The next director-general of the World Health Organization, the global public health agency of the United Nations, will come from Ethiopia, the U.K. or Pakistan, the group's executive board revealed Jan. 25, identifying the three candidates who are the finalists for the job.
Tedros Adhanom Ghebreyesus, David Nabarro and Sania Nishtar emerged as the frontrunners after WHO's executive board drew from a short list of candidates in a process that initially got underway in September 2016.
The final selection will be made in May when the WHO's 194 member states meet at the World Health Assembly in Geneva and take a vote.
The winner of that election will be stepping into the shoes of Margaret Chan, who is completing her second five-year term as director-general.
Chan, a doctor from the People's Republic of China, was installed in 2006 and re-elected in 2012. As director-general, she confronted the first human outbreak in 2009 of the H1N1 novel influenza virus, which spread to become a pandemic, killing an estimated 200,000 people worldwide, according to the Centers for Disease Control and Prevention.
She also oversaw the WHO's response in 2014-2015 to the Ebola outbreak in Guinea, Liberia and Sierra Leone, for which the agency was highly criticized for being too slow to recognize and take action. More than 28,600 people in 10 countries, including the U.S., were infected with the virus, which killed 11,310 patients.
In a Jan. 25, 2015, speech at a special session of WHO's executive board on Ebola, Chan said the outbreak pointed to the need to rebuild and strengthen national and international emergency preparedness and response, address the way new medical products are brought to the market and strengthen the way the global health agency operates during emergencies.
Chan barely had time to catch her breath when an outbreak of the Zika virus was identified in South America, eventually making its way to the Caribbean and the U.S.
WHO declared the Zika virus a public health emergency of international concern, saying the disease was "strongly suspected" of being linked to microcephaly, a rare neonatal malformation in which a baby's head is much smaller than normal, resulting in developmental and other disabilities.
While WHO declared an end to the public health emergency this past November, Chan said the virus and associated consequences remained a significant enduring public health challenge requiring intense action.
Whoever takes over for Chan likely will have another infectious disease to confront, whether it is a novel virus or a pathogen that has long-since faded into the background but re-emerges.
One of those contenders, Nishtar, is a cardiologist and former federal minister from Pakistan, where she was responsible for health, science, technology and education.
She built the nongovernmental organization Heartfile, an access-to-treatment initiative established to support universal health coverage in mixed health systems.
Nabarro, a physician, is a former director of human development for the U.K.'s Department for International Development but has been at the WHO since 1999, where he now serves as a special adviser to the UN secretary-general on sustainable development.
The candidate from Ethiopia, who goes by his first name Tedros, is a former health and foreign affairs minister, where he helped transform the nation's health system and expand care.
All three of the nominees are "very different candidates," Tom Frieden, the former director of the U.S. Centers for Disease Control and Prevention and a current member of the WHO executive board, tweeted Jan. 25.
The key, he wrote, is "who can make WHO relevant, effective, successful on [the] front lines."