A PHM preliminary reaction.
The former Minister of health of Ethiopia, Tedros, was elected as the new DG of the WHO, defeating David Nabarro of the UK by a massive margin. While 133 countries voted for Tedros, only 50 supported David Nabarro. The third candidate, Sani Nishtar from Pakistan, was eliminated in the first round of voting – she received 38 votes. Tedros is the first African to be elected to the post in the organisation 70 years history.
The elections this year was the first occasion when the entire Assembly voted through a secret ballot – earlier only the Executive Board would select the new DG. The massive margin for Tedros indicates that, in all probability, all the low income countries voted for him – a virtual tricontinental alliance. The massive margin had not been anticipated and possibly marks a silent vote against big power machinations in the WHO.
The WHO faces possibly its biggest crisis since it was set up in 1948. Its finances are in shambles and it faces a USD 500 million deficit this year – potentially meaning many work programs will not go forward and staff might be laid off. For years now the WHO has been dependant on donor funds (mainly from rich countries and Foundations like the BMGF) rather than through secured funding from countries. As a result, currently, 80% of WHO’s funding is tied to programs that donors cherry pick. Work programs that are vital to WHO’s mandate as a norm setting organisation remain under funded as they clash with the interests of big donors – especially rich countries of the North. Consequently WHO’s role as a leader in global health has been supplanted by other intergovernmental bodies such as the World Bank, and increasingly by big foundations like the BMGatesF. The organisations effectiveness has come under question, especially after its lack lustre role in containing the Ebola epidemic of 2014 in West Africa.
These are the challenges that Tedros faces after his election. While it appears that the llw income countries have voted against the domination of big powers, often through back room manoeuvres, it is yet to be seen if this unity will be maintained when the WHO debates different issues where the rich and poor countries are often arrayed against each other.