Zimbabwean President Robert Mugabe has been named a goodwill ambassador for the WHO.

The new head of the World Health Organization has named Zimbabwean President Robert Mugabe a goodwill ambassador for the agency, a move that has startled and dismayed public health experts.

The WHO director-general, Tedros Adhanom Ghebreyesus, announced the controversial appointment on Wednesday in a speech at a global conference on noncommunicable diseases in Montevideo, Uruguay.

Tedros, as he is known, described himself as “honored” that Mugabe — whose government has repressed protesters and the political opposition, has been accused of rigging elections, and has been implicated in widespread human rights violations — had agreed to serve as a goodwill ambassador on noncommunicable diseases for Africa. Those diseases include conditions like heart disease and cancer.

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News of the appointment has been slow to trickle out but has been met with disbelief.

Dr. Tom Frieden, president of the global health initiative Resolve to Save Lives, called it “indefensible.”

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“Although leadership by heads of state to stop NCDs can be very helpful … Mugabe is the wrong head of state. He has undermined civil society, led to economic collapse, and advocated for the tobacco industry; this is the opposite of what is needed from political leadership in public health,” Frieden said in an emailed statement.

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David Fidler, a professor of international health law at Indiana University, called the appointment “stunning.”

“Mugabe’s record in Zimbabwe involves so many things antithetical to the ethos of the global health community that this move by DG Tedros is unsettling,” Fidler told STAT in an email.

“The appointment is so surreal that finding a rationale seems like a fool’s errand. But there is a message, and it is a harsh one: DG Tedros is challenging conventional global health approaches and attitudes about Africa.”

A spokesman for the WHO, asked for comment, provided a link to Tedros’s speech, but said “no further details are available at this time.”

Goodwill ambassadors, according to the WHO’s website, “are well-known personalities … who commit to contribute to WHO’s efforts to raise awareness of important health problems and solutions.” Among other ambassadors is former New York Mayor Michael Bloomberg, who is also an ambassador for noncommunicable diseases.

Mugabe, who is 93 and reportedly in frail health, has led Zimbabwe since its independence from Britain in 1980, first as prime minister and for the past three decades as president. Independent international observers have criticized a series of elections that have maintained him in power.

Under Mugabe, Zimbabwe has struggled economically and has been seen as a pariah on the international stage.

Zimbabwe’s foreign minister celebrated Tedros’s announcement.

“This is a major health diplomacy coup for Zimbabwe and should be celebrated given the adverse impact of NCDs on the well-being of Zimbabweans particularly cancers, high blood pressure, cardiovascular diseases, diabetes and mental health diseases,” Foreign Minister Walter Mzembi told the country’s Daily News.

Jimmy Kolker, a longtime U.S. diplomat and former assistant secretary for global affairs at the Department of Health and Human Services, called the appointment a misstep.

Kolker, who during a 30-year diplomatic career spent 14 years in Africa — two in Zimbabwe — said many observers, including the U.S. government, are hoping Tedros, the first African to lead the WHO, will manage to engage the continent’s political leaders in the fight against health problems that are too often ignored.

But Mugabe’s track record of repressing civil society, academics, and others who are key actors in the battle against noncommunicable diseases make him unsuitable for the role, Kolker suggested.

Also troubling is the fact that Zimbabwe is Africa’s largest producer of tobacco, a sector the country is trying to expand. Kolker noted more than 50 percent of Zimbabwe’s tobacco crop is exported to China, which has an enormous tobacco consumption problem.

On noncommunicable diseases, he said, the country’s “track record is negligible. And their track record on other things they should be paying attention to is poor.”

A number of organizations that attended the Montevideo conference said in a statement Friday that they could not recognize Mugabe as a WHO goodwill ambassador.

Among the 24 organizations were the Global Alcohol Policy Alliance, the World Heart Federation, the Campaign for Tobacco Free Kids, and the nonprofit group Vital Strategies.

While noting that Mugabe was the only African head of state to attend the Montevideo conference, the groups said they “are shocked and deeply concerned to hear of this appointment, given President Mugabe’s long track record of human rights violations and undermining the dignity of human beings.”

“Given these systematic abuses and his approach to NCDs and tobacco control in the past, NCD civil society present in Montevideo believe that President Mugabe’s appointment as WHO Goodwill Ambassador for NCDs cannot be justified.”

The statement said the signatories raised their concerns with Tedros during a meeting at the conference.

“While we support WHO and Dr Tedros in their ambition to drive the NCD agenda forward, we are unable to recognize President Mugabe as a champion for NCDs.”

Tom Bollyky, a senior fellow global health, economics, and development at the Council on Foreign Relations, raised concern that the move would cost the WHO support among key backers.

“Naming Mugabe, who remains under international sanctions, to this role might help with a handful of national governments but it will certainly undermine international support for WHO and drive away many of the donors, industry, and most governments who are needed for WHO’s efforts on NCDs to succeed,” he warned.

Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law, said Mugabe’s appointment sends a troubling message. “His record on democracy and human rights has deeply concerned civil society for decades,” he said. “His appointment would signal a lack of sensitivity to human freedoms and civil liberties.”