The World Health Organization has announced the candidates for its top post of director general, one of the most powerful positions in international public health, after the death of the previous incumbent, Lee Jong-wook, in May (BMJ 2006;332: 1234).
Figure 1.
Candidates for the post of director general at WHO include (clockwise from top left): Dr Kazem Behbehani, from Kuwait; Dr Margaret Chan, China; Dr Alfredo Palacio González, Ecuador; Dr Bernard Kouchner, France; Dr Shigeru Omi, Japan; Dr Pascoal Manuel Mocumbi, Mozambique; Mr David Gunnarsson, Iceland; and Dr Julio Frenk, Mexico
Credit: P VIROT/WHO
Credit: P VIROT/WHO
Credit: P VIROT/WHO
Credit: P VIROT/WHO
Credit: P VIROT/WHO
Credit: P VIROT/WHO
Credit: TAAMALLAH MEHDI/ABACA/EMPICS
Credit: P VIROT/WHO
The 13 are a disparate group, and the timing of the election is unusual, because of Dr Lee's sudden death. The leading contenders include Julio Frenk, Mexico's minister of health, and two from Asian countries, Margaret Chan of China, whose reputation rests on her handling of the epidemics of severe acute respiratory syndrome and avian flu, and Shigeru Omi, who runs WHO's Western Pacific regional office.
The situation this year is complicated by a number of geopolitical factors. One is the understanding among members of the United Nations Security Council that the next UN secretary general will be Asian, making it unlikely that an Asian will also hold sway in the WHO race. On the other hand some countries are arguing that because Dr Lee, who was South Korean, was not able to finish the five year term, the Asian member states are somehow owed the post. Furthermore, the unspoken agreement that Security Council member states do not propose candidates for heads of UN agencies has been abrogated in this contest—twice.
Not only has China put forward Dr Chan, but France has nominated Bernard Kouchner, founder of Médecins Sans Frontières. France has also put forward a strong candidate for the directorship of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, Michel Kazatchkine.
Several candidates are WHO staff members or have previously run for director general—factors that make them known to the organisation's 192 member countries (current staff must take leave while campaigning for the post). Because of the timing of the election the campaign is short, so candidates who are familiar to WHO members will have an advantage.
Dr Frenk of Mexico, Karam Karam, a former Lebanese minister of health, and Pascoal Mocumbi, former prime minister of Mozambique, all ran in 2003. Although many people feel it is time for an African director general, the African states are said not to be unified in their support of Dr Mocumbi.
Current or former WHO officials in the running, in addition to Dr Chan, Dr Frenk, and Dr Omi, include Tomris Turmen of Turkey, executive director of WHO's division of family and community health, who is thought to be a strong candidate; Kazem Behbehani of Kuwait, a specialist in AIDS and infectious disease; and Pekka Puska, director general of Finland's National Public Health Institute.
Two candidates with strong qualifications, Professor Puska and David Gunnarsson, head of Iceland's health and social security ministry (and a past member of WHO's executive board) are from Nordic countries, which have twice before in WHO's history held the director general position.
Several candidates may fall victim to splintered regional alliances: Alfredo Palacio González, president of Ecuador, must battle with Dr Frenk for Latin America's allegiance. Similarly Dr Chan and Dr Omi will divide the Asian constituency. Nay Htun of Myanmar is another Asian, but his candidacy is hindered by the fact that his country is at present considered a pariah nation by the international community.
Three of the candidates are women, in an organisation that has only once before had a female chief, Gro Harlem Bruntland, who held the post from 1998 to 2003. In addition to Dr Chan and Dr Turmen, Spain's minister of health, Elena Salgado Mendez, former chairwoman of WHO's governing body, the World Health Assembly, is in the running.
The 34 members of WHO's executive board will meet at the organisation's Geneva headquarters on 6-8 November to winnow the contenders to a shortlist of five. A final selection will be made on 9 November, and that name will be presented to the World Health Assembly for ratification.