Eight medical doctors have served the World Health Organization (WHO) as its directors-general, through it the international community, in the post-war world from 1948 to the present, beginning with Dr. B.Chisholm of Canada, and now the incumbent another Canadian Dr. Margaret Chan, with dual citizenship (Chinese, Hong Kong).
The only exception in the making now for her successor is a non-medical doctor candidate from Ethiopia, its present foreign minister Dr. Tedros Adhanom Ghebreyesus, who also happens to be in top leadership position as an executive committee member of the ruling Tigrai People’s Liberation Front (TPLF).
By training, Dr. Tedros Adhanom has qualifications in: Biology (BSc.) from Asmara University (1986); Immunology of Infectious Diseases (MSc.) from the London School of Hygiene & Tropical Medicine in 2000, and Community Health from Nottingham University (PhD) in later years.
The question of whether he is qualified to the post, for that matter he should aim to break the WHO mold of medical doctors running it, may be academic, which eventually may render the conversation parochial with no productive exit at the end of it.
Which Candidate for WHO DG? What Qualifications?
For me, the question of which person adequately fills the director-general post is best defined by WHO’s fifth Director-General Dr. Gro Harlem Brundtland (MD), formerly Norway’s prime minister. In her acceptance speech on May 13, 1998, she iterated to the WHO Assembly the following position of principles:
“What is our Key mission? I see WHO’s role as being the moral voice and the technical leader in improving health of the people of the world. Ready and able to give advice on the key issues that can unleash development and alleviate suffering. I see our purpose to be combating disease and ill-health – promoting sustainable and equitable health systems in all countries”.
This filters out into something useful as to the requisite quality of the person and the commitment entailed in that person assuming WHO’s leadership; it has hugely appealed to me as educated and experienced person in international life, both as a diplomat and international civil servant, who at present is viewing things with rear view mirror from a retiree’s vantage point.
Therefore, the following pages, I believe, can deliver my reaction to the candidature of a fellow Ethiopian – Foreign Minister Tedros Adhanom, who has been nominated as Africa’s candidate in January 2016. I am actually prompted to react by his April 14, 2016 sort of self promotional as WHO candidate, appearing on the Huff Post, to which I would return in a moment.
In terms of qualifications, as stated above, I may not be the right person to assess whether he is qualified for the job. However, to the extent I get a hearing, I would be so doing with a superficial remark.
Let me say that I would agree his core education comports with the requirements of the job, if he is selected. It also means that I am hesitantly saying he may be able to run WHO, for that matter which since becoming operational in 1948, has transited across seven decades as health issues arm of the United Nations and sole inheritor from the League of Nations of the Office International d’Hygiène Publique and the old Health Organization that to this day medical doctor-directors-general have kept under their firm grips.
Needless to state that no one in his right mind would miss the implication of stating that, i.e., the WHO is not a corporation where mere technical skills should be relied upon; nor would it be safe sail for it to exclusively be pushed into the hands of business like management akin to a modern ‘firm’, thereby risking the danger of its moral responsibilities to the people of the world being adulterated by investor and bottom line concerns.
Having made that point, I should hasten to open up a little bit and add here that my countryman’s qualification might give rise to some legitimate concerns; no doubt about it. The nagging question in his candidacy would be his lack of any management training. It could bother some extremely as severe handicap in these trying times for the international community, where the prevalence of dangerous diseases in future may demand a combination of technical competence and management skills in the same pair of hands; there can be no luxury of overlooking this.
There is also wisdom to be uncovered in looking to the incumbent on the post at present. We are all aware that Dr. Margaret Chan, who is a medical doctor, as well is holder of degrees in public health (MSC), home economics (BA) and management training at Harvard Business School –something sorely lacking amongst my fellow countryman’s qualifications.
Inadequacies of Dr. Tedros Adhanom’s Candidacy
Not only the lack of formal education in management is hurting Dr. Tedros Adhanom. He has also hardly shown that he is a gifted manager either because of his innate capacities or temperament. Unfortunately, if one is to track the footprints he has left in the offices he ran/or is running in the past and in his current position as foreign minister, there are grievous lapses of judgment, some might see as diminution of the moral dimensions in his leadership.
