As the World Health Organization formally opens the nomination process for the next Director-General, Germany now appears likely to propose Helge Braun, former chief of staff in the government of then Chancellor Angela Merkel. But after slashing its global health budget, sources question if a German candidate can win wide support from other WHO member states? 

The WHO Director-General Tedros Adhanom Ghebreyesus has formally issued a call to WHO member states for nominations to the DG elections, scheduled for May 2027 in an invitation sent 24 April to all WHO member states, WHO confirmed in an email to Health Policy Watch. The invitations were sent via private letters to countries’ Geneva missions.

The period in which member states may nominate candidates will now run for six months, to 24 September. But contenders who have until now remained in the shadows are expected to begin coming forward publicly with their candidacies at the World Health Assembly in May.

From the German perspective, Berlin wants its financial weight reflected in executive influence at the multilateral level as the largest global health donor following the US announced withdrawal from the WHO in January 2025.

The withdrawal, combined with the US non-payment of back dues owed, thrust WHO into a budget crisis, prompting budget retrenchment and layoffs of about 25% of the workforce in the past year.  

German Foreign Ministry neither confirms nor denies

The German Foreign Ministry, formally responsible for the nomination, declined to confirm or comment on the potential candidacy when responding to a query by Health Policy Watch. 

Germany’s other potential candidates include the contested former Health Minister Karl Lauterbach and the lesser-known Paul Zubeil. 

In contrast, Braun’s dual profile as accomplished politician, skilled financial manager, and a trained physician and researcher who successfully built cross-party bridges offers a distinct advantage. But he is little-known outside of Germany.

A bridge-builder with executive and medical expertise

The current WHO leadership landscape demands a candidate capable of managing deep institutional fractures and uniting a divided global community. Despite him being largely unknown in the international community, Germany could be expected to emphasise Braun’s extensive fiscal and crisis management experience in any candidacy it mounts.

As ‘Head of the Chancellery’, effectively Chief of Staff, in Angela Merkel’s last term as Chancellor, from 2018 to 2021, Braun operated at the nexus of scientific advice and political implementation during the COVID-19 pandemic, notably comparing the Chancellery to an intensive care unit where acute problems must be solved.

Between 2021 and 2025, Braun then chaired the powerful Budget Committee of the German Bundestag (Parliament), overseeing the distribution and management of hundreds of billions of Euros with strict discipline

This profound understanding of macroeconomic management, coupled with his pragmatic defence of Germany’s controversial debt ceiling alongside crisis-driven special funds, makes him an attractive prospect for donor nations currently demanding more financial accountability and restructuring at WHO in Geneva.

Serving as a central mediator across government ministries, Braun built a reputation as a highly pragmatic problem solver whose past domestic political affiliations will not necessarily dictate his future approach to global health governance. This pragmatism complements his longstanding political advocacy for research into infectious diseases like Ebola and malaria.

And unlike many career politicians, Braun’s foundational expertise lies in medicine, having worked for years as an intensive care physician and anaesthesiologist. He returned to these roots in April 2025 by assuming the presidency of the University of Lübeck, an institution renowned for its focus on life sciences and artificial intelligence.

Why the candidacy might spark concerns

While Braun championed early interventions and massive digitisation projects in his role as Merkel’s Head of the Chancellery during the COVID pandemic, severe bureaucratic delays hampered the rollout of vaccination campaigns and testing strategies. This tarnished his crisis management legacy just as he exited the federal government.

His domestic political capital suffered further damage during the December 2021 Christian Democratic Union leadership election, where he lost heavily to conservative rival Friedrich Merz, now Chancellor. Party members largely rejected Braun as an establishment candidate, perceiving him as too closely aligned with the moderate legacy of former Chancellor Angela Merkel.

Additionally, it is questionable whether Braun would wield the necessary diplomatic connections and familiarity with foreign health systems to be effective on Day One of a term as WHO head. The Director-General must immediately command trust and authority on the international stage, particularly when dealing with health ministries and stakeholders in the Global South.

Most notably, the German government opposed the release of COVID-19 vaccine patents during his tenure, drawing sharp criticism from international health equity advocates. Defending this refusal in May 2021, Braun wrote in a guest article for the German newspaper Die Zeit that “patent protection as a driver of innovation is not the problem in this crisis, but an essential foundation for its solution.”

