The long wait is over: Tedros Adhanom Ghebreyesus has been elected as the World Health Organization’s new director-general by the World Health Assembly.
The former minister of health of Ethiopia beat two other finalists in the race — the U.K.’s David Nabarro and Pakistan’s Sania Nishtar — with a final vote of 133 out of a possible 186, according to an unofficial tally leaked to the press. The WHO, as was the case during the elimination round in January, did not release the final breakdown of votes.
The vote in Geneva on Tuesday took almost five hours, including pre-vote statements from each of the finalists.
Voting took place in three rounds. Based on unofficial results seen by Devex, Tedros won the first round of voting with 95 votes, while Nabarro came in second with 52 votes. In accordance with the electoral rules, Nishtar was eliminated after finishing in third place with 38 votes.
Despite a huge lead, Tedros would have needed two-thirds of the vote to be considered as having a “clear and strong majority,” avoiding further rounds of voting.
He took 121 votes in the second round, against Nabarro’s 62, sources told Devex. The final round saw Tedros secure 133 votes, and Nabarro 50.
The election concludes a year-long process that was unprecedented in the history of the U.N. health agency — the first time all member states have been given the opportunity to choose the next WHO leader.
However, the ballots were cast in secret, raising eyebrows among some who had been looking forward to a more transparent process.
The election is just the start of a long journey for Tedros, who will need to navigate his way in a challenging fiscal environment for the WHO and the wider global health community, with funding cuts looming among key donors such as the U.S.
He will also bear the task of making the case for the WHO’s relevance, an issue outgoing director-general Margaret Chan underscored in her opening address — and her last speech — at the World Health Assembly, pointing to the agency’s achievements.
Tedros had been a frontrunner throughout the campaign. He emerged on top in the two elimination rounds that took place in January and received strong support from high-profile individuals, such as billionaire philanthropist Tony Elumelu; Thomas Frieden, the former director of the U.S. Centers for Disease Control and Prevention; and the late doctor-statistician Hans Rosling.
However, his campaign was tarnished by concerns about human rights, due to his association with the Ethiopian government, and allegations that he had been involved in efforts to cover up disease outbreaks such as cholera during his time as health minister.
In a speech given before the election process began on Tuesday afternoon, Tedros said he was “astonished” at the direction his life had taken — from a childhood in Ethiopia, during which his younger brother died of disease, to standing among the final candidates for the leadership of the WHO.
Praise floods in for Ethiopia's Tedros following his election to the post of new director-general of the World Health Organization, as the global development community eyes his plans to pivot the organization and rebuild its reputation.
He made five promises, if he were to be elected as director-general: He would work “tirelessly” to achieve universal health coverage; ensure a robust response to emergencies; strengthen the frontlines of health through country ownership; transform the WHO into a world-class workforce; and place “accountability, transparency and continuous improvement” at its heart.
“Universal health coverage represents our most basic common values and aspirations,” he said. “It’s about delivering health and hope to our people and investing in the future of generations.”
Without building country capacities, he said “we’ll always be one step behind in the response.”
He also talked about an array of cross-cutting issues — from ensuring access to reproductive health services to tackling gender-based violence and the effects of climate change — and made a commitment to gender parity and staff diversity at WHO.
He argued there would be real value for member states in electing a leader who has worked in tough environments and has political leadership experience.
Toward the end of his speech, he pledged to work hard to listen to member states. “I will get up every day determined to make a difference,” he said.