Such discomfort is likely to heavily reside in those that have intimate knowledge of the Charter of the United Nations, especially its subtly crafted Preamble and the lofty objectives thereon as well as WHO’s Basic Documents, especially its Constitution that outlines its principles that govern the specialized agency’s raison d’être and modus operandi.
Indeed by choosing to ignore many unpleasant details that have facilitated corruption in Ethiopia’s ministry of health, when Dr. Tedros Adhanom was the minister (2005-2012) – monies coming in aid from governments and philanthropists, for instance, have been lost in several millions from those that needed treatments for HIV/aids in a country that has claimed hugely its toll in lives.
It is to be recalled that the media reported that this resulted in 79 percent cut in United States assistance. All this became public knowledge when the candidate was at the health ministry, and the investigation continued, the same year he had left office.
In other words, some had estimated at the time, “Aid to Ethiopia’s health sector would, according to the US government-run web portal ForeignAssistance.gov fall to US$171 million in 2013 from $390.6 million in 2012. A major cut would be felt in HIV/AIDS programmes, which would receive only $54.1 million, a dramatic cut from the $254.1 million allocated in 2012.”
It is the severity of the US cuts that made Amanda Glassman, Director at Global Health Policy and a senior fellow at the Center for Global Development, to lament writing on PlusNews on January 9, 2013, “There’s an AIDS spending cliff in Ethiopia, and the government is already in free fall. Next year, Ethiopia will experience a 79 percent reduction in US HIV financing from PEPFAR [the US President’s Emergency Plan For AIDS Relief]”.
Let it be clear that I am not in any form or shape accusing the minister of corruption. Nor has the US Government at the time publicly mentioned the word “corruption.” Nonetheless, there was visible movement about preparations in the United States already in February 2012 about the establishment of independent panel “to investigate the Global Fund’s fiduciary controls and oversight mechanisms after allegations of grant fraud in several recipient countries.”
The HIV/aids cut also coincided with similar action by four European nations (Denmark, Ireland, Norway and UK) cutting aid from Uganda on charges of official corruption in Kampala that has frayed many nerves in those donor countries.
In the case of Ethiopia, there were also widespread complaints by health officials , which included allegations“about unfair hiring practices, nepotism and preferential treatment to well-connected individuals.”
Lower level corruptions in Ethiopia, when Dr. Tedros Adhanom was minister in the health sector included:
(a) construction and rehabilitation of health institutions;
(b) purchase of equipment, supplies and drugs resulting in bribes, kickbacks;
(c) and political considerations influence specifications and winners of bids, bid rigging during procurement, lack of incentives to choose low cost and high-quality suppliers; and
(d) education of health professionals: bribes to gain place in medical school or other pre-service training, bribes to obtain passing grades, and political influence, nepotism in selection of candidates for training opportunities
Moreover, the reporting by the Center for Global Development in 2006 touched upon malaria prevention and treatment with funds made available by international donors being exposed to abuses. The concrete problems included the sale of unauthorized medicaments, whose consequences were not either felt at the time or least anticipated due to the high financial flows from donors into the country when the candidate was minister of health.
In addition, monies were secretly siphoned off by the ruling party’s cadres to build the propaganda infrastructures of the TPLF, such as Walta Information Center (WIC) and Fana Broadcast, while weakening state institutions. These were and even more so today are the giants in Ethiopia’s tortuous and blood-tainted politics, partly built with health funds that flowed under Dr. Tedros Adhanom’s tenure as minister of health.
I cannot say whether he had knowledge of it or if he thought it was for the good of his party. In any form, these are egregious deficiencies that occurred under his leadership, which under normal circumstances should neither be ignored or tolerated anywhere else, much less at the WHO.
