As the mandate of Dr Tedros Adhanom Ghebreyesus approaches its expiration in August 2027, the high-stakes manoeuvring for the next Director-General (DG) of the World Health Organization (WHO) has intensified in the halls of Geneva and capital cities worldwide. While the official call for nominations is expected in April 2026 and no candidate has formally declared, the global health “rumour mill” is already hard at work – floating the names of at least 12 candidates from Jakarta to Berlin.

Whoever makes the final list will have to deal with an existential convergence of crises facing the WHO.

Externally, the geopolitical earthquake of the United States withdrawal under the Trump administration has left the organization with a staggering $1 billion funding gap for 2026-2027, even after drastic budget cuts. And the US still owes over $260 million in dues.

Internally, the Organization is struggling with a 25% cut in staff following the loss of United States support, leading to a low in staff morale. The layoffs, a lack of transparency, sexual abuse scandals and a fear of retaliation among staff who have raised claims of harassment and damaged trust in the Organization’s leadership.

While American re-engagement may seem “imponderable” right now in the words of one diplomatic source, choosing a candidate with strong credentials as a technocrat and  “reformer” could eventually help unlock a path to Washington’s return – not to mention helping to right the tempest-wracked agency internally and regain public confidence. 

A ‘unicorn’ to navigate a convergence of crises

In the face of these immense diplomatic, economic and internal challenges, the ideal profile for the next WHO Director-General has been described as a “unicorn”: someone with the political skill to navigate a fractured world but the technical discipline to focus the agency’s ambitious mandate. They have to enforce long overdue fiscal reforms and fundamental changes in leadership.

Member states may also face pressure to find a candidate viewed as an outsider, rather than someone who is too cosy with the current “Tedros shop” – which the US rightly or wrongly blames for delaying key policy decisions in the initial stages of the COVID pandemic.

The emerging line-up researched by Health Policy Watch presents a complex set of choices: including competent insiders who nonetheless carry the legacy of the current administration, versus external reformers offering a clean break.

Here’s the brief candidate check, with some of the most talked about contenders lined up at the top – although this is still very early days.

Indonesia’s “CEO” potential

Budi Gunadi Sadikin, Indonesia’s Minister of Health, is emerging as a strong contender for the post of WHO Director-General, described by a senior insider close to the matter as “the real one” with a viable chance of leading the WHO through these turbulent times.

• Sadikin fits the emerging requirement for fiscal stewardship: a former banker with senior leadership roles in state-owned enterprises, he brings a financial rigour that the WHO desperately needs.
• While lacking medical training, his tenure as Minister has been marked by large-scale system reform following COVID-19, credited with modernising Indonesia’s digital health infrastructure. However, some of his reforms to medical education also sparked criticism, e.g. from the Indonesian Medical Association.
• According to European sources we spoke with, Sadikin enjoys support from key Asian powers, including Japan and India; other senior observers state that European candidates could be tough right now, “because of pushes against neocolonialism”.
• Sadikin is considered a potentially suitable candidate to bridge the gap between the Global South and Europeans pushing for fiscal reform and transparency, with keeping hopes of the US returning to the table alive.
• A point of contention mentioned is that, historically, WHO leadership rotates by region. With the tenure of Margaret Chan (China) still in recent memory, an Asian candidate might theoretically be an issue. However, sources indicate that this rotation is “no longer an issue”.

Scientific heavyweight from the United Kingdom

The UK’s Jeremy Farrar is another potential candidate with high chances of success to become the next WHO Director-General.

