he World Health Organization announced Wednesday that three finalists are in the running to become the next director-general of the global health agency.
Tedros Adhanom Ghebreyesus, 51, of Ethiopia, Dr. Sania Nishtar, 53, of Pakistan, and Dr. David Nabarro, 67, of Britain were selected as finalists in the competition to replace Dr. Margaret Chan, whose second term of office ends June 30. Their voting tallies were in that order, sources told STAT.
Knocked out of contention were Dr. Flavia Bustreo, 55, of Italy, a WHO assistant director-general, and France’s Dr. Philippe Douste-Blazy, 64, at one point considered a strong contender for the job.
The election of the global health agency’s eighth director-general will take place in May when its 194 member states convene in Geneva for the WHO’s annual general meeting, the World Health Assembly.
The contenders are vying to take the reins of the UN’s leading health agency, which has been buffeted by criticism in recent years, largely due to its slow response to massive outbreak of Ebola in West Africa in 2014.
Multiple post-mortem reports slammed the WHO’s handling of that crisis and called for an overhaul of the agency, particularly its emergency response capacity. That work is underway with the creation of a health emergencies program.
Dr. Jeremy Farrar, director of the Wellcome Trust, said whoever wins the role has a big job on his or her hands.
“Under the leadership of one of these candidates, the WHO needs to make the case for greater investment in public health and be fearless in calling out countries that fail to play their part,” Farrar said in a statement.
“This is a time for decisive, inspirational leadership. It’s a chance to start a new chapter in global health. We look forward to hearing more from the shortlisted candidates about how they will provide this leadership in the months remaining before the World Health Assembly.”
Originally six candidates were vying for the position, which carries a five-year term. But following rules set out for this election, the WHO’s executive board pared that list down to five on Tuesday, knocking out Dr. Miklós Szócska, 56, of Hungary.
The remaining five candidates were interviewed Wednesday behind closed doors, after which the 34-member executive board voted to winnow the list down to three.
It had been thought voting might go late into the night in Geneva, but the outcome was quick. As expected, the presence of multiple Europeans on the ballot appeared to have split theirs votes. That raises the possibility that Nabarro may benefit from the departure of Bustreo and Douste-Blazy.
Countries have been holding their cards close to their vests on this election. The US representative on the executive board, Dr. Tom Frieden — until last week the director of the Centers for Disease Control and Prevention — would not reveal for whom he’d been instructed to support.
Even if countries had declared their preferences, the voting process would have made it hard to predict the outcome.
In Wednesday’s voting, each representative voted for three people. The system may have been devised to try to ensure that the three strongest candidates made it to the final round. But observers predicted lots of strategic voting, with countries shoring up their favorites’ chances by using their second and third votes to support candidates who are perceived to be weaker than the rest.
Tedros — a former health and foreign affairs minister from Ethiopia, he is known by his first name — has the support of the African Union, potentially a bloc of 54 votes at the World Health Assembly. His is the only non-physician among the candidates; he has a PhD in community health.
Nabarro has spent much of his career in first the WHO and then the United Nations. He is currently the special adviser to the UN secretary general on sustainable development and climate change.
Nishtar is a former health minister from Pakistan with extensive experience both nationally and internationally in the civil society sector.