Further, if Dr. Tedros Adhanom is to be appointed WHO director-general, there is validity in about the ugly tradition of political nepotism his party, the TPLF; he may bring his local political traits, rampant in Ethiopian into his international assignment to turn WHO as sort of and the ruling party’s ethnic fortress through hirings and promotions. This fear is well-founded since that habit has followed him into the Ethiopian foreign ministry. For the TPLF, the purpose of such nepotism is to kill prospects of an emerging civil service system in a poor developing country for fear that the margin between political neutrality and independence being thin and thus the civil service going out of its control.
In 2006, I recall distinctly that the World Bank counseled against politicization of the civil service in its Interim Country Assistance Strategy. Included in there was proffering privileges on party members bringing with it opportunities for promotion or further education. Of course, the World Bank would not have said this today, since it has become political and a builder of tyrannical systems around the world.
In sum, the above is indication of weak financial and staff administration system. Perhaps the minister with little influence could have done little, although in all these cases, Dr. Tedros has been going with the political wave to protect his position in power. This should not give the impression that a company with an executive with good managerial skills is likely to succeed in eliminating corruption. Still better, a qualified executive in management would have better ears and feel for things than the non-management trained executive.
WHO standards and the qualification requirements
No doubt Dr. Tedros Adhanom is affable as a human being, who easily strikes friendship and sympathy of others to his views; but the politician he has proved to be with his double-talk and misrepresentation is hardly a recipe for good management.
That said, let me add here that WHO has its own standards for the nomination of its director-general, which came into existence in 1996, after years of negotiations within the different regional groups. The whole point of their negotiations and the efforts thereon was a struggle to see the discontinuation in WHO of the practice that WHO is exclusively run by professionals from the northern hemisphere, instead of regional rotation of the top leadership post given due regard and fair consideration.
The agreed upon document, prepared as a report by the WHO Secretariat, following years of intense negotiations is titled Election of the Director-General of the World Health Organization. It consists of criteria for nomination of an individual to the post of director-general, which, according to its paragraph 9 (EB128/27), the following are the requisite qualities and backgrounds acceptable in the candidates:
(1) a strong technical and public health background and extensive experience in international health;
(2) competency in organizational management;
(3) proven historical evidence for public health leadership;
(4) sensitiveness to cultural, social and political differences;
(5) a strong commitment to the work of WHO;
(6) the good physical condition required of all staff members of the Organization; and
(7) sufficient skill in at least one of the official and working languages of the Executive Board and Health Assembly.
As discussed above, and some to come hereafter show that the cards are stuck against the Ethiopian (African) candidate. The only reason he may not be held back is through pressure by donors, as he has been known as ‘the donor darling minister’, favored by philanthropists such as Bill Gates, Harvard medics, NGOs with interests in the health sector across Africa.
In organizational management, in addition to the above problems of corruption, there was an article on The Ethiopian Herald days ago titled, Don’t Touch Any Client Without Understanding the Ethics Proclamation! Basically, what it reveals is that Ethiopia has expanded health services through health extension workers and the construction of many health centers.
In a very strange way, The Herald is pointing out that is not the case. It argues that since the TPLF regime seized political power in 1991, it has built 16,251 health posts, of which only 3,335 were functional in 2014. For me, this has not come across as competency in organizational management, nor proven historical evidence for public health leadership.
Presenting Dr. Tedros Adhanom’s Candidature to the African Union
The TPLF regime presented the name of Dr. Tedros Adhanom to the African Union (AU) at its 26th summit in Addis Abeba in January 2016 toward his nomination as Africa’s candidate to run the WHO, one of the relatively better organized United Nations agencies.
Note that WHO is also an organization the centrality of whose global role has been reaffirmed by a resolution of the United Nations Security Council in September 2014 at the height of the Ebola crisis, notwithstanding media criticisms of its initial handling of the pandemic. The question is whether nations of the world have to collaborate with those that diminish such an important international institution.
The African Union foreign ministers (Executive Committee) that are typical in their love of pomp and any and all forms of delicacies were thus exceptionally treated to luxury at the expense of poor Ethiopians from January 24-26th – not in Addis Abeba, where the AU has its headquarters – but the regional capital of Tigrai in Mekelle, also home of the minority group ruing Ethiopia – the Tigrai People’s Liberation Front (TPLF) and the foreign minister’s too.