• As the former Director of the Wellcome Trust, Farrar managed a massive global research portfolio with a strong financial governance record. 
• A UK national, who was born in Singapore and grew up in New Zealand, Cyprus, and Libya, his training and research experience straddles Asia and Europe, and the Global North and South.
• His research track record commands deep respect: in 2004, he and his Vietnamese colleague Tran Tinh Hien identified the re-emergence of the deadly bird flu, or H5N1, in humans.
• Nonetheless, Farrar faces significant headwinds as a member of Tedros’ senior leadership team, and thus by association with Tedros’ own record.
• Additionally, Farrar has been a target of various attacks by proponents of the SARS-CoV2 lab leak theories – who disliked his positions favouring theories of a natural origin for the virus.
• While the jury is still out on that charged debate, with many reputable scientists lined up on either side, in a political climate where the U.S. administration is hostile to the WHO, Farrar’s proximity to these early positions is considered a possible “deal-breaker” for Washington, potentially alienating the very donor the WHO is eager to woo back.

A geopolitical ‘master stroke’ from Saudi Arabia?

While initially viewed as a regional candidate, Hanan Balkhy is increasingly being discussed as a strategic solution to the US as one of the WHO’s most pressing problems.

• Balkhy could be positioned as a “master stroke of diplomacy” to the Trump administration. While she’s serving in WHO as a Saudi national, she spent part of her childhood in the United States and later returned there to do her paediatric residency as well as post-doc stints.
• Balkhy currently leads the WHO Eastern Mediterranean Region (EMRO), a bloc that has never held the Director-General post.
• As an elected Regional Director rather than a direct appointee of Tedros, some analysts argue her association with the current “Tedros shop” is overstated, giving her enough distance to frame herself as a fresh start.
• According to sources, her unique profile allows her to stand as a representative of the Global South and an emerging power (Saudi Arabia), while simultaneously being sold to the White House as a “unifying candidate” capable of replacing the current WHO Director-General.
• Despite her administrative role and being a medical doctor by training, her primary weakness is tenure: having served as Regional Director for just over two years, critics argue she lacks the seasoned track record of a long-term administrator managing a huge agency like WHO’s.
• Finally, her candidacy would inevitably invite pushback from member states critical of Saudi Arabia’s domestic human rights record, as well as its policy positions on controversial issues such as sexual and reproductive health rights.

Does Germany have a ‘ticket free’ to the top?

As a major donor country to both the UN and WHO, Germany has explicitly signalled a desire to occupy more top leadership posts, in alignment with the level of its financial contributions. Following the failure to secure the UNHCR post for a German candidate, Berlin may believe it has “a ticket free” to mount a successful campaign for the WHO’s top post, with two names being floated in German media.

From the Bundestag in Berlin, Germany’s former Minister of Health, Karl Lauterbach, could seem like a perfect blend of competent technician and politician.

• He has an outstanding medical background as a trained physician and a long list of extensive academic achievements in public health and epidemiology. 
• As a former Minister with experience in fiscal reform, he checks all those boxes.
• However, sources we spoke with in Geneva suggested he has “little chance” due to his public praise of WHO and Tedros’ performance during the pandemic period.
• As a member of the centre-left Social Democratic Party (SPD) in the German Parliament, he could not only be contested by the conservative party to his right (CDU), led by Chancellor Friedrich Merz, Lauterbach also represents a political faction that is highly disliked by the current US administration.
• Finally, he has a somewhat polarising domestic reputation, linked (in part or largely) to the “mess on vaccines” –  related to Germany’s anxious over-procurement during the pandemic.

The second, lesser-known, but also less-charged candidate on the German wish list for WHO Director-General is Paul Zubeil.

• As Deputy Director-General for European and International Health Politics at the German Federal Ministry of Health, Zubeil is considered a “respected technocrat” responsible for coordinating German health financing to the WHO and UNAIDS.
• He also leads engagements with the G7 and G20 and possesses a reputation for fiscal discipline and institutional turnaround, backed by over a decade of experience with the UNFPA.
• Zubeil has strong ties to the conservative party in power (CDU), having been appointed by former Health Minister Jens Spahn, suggesting he could be well-positioned to navigate relations with the Trump administration.
• However, insiders warn that having experience “as a bureaucrat is not enough”. Unlike competitors who are former Ministers or prestigious scientists, Zubeil lacks the global public profile and “personal branding” typically required for the top job.

