Tedros Adhanom Ghebreyesus (Ge'ez: ቴዎድሮስ አድሓኖም ገብረኢየሱስ; born 1965) is an Ethiopian politician, academic, and public-health authority as well as Director-General of the World Health Organization (WHO). He has held the latter office since 2017. He served in the Government of Ethiopia as Minister of Health from 2005 to 2012[11] and as Minister of Foreign Affairs from 2012 to 2016.[12]

Tedros joined the Ministry of Health in 1986, after graduating from the University of Asmara.[13] An internationally recognized malaria researcher,[13] as Minister of Health, Tedros received praise for a number of innovative and system-wide health reforms that substantially improved access to health services and key outcomes. Amongst them were hiring and training roughly 40,000 female health extension workers, cutting infant mortality from 123 deaths per 1,000 live births in 2006 to 88 in 2011, and increasing the hiring of health cadres including medical doctors and midwives. In July 2009, he was elected Board Chair of The Global Fund to Fight AIDS, Tuberculosis and Malaria for a two-year term.[16]

Tedros was elected as Director-General of the World Health Organization by the World Health Assembly on 23 May 2017.[12][18][19] He took office for a five-year term on 1 July 2017.

Early life and education

Tedros was born in 1965 in Asmara[20], Eritrea to Adhanom Gebreyesus and Melashu Weldegabir. The family had its roots in the Enderta awrajja of the province of Tigray and, as a child, he recalls being "fully cognizant of the needless suffering and deaths" caused by malaria.[16] In 1986 he received his Bachelor of Science (BSc) degree in Biology from the University of Asmara and joined the Ministry of Health of the Derg as a junior public health expert.

After the fall of Mengistu Haile Mariam, Tedros returned to university to pursue a Master of Science (MSc) degree in Immunology of Infectious Diseases from the London School of Hygiene & Tropical Medicine[13] at University of London. He subsequently received a Doctorate of Philosophy (PhD) in Community Health from the University of Nottingham in 2000, with a doctoral dissertation on "The effects of dams on malaria transmission in Tigray Region, northern Ethiopia, and appropriate control measures".[21]

Early career

Head of the Tigray Regional Health Bureau

In 2001, Tedros was appointed head of the Tigray Regional Health Bureau.[13] As head of the bureau, Tedros was credited with making a 22.3% reduction in AIDS prevalence in the region, and a 68.5% reduction in meningitis cases. He oversaw a campaign to improve ICT access that installed computers and internet connectivity to most of the region's hospitals and clinics, whereas they had not been connected before.[22] Health care staffing was increased by 50%.[22] Immunization for measles was raised to 98% of all children and total immunisation for all children under 12 months was raised to 74%.

The percentage of government funding for the Tigray Regional Health Bureau was increased to 65%, with foreign donors' percentage falling to 35%. Overall, 68.5% of the population was provided with health care services within 10 km.[22]

State Minister for Health

In late 2003 he was appointed a State Minister (deputy minister) for Health and served for just over a year.[11] It was during this time he started crafting his ambitious health reform agenda.

Minister of Health

Tedros was appointed Minister of Health in October 2005 by Prime Minister Meles Zenawi. Despite the many challenges faced by the health ministry in terms of poverty, poor infrastructure, and a declining global economic situation, progress in health indicators was considered "impressive" in Ethiopia.[24] During the period 2005-2008, the Ethiopian Ministry of Health built 4,000 health centres, trained and deployed more than 30,000 health extension workers, and developed a new cadre of hospital management professionals.[24] Furthermore, in 2010, Ethiopia was chosen by the US State Department as one of the US Global Health Initiative Plus countries, where the US will support innovative global health efforts.

Upon assuming office in 2005, Tedros inherited a ministry with a strong vision but little capability to meet that vision.[24] The Ministry was somewhat beholden to a donor community that was focused on HIV/AIDS, Tuberculosis, and malaria programs when Tedros first assumed his leadership position with a diagonal, systems-based reform agenda. With little economic surplus, the country lacked capacity to build its own health systems, and much of the Ethiopian human resources for health had fled the country- for example, there are more Ethiopian doctors in the Chicago metropolitan area than in Ethiopia.[24][25] Tedros designed the health workforce "flooding" reform strategy that has resulted in the training and deployment of thousands of doctors, nurses, pharmacists, laboratory technologists and health officers. He is particularly recognized for his innovative efforts that improve the working environment and motivation of medical doctors.

