WHO Appoints First African Director-General: Public Health Watch Report

A day after a scathing report by the Associated Press (AP) brought the questionable travel expenditures to light, the World Health Organization (WHO) appointed its first African Director-General—Tedros Adhanom Ghebreyesus, PhD, during its general assembly in Geneva on May 23, 2017.

Interestingly, Dr. Ghebreyesus, a former health minister in his native Ethiopia, is not a medical doctor (another first); rather, he holds a PhD in community health, which may be an indication of WHO’s future priorities. According to a report on his election to the post published online by the National Public Radio (NPR), Dr. Ghebreyesus oversaw the creation of more than 16,000 health posts and 3,000 health centers in Ethiopia during his time as a health minister. These initiatives certainly fit in line with WHO’s stated objectives of improving access to care in the developing world.

However, NPR also noted that Dr. Ghebreyesus worked under an authoritarian regime in Ethiopia, which has been accused of taking steps to cover up an ongoing cholera outbreak in the East African nation. Dr. Ghebreyesus has been implicated in these alleged cover-ups in some media reports.

Perhaps ironically, in his final campaign speech for the position of Director-General, according to NPR, Dr. Ghebreyesus is reported to have said, “WHO must evolve to be more transparent, responsive, effectively managed, [and] adequately resourced.”

Indeed, the first African to take on the top leadership role at WHO does so at a time when the international organization is at a bit of a crossroads. In addition to the fresh controversy surrounding travel costs—the AP report suggests that the organization spends significantly more on travel for its personnel than it does on programs to prevent and/or treat diseases such as HIV/AIDS and malaria—the new Director-General needs to handle questions regarding WHO’s overall competence and efficiency. Dr. Ghebreyesus’ predecessor, Margaret Chan, MD, famously admitted to Time magazine that WHO’s response to the Ebola crisis in West Africa in 2014 was insufficient, echoing the sentiments of many global observers. Furthermore, an analysis published by US News & World Report in the aftermath of Dr. Ghebreyesus’ appointment hints that the organization is hindered by bureaucracy and lack of funding—the latter of which is particularly troubling given the $200 million it spends annually on travel (including luxury hotel rooms for staffers), as noted in the AP report.

That same US News & World Report analysis also quoted several US-based public health leaders as citing WHO for a lack of transparency. This potentially makes Dr. Gherbreyesus’ rise to influence within the organization all the more troubling, given the accusations surrounding the Ethiopian government’s handling of the country’s cholera crisis during his time in the health ministry. In addition, the organization was at the center of a political controversy during the general assembly in which Dr. Gherbreyesus was elected because China was reportedly able to block Taiwan from attending, according to ABC News.

Still, a commentary published by Black Star News (BSN)—a publication focusing on issues facing Africa and the African-American community—suggests that WHO “[got] the right man for the job” and lauds his success in lowering HIV infection rates in Ethiopia and reducing maternal and infant mortality in the country. The commentary quotes Tom Frieden, MD, MPH, former director of the Centers for Disease Control and Prevention (CDC) as follows: “[Dr. Gherbreyesus] is an excellent choice to lead WHO. He succeeded in Ethiopia, making remarkable health progress by rapidly reforming sclerotic bureaucracy and implementing effective community based services.” Dr. Frieden’s comments echo endorsements from peer-reviewed journals, such as The Lancet.

Perhaps best of all, though, given the recent news surrounding WHO, the new Director-General himself has promised to “innovate and measure our progress by clearly defined outcomes.”

As campaign promises go, it’s pretty vague. However, if fulfilled, it could bring WHO back to where it needs to be: leading global efforts to improve health and healthcare all over the world.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.