Eastern Mediterranean Regional Director Dr Hanan Balkhy will take immediate leave effective Tuesday to formally launch her campaign in the WHO Director-General Election, according to an internal notice from DG Dr Tedros Adhanom Ghebreyesus seen by Health Policy Watch.

Balkhy becomes the first serving regional director required to take leave after Tedros issued newly tightened election guidelines in July to resolve campaign finance and ethical concerns.

Under the new directive, all internal candidates must exhaust their accrued annual leave before transitioning to special leave on half-pay, effectively levelling the playing field.

Previously, regional directors enjoyed a distinct structural advantage over other internal candidates such as Assistant Directors-General by retaining their full salaries, travel budgets, and administrative machinery while actively campaigning.

To comply with the newly enforced guidelines, internal candidates must ensure a complete separation between official WHO functions and campaign activities.

“The election of the Director-General must be conducted in a manner that safeguards the independence, impartiality and integrity of the organization,” Tedros stated in the internal notice.

Ensuring regional continuity

To maintain regional operations during the leave period, Tedros has designated Dr Adham Ismail Abdel-Moneim as Officer-in-Charge of the Eastern Mediterranean Regional Office (EMRO).

Before assuming his current role as director of programme management in 2024, Abdel-Moneim served as the WHO Representative to Saudi Arabia, Yemen, and Iraq. Before these field assignments, he spent 13 years with the regional medicines team in Cairo.

In the circular note, Tedros expressed his gratitude to Ismail for assuming these responsibilities, stating he is confident that “WHO’s vital work will continue without interruption” and that the new officer-in-charge “will ensure continuity in the leadership and management of the Region”.

For Balkhy, her new status has significant consequences, as she must now withdraw from speaking in her official capacity at global forums such as the upcoming World Health Summit in Berlin in October.

The WHO code of conduct dictates that internal candidates must “clearly separate their WHO functions from their candidacy and avoid any overlap, or perception of overlap, between campaign activities and their work for WHO.”

Balkhy is, however, permitted to attend the Berlin summit as a private candidate on campaign leave. However, the code actively encourages candidates to utilise major international conferences to hold bilateral meetings and campaign activities strictly on the margins of the event.

Another procedural grey area persists regarding when a candidate is officially recognised. For instance, a nominating country can delay its formal request to allow their candidate to continue high-profile diplomatic travel.

Without strict enforcement during the pre-nomination phase, candidates may still utilise official platforms to build international support. This gap highlights the limits of voluntary ethical commitments before formal nominations are announced.

Narrowing field of prospective contenders

As the September deadline for official applications draws closer, the field is slowly taking shape, with the first candidates officially entering the Director-General election race.

However, several high-profile global health leaders have recently removed themselves from the succession race. The Pan American Health Organization’s regional director, Dr Jarbas Barbosa, ruled out a bid to focus on leading his region. WHO Chief Scientist Jeremy Farrar also told Politico he has “no intention” to run.

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Image Credits: WHO/EMRO, Hannan Balkhy, WHO.