As Minister of Health, Tedros was able to form a close relationship with most global health key players including former American president Bill Clinton and the Clinton Foundation and the Bill and Melinda Gates Foundation .[24] This ground for the Clinton -Ministry of Health Partnership was built on engagement of equal partners. Tedros brought to the partnership the leadership to sustain focus on the selected agenda, the political clout to facilitate enabling legislation as needed, and first-hand knowledge of what was needed. President Clinton and the Clinton HIV/AIDS Initiative (CHAI) brought to the partnership a commitment to assist Tedros' priorities and their network, which provided sources money, expertise, and credibility.[24] As a result, Tedros was able to restructure and reform the Ministry in order to better meet its goals.

Global Health Initiatives

During his time as Minister of Health of Ethiopia Tedros has been very active in global health initiatives and left a print of his influence in the wider area of the global health architecture. Ethiopia was the first country to sign compact with the International Health Partnership. He has served as Chair of the Roll Back Malaria Partnership (2007-2009), Programme Coordinating Board of UNAIDS (2009-2010) and the Global Fund to fight AIDS, Tuberculosis and Malaria (2009-2011) and Co-Chair of The Partnership for Maternal, Newborn & Child Health (2005-2009). He also served as member of the Global Alliance for Vaccines and Immunization (GAVI) Board as well as the Institute of Health Metrics and Evaluation (IHME) and the Stop TB Partnership Coordinating Board. He was also member of several academic and global health think tanks including the Aspen Institute and Harvard School of Public Health . He has also served as vice-president of the 60th World Health Assembly that was held on 14–23 May 2007.

The Global Fund to Fight AIDS, Tuberculosis and Malaria and its reform

Tedros was elected as Board Chair of the Global Fund in July 2009 for a two-year term. In a profile published in April 2010, the Lancet reported that Tedros was “a household name at the Global Fund Secretariat” before his election as Board Chair where his leadership was regularly cited at the Global Fund that resulted in Ethiopia to be named as an exemplary high-performing country.

In his acceptance speech, he said ’The honor of this overwhelming vote of support belongs to my country, Ethiopia, which I am very privileged to represent. I am deeply humbled by this election and recognize well the weight of the responsibilities that come with it. The Global Fund faces big challenges ahead. But I am also optimistic about the great opportunities we now have for ensuring that this unique and innovative organization continues to be a success over the coming years”.

During his tenure, Dr. Tedros has guided the Global Fund to address significant challenges and to make important decisions that has led to the development of a comprehensive reform agenda and a more efficient and effective Global Fund. The Board has acknowledged his outstanding leadership role in its decision point at the end of his tenure saying " He has served the Global Fund with high degree of commitment and Passion. He has led with commitment and determination a comprehensive reform agenda".[11]

Millennium Development Goals

Ethiopia has been noted by the UN as one of the "success stories" in terms of achieving the Millennium Development Goals (MDGs).[27] Three of the eight MDGs, goals four through six, deal directly with health:

  • Reducing child mortality rates,
  • Improving maternal health,
  • Combating HIV/AIDS, malaria, and other diseases

Maternal and Child Health

The rate of child deaths fell by 30 percent between 2005 and 2011.[24] Infant mortality decreased by 23 percent, from 77 to 59 deaths per 1,000 births, while under-five mortality decreased by 28 percent, from 123 to 88 per 1,000 births.[28] The number of expectant mothers who delivered with the help of a skilled provider rose from 6 percent in 2005 to 10 percent in 2011, according to the 2011 Ethiopia Demographic and Health Survey.[28]

Tuberculosis

During Tedros' tenure TB prevention and treatment services were included as one of the packages of the Health Extension Workers which has resulted in impressive improvement of performance and the achievement of the TB MDG targets well ahead of the target time.