In the Global South, this track record could thus reinforce the perception that Germany defends pharmaceutical interests over equitable technology transfer – especially in the face of current PABS Annex negotiations. Recent reports from Tagesspiegel Background indicating that the former minister was approached by Germany’s Association of Research-Based Pharmaceutical Companies to become their next president, when the post becomes vacant at the end of 2026,might further fuel these concerns.

Finally, Germany has been cutting back its Official Development Assistance (ODA) in general, including contributions to the World Health Organization, where it has historically been the largest member state donor after the United States. On Wednesday, the Merz government announced its 2027 budget plans with further ODA cuts following last year’s drastic 17% reductions. The likelihood of Germany fulfilling its original 2024 financial pledge to WHO for the current biennium (2026-27) also remains in doubt.  

“They can put forward a candidate, but I don’t think it’s going to get a lot of traction from other member states,” said one informed WHO source. “At a time when Germany is reducing global health funding to member states, I don’t think they can go ahead and claim the top seat.”

Step back and support allied candidates?

Furthermore, domestic opinion remains highly divided on mounting a campaign amidst the geopolitical strains on Chancellor Friedrich Merz’s coalition and reported urging from WHO Director-General Dr Tedros Adhanom Ghebreyesus to back allied candidates instead.

At the same time, the desire to seize more leadership in the UN system remains strong after Germany’s failed previous attempt to secure the top role at the UN High Commissioner for Refugees in 2025. Currently, Germany is also pushing for another attempt at a seat at the UN Security Council.

Should Germany mount a candidate, Foreign Minister Johann Wadephul, who will make the final decision, also faces a stark choice between Braun and the better known Karl Lauterbach, as well as Paul Zubeil with his strong international health and technical background. 

Advancing a WHO outsider like Braun against established public health veterans is thus a highly calculated risk for Berlin, which must first convince other European countries to rally behind him. 

In case Berlin formally nominates Braun, the success of his candidacy will depend entirely on how effectively the government can reframe his perceived lack of field experience and global networks as delivery on fresh, badly needed fiscal expertise and perspectives.

Grappling with WHO’s Global health funding crisis 

As the race for the next Director-General opens for formal nominations, the names of over a dozen high-profile, potential candidates are still circulating – from Indonesia to the United Kingdom.

Want to Become the Next WHO Director-General? Get in Line 

And the list is still growing. Among the newer names being floated is that of Dr Hanan Mohamed al-Kuwari, who served as Qatar’s Minister of Public Health until November 2024 and chaired the 153rd Session of the WHO Executive Board. 

Holding a PhD in healthcare management and bringing early career experience from the WHO, she represents a highly networked voice from the Arab world. She is personally celebrated for her crisis resilience and for shaping the WHO’s recent global work programme.

Another candidate who has been mentioned is Spain’s Dr Maria Neira, who recently retired from WHO as the director of Climate, Environment and Health. An iconic spokesperson for the climate, environment and health movement, Neira is known as a telegenic personality and adroit politically. As a young medical doctor, she worked in emergency relief in Latin America and Africa, and later served as Spain’s Vice Minister of Health and Consumer Affairs as well as President of the Spanish Food Safety and Nutrition Agency.

However, Spain also recently decided to nominate a candidate to head the UN Food and Agriculture Organization (FAO), when Qu Dongyu’s second term as Director General ends in July 2027, leaving doubts about whether it would want to mount yet another campaign, in parallel.

Grappling with continuing decline in ODA and global health aid

Whoever is elected will have to continue grappling with the continuing long-term declines in donor-driven ODA, and particularly global health aid – directly to countries and to WHO. 

While WHO 2026-2027 $4.2 billion base budget is now 85% financed, according to Tedros’ comments on Wednesday, declines in ODA continue to cast uncertainty on how the remaining $630 million gap will be filled.

And it’s unlikely that the $260.6 million in assessed US contributions still due for years 2024-2025, before the withdrawal became official in January, will ever be repaid, conceded WHO’s Tedros at a Geneva press briefing on Wednesday.

“We’re hoping to get the money, but no signals yet,” Tedros told journalists, adding: “No signals means maybe we may not be able to get the money. The likelihood could be not getting the money.”

“We’re looking at nontraditional donors. We’re looking at international financial institutions and other ways to mobilize that 15%,” Tedros said, in terms of filling that gap. “It’s not that we won’t go to the traditional donors, but I think we’re expanding that donor base.”

Image Credits: X/Dr Tedros, Deutscher Bundestag/Leon Kügeler, European Commission.