The World Health Organization (WHO) in Geneva, Switzerland, this morning unveiled the names of the six candidates who are vying to succeed Margaret Chan as director-general.
The elections, which will be held in May 2017, come at a critical point for WHO, which was widely criticized for its slow response to the Ebola outbreak in West Africa and is in the middle of implementing reforms. At the same time, public health crises like Ebola and the spread of Zika virus have moved global health up on the agenda of world leaders.
- Tedros Adhanom Ghebreyesus, nominated by Ethiopia. Ghebreyesus is now Ethiopia’s minister of foreign affairs and was the country’s minister of health from 2005 to 2012.
- Flavia Bustreo, nominated by Italy. Bustreo, a physician, is currently WHO’s assistant director-general for family, women's, and children's health
- Philippe Douste-Blazy, nominated by France. Douste-Blazy is a cardiologist who has served twice as France’s minister of health and is chairman of UNITAID, a global health initiative that aims to ensure access to life-saving drugs in poor countries.
- David Nabarro, nominated by the United Kingdom. In 2014 Nabarro, a physician, was appointed United Nations senior coordinator on Ebola, and he is currently leading the United Nations' response to the cholera outbreak in Haiti. He previously worked at WHO in the office of the director-general and other positions.
- Sania Nishtar, nominated by Pakistan. Nishtar is a cardiologist who was a minister for science and technology, education and trainings, and information technology and telecom in Pakistan’s caretaker government in 2013. In 2015, Nishtar was Pakistan’s candidate for U.N. high commissioner for refugees
- Miklós Szócska, nominated by Hungary. Szócska is less well known. A physician who was Hungary’s minister for health from 2010 to 2014, he’s now director of the Health Services Management Training Centre at Semmelweis University in Budapest.
Geography may play a role in the decision. Four of the candidates come from Europe, but African countries have long argued that it is time for someone from their continent to lead WHO. The African Union has declared support for Ghebreyesus, though some observers have suggested that francophone African countries might also support France’s candidate.
More important than where somebody comes from will be his or her style of leadership, says epidemiologist David Heymann, former assistant director-general for health security and environment at WHO who is now at the London School of Hygiene & Tropical Medicine. In the past there have been two types of director-generals, he says: "political leaders" who place their vision in front of member states and justify it with evidence, and "consensus leaders" who take their lead from member states. Right now WHO needs the former, Heymann says.
John-Arne Røttingen, who heads the Coalition for Epidemic Preparedness Innovations currently headquartered at the Norwegian Institute of Public Health in Oslo, says the next WHO leader will need “if not a political background at least a strong political understanding." “They should have a vision; they should have some clear goals for the organization," he says.
Who will get the job is hard to predict, especially because the election process has changed, says Ilona Kickbusch, an independent global health consultant based in Brienz, Switzerland. In the past, WHO’s executive board voted for a candidate, who was then confirmed by the World Health Assembly (WHA), comprising health ministers from all 194 member states. This time, the executive board will nominate up to three candidates early next year, and WHA will vote in May 2017. The winner will succeed Chan on 1 July 2017.
The outcome will also be the result of behind-the-scenes dealing by the different member states, Kickbusch says. “This is highly political and the foreign ministries of these countries will be very active over the next months." With other global health positions like leadership of the Joint United Nations Programme on HIV and AIDS and the Global Fund opening up in the near future, “there is a bit of a carousel going on," she says. The biggest risk may be the high expectations many people harbor, Kickbusch says. "People think, if we vote for the right person now, all of WHO’s problems can be solved." But that is unfair, she says: “The main decisions about the budget about the priorities are still decided by the member states."