David Nabarro

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Sir
David Nabarro
David Nabarro April 2016 (26106492653) (cropped).jpg
Nabarro in 2016
Personal details
Born (1949-08-26) 26 August 1949 (age 73)
London, England
Education Oundle School, University of Oxford (BA, MS, MBBS)
University of London (MS)

Sir David Nunes Nabarro KCMG CBE (born 26 August 1949) is a Special Envoy on Covid-19 for the World Health Organization. [1] He has made his career in the international civil service, working for either the Secretary-General of the United Nations or the Director-General of the World Health Organization. Since February 2020, he has helped the DGWHO deal with the COVID-19 pandemic.

Contents

Early life and education

Nabarro is the son of the late Sir John David Nunes Nabarro, whose cousin was the late Sir Gerald Nabarro, MP. He was formerly consultant endocrinologist at University College Hospital (UCH) and Middlesex Hospital, London. He attended Oundle School in Northamptonshire, [2] leaving in the summer of 1966.

In a gap year between school and university, Nabarro was a community service volunteer. He spent a year as the organiser of Youth Action, York. A BBC television documentary was made about his volunteer work. [3]

Nabarro studied at the University of Oxford and the University of London, and qualified as a physician in 1973. He is a member of the Faculty of Public Health (FPH) and the Royal College of Physicians by distinction (where he is also a Fellow). [4]

Career

Early career

Nabarro worked as a medical officer in North Iraq for Save the Children, before joining the United Kingdom's (UK) National Health Service (NHS) for a short time. From 1976 to 1978, Nabarro worked as District Child Health Officer in Dhankuta District, Nepal. Later, he moved to the London School of Hygiene and Tropical Medicine, and in 1982, he became Regional Manager for the Save the Children Fund in South Asia, based in the region. In 1985 he joined the University of Liverpool Medical School as senior lecturer in International Community Health.

He moved to the Overseas Development Administration (now part of Foreign, Commonwealth and Development Office) as a strategic adviser for health and population in East Africa, based in Nairobi, in 1989.

Nabarro later took up the post of chief health and population adviser at the Overseas Development Administration (London office) in 1990, and moved on to become director of human development (as well as chief health adviser) in 1997. [5]

World Health Organization (1999–2005)

Nabarro joined the WHO in January 1999, as project manager of Roll Back Malaria, then moved to the Office of the Director General as executive director in March 2000. In this capacity, he worked with the director general Gro Harlem Brundtland for two years on a variety of issues, including the Commission on Macroeconomics and Health, Health Systems Assessments and the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria. As part of this work, he became for 1999-2001 a member of the board of directors of Medicines for Malaria Venture. [6]

Nabarro transferred to the Sustainable Development and Healthy Environments cluster in 2003 and was appointed representative of the DG for health action in crises in July 2003. [7]

Nabarro was stationed in the Canal Hotel in Baghdad, Iraq, when it was bombed on the afternoon of 19 August 2003. [8] The blast targeted the UN, which had used the hotel as its headquarters in Iraq since 1991.

He has also coordinated support for health aspects of crisis response operations in Darfur, Sudan, and in countries affected by the 2004 Indian Ocean earthquake and Tsunami. [9]

UN System senior coordinator (2005–2014)

In September 2005, Nabarro was seconded from WHO and appointed senior UN system coordinator for avian and human influenza by secretary-general of the UN Kofi Annan to ensure that the UN system made an effective and coordinated contribution to the global effort to control the epidemic of avian influenza (also known as 'bird flu'). [10]

Coordinator of Global Food Security (HLTF) (2008–2014)

In January 2009, Nabarro took on the responsibility of coordinating the UN system's High-Level Task Force on Global Food Security (HLTF). [11] The HLTF brought together 23 different organizations, funds, programs and other entities from within the UN family, as well as the Bretton Woods Institutions, the World Trade Organization (WTO), and the Organisation for Economic Co-operation and Development (OECD), [12] and tasked them with establishing a common strategy for addressing food and nutrition insecurity in a more sustainable, coordinated and comprehensive way. Nabarro left the HLTF coordinator position in 2014 and was succeeded by Giuseppe Fantozzi. [13]

Special representative of the UN Secretary-General (2009–2017)

Nabarro addresses global food security crisis at Global Commodities Forum, United Nations Conference on Trade and Development Mr. David Nabarro, Special Representative on Food Security and Nutrition, UN High-level Task Force on the Global Food Security Crisis (6139808071).jpg
Nabarro addresses global food security crisis at Global Commodities Forum, United Nations Conference on Trade and Development

