The World Health Organisation has its first ever director-general from Africa, after the election of Dr Tedros Adhanom Ghebreyesus, the former Ethiopian health minister.

Dr Tedros, as he is known, beat the British candidate, Dr David Nabarro, after three tense rounds of voting on Tuesday. Third was Pakistan’s Dr Sania Nishtar. The decision by member states came at the World Health Assembly in Geneva after a fraught campaign.

Vote for WHO top job takes place after weeks of mud-slinging Read more

Dr Tedros was well-regarded, particularly by aid donors, for his stewardship of health in the Ethiopian government from 2005 to 2012. In the latter stages of the campaign, however, there were allegations about the human rights record and lack of transparency of the government of which he was a member. One US academic accused him of trying to hide a cholera epidemic that occurred in Ethiopia on his watch.

Dr Nabarro’s pitch for power rested on his long career at the UN, where he has played a trouble-shooting role in a number of epidemics. He promised reform of the WHO, which was strongly criticised around the world for failing to respond quickly enough to the Ebola epidemic in west Africa. Nabarro was sent in to boost the response by the UN Secretary General, then Ban Ki-moon. Later he chaired the advisory committee set up by the outgoing WHO Director General Margaret Chan, which put in place a blueprint for reform.

The campaign to lead the WHO has been long and hard fought. It began with the nominations of six candidates in September last year. The first one to fall by the wayside in January, when the WHO’s executive board selected the finalists, was the Hungarian former health minister Dr Miklós Szócska, followed swiftly by Italy’s Dr Flavia Bustreo and France’s Professor Philippe Douste-Blazy.

The candidates crisscrossed the world, seeking to win the votes of member states. For the first time, they debated together on public platforms and set out their manifesto commitments in online videos. But in spite of the greater transparency, there were allegations of dirty tricks behind the scenes.

The stakes were particularly high in the wake of the scandal that engulfed the WHO during the Ebola epidemic in west Africa. Investigations revealed that officials in the Africa regional office and also in the Geneva headquarters had not wanted to upset the governments of the three affected countries, Sierra Leone, Liberia and Guinea by declaring an epidemic. There were calls from some for the abolition of the WHO and the creation of a more effective body.

The new director-general will have not only the reform agenda but also a struggle for more financial stability to contend with. Member states have been reluctant to give the UN organisation core funding and much of its income has been tied to specific projects, giving it less flexibility.

Dr Jeremy Farrar, director of the Wellcome Trust, said: “I’m pleased to extend my congratulations to Dr Tedros on his appointment to the most important job in global health. As someone who has worked tirelessly to reform health systems in Ethiopia and across Africa, he will bring great insight and the political leadership necessary to restore trust in the WHO at a critical moment in its history.

“Tedros’s predecessor has done much to improve the WHO’s response to epidemics in the wake of the Ebola crisis of 2014/15, but there is more to be done. Tedros has the power to herald a new era in how the world prepares for and responds to epidemics, including building partnerships, strengthening public health systems, and developing new vaccines and therapies that are available to all who need them.”

