What kind of leader does WHO need next?

The rumor mill around potential candidates to be the next World Health Organization director-general, or DG, is already buzzing. Names being floated include WHO and United Nations insiders, global health leaders, and country ministry of health officials. The election will take place in 2027, but contenders are expected to start emerging later this year, ahead of the World Health Assembly. As in the 2017 race, every member state that is up to date with its dues will get the chance to vote for the next WHO chief. In previous elections, the candidate was selected by the executive board and confirmed by the WHA. But whoever takes up the mantle at the agency will have their work cut out for them. Funding constraints have become a constant fixture of WHO’s DNA. The agency’s purpose and scope of work have consistently been questioned. COVID-19, misinformation and disinformation amplified by social media, and current geopolitics have also compounded the challenges facing the current WHO leader — and whoever succeeds him. The transition also takes place amid calls for U.N. reform and rethinking the global health architecture. Some experts said WHO is currently facing a crisis of credibility. Science — the very foundation of its work — is under attack. And for the first time in the agency’s history, it will be operating without its biggest funder — the United States. WHO needs “a unicorn” with the political skill to navigate the current international politics while setting a clear vision and agenda for the agency, they said. "The DG can influence what happens at the [World Health] Assembly, what happens at the executive board, to a great extent, and can exert discipline over the organization to try and make sure that it is not spreading itself too thin and it is not taking on responsibilities that it really can't afford to or is not going to be good at fulfilling," William “Bill” Steiger, the new CEO of Malaria No More and former chief of staff at USAID during U.S. President Donald Trump’s first administration, told Devex. “However, it is true that the DG is going to have to listen to the member states and … can’t go it alone. So it is that very delicate balance between assertive vision and leadership and negotiation with the member states that a really good DG knows how to do, and those who are very successful manage to strike that balance.” A ‘master politician’ When Tedros Adhanom Ghebreyesus won the WHO elections in 2017, he made a few historical firsts — the first African to lead the agency, the first to be elected through a vote open to the entire World Health Assembly, and the first WHO head that’s a public health official but not a licensed medical doctor. His political background — having served as Ethiopia’s minister of health and then minister of foreign affairs prior to taking over WHO — was seen as a benefit to the agency. During his term, Tedros has raised the profile of the agency. He has become a prominent figure in global health, and a highly sought-after speaker in health events. WHO insiders said it is helpful that Tedros can speak directly with leaders and persuade them to act on certain health issues and events. One former WHO official who spoke on condition of anonymity said Tedros was able to persuade the Tanzanian president to pay attention to the Marburg outbreak in the country in early 2025. But under Tedros’ leadership, WHO also faced criticisms from its member states. The Trump administration accused him of praising China’s COVID-19 response despite its delays confirming human-to-human transmission, and said WHO failed to adopt much-needed reforms. Outside of COVID-19, Israel has also accused the agency of bias, and the Ethiopian government criticized him over comments he made on the Tigray crisis. “There has been a perception even within WHO that our leadership in Geneva has not always been adept politically, and has actually misstepped on several occasions … I mean, not just with COVID-19, but the whole Gaza situation … was also a political minefield,” said a current WHO official who also spoke on condition of anonymity. Health leaders said the next WHO leader will need the political acumen to navigate the current landscape and set the agenda for the agency, while continuing to ensure buy-in from member states. And for some of them, that’s even more important than the director-general being a physician or having a strong technical background. But the next DG should surround themselves with people with the right technical expertise — although easier said than done when dealmaking is often what helps clinch an election. The DG gets to appoint assistant directors-general, but these are often seen as political appointments, the former WHO official said. “But the directors are supposed to be people with technical expertise.” The trust builder The next leader also needs to be a good communicator who can stand up to misinformation and disinformation. “If you’re a normative agency, you’re trying to set guidance and anchor your guidance in global scientific consensus. You have to be able to communicate that and communicate why people that oppose it or discredit it are wrong,” Elisha Dunn-Georgiou, president and CEO of the Global Health Council, a global health membership organization. But the next DG needs to also build back trust in the organization, and boost the agency’s credibility — one of its biggest challenges, according to Dr. Ahmed Ouma Ogwell, CEO of VillageReach, a nonprofit that works to improve access to health care. “The projection that WHO is meeting its mandate consistently may be their biggest single problem,” he said. He gave the example of mpox vaccines. Even though many countries in Africa are under great threat of mpox outbreaks, stockpiles of the vaccines are kept largely by high-income countries such as the United States. In 2024, WHO faced criticism for delays in approving the shots to help stem the mpox outbreak in the continent, leaving African countries without access to the vaccines for weeks and relying on donations. “It will be WHO’s role to … make sure that those stockpiles are being directed to where they are needed the most,” Ogwell said. WHO also continues to face criticism for its COVID-19 response, nearly three years after declaring its emergency phase over. When the U.S. announced its withdrawal from WHO, it said it was due to the agency’s “mishandling” of the COVID-19 response, including WHO’s failure to acknowledge early on that the virus can spread through the air. WHO insiders said COVID-19 has become heavily politicized, and WHO has become a convenient scapegoat for countries. But the next director-general can help repair its relationship with countries such as the United States. “A lot of what has driven the United States out of the organization has been