What a lovely idea it was to organize the election of the Board of Health Systems Global, the new international society for health systems research, around the same time as the presidential elections in the US and the power shift in China!

Indeed, so far the nomination and election of the Board members have all the ingredients of a real political election ( feel free to choose another term, like “soap”/”reality show”, … ). Yet, things can surely still be improved on that front, especially if the aim is indeed to “ensure broad ownership, transparency and the engagement of all interested stakeholders, wherever they may reside.” (as stated in Kraushaar et al.’s Roundtable Discussion introduction, in a forthcoming issue of Health Policy & Planning). We’ll offer a few suggestions in this blog post. Given the setting and timing of the Board election, in Beijing, just before the 18th Party congress and the Romney-Obama clash, surely many positive synergies can be found.

Granted, there is full transparency about the number of Board members – 11 people will be selected, as much as the Barcelona football team. The aim is a nice mix of people, in order to get a representative ‘world class’ board. World class as in Messi, Xavi and Iniesta. Special attention will be given to gender, young people, and geographic balance. Marvellous. But there are also other factions in the HSR community – institutional, donors, methodological ones…. Yes, very much like in the Chinese Communist Party, a house with many rooms. So it would be nice if, just like the Chinese CP does, the HSR community made an effort to have all these factions represented too. If necessary, by coopting them? After all, the Barcelona bench has about 20 more world class players.

Of course positive discrimination is also important, so we should also go for a nice balance in terms of sexual orientation of the Board members – engaging in inappropriate sexual relations with several women/men is not recommended, though.

Also, as the HP&P editorial pieces all argue for reaching out to decision makers and civil society, apart from health systems researchers, wouldn’t it be great if we also had a couple of high-level decision makers in the Board, or a People’s Health Movement representative? And a (token) representative of the evil private sector (Big anything)? And just like rating agencies and corporate donors tend to have a major impact on western elections nowadays, behind the scenes or in plain sight, we surely need also similar actors or their representatives in the Health Systems Global Board. We want a Board with not only Chinese but also American characteristics. Let’s go for a house with many rooms, including a dark room.

Transparency then. The election procedures still feel somewhat opaque for most of us – the whole thing has a bit the feel of the nomination procedure of the boss of the World Bank so far. In our worst moments, some of us even sound like Tea Party people who feel duped by the Republican party leadership at the Convention.

It’s true, though – if you do ask for clarification on the election procedures, you get a polite mail back. Yet, the mail’s implicit message feels like “the computer says no…” (see the comedy show “Little Britain”). The Great Copenhagen Firewall, if you allow us. Some more transparency as well as slightly better timing of information would thus be welcome.

For example, right now, we don’t know whether this is an election in stages (with “primaries”), whereby potential candidates would first come up with a rather extreme programme, to shift – in the decisive round – towards a more mainstream position. And if it is to be an election in stages, who would make good campaign leaders and spin doctors? And will there also be ‘running mates’ then? (if so, your safest bet is our boss Wim Van Damme, he runs marathons in his free time).

And how do we have to vote? Can we vote tactically? Will there be alliances – well, there is an Alliance, obviously, but it’s some sort of a stakeholder itself. Will there be some ‘global expert’ positions in the board, who have HSR expertise of several WHO regions? And given the setting, is a tsunami ‘Lincoln Chen’ effect possible in Beijing – see the way Yao Ming tended to dominate the NBA all stars election through internet voting. Will there be fact checkers, to check whether candidates tell downright lies on UHC or HSS? Does every man/woman have one vote? Or will some votes count more than others? How many candidates will be allowed? 25? 100? The election is a bit of a poker game so far – if that’s the aim, we’d better organize it in a Macao casino.

Are campaign adverts possible, on YouTube or CCTV 9? Like in “Tim Evans endorses this message.” Or: “If you want your health system to go horribly wrong, vote for Julio Frenk.” “We will organize UHC on the Diaoyu (Senkaku) islands within 4 years!” Etc. Can candidates also organize mass rallies and chanting of progressive hymns like “We believe in UHC!”? And how about organizing a few live debates between possible frontrunners, with Yang Rui (from CCTV 9) as the moderator, in a sort of ‘Dialogue’? Anchorman Yang Rui can be trusted to engage in some Western/American bashing, so there will definitely be an audience.

We would have to inform the Chinese authorities though, that health systems researchers are planning a state of the art election in this sensitive month of November. But that shouldn’t be a problem, as decision makers around the world are well aware that health systems researchers, like other public health people, never hesitate to take on vested interests.

It should be great fun. Official messages you’ll find on Twitter (which you will have to check using a VPN connection in Beijing), while for the latest rumours and crazy gossip (including on possible ‘coups d’états behind the HS Global scenes) you will obviously need an account on Sina Weibo. To get really universal media coverage, we still need a HSR heavyweight to get involved in some lurid affair, and a drunk Brit disposed of in a hotel room. Plenty of candidates there. Finally, once the board members are selected, they should all go on stage, one after another, in order of importance (for the men: no need to get your hair painted black).

So let the Games begin! We welcome your campaigns on the IHP blog! Tell the world what your programme for the Society will involve. Do you want the next symposium to be in Dhaka, Cape Town, Beijing, Washington, Brussels, Maldives… ?

Only an open and transparent campaign will ensure a world class, balanced and harmonious Board. An extension of the deadline would be a good start. After all, finalizing the 18th Party Congress also took some time, so why all the hurry?
The IHP editorial team

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3 Responses to Health Systems Global: let the campaign begin!

  1. Prashanth says:

    I think the tone of the editorial is excessively harsh on the organisers. I agree with all the points raised, especially about transparency of the process. Also with Walter’s point about need to manage online voting better, but I think we need to be constructive in our criticism of the process.

    An excellent initiative by the IHP team is to host brief profiles of the candidates on the website and perhaps link them to the election page? Perhaps candidates could also respond to discussions/questions raised. At least, this is what we follow in Wikipedia – another place where a global community governs itself.

  2. Walter Flores says:

    Dear all,
    From the beginning, it has not been clear to me the hurry to have elections before the symposium. In most societies, the elections occur at the conference or immediately after. With all these problems of lack of information on the process and the faults with the electronic votes (as you describe in your emails), probably we should not vote now and instead, request that the process is put on hold until there are more information and the electronic voting process is improved-in other words, delay it after Beijing. What do you think?

  3. David Hercot says:

    Dear all,

    Personally, I didn’t get any update on the election process so far. Apparently I’m not the only one in this situation. Please let’s share the word to your network to check that everybody is aware that the voting has started and that you should have had an invite already. If it is not the case, leave a comment here and contact the organizers. http://healthsystemsglobal.org/AboutUs.aspx

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