Charles Clift
Senior Consulting Fellow, Centre on Global Health Security
Even with its limited reforms, the UN health agency's new and more transparent process for choosing its director-general should improve the quality of elections and leadership.
Chatham House convened a forum for the candidates that sought to engage these non-state actors with the election debate. Photo: Chatham House.Chatham House convened a forum for the candidates that sought to engage these non-state actors with the election debate. Photo: Chatham House.

Until now the World Health Organization’s (WHO) member states elected a new director-general entirely in secret. In the last contested election in 2006, the names of the candidates were publicly announced but the shortlisting by the WHO’s 34-member executive board, and its nomination for the next director-general, were held in private.  The board’s single nomination was then endorsed by the World Health Assembly (WHA), consisting of representatives of all the WHO’s 194 member states.

This time the procedure has been substantially revised, based on the deliberations of a member state working group established in 2011. There is a new code of conduct for the election process emphasising greater transparency, including, for instance, member states ‘considering’ disclosing contributions to their candidate’s election campaign. There is a web forum where member states can ask questions of candidates. On 1-2 November a candidates’ forum was held in Geneva where each candidate made a half-hour statement before taking questions from member states for another half an hour. This was webcast to the global public.

A further innovation is that the executive board in January will shortlist three candidates based on nine agreed criteria for the qualities sought in candidates. A shortlist of five will be generated through successive ballots and up to three of those will be nominated for WHA consideration. The WHA in May will then hold successive ballots until there is a ‘clear and strong’ majority for one of them, who will take office on 1 July. Since last year all meetings of the WHO’s executive board and WHA have been webcast.

In health many non-state actors play an important role - the private sector and foundations, NGOs, health workers and the academic and research communities. Chatham House and the Graduate Institute, Geneva convened a forum for the candidates, also webcast, on 3 November that sought to engage these non-state actors with the election debate. They cannot vote for the director-general but their cooperation is essential if the WHO is to fulfil its mandate. While not part of the official WHO process, feedback from Twitter and participants compared it favourably to the preceding WHO forum as a means of assessing the qualities of candidates.

Best in class

This process does not seem that radical but has to be seen against the usual practices in UN agencies, which are often seen as an invitation to the exercise of patronage, horse-trading, or worse, because the processes mainly take place behind closed doors and are open to abuse as nominating governments strive to garner support for their candidates. The new WHO regime –by increasing transparency, laying down clear rules for conduct and providing criteria against which the candidates will be judged – seeks to give prominence to the many challenges the WHO currently faces, and through a process of interaction with candidates to allow member states to take an informed view on which candidate is best to deal with them.

This is probably unprecedented in the UN system but it cannot totally remove the possibility of undue influence being exerted by nominating member states or candidates. They may still hold bilateral meetings with other member states where promises of one kind or another, either legitimate or illegitimate, may be made. An election, after all, is a political process as much as it is a scrutiny of the candidates for a high-level executive job. And the openness only goes so far: in the WHO web forum the questions put to candidates by member states and their answers are not made public.  

Other UN agencies have a multitude of ways of electing their chief executives – but none of them bear comparison in terms of openness and transparency with the WHO’s new process. For example, the WHO’s close neighbour in Geneva, the International Labour Office, is concurrently electing a new director-general in a private sitting after a one-hour hearing.    

The new director-general will face many challenges, including restoring faith in the organization’s ability to cope with disease outbreaks following its acknowledged failures in dealing with the Ebola crisis; finding ways to persuade member states that it deserves better and more sustainable funding; adjusting to an ageing world population and the increasing prevalence of non-communicable diseases; addressing the health implications of climate change; and promoting the recently agreed sustainable development goals, including universal health coverage. A more open selection process – and the perception of legitimacy this confers – will give them an important starting push.

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