Variation between the six regions of the World Health Organization (WHO) on how their regional directors are nominated – and whether these should be standardised – generated substantial discussion at the body’s executive board (EB) meeting on Tuesday.

A report from the WHO’s legal counsel on regional nominations noted key areas where a  lack of alignment between the regions could be addressed, including on the scrutiny of candidates and transparency of procedures.

For example, criteria for the assessment of candidates are inconsistent, with some not specifying educational qualifications, professional experience or managerial skills. The Africa region is alone in specifying “a medical background”.

The Pan American Health Organization (PAHO) does not have a code of conduct for the nomination process, aimed at promoting an open, fair, equitable and transparent nomination process.

South-East Asia Region does not specify the shortlisting of five candidates if there are more than five candidates for the position, or how this would take place.

All regions provide for the interviews of candidates with the exception of the European Region, where the interviews take place at a private meeting of the Regional Committee. 

Only PAHO and Europe hold a live candidates’ forum, comprising an oral presentation and a question-and-answer session between candidates and members of the region.

All regions except Europe and the Western Pacific Region explicitly limit nominations to people from the region.

Too prescriptive

However, Canada contended that “a minimum common standard beyond the current direction from the EB regarding criteria might be found to be too prescriptive or limiting” and “would also represent a considerable extension of the board’s authority over these processes”. 

Instead, it proposed that the EB put forward “a menu of best practices that regions can draw on from as appropriate”.

Australia contended that any minimum common standard “should be supported by accepted best practice” and also “protect autonomy to account for regional contexts”.

It supported the proposal for the WHO Secretariat to prepare documents for regional committees on “ways to enhance transparency, accountability and integrity of the election process”.

Meanwhile, Comores on behalf of the 47 African members, rejected a “single approach which will be to the benefit of some regions but not necessarily to the benefit of all”. 

Later, the Africa region represented by Ethiopia said it would support “measures to enhance transparency, accountability and integrity of the election process” for the WHO Director General. Ethiopia previously contested the reappointment of Dr Tedros Adhanom Ghebreyesus.

The board deferred any decision on regional director election processes at the request of Denmark, which asked for more time to achieve consensus. 

Wide support for measures to stop sexual exploitation 

The Director-General’s report on the implementation of measures to prevent and respond to sexual misconduct was also discussed on Tuesday, receiving appreciation and support from a wide range of EB members.

The implementation plan focuses on a range of issues including accountability, policies, investigation capacity, training, dedicated human resources, victim- and survivor-centred support and culture change. 

“The Secretariat is ensuring alignment and consistency between the implementation plan and the three-year strategy on preventing and responding to sexual misconduct, 2023 to 2025,” according to the report.

Commending the WHO secretariat’s efforts to root out sexual exploitation, the EB’s programme, budget and administration committee (PBAC) proposed “a comprehensive stocktaking review no later than January 2025 to assess whether the key actions and the reforms contained in the three-year strategy had led to the intended results”.