Will WHO election favor the weak?

With eight weeks to go until the World Health Organization appoints its new director general, there are 13 candidates vying for the most prominent position in global health. But some observers worry that the election process to select the successor to Lee Jong-Wook could favor the weaker candidates.

The issue lies with the way the election is run within the WHO Executive Board. The board's 34 members, each representing a WHO member country, must first cut the long list of 13 names down to five, and then select a candidate to put forward to the World Health Assembly on November 9.

To generate the shortlist, each board member puts forward a list of his or her favorite candidates, and the five with the most votes get through. For the past two elections, board members have been asked to choose exactly five names, although that number could change, WHO spokeswoman Christine McNab told The Scientist.

Only once the shortlist is made are the candidates officially given a chance to lay out their policy manifestoes with speeches and so on.

Derek Yach, director of the Rockefeller Foundation's program on global health and a former executive director at WHO, is concerned that the best candidates may not make it through the cut from 13 to five. "The trouble is, how do you get from 13 down to five and ensure that the strongest candidates get past that point?" he said in an interview with The Scientist.

There is a risk that tactical voting within the board could twist the process, Yach said. Representatives who support a particular candidate might be tempted to create a list that includes their favorite candidate and four other candidates they think are too weak to represent a challenge.

Modeling the probabilities of who will be chosen in that kind of process suggests that "the weakest of the weakest" could make it through. "There are some good candidates out there," Yach said. "The question is whether those people are going to make it to the shortlist."

This kind of tactical voting hasn't been a feature of recent elections, but this year's candidate pool of 13 is particularly large and contains an unusual number of candidates from significant countries. That could raise the chances that tactical voting will have an impact, said Christopher Murray, director of the Harvard Initiative for Global Health and another former executive director at the World Health Organization.

"One could say that when you go from 13 to five, the potential for even a few tactical voters to sway the outcome is higher," he told The Scientist. "A small number of tactical votes could lead to some unusual results. That's the part everyone worries about."

Richard Horton, editor of The Lancet, has been critical of the WHO election process for some time. On the journal's podcast this week, he points out that "electing the pope is more transparent than electing the director-general of the WHO."

In the podcast, he mentions the concern that the weakest candidates could end up getting the most votes. "This would be utterly mad," he says. "But this is how we're electing our WHO leader."

Stephen Pincock
spincock@the-scientist.com


Links within this article

S. Pincock, "Hunt for new WHO head heats up," The Scientist, July 25, 2006.
http://www.the-scientist.com/news/display/24063/

S. Pincock, "Who's up for top WHO job?" The Scientist, September 7, 2006.
http://www.the-scientist.com/blog/browse/blogger/10/

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

WHO Executive Board
http://www.who.int/governance/eb/en/

Derek Yach
http://www.rockfound.org/AboutUs/FoundationAnnouncement/117

Christopher Murray
http://www.hsph.harvard.edu/facres/mrry.html

The Lancet
http://www.thelancet.com/