Thread by @kakape

At the end of this month @doctorsoumya is leaving @WHO.
I talked to her about her time as the agency’s first chief scientist, her biggest accomplishments, like the mRNA hub, and her biggest regret: not acknowledging earlier that #SARSCoV2 is airborne
🧵👇

science.org/content/articl…

First of all: Her departure is part of a larger shake-up in @WHO‘s top ranks with half the senior leadership slated to leave, as has been reported by @HealthPolicyW. Some - like Swaminathan - were planning to leave anyway, others not so much.

healthpolicy-watch.news/half-whos-seni…

It will be interesting to see how @DrTedros changes things. There’s been some pressure to reduce the number of assistant DGs so there may be some consolidation, but @drsoumya told me that she expected the chief scientist role to definitely be filled again even if takes some time

So why is she leaving:

„The most important reason is that after 5 years of working at the global level, I feel an urge to go back and work at the national level.“ She plans to work in Chennai for a research foundation for now.

Some countries‘ interest in health is big now, she told me. „There is probably a once-in-a-century opportunity to really transform the way we approach health, with more focus on a systems approach, on prevention and health promotion, [and] attention to the determinants of health“

While WHO can highlight issues, present data and release guidelines „all the work is done in countries: the investment, the translation of policy, the actual implementation“.

For example, „the majority of countries around the world do not have a good system to measure and report the causes of death. That's a huge disadvantage. You can't do proper policy planning if you don't know what the burden of different diseases is and how that is evolving…“

What many people don‘t understand about @WHO is that one of its key roles is really to set norms and standards, which often means writing long guidelines for instance on how to treat a certain disease.
Improving that work was one of her priorities @doctorsoumya told me:

„We want to develop what we call the living approach to guidelines, which means updating all our recommendations practically in real time, like we did for COVID-19 treatments. But also producing them in a format that's easy for countries to adopt…“

The chief scientist has to defend these guidelines,she told me, for instance one saying antibiotics should not be used for growth promotion or disease prevention in animals because that contributes to antimicrobial resistance. „A couple of member states were very upset.“

I asked her about not calling #SARSCoV2 airborne earlier in the pandemic and whether that was her biggest mistake:

„We should have done it much earlier, based on the available evidence, and it is something that has cost the organization.“

„…when it comes to mitigation, we did talk about all the methods, including ventilation and masking. But at the same time, we were not forcefully saying: “This is an airborne virus.” I regret that we didn't do this much, much earlier.“

Will be interesting to see this:

„I was asked to convene both an internal and an external group to see if it's time to change the definitions and the terms we use to describe this. I was hoping that this would be out before I leave, but it is likely to take a few more months.“

„So, I think what I would say to the next chief scientist: If there's any situation where there's new evidence emerging, particularly from other disciplines, that’s challenging our understanding, get involved early on!“

If that was her biggest mistake what were her biggest accomplishments?
„setting the science division on a path, giving it a lot of visibility globally and forging links with the big science communities“ and setting up the mRNA hub that aims to provide Africa with mRNA vaccines

„Moderna and BioNTech-Pfizer refused to share any technical know-how or help us in any way, but the South African scientists were still able to create a vaccine. Of course, now that has to go through all the stages of clinical testing …But the early results are very encouraging“

And I had to ask about Twitter of course:
„I'm just waiting and watching. But I'm not very optimistic that it will continue to be a good platform. If a lot of public health people start leaving Twitter, then it doesn't make sense to stay there, but it's too early to judge.“

You can read the entire interview here:
science.org/content/articl…