Malaria

Deaths from malaria fell by more than 50% from 2005-2007.[24] The rate of new malaria admittances fell 54% in the country over the same period, while the number of childhood malaria cases reported at clinics fell by 60%.[28] The Health Ministry conducted the distribution of 20.5 million insecticide-treated bed nets to protect over 10 million families in malaria-prone areas between 2005 and 2008.[28]

According to the WHO’S Africa office (WHO-AFRO), in 2011 when Adhanom was the minister of health, 75% of the land and 60% of the population is exposed to malaria in Ethiopia, although malaria admissions and deaths marginally fell in the recent years (afro.who.int/en/ethiopia/country-programmes/topics/480-ethiopia-malaria.html)

The National Malaria Guideline (3rd Edition) prepared by the Ministry of Health of Ethiopia in 2012, before the departure of Adhanom to the Ministry of Foreign Affairs, states that “52 million people (68%) live in Malaria-risk areas”. The document further reveals that “Ethiopia is one of the most malaria- prone countries in Africa, with rates of morbidity and mortality increasing dramatically (i.e. 3.5 fold) during epidemics” (page 15) (for details see malariaconsortium.org. The same document alleges serious policy failures of the Government of Adhanom who was the Minister of Health until 2013. It argues “Ethiopia faces many challenges related to human resources for healthcare, including the shortage of skilled health workers, high turnover and lack of retention of health professionals” (page 64). In addition to these challenges, the National Malaria Guideline stresses once again, “serious problems in coordinating health interventions and implementing partners” (page 65)

AIDS

Under Tedros, the Ministry of Health was able to turn around Ethiopia’s record of the highest number of new HIV infections in Africa, taking the number down dramatically.[28] The prevalence was reduced from its double digit record to 4.2 in cities and 0.6 in rural areas.[28] According to the HIV/AIDS Prevention and Control Office (HAPCO) said the rate of HIV infection in Ethiopia has declined by 90% between 2002 and 2012, while the rate AIDS-related death has dropped by 53%.[28] The number of people starting HIV treatment increased more than 150-fold during 2005-2008.[24]

The decline in the infection rate has been attributed to the concerted effort of the Ministry of Health in providing medicines and organizing various awareness-raising programs.[28] The office has managed to integrate the people in HIV prevention and control activities. The wide range of media campaigns to inform the public about the disease has definitely paid off as it has helped achieve behavioral change. Prevention measures like the use of condoms have shot up starkly with increased awareness on the disease and advertising urging safe sex practices and condom use.[28] The government’s collaboration with local and international governmental and nongovernmental organizations has also positively influenced access to HIV/AIDS related service centers.[28]

Family planning

Under Tedros' tenure, the unmet need for family planning in Ethiopia has declined, and the contraceptive prevalence rate has doubled in 5 years. Based on the current trends, contraceptive prevalence rates will reach 65% by 2015 by reaching additional 6.2 million women and adolescent girls.[29] Recognising that early childrearing is a major factor in infant mortality, the Ministry of Health is targeting its efforts on adolescent girls (15 to 19 years) who have the highest unmet need for family planning.[29]

Criticism

In May 2017, just prior to the WHO election, stories surfaced about an alleged cover up of three possible cholera epidemics in Ethiopia in 2006, 2009 and 2011. The outbreaks were allegedly wrongly labelled as "acute watery diarrhea" (AWD)—a symptom of cholera—in the absence of laboratory confirmation of Vibrio cholerae in an attempt to play down the significance of the epidemics.[11][31] UN officials said more aid and vaccines could have been delivered to Ethiopia if the outbreaks had been confirmed as cholera. The allegations were made by Larry Gostin, an American law professor, who was acting as an adviser to rival candidate David Nabarro from the UK.[31] The African Union delegation to the UN dismissed the report, published in The New York Times, as "an unfounded and unverified defamation campaign, conveniently coming out only days before the election."[32] Tedros Adhanom denied the allegation of a cover up and said he was "not surprised at all but quite disappointed" by what he called a "last-minute smear campaign."[31]

Minister of Foreign Affairs

In November 2012, Tedros was appointed Minister of Foreign Affairs, as part of Hailemariam Desalegn's cabinet reshuffle after he was approved by the EPRDF as party leader (and thus Prime Minister).