Not surprisingly, until then, the TPLF media hardly talked openly about Dr. Tedros Adhanom’s WHO candidacy or his prospects, until the AU Executive Committee did what it was asked to deliver – nominate the man as Africa’s candidate – which some say was already secured in Mekelle.
Of this, the AU announced in its press release Mekelle to host Ministerial Retreat of the Executive Council about the Ethiopian foreign minister hosting them, along with the region’s top officials.
Does Dr. Tedros Adhanom possess the moral capacity, I mentioned at the beginning? Perhaps this could be looked at from a different angle. Recall that Dr. Tedros Adhanom’s nomination was taking place at the start of the New Year, the AU has also declared the year, among others, #YearofHumanRights. Already two months before that the TPLF unleashed its killing machine against Ethiopian Oromos, protesting its land grab; the foreign minister has been part of the killing team within the TPLF. The same tragedy has also been happening in Gondar, South Omo Valley, Afar, etc.
Readers should judge whether Tedros Adhanom’s candidature is consistent with the requirements inscribed inAU Constitutive Act or the United Nations Charter, both of which unwaveringly rebuke and condemn human rights violations, killings of citizens and impunity of all forms!
Dr. Tedros has been part of the ruling party’s top decision-making body. Unfortunately, all his statements speak of his support for repressive policies in the name of development, such as the land grab and the killings of citizens by tyrannical regime.
The worst part of it is that in the second five-year plan (2016-2020), the TPLF is prepared to seize over 750,000 hectares of prime lands in different parts of the country, dislocating citizens, and not paying them compensation, just throwing them into the streets. This has pushed so many Ethiopians into poverty, when the members of the ruling party, minority as they are have enriched themselves and in these 25 years have been leading first world life-styles surrounded by a sea of poverty and inequality. The foreign minister attachment to his personal success and comforts, in a man aspiring the highest job in WHO indicates lack of principles and moral courage.
Notwithstanding the moral and political dilemma of assigning such a person, the AU, which in October 2015 had voted for Burundi to become a member of the United Nations Human Rights Council, while the Security Council and the UN Human Rights Commissioner were seized with the situation in that country, in the same manner they continued in their business as usual attitude in the case of this candidature that was approved in the face of deaths and massacres of Oromos and others in Ethiopia, which still is taking place, without any rebuke of the actors.
Recall that the while the world had already reacted to it in the strongest terms possible, including the regime’s bankrollers, i.e, the European Union Parliament (EU) ‘strongly condemning it, while the United States expressing concerns.
Surely, after the retreat to Mekelle, the AU ministers did what they are supposed to do without much ado; they affixed to Tedros Adhanom’s name the imprimatur contained in executive decision EX.CL/949(XXIV), with no reference to the hundreds of executions already by then hundreds of schoolchildren belonging to the Oromo ethnic group, constituting about 40 percent of the Ethiopian population and contributing over 60 percent of the nation’s gross domestic product (GDP)
Frankly, I found the decision revolting; most apparent to me was the extent of self-interest on all sides – Africans and Africa’s development partners – colluding in such an undertaking that had me gasp with a terrible disappointment.
It is inevitable that some out of goodness, and still others to their own peril, may thus take Dr. Tedros Adhanom as Ethiopia and Africa’s candidate to the WHO director-general post, as the 26th AU summit had peoples across the region made believe.
Did the Ethiopian people, as consumers of the poor health service in the country whose availability is no different from its non-existence, have any say in his candidacy? Not at all!
In fact, Dr. Tedros Adhanom’s friendship with donor nations has benefitted him more than the poor people of Ethiopia. The country has become all the more dependent, and the ethnic elites, led by the TPLF, rendering it a country of unequals, for a population, by UNFPA calculation, this year would surpass the 100 million mark.
