the Nobel prize. This opportunity should not be missed."
Dr Horton concludes: "UNICEF's Executive Director is an important global leader in health. The person appointed should not be in the gift of one powerful government. Instead, UN Secretary-General Ban Ki-moon should announce that the next Executive Director of UNICEF will be selected through a transparent, merit-based appointment process... the next Executive Director of UNICEF should be someone with a proven track record in children's issues, including child health. He or she should be a person who can command the confidence of countries, political leaders, and technical staff. That person should also be someone who has demonstrable leadership and communication skills. UNICEF is too important an agency to leave to the contingency of domestic US political pay-back. Such an appointments process only erodes the integrity of the UN. It is time to stop that erosion."
The Lancet Press Office. T) +44 (0) 20 7424 4949 E) pressoffice@lancet.com
For full Comment, see: http://press.thelancet.com/veneman.pdf
Journal
The Lancet