The third Financing for Development Conference (FfD3)

Tedros was instrumental in the successful outcome of the Conference which was held in Addis Ababa, Ethiopia, on 13–16 July 2015 demonstrating his negotiation and consensus building skills. He played key role in saving the Forum from collapse by bringing polarized positions closer. The outcome document, called the Addis Ababa Action Agenda (AAAA), set policy actions by Member States, which draw upon all sources of finance, technology, innovation, trade, and data in order to support the implementation of the Sustainable Development Goals.[33] The Conference, however, was criticized by a few observers for failing to come up with new money for implementing the SDGs during its process [34] while a follow up report by the Economic and Social Council Forum in April 2016 was much more optimistic and provided the framework to monitor the commitments.[35] Dr Tedros served as a member of the High Level Task Force for innovative financing for Health Systems chaired by former World Bank President and Prime Minister of UK, Gordon Brown.[37]

Agenda 2063 of Africa Union

As Chair of the Executive Council of the AU in 2014, Dr. Tedros highlighted the need for a paradigm shift in Africa’s political and socio-economic governance and development in order to realize the continent’s long-term agendas. He emphasized the need for Africa to focus on issues of economic emancipation, peace and stability, the acceleration of rapid economic growth, governance and democratization. During his tenure, the AU adopted its First Ten Year Implementation Plan for Agenda 2063 – a roadmap for achieving a prosperous Africa based on inclusive growth and sustainable growth, which has placed health as its centerpiece. His leadership and skills in conflict resolution have also helped resolve regional disputes—such as the agreement between the Federal Government of Somalia and Jubaland Political Actors—which was critical to improving the delivery of health services and protecting the safety and security of Somali citizens.

West Africa Ebola Crises

As Minister of Foreign Affairs Dr Tedros played a pivotal leadership role in the Africa Union's response to the Ebola epidemic. He particularly facilitated greater country ownership and urging countries to adhere to the WHO guidelines including the full implementation of the International Health Regulations. He also advocated that the Ebola crises offer a unique opportunity to strengthen primary health care and highlight the importance of health as a critical security issue. In an interview he conducted with Devex in November 2014 Tedros discusses what “disappointed” him in the global response to Ebola, the importance of solidarity in overcoming the outbreak, and how the deadly virus has transformed to a crisis beyond health.[38] He also promptly mobilised 200 Ethiopian health workers highly trained in management of public health emergencies and surveillance (by an initiative he has created when he was the Minister of Health) to join the African Union response team.[39]

Hidase Dam controversy

In May 2013, controversy intensified over the under-construction Hidase Dam in the Benishangul-Gumuz near Sudan as Ethiopia began diverting the Blue Nile for the dam's construction. By that time it was more than 22 percent complete, and the dam is expected to produce 6,000 megawatts, which will make it Africa’s largest hydroelectric power plant. The dam is expected to have a reservoir of around 70 billion cubic meters, which is scheduled to start filling in 2014. Egypt, Ethiopia and Sudan established an International Panel of Experts to review and assess the study reports of the dam. The panel consists of 10 members; 6 from the three countries and 4 international in the fields of water resources and hydrologic modelling, dam engineering, socioeconomic, and environmental.[40] The panel held its fourth meeting in Addis Ababa in November 2012. It reviewed documents about the environmental impact of the dam and visited the dam site.[41] The panel submitted its preliminary report to the respective governments at the end of May 2013. Although the full report has not been made public, and will not be until it is reviewed by the governments, Egypt and Ethiopia both released details. The Ethiopian government stated that, according to the report, the dam meets international standards and will be beneficial to Egypt, Sudan and Ethiopia. According to Egyptian government, the report found that the dimensions and size of the dam should be changed.[40][42]