In November 2009 UN Secretary-General Ban Ki-moon appointed Nabarro as special representative on food security and nutrition. As special representative, Nabarro's role was to:

Coordinator of nutrition movement (2010–2015)

In September 2010, Nabarro was appointed coordinator of the Scaling Up Nutrition (SUN) Movement. [14] SUN brings together government officials, civil society, the UN, donors, businesses and researchers in a collective effort to improve nutrition. [15]

Betimes, he became Member of the WHO Commission on Ending Childhood Obesity (2016), 2013–2014. [16]

Special envoy on Ebola (2014–2015)

David Nabarro speaks at World Organization for Animal Health Dr. David Nabarro, UN Secretary-General's Special Envoy on Ebola speaks at World Organisation for Animal Health.jpg
David Nabarro speaks at World Organization for Animal Health

In August 2014, Nabarro was designated as special envoy of the UN Secretary-General on Ebola, with the responsibility for ensuring that the UN system makes an effective and coordinated contribution to the global effort to control the outbreak of Ebola. [17] The epidemic is believed to have begun in December 2013 with the death of a 2-year-old boy in a remote area of Guinea, but was not recognized until March 2014. [18] For several months the epidemic was spreading. This is something that public health experts in the affected locations, such as Medecins Sans Frontières (Doctors Without Borders), claimed was due to a deeply flawed and delayed response by health and government officials. [19]

In an interview later in 2015, once Ebola had largely been brought under control, Nabarro said that when he started working on Ebola in 2014, he "was aware that we were in the middle of a disease outbreak of enormous proportions. The number of people getting sick was doubling every week. Facilities were completely overloaded. Communities were in a state of despair." He added that the international community had learned important lessons from the epidemic: "The world is going to be different as a result of this Ebola outbreak, much more confident, much more assured, and much, much more capable to ensure the well-being of its citizens." [20]

Chair of the Advisory Group on Reform at WHO (2015–2016)

Nabarro was responsible for leading a high-level advisory group to guide reform of WHO's response to outbreaks and emergencies, prepare reports based on the group's recommendations and advise on the manner of their implementation. [21]

Head of UN's response to cholera in Haiti (2016–2017)

In 2016 Nabarro was tapped to lead the UN's response to Haiti's cholera epidemic. Cholera had killed more than 10,000 Haitians in the six years since the disease was introduced by UN peacekeepers in 2010. [22] After UN Secretary General Ban Ki-Moon issued a long overdue apology for the UN's "role" in the epidemic, Nabarro oversaw efforts to raise $400 million from UN member states to fund the Secretary General's proposed "New Approach" to cholera in Haiti. [23] Nabarro was the second UN appointee to work on the cholera crisis in Haiti. Pedro Modrano Rojas previously served as a senior coordinator for the cholera effort, but left at the end of an 18-month term, stating that he was disappointed by the international community's "failure to acknowledge the fact that we have in Haiti the largest epidemic in the western hemisphere." [24] Nabarro's efforts were no more successful—as a result of a lack of support from the UN Secretary General and from member states, Nabarro was only able to raise $2.7 million of the promised $400 million before being replaced by Josette Sheeran—though Sheeran would face the same obstacles as Nabarro. [25]

Special adviser on Sustainable Development and Climate Change (2016–2017)

In January 2016, Nabarro was appointed special adviser on the 2030 Agenda for Sustainable Development by then UN Secretary-General Ban Ki-moon.

One of Nabarro's responsibilities in this role were to lead the UN's response to the cholera epidemic its peacekeepers sparked in Haiti in October 2010 when untreated, infected sewage from a UN base was deposited in the country's main river system. As of August 2016, at least 10,000 people had died and more than 800,000 have been sickened in the epidemic. [26]

Candidate for WHO Director-General (2016–2017)

In September 2016, Nabarro was nominated by the UK's First May ministry to stand for the post of director-general (DG) of the World Health Organization (WHO). [27] An article co-authored by the UK's chief medical officer, Sally Davies, was published in The Lancet . It outlined the criteria that the next DG of the WHO must fulfill.

Nabarro was one of six candidates put forward by their individual governments to succeed DGWHO Margaret Chan. [28] Nabarro outlined his four priorities as follows: [29]

  1. Alignment with the Sustainable Development Goals
  2. Transforming the WHO to respond to outbreaks and health emergencies
  3. Trusted engagement with Member States
  4. Advancing people-centred health policies.