And, notably, both German candidates face distinct challenges from member states in the Global South, and particularly in Africa, where Germany is often perceived as a “champion of defending industry interest” over equity, when it comes to technology transfer and access to health products.

A “safe pair of hands” from Brazil?

While currently serving as the WHO Regional Director for the Americas, Jarbas Barbosa is increasingly being discussed as a technocratic solution to the WHO’s credibility crisis.

• According to PAHO sources, Barbosa is a pragmatist with skills that might help him navigate the “Americas problem”, where the US has exited the WHO but remains a member of the Pan American Health Organization (PAHO). He could offer a path to cooperation with the US without requiring an overt political endorsement from the Trump administration.
• As an elected Regional Director rather than a direct appointee of Tedros, he possesses the necessary distance to frame himself as a “fresh start”.
• His background in health surveillance and ANVISA regulation is said to signal competence in “boring-but-decisive” institutional delivery, potentially appealing to donors seeking a “post-COVID repair” agenda.
• Sources tell us, his profile allows him to stand as a representative of the Global South who is a “technocrat” rather than a “firebrand,” making him marketable to a coalition of Latin American, EU, and Asian states.
• However, while Barbosa is a trained physician and epidemiologist, he has never served as a Minister of Health and his primary weakness is timing: having only started his term in February 2023, running in 2027 would mean leaving PAHO mid-mandate.
• Finally, his candidacy faces a unique financial hurdle: with PAHO heavily exposed to US arrears and funding pressure, opponents may argue that if he cannot stabilize the finances of his own regional house, he may struggle to manage the wider WHO in a post-US environment.

French ministers and diplomats

While sources indicate Paris may ultimately sit this election out, three distinct profiles have emerged in the conversation, representing the spectrum from political heavyweight to technical negotiator.

Agnès Buzyn, mentioned by informed circles as a possible candidate, theoretically ticks every box.

• Buzyn is a prestigious scientist as professor of haematology and former French Health Minister (2017-2020).
• Her portfolio includes leading high-stakes national agencies like the French National Cancer Institute (INCa) and the High Authority for Health (HAS), followed by recent internal WHO roles as the Director-General’s Envoy for Multilateral Affairs and Executive Director of the WHO Academy, positioning her as an insider with external political value.
• However, her domestic political baggage is heavy, as her resignation from the Ministry at the dawn of the pandemic in February 2020 to run for Mayor of Paris was widely criticized as abandonment.

With 48 years of age, Anne-Claire Amprou would be the youngest candidate to run for election.

• Her primary asset is her technical knowledge of the WHO’s current reform architecture as France’s Ambassador for Global Health.
• As a chief negotiator and co-chair of the WHO Pandemic Agreement, she has demonstrated credibility in navigating complex multilateral texts.
• However, insider assessments are blunt: confidential sources state she stands little chance, as her experience in global health is too recent with the primary concern being her shortfall of political weight: Amprou has never been a minister and lacks the medical credentials of a prestigious scientist, as she is not a doctor.

Marisol Touraine, too, is a strong candidate as an experienced political operator.

• She served a full five-year term as Minister of Social Affairs and Health.
• Sources claim she offers the “ministerial weight” and legislative toughness that is required to force through WHO reforms, having passed significant legislation, including plain packaging for tobacco.
• Her strong point is her current leadership role in global health governance as President of Unitaid.
• However, she represents a more traditional political profile, which sources suggest may not perform well in the current UN climate.

Longer shots from Belgium, Norway, and Pakistan? 

Word is that the Regional Director for Europe and trained physician, Hans Kluge (Belgium), would be eager to step up as WHO Director-General.