On 3 June 2013 while discussing the International Panel of Experts report with President Mohammad Morsi, Egyptian political leaders suggested methods to destroy the dam, including support for anti-government rebels.[43][44] The discussion was televised live without those present at meeting aware.[43] Ethiopia requested that the Egyptian Ambassador explain the meeting.[45] Morsi's top aide apologized for the "unintended embarrassment" and his cabinet released a statement promoting "“good neighborliness, mutual respect and the pursuit of joint interests without either party harming the other.” Morsi reportedly believes that is better to engage Ethiopia rather than attempt to force them.[43] However, on 10 June 2013, he said that "all options are open" because "Egypt's water security cannot be violated at all," clarifying that he was "not calling for war," but that he would not allow Egypt's water supply to be endangered.[46] Tedros said the dam will be used exclusively for power generation and is being constructed in a way that takes Egypt’s water security concerns into account.[47] On 18 June, Tedros and Egyptian Foreign Minister Mohamed Kamel Amr issued a joint statement reiterating "their commitment to strengthen their bilateral relations and coordinate their efforts to reach an understanding regarding all outstanding issues between both countries in a manner of trust and openness building on the positive developments of their relations".[48] Both agreed to review the report of the International Panel of Experts and implement their recommendations, working to defuse the tensions and ease the crisis.[48]

Awards and Publications

A globally recognized malaria researcher, Dr. Tedros has co-authored numerous articles on this subject and other global health issues in prominent scientific publications, including Annals of Tropical Medicine and Parasitology, The Lancet, Nature and Parasitologia and the British Medical Journal. His seminal work earned him the distinction of Young Investigator of the Year from the American Society of Tropical Medicine and Hygiene and in 2003 he received the Young Public Health Researcher Award from the Ethiopian Public Health Association. In 2011, Dr. Tedros became the first non-American recipient of the Jimmy and Rosalynn Carter Humanitarian Award conferred by the US National Foundation of Infectious Diseases. In March 2012, he received the prestigious Honorary Fellowship from the London School of Hygiene and Tropical Medicine and the Stanley T. Woodward Lectureship, Yale University (2012). He also received the Women Deliver Award for Perseverance for his tireless efforts to improve the lives of women and girls at the fourth Women Deliver Conference on May 19, 2016.

One of 50 people who will change the world in 2012

Dr Tedros was named as one of the 50 people who will change the world in 2012 by the UK Wired Magazine. The Magazine wrote " Dr Tedros has used innovative techniques to save the lives of millions of Ethiopians. Rather than building expensive hospitals, he has set up programmes to train 35,000 health workers. The workers then go on to provide care in nearly every community across Ethiopia -- especially for women and children, who are often the most vulnerable and underserved. As a result of this, women have access to family planning and are now able to plan the timing and spacing of their children. And children now receive life-saving vaccines and treatment for deadly illnesses such as pneumonia, malaria and diarrhoea. In five years, his work has reduced the death rate of Ethiopian children under five by 28 per cent. Does it get more inspiring than that?" [49]

One of the 100 most influential Africans for 2015

The New African Magazine, a best-selling pan-African magazine published in the UK, listed Tedros as one of the 100 most influential Africans for 2015 in the category of politics and public service. The magazine named him as " the trailblazer" and signified his reformist agenda as Minister of Health of Ethiopia where he transformed the health sector of the country through massive deployment of health extension workers which has resulted in massive gains. The magazine said Tedros put people at the center of his policies again as Minister of Foreign Affairs and mentioned his massive social media followers. His role as a key player in Ethiopia′s strategic regional interventions and mediation in Sudan and Somalia also contributed for his naming as one of Africa′s influential people for 2015.

World Health Organisation

Candidature and election

On May 24, 2016, in the margins of the 69th World Health Assembly, Dr Tedros had officially announced his candidacy for the post of the Director-General of the World Health Organisation as the sole African candidate, with endorsement from African Union and Ministers of Health of the continent. His official launch of candidacy in Geneva was attended by the chairperson of the African Union Commission, Nkosazana Dlamini-Zuma, Minister of Foreign Affairs of Rwanda and Kenya, and Ministers of Health of African countries represented by the Algerian Health Minister Abdelmalek Boudiaf. During the launch, it was stressed that the nomination of Dr Tedros was based on merit and his prolific national and global credentials. His campaign tagline was 'Together for a Healthier World' and he also launched a campaign website at . He argued that he will bring a fresh perspective to the WHO as he has lived with the most pressing conditions of our time. His launch has got wide media coverage and support.

