Tedros Adhanom Ghebreyesus was watching late-night television when he saw a hospital boss criticizing him and Ethiopia’s Health Ministry, which he was leading at the time, for doing a terrible job. Instead of responding with a furious diatribe, as some political leaders might when watching their detractors on TV, he contacted the man, Dr. Kesete Admasu.
“Tedros called him in and said, well, if you have ideas and you’re critical get in here and help us fix it, and made him Deputy Minister, which gives you a sense of his leadership style in bringing in the smartest and the best and empowering them,” United States diplomat Mark Dybul, a professor at the Georgetown University Medical Center and co-director of the Center for Global Health Practice and Impact, told CNN.
“He took one of the worst ministries of health in the world, transformed it into one of the best, had to make very difficult political and health decisions and moves to make that happen,” Dybul said.
Today, Tedros – who is usually known by his first name, as is typical in Ethiopia – is again facing harsh criticism as he tries to balance powerful interests and reform a troubled institution facing a monumental challenge. Some believe that if anyone can change the World Health Organization and help the world deal with the coronavirus pandemic, it’s him.
“I think he’s doing an incredible job,” Peggy Clark, Executive Director of the Aspen Global Innovators Group who has worked closely with Tedros, told CNN. “I think that he is managing the situation as well as he can, even with the kind of ridiculous position that the US is taking at this time.”
US President Donald Trump has regularly attacked WHO during the pandemic, blaming it for multiple failures and alluding to China’s alleged influence at the organization as he moved to withdraw tens of millions in funding and, eventually, US membership.
Tedros has mostly reacted to these onslaughts with equanimity, but earlier this month condemned a “lack of leadership” in fighting the pandemic and made an emotional plea for global unity.
And when US Secretary of State Mike Pompeo claimed the Director-General had been “bought” by China, Tedros pushed back harder, calling the comments “untrue and unacceptable.”
Tedros said that what “should matter to the entire international community is saving lives,” adding that WHO would not be distracted.
‘Rock star in the health world’
It is this single-minded determination that has characterized Tedros’s rise to global fame, with the WHO Director-General known for his passion and drive, say observers.
In a speech before he was voted in for a five-year term in May 2017, Tedros said that when he was seven, his younger brother died “from one of the many child killers in Africa,” Science Magazine reported. Tedros said that could easily have been him, and it was “pure luck” that he was now on stage running for a global leadership position. He said he was committed to reducing inequality and ensuring universal health coverage because he had grown up “knowing survival to adulthood cannot be taken for granted, and refusing to accept that people should die because they are poor.”
His path soon became clear. As a child living in Eritrea, then a region of Ethiopia, the WHO filtered into his consciousness, Tedros said in a speech last year. “I remember walking through the streets of Asmara with my mother as a small boy, and seeing posters about a disease called smallpox. I remember hearing about an organization called the World Health Organization that was ridding the world of this terrifying disease, one vaccination at a time.”
After gaining a biology degree from the University of Asmara in 1986, he began working for Ethiopia’s Ministry of Health and studied in Denmark, which opened his eyes to the value of universal healthcare. In 1992, he received a WHO scholarship for a Masters degree at the London School of Hygiene and Tropical Medicine, before completing a PhD in community health at the University of Nottingham in 2000.
His thesis on malaria in the Tigray Region, where he grew up, was “outstanding” and “innovative,” his former supervisor wrote in a letter to The Lancet medical journal supporting his bid for the WHO job. “A lasting memory of that collaboration was Tedros’ innate ability to mobilize and inspire communities towards better health,” wrote Peter Byass.
Tedros became head of the Tigray Regional Health Bureau and spent a year as a minister of state before serving as health minister from 2005 to 2012. “There were really only a handful of ministers of health, globally, who were really doing exceptional work in the developing world, and one was Minister Tedros,” said Clark.
He found fame for “showing the way to a new era in world health,” in the words of former USAID Administrator Ariel Pablos-Mendez, particularly through his bold vision to hire 38,000 young, female community health workers in every village in the country to deliver basic family planning, child health and malaria care.
His work helped to reduce child mortality by two-thirds, HIV infections by 90%, malaria mortality by 75% and tuberculosis mortality by 64%, according to his WHO application.
“Tedros became kind of a superstar. He was a rock star in the health world, and everybody loved him, not only because he was really so charismatic and brilliant but also because as a man, he really was setting up for family and children and women; it was very unusual,” said Clark.
Clark believes Tedros’s health worker program made a profound difference to a poor country, and he announced similar priorities around universal healthcare, women and children and health emergencies on taking office at WHO.
Many leaders in developing countries were dependent on wooing donors, said Clark,”but Tedros was so revered and beloved, he could literally walk into a room with donors and walk out with a multimillion-dollar check.”
Teshome Gebre, then the Carter Center’s Ethiopia representative for health programs, visited Tedros with his US bosses in 2006 to solicit help with tackling neglected tropical diseases. In a remarkable turnaround, Tedros instead persuaded them to donate $35 million to his malaria program, arguing that this was more urgent, life-saving work aimed at impoverished, marginalized people.
“They were extremely impressed with the way he really presented his arguments, his business case was so compelling,” Teshome told CNN.
“This is for me one of the most memorable experiences that I have ever had with Dr. Tedros. I think I can say in my lifetime, I have never seen this kind of completely unexpected outcome.”
He has strong support from the continent, where South Africa in particular faces a battle to contain the virus.
On April 8, Tedros said he had been receiving death threats, abuse and racist comments, but brushed them off. “I’m proud of being black,” he said. “I don’t give a damn.”
He said when the whole black community or Africa was insulted “then I don’t tolerate it, then I say, people are crossing the line.”
His stint as Ethiopia’s Minister of Foreign Affairs between 2012 and 2016 saw him refine his diplomatic skills, persuading 193 countries to commit to financing the Sustainable Development Goals under the Addis Ababa Action Agenda.
He forged a friendship with former US president Bill Clinton through the Clinton HIV/AIDS Initiative, he has backing from tech tycoon Bill Gates, and he is on close terms with leaders including French President Emmanuel Macron and South Africa’s Cyril Ramaphosa.
But some doubt Tedros precisely because of his diplomatic aptitude.
There were concerns when he was running for WHO leadership over his connection to an authoritarian government, one that Teshome concedes was “not very democratic.”
Georgetown University professor Lawrence Gostin, a supporter of Tedros’s WHO leadership rival David Nabarro, told CNN he was worried at the time because of Ethiopia’s “abysmal human rights record.”
Gostin – director of the O’Neill Institute for National and Global Health Law, now a WHO Collaborating Center – had reservations over alleged cover-ups of cholera outbreaks in Ethiopia, which Tedros denies.
Teshome agrees Tedros was “not transparent enough,” but observed that “if he does otherwise, he will be fired from his position.”
Gostin now speaks with Tedros regularly and calls him an “extraordinarily good” leader, and “one of the strongest director-generals in recent memory.”
Tedros inherited what The Lancet called a “bruised and apologetic” WHO after its poor response to the 2013-2016 Ebola epidemic in West Africa. The organization was bureaucratic, politicized, and underfunded and reform was desperately needed.
Tedros’s success in containing the Ebola epidemic in the Democratic Republic of the Congo (DRC) was widely praised. “Unlike most director-generals, he leads from the front,” said Gostin. “He was on the ground, and probably, in harm’s way.”
WHO spokeswoman Margaret Harris was in the DRC at the time, and recalls Tedros genuinely participating on those visits, talking to local people and taking selfies with anyone who asked. When a public health emergency was declared, Tedros called in from the DRC, said Gostin.