• Kluge offers a leadership profile defined by “permanent crisis management”, having navigated a fractured region through the COVID-19 pandemic, the war in Ukraine, and significant refugee health challenges.
• While technically an internal candidate, sources note that Kluge “openly disagreed” with Director-General Tedros during the pandemic and pursued distinct regional policies, allowing him to potentially market himself as a “reformist insider” capable of independent leadership despite never holding the rank of Minister.
• Still, he faces a unique geopolitical hurdle: with the former Belgian Prime Minister Alexander De Croo recently appointed as UNDP Administrator, it is diplomatically improbable for the country to hold two top UN spots simultaneously.
• Additionally, Kluge’s current mandate as Regional Director for Europe runs through 2029. While this is not a formal hurdle, there is an expectation among member states that he fulfil the term he was elected to serve, rather than pivoting to a campaign to become WHO’s Director-General.

Just this week, Norway’s Cathrine Lofthus was also mentioned in the Swiss media outlet NZZ as a possible candidate.

• Lofhus, a tough and ambitious and outspoken Director-General of Health, stood out during the recent WHO Executive Board debates on sexual and reproductive health rights, when she brokered a deal with the Organization of Islamic states, led by Egypt, to abstain from opposing the renewal of WHO relations with a number of reproductive health NGOs. A compromise text emphasized the  “sovereign” right of member states to choose their own engagements with non-state actors.
• Norway has led the WHO successfully in the past, under the guidance of former Norwegian Prime Minister and WHO Director General Gro Harlem Brundtland (1998-2003). Brundtland gained international recognition for her management of the 2002-2003 SARS outbreak, as well as overseeing the adoption of the WHO Framework Convention on Tobacco Control, and redefining the connection between poverty, health, and development.
• As a progressive European nation with a large donor portfolio and strong positions supporting climate, environment, and health equity in the Global South, a Norwegian candidate could potentially appeal to low and middle income countries – although not necessarily to social conservatives or the United States.

And finally, Sania Nishtar (Pakistan), CEO of Gavi, has also been mentioned as a potential candidate, who possesses the “stage presence skills” and consequent appeal. She ran against Tedros for WHO Director-General in 2017, as one of three short-listed scientists to succeed outgoing DG Margaret Chan. But precisely for that reason, her candidacy ten years later might not be perceived as the ‘fresh blood’ the organization needs now. 

• As a former Federal Minister who oversaw Pakistan’s massive social safety net, Nishtar combines the “technical discipline” of a cardiologist and researcher with the “executive weight” of a cabinet member.
• However, according to informed circles, her bid faces significant internal and external obstacles.
• Observers say, she could have difficulty securing support from her government, and the regional conflict between Pakistan and India complicates coalition-building.
• As a nominee from Pakistan would likely also be supported by China, this alignment renders her candidacy unlikely given the current geopolitical ruptures and the critical need to secure American re-entry.

Fierce competition on an arduous path

For any of the candidates entering the race, the election process will be arduous. According to WHO rules and previous election protocols, expect the cycle to formally begin in April 2026 when the current WHO Director-General issues the first call for candidate proposals, closing in October. In late January or early February 2027, the WHO Executive Board will then screen the candidates and nominate up to three finalists. The World Health Assembly casts the decisive vote in May 2027, with the new Director-General assuming office in August.

Winning will require more than just staying power, it means satisfying a contradictory set of demands: the successful candidate must straddle the divide between the Global South demanding equity and European countries like France, the UK and Germany, insisting on fiscal accountability. The new DG will have to negotiate deep geopolitical divides while preparing the Organisation for future pandemics or other global health crises. And this, while also managing the daunting post-COVID challenge of reaching at least some of the targets for the 2030 Sustainable Development Goal 3, Good Health and Wellbeing, including critical indicators of infectious and chronic disease in which the world lags far behind. Not to mention Universal Health Coverage. 

And, if the winds blow more favourably in Washington DC, trying to get the US back onboard.

Editor’s note: We extend our sincere gratitude to the experts and former WHO staff members whose dedicated research and perspectives were instrumental in the development of this analysis.

Image Credits: WHO/X, Anonymous/HPW, Kementerian Kesehatan, John Sears, Hannan Balkhy, Steffen Prößdorf, Germanhealth100, PAHO/WHO, Amélie Tsaag Valren, EU/Julien Nizet, EU, WHO, John Sears.