During its 140th meeting in January 2017, the Executive Board of the WHO shortlisted Dr Tedros as the front runner out of six candidates through two rounds of secret voting. He collected the most votes during both rounds. On May 23, 2017, Dr. Tedros was elected as the next Director-General for the World Health Organisation with an overwhelming 133 votes out of 185.[50] [52] His historical campaign was hailed as highly organised and strategic. His Campaign Chair was Prof Senait Fisseha, who is an Ethio-American lawyer and a Professor of Gynaecology and Obstetrics from University of Michigan. She is a long time friend of Dr Tedros and was instrumental for leading his Campaign to victory and her overall influence and role was acknowledged by Dr Tedros during a victory party on May 24, 2017 [53]. Prof Senait also later led his transition team. The election of Dr Tedros was felt as a victory for Africa. Negash Kebret Botora, Ethiopia’s ambassador to the UN and international organisations in Geneva, who also played critical role in the victory, said the win was “a big victory for Africa and the developing world. It’s the first time in 70 years we have an African candidate win by a landslide”[54]. His campaign was supported by a Fund created by East African countries. [55]

Tenure

After assuming office, he has appointed the most diverse leadership team composed of 60% women and he has got a global acclaim for fulfilling his campaign promise of gender equity and promoting women. It was said that his Leadership Team "could change the planet's approach to health" [56]. His appointees were:

  • Dr Soumya Swaminathan of India as Deputy Director-General for Programmes;
  • Ms Jane Ellison of UK as Deputy Director-General for Corporate Operations;
  • Dr Peter Salama of Australia will remain in his role as the Executive Director of the Health Emergencies Programme;
  • Dr Bernhard Schwertländer of Germany as Chef de Cabinet;
  • Dr Naoko Yamamoto of Japan, Assistant Director-General for Universal Health Coverage and Health Systems Cluster;
  • Professor Lubna A. Al-Ansary of Saudi Arabia, Assistant Director-General for Metrics and Measurement;
  • Dr Svetlana Akselrod of Russia , Assistant Director-General for Noncommunicable Diseases and Mental Health;
  • Ambassador Michèle Boccoz of France, Assistant Director-General for External Relations;
  • Dr Ranieri Guerra of Italy, Assistant Director-General for Special Initiatives;
  • Dr Ren Minghui of China, Assistant Director-General for Communicable Diseases;
  • Dr Mariângela Batista Galvão Simão of Brazil, Assistant Director-General for Drug Access, Vaccines and Pharmaceuticals;
  • Dr Princess Nothemba (Nono) Simelela of South Africa, Assistant Director-General for Family, Women, Children and Adolescents;
  • Mr Stewart Simonsson of US, Assistant Director-General for General Management;
  • Dr Joy St John, Assistant Director-General for Climate and Other Determinants of Health. [57]

The announcement of this senior leadership team was followed by another similarly high-profile and well-received appointment. He has appointed Dr. Sania Nishtar, whom he ran against for the director-general position, to chair a high-level commission on noncommunicable diseases that WHO will be establishing ahead of the third U.N. high-level meeting on NCDs in 2018. She will co-Chair the Commission with the President of Uruguay. His 100 days as Director General of WHO was appreciated as a good start.[58]

Mugabe Goodwill Ambassador controversy

On 21 October 2017, Tedros Adhanom announced that he had chosen President Robert Mugabe of Zimbabwe to serve as a WHO Goodwill Ambassador to help tackle non-communicable diseases for Africa. He said Zimbabwe was "a country that places universal health coverage and health promotion at the centre of its policies to provide health care to all". Mugabe's appointment was severely criticised, with WHO member states and international organisations saying that Zimbabwe's healthcare system had in fact gone backwards under his regime, as well as pointing out Mugabe's many human rights abuses. It was also noted that Mugabe himself does not use his own country's health system, instead travelling to Singapore for treatment.[59][60] Following widespread condemnation, Tedros Adhanom was forced to rescind Mugabe's goodwill ambassador role the following day.[61][62].

Personal life

Tedros Adhanom is married and has five children.[63]