a lack of trust in its performance, in its leadership, in its integrity,” Steiger said. “The next DG has an opportunity to repair that relationship, but has to recognize, from a sense of humility, that the organization has flaws and that the DG can go a long way towards fixing many of those flaws.” He hopes that candidates would include as part of their platform plans to try and bring the United States back into WHO through a set of reform proposals enticing enough for the U.S. administration. “We’ll have to see if that’s possible. But I think it certainly ought to be part of their campaign platforms,” he added. “It would be a mistake for the next DG to not try.” A visionary WHO also needs a visionary. Most health experts Devex spoke to agreed that the next leader needs to clarify the agency’s role and responsibilities — and identify activities where other agencies or organizations are better suited to lead. Many of them recognized the importance of WHO’s role in pandemic preparedness and response, and its work providing standards and technical guidance that help ensure good practices for how medicines are produced, that medicines and vaccines are safe and effective to use, and how treatment is provided for different diseases. But WHO should cede or reduce its work on procurement, local manufacturing, the prequalifying of medical products, and discussions around intellectual property — a highly charged topic between member states at WHO — to reduce duplication, they said. Organizations such as UNICEF and The Global Fund to Fight AIDS, Tuberculosis and Malaria, for example, have already established expertise and systems in the area of procurement. The World Trade Organization and the World Intellectual Property Organization are well versed on intellectual property discussions and rights — although some experts believe WHO also has a key role in leading discussions on the impact of IP on access to medicines. WHO can provide guidance on what medical products can be best manufactured locally or regionally, but leave the responsibility of boosting local manufacturing to other experts. When it comes to prequalification meanwhile, experts said WHO can rely on established regulatory authorities and focus its energies on prequalifying products that have not received approval or may not be a priority for these regulatory bodies. This can help the organization save time and energy, and avoid delays in the introduction of new innovations in countries. International agencies and organizations such as UNICEF, The Global Fund, and Gavi, the Vaccine Alliance require WHO prequalification for medical products they procure or fund. “In a world of constrained financial resources, and where mandate is being questioned, it’s absolutely critical to strip back right to the core mandate of what WHO is all about, and then to cede responsibility and the operational implementation to other bodies who are either tasked with that or have the ability to do it,” David Reddy, director-general of the International Federation of Pharmaceutical Manufacturers and Associations, told Devex. Health leaders recognize this will require intensive dialogue with different organizations and WHO’s governing bodies, which could be a challenge given that WHO’s mandate expanded over the years because of resolutions passed by its own member states. But it will tremendously help to give clarity to the next WHO leader where and how to allocate the agency’s limited resources. “We are splitting too many shillings and dollars instead of optimizing what they can … do,” Ogwell said. By identifying WHO’s focus, the next leader then can identify what kind of structure and staffing the agency needs to make it fit for purpose, instead of scrambling to restructure in the face of funding cuts. The former WHO official said Tedros failed to preempt the shrinking of the agency’s funding in 2025 with the U.S. withdrawal. The official said WHO should have started slowing down on hiring as it was clear that staff costs were driving the organization’s budget, but a hiring freeze was only instituted after the U.S. announced its withdrawal in January 2025. Now, even after restructuring, WHO still faces a funding gap of $660 million for its work between 2026 and 2027, and can suffer further staff reductions if it fails to raise the full amount needed amid a difficult fundraising environment. Health leaders also hope the next WHO chief can set a vision for how to better engage civil society and the private sector. Reddy noted concerns that the role the private sector can play is often minimized in WHO discussions. “I think a lot of energy goes into trying to minimize the influence that industry can have, whereas the effort should be, within an appropriate framework, how to maximize the impact we can jointly have,” he said. Dunn-Georgiou, meanwhile, said that while the WHO Civil Society Commission was established during Tedros’ term to make WHO more inclusive of civil society, it was more of a “pet project” by the current WHO chief rather than a member-state-approved process. “Whoever comes in can sort of just disband that, and then you’re back to the same sort of nonstate actor process, with some member states not wanting nonstate actors [while] there are others welcoming it,” she said. Insider or outsider Some experts see the need for WHO to further reform, while former officials think it would be useful for the next director-general to stabilize the organization. But whether that requires an insider who already knows how the institution works or an outsider is up for debate. The current WHO official said the global health institution needs someone who is already acutely aware of how it works and its failures. “You cannot change an institution like WHO or any U.N. entity, for that matter … without knowing how the system works. Otherwise, you will be swallowed alive,” the official said. But others believe there are pros and cons to both types of candidates. An internal candidate has institutional knowledge and may be able to easily identify what needs to change, or be improved. But they may also have difficulties in making changes. Meanwhile, external candidates are often viewed as changemakers — someone who can shake things up within the organization. But they lack the institutional memory of the organization, Dunn-Georgiou said. “It’s [an] incredibly difficult job to be the director general of WHO … I mean, think about all the stakeholders that have to be satisfied in that role — member states, private sector, civil society, WHO staff itself … country health ministries,” she said. “You really have got to have a very good diplomatic leadership style, as well as a willingness to make hard decisions and be held accountable for those without losing anybody. So it’s a little bit of a unicorn kind of a position,” she added.