On Tuesday 23 May, at the 70th World Health Assembly, Nabarro came second in the race to become the next director general, receiving 50 votes to Dr Tedros Adhanom's 133 in the third and final round of voting. [30]

4SD Foundation (2018 - present)

In 2018 David Nabarro and Florence Lasbennes established the 4SD Foundation in Geneva. The Foundation is focused on skills, systems, and synergies for sustainable development, and accompanies leaders as they navigate their way through complex sustainability challenges. [31]

Imperial College London Professor (2018–present)

In 2018 he was appointed Professor at the Institute of Global Health Innovation at Imperial College London and then appointed in 2019 as Co-Director with surgeon Ara Darzi, Baron Darzi of Denham.

COVID-19 pandemic (2020 - present)

On 21 February 2020, he was appointed as one of six Special Envoys from the DGWHO, who were tasked to respond to the COVID-19 pandemic. [32] In October 2020, Nabarro gave an interview with The Spectator on YouTube in which he highlighted the WHO's updated position on lockdowns in regards to national responses to COVID. As a Special Envoy on COVID-19 for the World Health Organization, Nabarro said: "We in the World Health Organization do not advocate lockdowns as the primary means of control of this virus ... the only time we believe a lockdown is justified is to buy you time to reorganize, regroup, rebalance your resources, protect your health workers who are exhausted, but by and large, we'd rather not do it." [33]

He argued that lockdowns should be used as "circuit breakers" and as a reserve measure to control the virus rather than a primary measure. In an interview with BBC Radio 4, he cautioned against a full national lockdown, describing it as "a very extreme restriction on economic and social life" that temporarily "freezes the virus in place". He said: "You don't want to use those as your primary, and I stress that, primary, means of containment. Because in the end living with the virus as a constant threat means maintaining the capacity to find people with the disease and isolating them."

His comments were taken by some as meaning that the WHO did not support lockdowns. Rather, he emphasises that they do not support lockdowns as a primary measure for tackling the virus, and instead believe that having a robust test, trace and isolate system should be the priority for all governments, ensuring all those who are positive or who have been close to those infected are quarantined, with lockdown as "the reserve that you use to take the heat out of the system when things are really bad". [34] [35] [36] [37]

Honours, recognition and awards

Nabarro was appointed Commander of the Order of the British Empire (CBE) in 1992 for services to international public health and Knight Commander of the Order of St Michael and St George (KCMG) in the 2023 New Year Honours for services to global health. [40]

Related Research Articles

<i>Cordon sanitaire</i> (medicine) Quarantine of a geographic area

A cordon sanitaire is the restriction of movement of people into or out of a defined geographic area, such as a community, region, or country. The term originally denoted a barrier used to stop the spread of infectious diseases. The term is also often used metaphorically, in English, to refer to attempts to prevent the spread of an ideology deemed unwanted or dangerous, such as the containment policy adopted by George F. Kennan against the Soviet Union.

<span class="mw-page-title-main">United Nations Stabilisation Mission in Haiti</span> 2004-2017 United Nations peacekeeping mission in Haiti

The United Nations Stabilisation Mission in Haiti, also known as MINUSTAH, an acronym of the French name, was a UN peacekeeping mission in Haiti that was in operation from 2004 to 2017. The mission's military component was led by the Brazilian Army and commanded by a Brazilian. The force was composed of 2,366 military personnel and 2,533 police, supported by international civilian personnel, a local civilian staff and United Nations Volunteers.

<span class="mw-page-title-main">Disease surveillance</span> Monitoring spread of disease to establish patterns of progression

Disease surveillance is an epidemiological practice by which the spread of disease is monitored in order to establish patterns of progression. The main role of disease surveillance is to predict, observe, and minimize the harm caused by outbreak, epidemic, and pandemic situations, as well as increase knowledge about which factors contribute to such circumstances. A key part of modern disease surveillance is the practice of disease case reporting.

<span class="mw-page-title-main">Josette Sheeran</span> American non-profit executive and diplomat

Josette Sheeran is an American non-profit executive and diplomat who served in the United States Department of State. Sheeran serves as the seventh president and CEO of Asia Society since June 10, 2013. Sheeran was also the United Nations's Special Envoy for Haiti.

