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First African WHO chief tamed malaria

Ethiopia’s Tedros Adhanom after his election to lead the WHO. PHOTO AFP
Ethiopia’s Tedros Adhanom after his election to lead the WHO. PHOTO AFP  

“I am often asked what I honestly think of the path that my life has taken. When I was seven years old, my younger brother died from one of the many child killers in Africa. It could easily have been me. It was just pure luck that I survived. Pure luck.”

That was the introductory remark that Ethiopia’s Tedros Adhanom Ghebreyesus, the new director-general of the World Health Organisation (WHO), made while delivering a final appeal to delegates before the vote on Tuesday.

The father of five who prefers to go by his first name said his humble background taught him to refuse “to accept that people should die because they are poor.” Therefore, if elected, he said, he would work “tirelessly to fulfil WHO’s promise of universal health care,” among other pledges.

“There is real value in electing a leader who has worked in one of the toughest environments,” Tedros said, adding that he could “bring an angle the world has never seen before.” It is probably this final emotional appeal to the WHO coupled with an impressive track record that saw Dr Tedros win with a landslide vote of 133.

As Ethiopia’s former Minister of Health the 52-year old malaria expert spearheaded major reforms to his country’s health system, including a massive expansion of primary health care infrastructure and a dramatic increase in health human resource.

He oversaw a rapid increase in the training of doctors, shifted the responsibility for key interventions such as caesarean sections to mid-level workers, and the introduction of community-level workers (health extension agents).

But he is best known for having drastically cut deaths from malaria, Aids, TB and neonatal problems.

His election to head the United Nations international health agency opened a chapter of firsts.

Early this week (Tuesday) Dr Tedros did not only become the first African to be voted director general of the WHO in its 70-year history but is also the first non-medical doctor tapped to lead an influential agency that helps set health priorities worldwide.

In a five-hour vote, health ministers and other senior envoys to WHO’s annual World Health Assembly in Geneva Switzerland elected Tedros over British candidate  and UN veteran David Nabarro, after two rounds of voting by winning 133 votes against Nabarro’s 50.

In his victory speech, Tedros noted it is a “challenging time for global health” but added that his priority was to achieve universal health coverage.

Although the voting took place in a closed-door session in which the health ministers of 186 countries cast their ballots in secret, this was the first time the election was being conducted by the WHO under more open and democratic rules.

Previously the organisation’s executive board selected the DG of the UN health agency’s 194 member states, 185 were eligible to cast ballots. Nine others were either in arrears on their dues or were not represented at the gathering.

“This election has been unprecedented in that it brought transparency to the organisation, and even greater legitimacy to the director-general,” Tedros said. “I will exercise this legitimacy to bring the change and reform we need for this noble organisation to reclaim its trust from member States and from every citizen of the world.”

For many, this election has been a cause for celebration.

However, the race, which began in 2015, turned bitter in the weeks running up to elections when an adviser to Dr Nabarro accused Tedros of having covered up repeated outbreaks of cholera in Ethiopia, which may have delayed the international response and, more recently, the use of a cholera vaccine there.

He was also accused of complicity in his country’s dismal human rights record, which includes massacring of protesters and jailing and torturing journalists and political opponents.

But away from the controversies, Tedros also takes the helm at a critical time, when the legitimacy of the agency is at stake. The WHO is experiencing its greatest crisis since its founding in 1948.

The agency has stumbled in recent years, most notably in its fumbling response to the 2014 Ebola outbreak in West Africa, making all three candidates vow to overhaul the agency to restore credibility.

Another big challenge is strengthening health systems particularly in developing regions like Africa and Asia, which face drastic resource shortages.

The organisation is also facing a financial crisis with a Sh46 billion (US$ 456 million) deficit this year, meaning that there will have to be major trimming of some programmes, with some even risking closure. Retrenchments are also on the cards.

For the past few decades the international health agency has increasingly relied on donor funds because member states, particularly richer ones, have been reducing their contributions. An estimated 80 per cent of the organisation’s funding is now from sources other than member states, with donors such as the Bill and Melinda Gates Foundation making major contributions.

In his resume, Tedros notes that he holds a doctorate in community health and a master of science in immunology of infectious diseases. He has been recognised for his study of malaria in Ethiopia, and in 2011 became the first non-American to receive the Jimmy and Rosalynn Carter Humanitarian Award.

Tedros will replace Dr Margaret Chan after 10 years at the helm end of June as the eighth head.

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