By Laura Entis
May 23, 2017

Greetings. This is Laura Entis, filling in for Sy (who is on a well-deserved tropical vacation.)

This afternoon, World Health Organization members from 194 nations will vote to elect the agency’s next leader, putting an end to what has been a high-profile, political, and at times, ugly campaign. The race, which is believed to be a toss-up, is between Tedros Adhanom Ghebreyesus of Ethiopia, David Nabarro of the United Kingdom, and Sania Nishtar of Pakistan. Later today, each will briefly address the assembly, gathered in Geneva, before ballots are cast.

The winner will shape the organization’s efforts to improve global health, an enormous challenge. Issues on the table include: preparing for health emergencies (from the next Zika and Ebola to a potential globe-spanning influenza outbreak), antimicrobial resistance, access to medicines and vaccines, adolescent health, chemicals management, and climate change. And that’s far from an exhaustive list.

He or she will also take the reins of a cash-strapped agency embroiled in controversy. Earlier this week, the Associated Press placed the WHO’s annual travel budget at around $200 million (a sum that includes business class tickets and five-star hotel bookings), which is more than the agency spends on combatting AIDS, hepatitis, malaria, and tuberculosis, combined.

The position is an hugely important one, and the spotlight can be (appropriately) glaring.

Here are the candidates:

Tedros Adhanom Ghebreyesus of Ethiopia. While the race is expected to be close, Tedros might have an edge as he’s unanimously backed by the African Union (which will cast 54 votes). The former health minister of Ethiopia is also backed by ex-CDC director Tom Frieden.

Tedros’ campaign hasn’t been without controversy, however. Earlier this month, the New York Times published an article detailing accusations that, as Ethiopia’s health minister, Tedros covered up multiple cholera outbreaks by labeling them “acute watery diarrhea.” The charges reportedly originated from backers of David Nabarro—who also happens to be running for the director-general position. Tedros lashed back at these accusations, telling the Times that Nabarro’s supporters have a “typical colonial mind-set aimed at winning at any cost and discrediting a candidate from a developing country.” (Frieden has since come to Tedros’ defense.)

David Nabarro of the United Kingdom. Despite the controversy above, Nabarro is a well-respected and long-time public health specialist, who is closely associated with the UN, where he has worked to address multiple crises, including the 2014-16 Ebola outbreak in West Africa and the ever-present threat of influenza.

Sania Nishtar of Pakistan. A cardiologist and specialist in noncommunicable diseases, Nishtar is also the founder of Heartfile, a non-profit NGO that works to bring sophisticated cardiovascular treatment to third-world countries. She has promised to run only for a single term, according to the Chicago Tribune, as a precaution against politicking. Considered a long-shot—her candidacy is opposed by China and India—she could prove the upset victor if neither of her opponents is able to secure enough votes to win in a single round.

More news below.

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