As the campaign to elect a new World Health Organization Director-General officially opens, a timeline and guidelines for the process have been published by outgoing DG Dr Tedros Adhanom Ghebreyesus for consideration by member states at next week’s World Health Assembly and the upcoming Executive Board. While these aim to promote a transparent and level playing field, structural loopholes remain.

With the call for nominations for the next World Health Organization (WHO) Director-General officially underway, the global health community is bracing for an intense, year-long campaign season. The upcoming 2026/2027 WHO DG election cycle marks a definitive departure from the previous race in 2021, which unfolded amidst the COVID-19 pandemic, featured an incumbent, and relied heavily on remote adaptations.

The current contest expects a full return to “normal” physical in-person campaigning at regional committee sessions. However, a “new normal” is also unfolding under complex conditions, as the WHO grapples with a sharply polarized body of member states and a drastically reduced budget following the United States’ withdrawal last year, forcing it to implement massive, ongoing workforce reductions.

To maintain fairness in this highly pressured, post-pandemic landscape, WHO has published a draft set of guidelines that would help create a firewall between candidates’ campaign activities and official organisation business – rules that will be particularly important for candidates that emerge from within WHO’s ranks.

The Director-General’s recommendations on the election process, to be reviewed by Member States at the upcoming World Health Assembly and Executive Board, aim to reinforce established parameters from the previous election cycle. But enforcement still relies mostly on ‘good faith’ as compared to legally binding measures.

WHO staff members who join the race will have to go on leave – but Regional Directors may be exempt

Prospective candidates also must not conduct campaign activities as part of WHO regional committees’ official programmes. Reaffirming the standing rules, candidates will not be given speaking time during official meetings to promote their campaigns, and must instead restrict their promotional events strictly to the margins of these meetings.

The guidelines also set forth a proposed timeline – following the Director-General’s invitation to member states to nominate candidates, which was delivered by letter to Geneva’s UN missions on 24 April. After nominations close on 24 September, contenders would participate in a live candidates’ forum, with a proposed date of November 18. The field would then be narrowed to up to three finalists during the 160th Executive Board session, preliminarily set for 25 January-2 February 2027. After a second interactive forum, tentatively set for 15 March 2027, member states will vote at the May 2027 World Health Assembly, with the winner taking office in August 2027.

A gauntlet of public appearances

The framework further aims to create a gauntlet of public scrutiny for the election process. During the first live candidates’ forum, contenders will face structured 60-minute interviews. To ensure the question and answer process is not rigged, member states will drop colour-coded tokens into receptacles, which the Chair of the Executive Board will draw by lot to determine exactly who gets the opportunity to ask the candidates a question.

To curb the potential for opaque backroom deals, the WHO relies on a Code of Conduct to oversee activities on the physical campaign trail. Originally adopted by the World Health Assembly in 2013 and most recently amended in November 2020, this framework was specifically designed to promote an open, fair, equitable, and transparent election process.

Additionally, previous World Health Assembly decisions and WHO Secretariat practices guarantee financial travel support. Specifically, this involves provision of an economy-class airline ticket and a daily per diem for every candidate participating in both of the two live public forums that will be sponsored by WHO, and, upon request, for their interviews at the 160th session of the Executive Board.

This logistical support aims to ensure prospective leaders from lower-income regions receive a genuinely fair opportunity without relying entirely on massive domestic or private funding.

Guardrails built on ‘good faith’ – no binding enforcement

While these guidelines aim to promote a transparent and level playing field, structural loopholes remain. A closer reading of the WHO’s rulebook reveals that the Code of Conduct is not legally binding. The framework openly acknowledges it is merely a “political understanding” that recommends “desirable behaviour”, relying on the good faith of candidates and member states to honour its contents.

This lack of binding enforcement mechanisms leaves critical transparency measures vulnerable. For instance, candidates and member states are instructed to promptly disclose all campaign activities and funding sources to the Secretariat for public posting. But this system relies on self-reporting without independent audits.

Furthermore, while the regulations state that campaign-related travel should be “limited” to prevent financial inequality, and that using official technical meetings as a guise for electoral promotion “should be avoided”, these vague parameters leave vast room for interpretation.

Ultimately, as the mandate of Dr Tedros Adhanom Ghebreyesus approaches its expiration after the end of the upcoming election cycle, the focus will inevitably shift from the rules of the campaign trail to the monumental task awaiting his successor. Whoever emerges victorious from this highly scrutinised election must not only navigate deep geopolitical divides and restore internal trust, but also prepare the global health body for future crises.

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Image Credits: WHO/Christopher Black , Felix Sassmannshausen/HPW, Alexander Schimmeck via unsplash.