By Haile Debas, MD
When I called Ethiopia to speak to my nephew on May 23, I could hear music, laughter and cheers in the background. Africa was rejoicing because, for the first time, one of its sons was elected Director-General of the World Health Organization (WHO). The celebration was particularly raucous in the bars, restaurants and nightclubs in Addis Ababa and wherever there was a concentration of Ethiopian diaspora.
In Vancouver, Canada, where I was holidaying when Dr. Tedros Adhanom Ghebreyesus’s election was announced, the Axum Ethiopian Restaurant opened its doors to Ethiopian residents of the city for a most festive dinner punctuated by frequent toasts and cheers. The Ethiopians had always believed that Dr. Tedros was the strongest candidate for the post. But they also knew that the election of the WHO Director-General was always political. One difference this time was that the ballot was secret.
Dr. Tedros, known for his research in malaria, is a biologist, infectious disease immunologist, and community health expert. He served as the Ethiopian Minister of Health and subsequently as the Minister of Foreign Affairs, thus bringing a rich experience in public health, health care administration, and international diplomacy to his new post. It is this relevant experience combined with an enviable record of solid achievement that enabled him to be elected against two formidable finalists: Dr. David Nabarro of Great Britain and Dr. Sania Nishtar, a cardiologist and former Minister of Health of Pakistan.
As Minister of Health, Dr. Tedros implemented far-reaching health reforms that transformed the Ethiopian healthcare system. He trained 40,000 “Health Extension Workers,” mostly women, and assigned two of them to every village. He also initiated the building of some 12 medical schools, greatly increasing the number of doctors. During his tenure, he garnered the trust and respect of key global health funders, who were comfortable in investing generously in the Ethiopian health care revolution. Maternal and fetal mortality and mortality from AIDS, malaria and tuberculosis were cut drastically.
A difficult path lays ahead for Dr. Tedros, made even more so by, perhaps, unrealistic expectations of the global community. A number of factors have reduced confidence in and threatened the relevance of WHO. As a membership organization, its deliberations and decisions have to be made by consensus of its 194 member states. It has been accused of burdensome bureaucracy and inefficiency. Two very important programs that should have been part of a well-functioning WHO are not: the United Nations Program on HIV/AIDS (UNAIDS) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Only 20 percent of its budget comes from member nations, while for the remaining 80 percent it is dependent on major donors such as the US, UK, EU, Norway, the Gates Foundation and others. President Trump’s budget is likely to have adverse effect on the US contribution. It is clear, therefore, that the new WHO Director-General has a steep hill to climb.
In his acceptance speech to the UN General Assembly, Dr. Tedros showed just what kind of man he is. In talking about the election and the three finalists, of which he was one, he said: “The bottom-line is the world needs all three of us,” and pledged to work with his rivals. Given the enormity of the task ahead of him, he identified a few clear priorities:
- Make universal health coverage a central priority
- Build efficient and accountable governance
- Build effective partnerships
- Always focus on the most vulnerable
He is a man of vision and integrity who believes in clear goals and outcome measurements. His track record shows that he is a great implementer. He appears to have global support and goodwill. I have every confidence he will be a successful Director-General.
Finally, despite the hard times and sagging influence the WHO might have experienced in the past, it remains an indispensable organization to coordinate global efforts to prevent, declare and control pandemics and to set international standards. All nations and the global community, in general, must support WHO so that its authority and funding is commensurate with its responsibilities.
As a fellow countryman, I say to Dr. Tedros: godspeed and may success meet you at every turn.
Haile Debas, MD is UCSF Chancellor Emeritus and the founder of UCSF Global Health Sciences.