The nomination by the Kochon selection committee of the Tibetan Tuberculosis Control Programme based at Delek Hospital, Dharamsala, India, for the Stop TB Partnership-Kochon Prize 2013 award—a prize worth US$65 000—for its work for more than 30 years to control tuberculosis in Tibetan refugees is a recognition of an important public health work in a vulnerable population. It could be seen as a thoughtful and much needed investment into a vital organisation directly involved in saving the lives of hundreds of young patients with tuberculosis. This selection was in agreement with the 2013 Kochon prize theme “[Tuberculosis] in conflict and refugee areas”.
However, WHO Director General Margaret Chan disapproved this nomination and deprived the health-care workers and patients at Delek Hospital from a vital source of inspiration, hope, and funding, which could have all promoted excellence within the programme (1). The Tibetan tuberculosis programme has been run with a very limited budget for decades, but achieved a 93% treatment success rate in 2012.
Tibetan refugees have one of the highest rates of tuberculosis in the world. The incidence of tuberculosis in the Tibetan population in India was 645 per 100 000 in 2012, whereas global incidence is 122 per 100 000 and India's incidence is 176 per 100 000 (2). Over-crowding, poor nutrition, migration, and exposure to different climate, language, and culture are important epidemiological, socio-environmental, and political factors that could explain the high disease burden in this population.
When decisions to honour and support leadership, innovation, and achievement in global health in the poorest areas are surrendered to political influence, how confidently can we confide in, support, and implement WHO's magnanimous goals of poverty eradication, disease elimination, and universal health coverage? (3, 4)
As we accelerate work on the health-related Millennium Development Goals, we hope that social activism—through press and internet-based social media—will help global health organisations to make righteous choices4 and decisions so that matters such as public health and saving lives are not held subservient to politics and economics.
I declare that I have no competing interests.
1 TB Prize selection gets caught in politics. . http://online.wsj.com/news/articles/SB10001424052702304281004579219970258410400. (accessed Jan 30, 2014).
2 Global tuberculosis report 2013. . http://www.who.int/tb/publications/global_report/gtbr13_annex_4_key_indicators.pdf?ua=1. (accessed Jan 29, 2014).
3 Global health 2035: a world converging within a generation. . Lancet 2013; 382: 1898-1952. Full Text PDF(2940KB) CrossRef PubMed
4 Investing in health: progress but hard choices remain. . Lancet 2013; 382: e34-e35. Full Text PDF(427KB) CrossRef PubMed
Kunchok Dorjee a
a Delek Hospital, Tuberculosis, Dharamsala 176215, India
WHO disapproves Kochon prize for Tibetan TB Programme — WHO's reply
The Delek Hospital has long been recognised within the tuberculosis community as providing excellent care for patients with tuberculosis and we applaud all who work there for what they have done in tuberculosis control. However, the Board of Directors of Delek Hospital is presided over by the Minister of the Department of Health of the exiled Central Tibetan Administration. This Board also includes several other Central Tibetan Administration members. The hospital is accountable to, and audited by, the Central Tibetan Administration. Despite the good work of this hospital, WHO, as an inter-governmental organisation and in its capacity as administrator of the Kochon prize, was unable to approve the award of the 2013 Kochon prize to an institution that is dependent on an authority that is not recognised by the United Nations. WHO's approach in dealing with such matters is consistent with practice within UN organisations.
Christy Feig a
a Communications, World Health Organization, Geneva 1012, Switzerland
Source: The Lancet (here and here)