Second five-year term for WHO chief Tedros Adhanom Ghebreyesus

World Health Organisation (WHO) director-general Tedros Adhanom Ghebreyesus has been elected to serve a second five-year term by the UN health agency’s member countries.

No other candidate challenged Dr Tedros for the post amid the ongoing difficulties of responding to the devastating coronavirus pandemic.

“This is overwhelming,” Dr Tedros said, after another WHO official asked everyone in the room to stand and applaud him.

Fighting back tears, Dr Tedros described himself as “a child of war” after signing the contract for his extension.

He said that after witnessing his younger brother’s death at an early age, it was “luck (that) brought me all the way here”.

Dr Tedros, a former government minister from Ethiopia, has directed the WHO throughout its management of the global response to Covid-19, and withstood occasionally withering criticism over its multiple mis-steps.

He is the first African to lead the agency and the only director-general not qualified as a medical doctor.

Dr Tedros is also the first WHO leader not to be supported by their home country. Ethiopia has previously accused him of “misconduct” after his sharp criticism of the war and humanitarian crisis there.

Under Dr Tedros, the UN health agency failed to call out countries including China for blunders that WHO officials grumbled about privately, advised against mask-wearing for months, and said initially that the coronavirus was not likely to mutate rapidly.

Scientists drafted by the WHO to investigate the coronavirus’ origins in China said the critical probe was “stalled” last year, after issuing a report that even Dr Tedros acknowledged had prematurely ruled out the possibility of a laboratory leak.

“There have been some mishaps, but Tedros has also been a steady voice throughout the pandemic, advocating for an equitable response,” said Javier Guzman, director of global health policy at the Centre for Global Development in Washington.

He said despite reservations about Dr Tedros’ leadership, some countries were not willing to push for change.

“We are in the middle of the pandemic and there is some pressure for consistent leadership to take us through this difficult moment,” Mr Guzman said.

Dr Tedros has frequently railed against rich countries for hoarding the world’s limited supply of vaccines and insisted that pharmaceuticals are not doing enough to make their medicines available to the poor.

Amid the near-universal focus on Ukraine after the Russian invasion, Dr Tedros slammed the global community for not doing enough to solve crises elsewhere, including in Yemen, Syria and Afghanistan, arguing that it was possibly because those suffering were not white.

Still, critics say Dr Tedros has failed on some fundamental issues, like holding staff accountable after allegations that dozens of outbreak workers managed by the WHO sexually abused young women in Congo during an Ebola outbreak that began in 2018, in one of the biggest sex scandals in UN history.

None of the senior WHO managers alerted to the abuse allegations and who did little to stop the exploitation have been sacked.

Public health expert Mr Guzman said the apparent culture of impunity at the WHO was problematic.

“We do need to see a stronger (WHO) director-general going forward, where misconduct is not tolerated,” he said, calling for extensive reforms to make the agency accountable.

As Dr Tedros begins his second term, some experts have also raised concerns that the WHO is not fulfilling its primary role as a technical agency providing science-based guidance to countries.

Dr David Tomlinson, a cardiologist who has campaigned for better protective equipment for health workers in the NHS, says he has been appalled by WHO advice, most notably their reluctance to acknowledge that Covid-19 is widely spread in the air.

In July 2020, more than 230 scientists published a paper appealing to the WHO to recognise the coronavirus was airborne; that later prompted the organisation to alter some of its recommendations.

Dr Tomlinson and others say Dr Tedros should ensure the WHO’s top priority during future health emergencies is evaluating the science.

“They have perpetuated untruths that have ultimately led to the deaths of millions of people,” he said, citing the estimated 15 million people who have died during the pandemic.

“We need an agency that’s unafraid to tell the truth, but that’s unfortunately not what we have.”