Campaign marred by spin comes to an end as representatives from 194 countries gather to elect the new director general of the World Health Organization

Delegates are gathered in Geneva for a behind-closed-doors election for one of the most powerful positions in the United Nations, after a campaign dogged by mud-slinging and spin from supporters of the British and Ethiopian candidates.

Representatives from 194 countries will elect a director general of the World Health Organization (WHO) from a shortlist of three, which includes Dr David Nabarro, whose candidature has been financially backed by the British government, Ethiopia’s former health minister Tedros Adhanom Ghebreyesus, and Pakistani medic Dr Sania Nishtar.

It is the first time a vote has been allowed for the WHO’s top post. Previously, the board selected a director general whom countries then approved, but the organisation, heavily criticised for its sluggish response to the Ebola epidemic in west Africa that killed more than 11,000 people, has been coming under fire for a lack of transparency. Critics also say it has failed to make much-needed reforms after a decade under its current head, Margaret Chan from China.

The Ethiopian candidate, Tedros, has come in for the most criticism in recent weeks. Lawrence Gostin, a public health expert at Georgetown University in Washington DC with links to the UK’s Nabarro campaign, accused him this month of covering up three outbreaks of cholera when he was health minister between 2005 and 2012. Ethiopia’s government described the disease as acute watery diarrhoea instead. A similar unwillingness for countries to admit they had Ebola is believed to be part of the reason for the WHO’s delayed response to the crisis. Tedros was reported to have said that the intervention showed the UK campaign’s “colonial mindset”.



Gostin is in the “kitchen cabinet” for Nabarro’s campaign. That position was initially revealed in emails leaked by senior development figure Mukesh Kapila, who is backing Tedros and is heavily critical of Nabarro and his working style. But Nabarro said that while Gostin was a supporter, he had no part in his decision to comment on Tedros’s suitability. “I had absolutely nothing to do with what Larry Gostin has done,” Nabarro said in an interview.

Tedros is a leading member of Ethiopia’s ruling coalition, which controls all parliamentary seats. The country is under a state of emergency after being rocked by violent protests last year, and the government is frequently accused of abuses by human rights organisations.

Nabarro has been an adviser to UN secretary generals on Ebola, bird flu, food security, nutrition and climate change, and has previously held three top jobs at the WHO. The British Foreign Office is supporting his appointment financially and politically, while the prime minister, Theresa May, praised his leadership skills and said she had “no doubt at all” that he was the best person for the job. Nabarro also has the backing of the development secretary, Priti Patel, England’s chief medical officer, Sally Davies, and the health secretary, Jeremy Hunt.

Tedros has been praised as the best person for the job by former development minister Andrew Mitchell, who said a non-insider was needed to reform the institution.

Kapila, who used to be UN humanitarian coordinator in Sudan, accused Nabarro of a campaign of dirty tricks against Tedros. Kapila worked with Nabarro at the WHO in the 1990s where he alleges the UK candidate intimidated staff to extend his influence. “I think the man is just untrustworthy at all levels because he’s capable of stabbing people in the back,” Kapila said.

Nabarro told the Guardian the claims were untrue, and that Kapila was supporting him until they had a disagreement this year. Nabarro pointed to his achievements and said he had a “calling” to become director general. “I have not come into this to try to have a negative process,” he added. “I’ve, in a way, put myself forward to lead the WHO because I worked as an international public servant for 18 years and I have been able to achieve some extraordinary results that otherwise would not have happened.”

Tedros, whose campaign is funded by Ethiopia’s government and the East African Community group of nations, is supported by the African Union. He said achieving “universal health coverage” would be his top priority at the WHO, while Nabarro said his foremost target would be to improve the way the organisation responds to emergencies.