Does the international community have any say in Dr. Tedros Adhanom’s candidacy? Certainly, yes! But if nations act with their better judgements and better interests at heart the outcome would be different.
I am actually provoked to write this piece by Dr. Tedros Adhanom jabbering on the Huff post of April 14, 2016 with his WHO promotional under the title: Peace, Prosperity and Global Health Security. It has come to me as a vain attempt to magnify the link between health and all other securities, when it has been already long done by better thinkers.
After his first two paragraphs, therefore, he did not succeed doing what he set out to do. His third paragraph simply jumps to state “Prior to joining the Ministry of Foreign Affairs, I was the Minister of Health of Ethiopia for seven years.” Unless that is his message, instead of reinventing the wheel, he could have simply borrowed the language of the UN Security Council, wherein its Resolution 2177 of September 2014 has exceptionally described, for instance, “the Ebola outbreak in Africa [as] a threat to international peace and security.”
What else is there then to jabber-walk about this?
As donors’ darling, the man actually is a candidate very well embraced and supported by wealthy philanthropists well-looped into market control; he is connected to the pharmaceutical industries through their principal investors. I could boldly say that the Gates Foundation is his primary promoter.
The Melinda and Bill Gates Foundation has been experimenting a number of things in Ethiopia. With their philanthropic generosity as a tool, they have had business interests in the country, their operations in Ethiopia have expanded; all that was seeded at a time when Dr. Tedros Adhanom was minister of health.
In Africa, the Foundation got name, with Ethiopia as its stepping stone for their bold and generous contributions to saving the under-five children. However, this did not restrain them from promoting genetically modified foods and seeds (GMOs), as Mr. Gates is one of the largest investors in them. It did not compel them to stop and think when people are pushed into poverty, farmers are pushed off their lands and the ruling party’s cadres and military officers become the owners of those lands. Mr. Gates has never uttered a word against the danger of land grab in Ethiopia.
And yet he defends the regime’s policies, records and rhetorics, especially in the fields of agricultural development. His 2014 tweet is about Ethiopia’s economic growth, which he said is growing faster than China’s, when in reality Ethiopia has remained a hungry nation. The United Nations Food and Agricultural Organization in May 2015 produced a report, which described 32 percent of Ethiopians undernourished, meaning chronically hungry.
I have listened to his Stanford University presentation of April4, 2012 again and again. At that time, Mr Gates vowed that Ethiopia would attain status of food secure nation status by 2015 and become a good example for other developing nations.
I had written six-part articles, Bill Gates vows to defeat hunger & diseases in Ethiopia: Could entrenched political interests allow him?, hoping that would come true for the people of Ethiopia. Unfortunately, Ethiopia to this day is still a hungry nation, if not a hungrier nation.
Tedros Adhanom attained professionalism as Ethiopia’s minister of health (2005-2012), liked by several citizens; he attained positive name. This was not a matter of his contribution to the poor nation’s health or development; it was merely because of his approachability, charm good demeanor – unlike almost all TPLF leaders, whom Ethiopians see as robbers, schooled in violence and killings as members of the Tigrai People’s Liberation Front.
Unfortunately, Dr. Tedros Adhanom is not any different from anyone of them. This puts to doubt his commitment to the goals of WHO and its principles, if he is selected.
I recall with shock his sense of cruelty, when he told Ethiopians (through the Voice of America – VOA) that Andrgachew Tsige, Secretary-General of Ginbot 7, who was kidnapped from Sanaa Airport in Yemen, nearly two years ago, was well and has gained weight busy writing a book, visiting development activities. The foreign minister lied to the Ethiopian people even on a matter such as this.
If what he said indeed is true, the question then is why does the British government complain about its citizen’s condition in prison? Is it merely because the British were under pressure from human rights activists? Even then, why do international human rights activists campaign against his imprisonment in isolation? It is unlikely that Dr. Tedros can answer to these questions?
Why the lie? There have been many such instances that we have documented! They worry us, if the outside world unawares is led to putting him onto the leadership of WHO, as I said before, one of the few better organized and run United Nations specialized agencies!