Spain has officially submitted Dr María Neira’s nomination for the WHO Director-General election ahead of Thursday’s statutory deadline, sources close to the matter told Health Policy Watch. The submission expands the candidate pool by introducing a focus on primary prevention and climate-related health risks to the race.

Before Neira’s nomination, a coalition representing over 100 civil society groups had petitioned the Spanish government to support her candidacy, framing her technical expertise as essential to address extreme heatwaves and environmental health risks in vulnerable communities. Co-led by Nobel Peace Prize Laureate Adolfo Pérez Esquivel and Dr Carlos Ferreyra of Climate, Life and Health International, the petition unites indigenous leaders, elder-rights advocates, and public health networks across Africa, Asia, and Latin America.

Observers describe her candidacy as the first real grassroots campaign for a WHO Director-General election.

Health Policy Watch reached out to the Spanish government for comment prior to publication, but received no response. Neira declined to comment.

A vision focused on scientific evidence

Neira is set to enter the contest as the fifth candidate alongside Dr Hans Kluge of Belgium, Dr Hanan Balkhy of Saudi Arabia, Dr Hanan Al-Kuwari of Qatar, and Budi Gunadi Sadikin of Indonesia.

Her career combines frontline medical work in conflict zones across Africa and Latin America for organisations like Médecins Sans Frontières with two decades as former WHO Director for Environment, Climate Change and Health. In a recent LinkedIn post, Neira outlined a policy vision calling for a shift toward primary prevention to target the root causes of disease before people require treatment.

Rather than viewing environmental policy as an economic burden, she treats public health as a key benefit of clean energy, sustainable transport, and urban planning. Neira argues the agency requires a leader willing to push for policies that “the evidence demands”.

Election unfolds amid financial and geopolitical pressures

The election takes place against the backdrop of financial pressures across the WHO, which faces severe budget shortfalls and political divisions following the withdrawal of US funding.

Addressing the agency’s financial constraints, Neira outlines what she terms the “Health Impact from Institutional Influence Principle,” arguing that the WHO’s power relies on scientific and moral authority rather than budget size alone. By setting global standards and translating evidence into policy, she maintains the agency can guide international health action far beyond its direct funding capacity.

Following Thursday’s nomination deadline, contenders will face Member States at the first live candidates’ forum in November. The WHO Executive Board will then shortlist up to three finalists in early 2027 before the World Health Assembly casts the decisive vote in May.

See related story:

As Deadline Nears, Civil Society Urges Spain to Nominate María Neira in WHO DG Election

Image Credits: WHO, Felix Sassmannshausen/HPW.