The former Minister of health of Ethiopia, Tedros, was elected as the new DG of the WHO, defeating David Nabarro of the UK by a massive margin. While 133 countries voted for Tedros, only 50 supported David Nabarro. The third candidate, Sani Nishtar from Pakistan, was eliminated in the first round of voting – she received 38 votes. Tedros is the first African to be lected to the psot in the organisation 70 years history.
The elections this year was the first occasion when the entire Assembly voted through a secret ballot – earlier only the Executive Board would select the new DG. The massive margin for Tedros indicates that, in all probability, the entire South voted for him – a virtual tricontinental alliance. The massive margin had not been anticipated and possibly marks a silent vote against big power machinations in the WHO.
The WHO faces possibly its biggest crisis since it was set up in 1948. Its finances are in shambles and it faces a USD 500 million deficit this year – potentially meaning many work programs will not go forward and staff might be laid off. For years now the WHO has been dependant on donor funds (mainly from rich countries and Foundations like the BMGF) rather than through secured funding from countries. As a result, currently, 80% of WHO’s funding is tied to programs that donors cherry pick. Work programs that are vital to WHO’s mandate as a norm setting organisation remain under funded as they clash with the interests of big donors – especially rich countries of the North. Consequently WHO’s role as a leader in global health has been supplanted by other intergovernmental bodies such as the World Bank, and increasingly by big foundations like the BMGF. The organisations effectivity has come under question, especially after its lack lustre role in containing the Ebola epidemic of 2014 in West Africa.
These are the challenges that Tedros faces after his election. While it appears that the South has voted against the domination of big powers, often through back room manoeuvres, it is yet to be seen if this unity will be maintained when the WHO debates different issues where the North and the South are often arrayed against each other.
The election of Tedros is both an opportunity and a challenge for India. India is seen in the WHO as one of the natural leaders of the South and is usually heard with attention. India can possibly provide leadership to the South in pressing for decisions in the WHO that promote the interests of the South. Such interests range from promoting WHO’s role in medicines access by addressing trade and IP barriers, pressing for technology transfer and capacity building in areas where the South remains deficient, and measures that curb the interests of mainly Northern MNCs in the medicines, Food and Beverages, Alcohol and Tobacco industries.
However India’s voice has often been muted by its reluctance to be seen as squarely opposing the US and other Northern countries. Increasingly, Indian negotiators seem to have their hands tied by signals from Delhi not to push beyond a point in challenging the agenda of Northern countries.
The coming days will perhaps provide an indication if India would work to build the solidarity of the South or continue to play an ambiguous role.