Hunt for new WHO head heats up

The process of appointing a new director general to the World Health Organization after the death of Lee Jong-Wook is in full swing, with three high-profile candidates already in the running, and at least one other being discussed.

Finland has nominated Pekka Puska, director general of its National Public Health Institute, for the director general's post, The Scientist learned yesterday (July 24). From 2001 to 2003, Puska was director of noncommunicable disease prevention and health promotion at WHO.

He joins a growing list of candidates. Last Monday (July 17), it emerged that Mexico had proposed its health minister, Julio Frenk, for the job. Frenk, a 52-year-old former academic with a PhD in health care organization and psychology, had previously been WHO's executive director, evidence and information for policy.

In early June, WHO's regional director for the Western Pacific, Shigeru Omi, also became a candidate for the top job. "I can confirm that Dr. Omi has taken a leave of absence," WHO spokeswoman Christine McNab told The Scientist. This is in accordance with the organization's rules, and "any WHO staff member who is a candidate would do the same," she said via Email.

WHO plans to appoint the new director general on November 9, succeeding Lee, who died suddenly on May 22 after surgery to remove a blood clot in his brain.

Member nations of WHO have until September 5 to make their nominations, which the organization's 34-member executive board will gradually reduce to a single nomination during a meeting from November 6-8.

A special one-day session of the World Health Assembly is expected to ratify that nomination on November 9, and decide the details of when the new leader takes up the contract. Until then, Anders Nordstr￶m will continue as acting director-general.

There are plenty of possible contenders out there, said Gill Walt, professor of international health policy at the London School of Hygiene and Tropical Medicine. "I get the feeling that there are quite a few credible candidates," she told The Scientist.

But the process of deciding who gets the job is steeped in politics, particularly jostling among countries from the WHO's six different global regions, seasoned WHO-watchers told The Scientist. "It's always a political process, and bound by who supports whom," Walt said. "There are always machinations."

"Partly it's the regions saying that we haven't had a Latino or South Asian director general, for example," said Mohga Kamal Smith from Oxfam. "And behind the scenes there's also US pressure to get somebody they want, too."

In fact, there are numerous political factors at play, said Derek Yach, director of the Rockefeller Foundation's program on global health, and a former executive director at WHO. "Few people are na￯ve enough to believe that [it's only about] the best person with the soundest policies."

He agreed that the support of the US is an important factor for any candidate. "The US is looking for people who have a good strong track record...and a few hot-button issues, like reproductive health and intellectual property."

But there are other countries who have strong influences on the proceedings, including the European Union, developing nations like India and Brazil, and Nordic countries, Yach told The Scientist.

African nations may also feel the time has come for a director general from that continent. One possible candidate mentioned by several of those contacted by The Scientist is Anarfi Asamoa-Baah, an assistant director-general of WHO from Ghana.

Considering the accelerated pace of this election process, it's unlike there will be many contenders, Yach said. "I think if they get up to five it'll be very interesting. People know the composition of the board, so they know how they are going to get the 16 or 17 votes" out of 34, needed for a majority.

Stephen Pincock
spincock@the-scientist.com

Links within this article

Pekka Puska
http://www.ktl.fi/portal/english/osiot/ktl/organization/director_general/

Julio Frenk
http://www.presidencia.gob.mx/gabinete/index.php?contenido=15038&gabinete=desarrollo

Shigeru Omi
http://www.wpro.who.int/regional_director/RD.htm

Candidacy of Dr. Shigeru Omi, WHO Regional Director for the Western Pacific for the Post of Director-General of the World Health Organization (WHO)
http://www.mofa.go.jp/announce/announce/2006/6/0605.html

Consideration of the acceleration of the procedure to elect the next director general of the World Health Organization, May 30, 2006.
http://www.who.int/gb/ebwha/pdf_files/EB118/B118_R2-en.pdf

S. Pincock, "WHO ponders future without Lee," The Scientist, June 2, 2006.
http://www.the-scientist.com/news/display/23487/

I. Ganguli, "WHO head dies," The Scientist, May 23, 2006.
http://www.the-scientist.com/news/display/23475/

Gill Walt
http://www.lshtm.ac.uk/hpu/staff/gwalt.html

WHO regional offices
http://www.who.int/about/regions/en/

Anarfi Asamoa-Baah
http://www.who.int/dg/adg/asamoa_baah/en/index.html