David L. Heymann is an American infectious disease epidemiologist and public health expert, based in London.

The International Health Regulations (IHR), first adopted by the World Health Assembly in 1969 and last revised in 2005, are a legally binding rules that only apply to the WHO that is an instrument that aims for international collaboration "to prevent, protect against, control, and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks and that avoid unnecessary interference with international traffic and trade". The IHR is the only international legal treaty with the responsibility of empowering the World Health Organization (WHO) to act as the main global surveillance system.

International Medical Corps is a global, nonprofit, humanitarian aid organization that provides emergency medical services, healthcare training and capacity building to those affected by disaster, disease or conflict." It seeks to strengthen medical services and infrastructure in the aftermath of crises."

Anthony Banbury was appointed the President and Chief Executive Officer of the International Foundation for Electoral Systems (IFES) in 2018. He served as United Nations Assistant Secretary-General for Field Support until 5 February 2016. He resigned from this position, stating that the UN is in dire need of reform. Drawing on more than 20 years of experience with the UN, he criticized its sclerotic personnel system, a lack of accountability, insufficient impact and the UN's inability to deal with transgressions by its own staff.

<span class="mw-page-title-main">2010s Haiti cholera outbreak</span> 2010-2019 cholera outbreak in Haiti

The 2010s Haiti cholera outbreak is the first modern large-scale outbreak of cholera—a disease once considered beaten back largely due to the invention of modern sanitation. The disease was reintroduced to Haiti in October 2010, not long after the disastrous earthquake earlier that year, and since then cholera has spread across the country and become endemic, causing high levels of both morbidity and mortality. Nearly 800,000 Haitians have been infected by cholera, and more than 9,000 have died, according to the United Nations (UN). Cholera transmission in Haiti today is largely a function of eradication efforts including WASH, education, oral vaccination, and climate variability. Early efforts were made to cover up the source of the epidemic, but thanks largely to the investigations of journalist Jonathan M. Katz and epidemiologist Renaud Piarroux, it is widely believed to be the result of contamination by infected United Nations peacekeepers deployed from Nepal. In terms of total infections, the outbreak has since been surpassed by the war-fueled 2016–2021 Yemen cholera outbreak, although the Haiti outbreak is still one of the most deadly modern outbreaks. After a 3 year hiatus, new cholera cases reappeared in October 2022.

<span class="mw-page-title-main">History of cholera</span> Worldwide outbreaks and pandemics of cholera

Seven cholera pandemics have occurred in the past 200 years, with the first pandemic originating in India in 1817. The seventh cholera pandemic is officially a current pandemic and has been ongoing since 1961, according to a World Health Organization factsheet in March 2022. Additionally, there have been many documented major local cholera outbreaks, such as a 1991–1994 outbreak in South America and, more recently, the 2016–2021 Yemen cholera outbreak.

<span class="mw-page-title-main">Tedros Adhanom Ghebreyesus</span> Ethiopian public health official (born 1965)

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<span class="mw-page-title-main">Public health emergency of international concern</span> Formal declaration by the World Health Organization

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Organizations from around the world responded to the West African Ebola virus epidemic. In July 2014, the World Health Organization (WHO) convened an emergency meeting with health ministers from eleven countries and announced collaboration on a strategy to co-ordinate technical support to combat the epidemic. In August, they declared the outbreak an international public health emergency and published a roadmap to guide and coordinate the international response to the outbreak, aiming to stop ongoing Ebola transmission worldwide within 6–9 months. In September, the United Nations Security Council declared the Ebola virus outbreak in the West Africa subregion a "threat to international peace and security" and unanimously adopted a resolution urging UN member states to provide more resources to fight the outbreak; the WHO stated that the cost for combating the epidemic will be a minimum of $1 billion.

The Global Outbreak Alert and Response Network (GOARN) is a network composed of numerous technical and public health institutions, laboratories, NGOs, and other organizations that work to observe and respond to threatening epidemics. GOARN works closely with and under the World Health Organization (WHO), which is one of its most notable partners. Its goals are to: examine and study diseases, evaluate the risks that certain diseases pose, and improve international capability to deal with diseases.

<span class="mw-page-title-main">2016–2022 Yemen cholera outbreak</span> Outbreak of cholera in the war-torn country of Yemen

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<span class="mw-page-title-main">Food security during the COVID-19 pandemic</span> Famines related to the pandemic caused by coronavirus disease 2019.

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