On May 23, 2017, the World Health Assembly, the decision-making body of the World Health Organization, elected Tedros Adhanom Ghebreyesus as the new Director-General of WHO. Dr Tedros, a former Ethiopian Health Minister, is the first African leader of the international organization. WHO is distinct among international organizations for its ability to initiate both treaties and international regulations binding on party states. The most important exercise of the latter authority has been the International Health Regulations (2005), which give the WHO Director-General significant discretion and control to declare public health emergencies of international concern and to recommend measures to address those emergencies.
There has in recent times (as with other international organizations including the UN) been a tendency to take the election of a given leader as representative of broader trends and concerns in the international community. Margaret Chan, the outgoing D-G, is an infectious disease expert who handled Hong Kong’s responses to both the 1997 H5N1 influenza outbreak and the 2003 SARS epidemic. Her leadership fit with an organization that had recently adopted sweeping changes to the International Health Regulations to reflect new and emerging infectious diseases. Dr Tedros, by contrast, established himself as a malaria expert – 92% of malaria deaths occur in Africa – before leading Ethiopia’s Health Ministry while it created 3500 new health centers, increased the number of health workers by 38,000, and strengthened relationships with international funding organizations like the Bill & Melinda Gates Foundation committed to building healthcare capacity in resource-poor countries. Malaria deaths declined by 50% under his leadership, new HIV infections dropped dramatically, and infant mortality rates declined by 23%. He also served as Ethiopia’s Minister of Foreign Affairs during the Ebola emergency. He eventually served as the Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
After an Ebola episode that left the WHO subject to significant criticism that it had moved too aggressively to an agenda focused on non-communicable diseases (which affect both rich and poor countries in large numbers), neglected diseases that uniquely affected low-resource countries, and failed to focus on core capacities under the IHR, Dr Tedros’s election makes a great deal of sense.