The former Ethiopian Minister of Health and perhaps more importantly Minister of Foreign Affairs, 2012–2016, announced his candidacy for Director-General of the World Health Organization in 2016.
If you recall those were were the years when the New Silk Road became the OBOR, One Belt One Road Strategy. The world was amazed, the Chinese were talking of a trillion dollar investment and we had not yet seen the debt effects on places like Sri Lanka and Djibouti and Kenya and Pakistan was raring to go and, well, it was 2016.
And China's Margaret Chan was going to wrap up her second five year term as D-G in 2017 and that spelled opportunity.
But first they had to change the rules and this is where we'll start the story.
From the author's mini-bio:
Laurie Garrett is a senior fellow at the Council on Foreign Relations where she directs the think tank’s global health program. Author of the acclaimed books The Coming Plague and Betrayal of Trust, Garrett is a prize-winning journalist whose recognitions include the Pulitzer, Peabody and Polk awards.And from Humanosphere,
Secret vote on WHO bodes ill for future of global health
By Laurie Garrett, special to Humanosphere
With the future of global health more uncertain than it has been in more than a decade, the first hats have been tossed into the election ring for top leadership at the World Health Organization. It is a dire time for WHO, which has seen its financial and political support erode steadily for the last decade, its credibility suffering mightily over its slow and sloppy response to the 2014 Ebola outbreak.
Everybody is talking about how best to reform the WHO, arguably the best vehicle for coordinating the ever-changing global health agenda. But a new election process using secret ballots for appointing the next director-general is hardly a promising start.
The director-general (DG) vote will take place at the World Health Assembly in May 2017 in an unprecedented, one-country-one-vote procedure conducted via secret ballots. Some are concerned this new, secretive process is unlikely to produce a leader who can restore the WHO’s position of global leadership, its respect, authority and financing.
How the leader of the World Health Organization is chosen
For the first time since it was founded in 1948, the WHO will select a new DG via a process that gives Niue, population of 1,612, an equal vote with China, population of 1.4 billion – and Lichtenstein, population 33,720, equal voting power with India, population 1.25 billion.
Procedurally, candidates have until September to formally put their names in nomination and will campaign around the world throughout the fall and winter of 2016. In mid-January, the 34 members of the WHO executive board (which includes China and some of the largest donors: the United States, United Kingdom, Japan, Sweden and France) will formally interview the candidates, selecting three finalists. The finalists will then have five undoubtedly peripatetic and frantic months to make their cases all over the world.....MUCH MORE
And then, for the first time in its history, the 194 members of the World Health Assembly will vote, by secret electronic ballot, choosing the next leader, who will formally take the helm at WHO in Geneva on July 1, 2017.
Previously, the WHO’s leaders were selected by the executive board, and merely ratified by the Assembly five months later. The 34 nations lucky enough to have seats on the executive board during an election cycle held enormous power and were subjected to spectacular appeals, including overt bribery. Under Rules 48 and 52 of the WHO procedural guidelines, the executive board members, most of whom are ministers or secretaries of health from their respective nations, would write down their votes on sealed ballots, often through several rounds of debate and voting, until a nominee drew a majority.
For decades, the WHO election process has been denounced as corrupt. Some countries have challenged it on the grounds that undue clout is given to a handful of ministers operating in secrecy. In particular, poor nations complained that the United States and other wealthy countries had too much influence over the selection of top candidates and ultimate voting. So in December 2015, the executive board issued new voting guidelines, updated from a reform process that the board initiated three years earlier.
Allegations of bribery have taken many forms over the decades and largely been the subject of whispers and winks, with no serious public scrutiny or investigation.
I personally witnessed an incident in 1991, when DG Hiroshi Nakajima’s Japanese government backers were trying to promote re-election of the much-reviled WHO director. I was then a reporter for Newsday, doing research at WHO headquarters in Geneva. Beneath the grand marble staircase that descends from the building’s mammoth entry to a lower level leading to its meeting hall was a private conference room, post office and newsstand. I was in a queue at the post office when the conference room door flung open at my back and an enormous rolled rug flew out, narrowly missing me and landing with a loud thud that couldn’t cover the sound of an African minister of health’s roaring voice.
