Science1 publisher2 min readPublished
At least five candidates seek to lead a WHO that lost its largest funder
At least five candidates, three of them WHO officials, are vying to succeed Tedros at an agency that has lost its largest funder, the US. The winner takes office in August 2027 and must decide whether to court Washington back.
The Scientist · Science desk
What happened
- The WHO's nomination period for director-general closed with five candidates listed, the last to enter being Maria Neira, a WHO division director nominated by Spain.
- The race follows the withdrawal of the United States, the WHO's largest funder, and a broader contraction in international spending on global health.
- Tedros Adhanom Ghebreyesus's successor is scheduled to take office on Aug. 16, 2027.
- The WHO will not publish an official candidate list until its regional divisions finish their fall meetings in early November, and further names could in theory still appear.
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Why it matters
- decision Member states choosing a director-general are also choosing who decides whether the WHO spends its next years courting a US return or planning around the gap.
- constraint A strategy built on US re-engagement leaves the broader contraction in international global health spending unaddressed, so the winner needs a funding plan that does not hinge on Washington alone.
- constraint If regions do not vote as blocs, no candidate can count on a home-region base, and the winner will need votes from several regions.
"I think this DG election is the most consequential DG election in modern WHO history," said Lawrence Gostin, director of Georgetown University's World Health Organization Collaborating Center on Public Health Law and Human Rights. "Because the organization is more vulnerable, in a more perilous position, than it's been at any time in the last 25 years that I can recall." [6]
STAT puts the US question, whether or how to entice Washington back or at least into more frequent and collaborative work with the agency, among "many significant issues" awaiting the winner [5]. Three of the five candidates hold WHO posts now. The other two have served as national health ministers [13].
Hans Kluge has directed the WHO's Europe region since early 2020 and led it through Covid-19 and the emergence of mpox in Europe [10]. Hanan Balkhy has run the Eastern Mediterranean region since early 2024, after a stint at headquarters as assistant director-general for antimicrobial resistance [8]. Maria Neira has worked at the WHO for 21 years and earlier served in Spain as vice minister of health and consumer affairs [11].
Of the two from outside the agency, Hanan Al-Kuwari was Qatar's public health minister from 2016 to 2024 and has sat on the WHO's Executive Board [7]. Budi Gunadi Sadikin, Indonesia's health minister since late 2020, built his career mainly in banking and holds a bachelor's degree in engineering physics [12]. He would be the first director-general with neither a medical degree nor an advanced degree [12].
The thing these resumes don't tell you is where any of the five stands on the United States. The nearest link in the record is biographical. Balkhy, a pediatrician who trained in Saudi Arabia and the US [8], was born in the US and holds dual citizenship, a fact STAT reports she does not emphasize [9]. "I'm Saudi," she told STAT in April [9].
Thomas Bollyky, director of the Council on Foreign Relations' global health program, said he was not surprised by the number of candidates but had expected a more geographically diverse field [14]. No director-general has come from the Eastern Mediterranean region, and before Tedros none had come from Africa [15]. STAT reported that the experts it spoke with thought that history unlikely to be a factor [15]. Suerie Moon, director of the global health center at the Geneva Graduate Institute, said that with two candidates from each of two regions, votes within at least one of those regions are likely to split [16]. "I doubt most regions will vote as unified blocks, in any case," she said [17].
What to watch
- Any public statement by one of the five on whether to pursue US re-engagement or plan the agency's finances around its absence.
- Whether US engagement with the WHO changes in any form before the new director-general takes office.