“A rug! A rug?” the large East African woman shouted at a trio of Japanese diplomats scampering out of the chamber. “You think you can buy my vote with a rug? Do you think I am that cheap?”The enraged minister then loudly delineated a list of “promises” (a.k.a. bribes) the Japanese had reportedly made to other voting members of the executive board, including construction of a hospital, payment of school fees for the children of Switzerland-based nationals employed at WHO, promised employment in plush Geneva for friends and family of the would-be voter and a range of big construction projects. The episode was astounding not because it transpired, but that it did so in front of many witnesses, including an American journalist.
None of the former candidates for DG has publicly described bribes and demands made in the past – I wish they would. But many past nominees and their campaign staff have spoken to me off-the-record, describing health and development projects built in poorer countries as “payment” for their ministers’ votes on behalf of a candidate from a middle-income or wealthy nation. There is code language used in global health diplomatic circles to describe why seemingly outstanding candidates in past elections failed to garner executive board votes – “the country didn’t give him/her sufficient support.”
One former candidate whose government had strong anti-bribery laws told me that a voting minister approached him at a reception, suggesting that in lieu of cash or a promised major construction project in his country, the vote could be had in exchange for a vow to place the minister in a cushy position in WHO headquarters with sufficient stipends to cover posh housing, private schooling for all his children and relocation costs. A diplomat from one of WHO’s largest donors detailed a litany of such promises made, and fulfilled, by past DG candidates, resulting in appointments of over-paid, ill-qualified managers scattered among the 7,000-employee WHO Secretariat. The campaign manager for another excellent past nominee complained that the winning candidate’s country built hundreds of millions of dollars’ worth of projects across Africa to garner votes.
While I have never been provided with evidence that the most powerful donors have thrown money at candidates, there have been choices made, I have repeatedly been told, based on political issues well outside of the health arena. The United States, Germany, the United Kingdom, Japan and other major donors have pushed agendas related to such matters as North Korean nuclear deterrence, Chinese trade negotiations and European Union relations with Russia and eastern regions – weighing their votes against larger political promises.
What is likely to happen now, if the process proceeds without any regulation or reform?
To date, three candidates, representing France, Ethiopia and Pakistan, have formally announced their candidacy, and many more have been discreetly exploring potential runs and are expected to nominate. From France, two-term former Minister of Health and one-term former Foreign Minister Philippe Douste-Blazy tossed his beret in the ring. Douste-Blazy has retained serious campaign professionals in Paris and Washington, D.C. and has been making his case around the world discreetly for several months, citing his leadership of UNITAID, the innovative financing scheme that underwrites HIV, TB and malaria treatment in poor countries.
Ethiopia’s current Foreign Affairs Minister (and former Minister of Health) Tedros Adhanom Ghebreyesus is in the running, and his government recently pressured the African Union to pledge all its 54 votes to Tedros. That move may have effectively knocked four other African rumored contenders out of the race – Senegal’s Minister of Health Awa Marie Coll-Seck, Rwandan Minister of Health Agnes Binagwaho, Nelson Mandela’s widow Graca Machel (formerly of Mozambique, now South Africa and former Chair of the Board of GAVI) and Mali’s Michel Sidibé who currently heads the U.N. AIDS program. There are indications, however, that the African Union solidarity behind Tedros is eroding, as African leaders tell me they are considering Francophone alliances or Eastern African interests. Moreover, Africa’s tremendous dependence on Chinese development projects and Sino-investment renders many countries vulnerable to messaging from Beijing, should the Xi government choose to flex its diplomatic muscle on behalf of a candidate other than Tedros....
We'll have more on the money angle over the next week or so.
