Tedros Adhanom

Tedros Adhanom Ghebreyesus ( ti, ቴዎድሮስ አድሓኖም ገብረኢየሱስ, sometimes spelt ti, ቴድሮስ ኣድሓኖም ገብረየሱስ, label=none; born 3 March 1965) is an Ethiopian public health official, researcher, and Director-General of the World Health Organization since 2017. Tedros is the first African to become WHO Director-General, receiving an endorsement for the role by the African Union. He played a role in the response to the Ebola virus epidemic, the ongoing COVID-19 pandemic, and the ongoing 2022 monkeypox outbreak.

Prior to serving as Director-General, he held two high-level positions in the government of Ethiopia: Minister of Health from 2005 to 2012 and Minister of Foreign Affairs from 2012 to 2016. Tedros was included in ''Time''s 100 Most Influential People of 2020.

Early life and education

Tedros was born in Asmara, Eritrea (at that time part of the Ethiopian Empire), to Adhanom Gebreyesus and Melashu Weldegabir. His family originated from the Enderta awrajja of Tigray. Tedros recalled that as a child he was very aware of the suffering and death caused by malaria. His younger brother died at the age of 3 or 4 years, possibly of a preventable disease like measles, which Tedros often discusses as a defining personal experience in regards to the need for global healthcare.

In 1986, Tedros received a Bachelor of Science degree in biology from the University of Asmara. He studied at the London School of Hygiene & Tropical Medicine and was awarded a Master of Science degree in immunology of infectious diseases from the University of London in 1992. In 2000, he earned a Doctor of Philosophy in community health from the University of Nottingham for research on the effects of dams on malaria transmission in the Tigray region.

Early career

In 1986, after his first degree, Tedros joined the Ethiopian Ministry of Health as a junior public health expert.

Tedros joined the Tigray People's Liberation Front, the leading group in a coalition of movements known as the Ethiopian People's Revolutionary Democratic Front in a successful bid to overthrow Mengistu Haile Mariam.

In 2001, Tedros was appointed head of the Tigray Regional Health Bureau. In 2003, he was appointed a State Minister (deputy minister) for Health, a post he held for just over a year.

Ethiopian politics

Minister of Health of Ethiopia (2005–2012)

In October 2005, Tedros was appointed Minister of Health of Ethiopia by Prime Minister Meles Zenawi of Tigray People's Liberation Front. At this time the Ethiopian health ministry faced challenges that included poverty, poor infrastructure, and a declining global economic situation; Ethiopia employed fewer doctors than the number of Ethiopian doctors working in the Chicago metropolitan area. A review published in ''Global Health Governance'' considered progress in health indicators during this period to be significant. The Health Ministry's activities from 2005 to 2008 were supported by US$1.9 billion in development aid, increased focus on links between community and centralized health systems, and less exclusive attention to HIV/AIDS and malaria. 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. This program included the construction of 4,000 health centres, trained and deployed more than 30,000 health extension workers, and developed a new cadre of hospital management professionals as part of a Health Extension Program (HEP). A 2011 Demographic Health Survey suggests these efforts reduced Ethiopian infant mortality from 123 deaths per 1,000 live births in 2006 to 88 in 2011.

As Minister of Health, Tedros was able to form a close relationship with prominent figures and organizations including former American president Bill Clinton, his Clinton Foundation and the Bill & Melinda Gates Foundation. In 2010 the US State Department named Ethiopia as one of the US Global Health Initiative Plus countries, providing the country with greater access to resources for public health projects.

Global health initiatives

During his time as Minister of Health of Ethiopia, Tedros was very active in global health initiatives. Ethiopia was the first country to sign a compact with the International Health Partnership. He was chair of the Roll Back Malaria Partnership (2007–2009), a member of the Programme Coordinating Board of UNAIDS from 2009 to 2010 and the Global Fund to fight AIDS, Tuberculosis and Malaria from 2009 to 2011 and co-chair of the Partnership for Maternal, Newborn & Child Health (2005–2009). He also served as a 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 a member of several academic and global health think tanks including the Aspen Institute and Harvard School of Public Health. He served as vice-president of the 60th World Health Assembly that was held on 14–23 May 2007. From 2008 until 2009, he was a member of the High Level Taskforce on Innovative International Financing for Health Systems, co-chaired by Gordon Brown and Robert Zoellick.

The Global Fund to Fight AIDS, Tuberculosis and Malaria

In July 2009, Tedros was elected board chair of The Global Fund to Fight AIDS, Tuberculosis and Malaria 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 being named as an exemplary high-performing country.

Maternal and child health

Tedros oversaw a program introducing 30,000 health extension workers, focused on reducing maternal mortality and child mortality.

The rate of child deaths fell by 30 percent between 2005 and 2011. 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. 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.

Tuberculosis

During Tedros's tenure as Minister of Health, tuberculosis prevention and treatment services were included as one of the packages of Health Extension Workers, which has resulted in improvements in performance and the achievement of the tuberculosis ''Millennium Development Goals'' (MDG) ahead of the target date.

Malaria

Deaths from malaria fell by more than 50% from 2005 to 2007. 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%. 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.

According to the WHO Africa office (WHO-AFRO), in 2011 when Tedros was the minister of health, 75% of the land and 60% of the population was exposed to malaria in Ethiopia, although malaria admissions and deaths marginally fell in recent years.

The National Malaria Guideline (3rd Edition) prepared by the Ministry of Health of Ethiopia in 2012, before the departure of Tedros to the Ministry of Foreign Affairs, states that "52 million people (68%) live in malaria-risk areas." The document also states, "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" and alleges serious policy failures of the Government of which Tedros 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." In addition to these challenges, the National Malaria Guideline stresses "serious problems in coordinating health interventions and implementing partners."

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, bringing the number down dramatically. The prevalence was reduced from its double-digit record to 4.2 in cities and 0.6 in rural areas. According to the HIV/AIDS Prevention and Control Office (HAPCO), Ethiopia's rate of HIV infection declined by 90% between 2002 and 2012, while AIDS-related death dropped by 53%. The number of people starting HIV treatment increased more than 150-fold during 2005–2008.

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. 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 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. The government's collaboration with local and international governmental and non-governmental organizations has also positively influenced access to HIV/AIDS related service centers.

Family planning

Under Tedros's tenure, the unmet need for family planning in Ethiopia declined, and the contraceptive prevalence rate doubled in five years. Contraceptive prevalence rates reached 65% in 2015 by reaching an additional 6.2 million women and adolescent girls. Recognising that early childrearing is a major factor in infant mortality, the Ministry of Health targeted its efforts on adolescent girls (15 to 19 years) who have the highest unmet need for family planning.

Minister of Foreign Affairs of Ethiopia (2012–2016)

In November 2012, Tedros became Ethiopia's Minister of Foreign Affairs. He held this position until 2016, as part of Hailemariam Desalegn's cabinet reshuffle after he was approved by the EPRDF as party leader (and thus Prime Minister).

Financing for Development Conference (FfD3)

Tedros was instrumental in the successful outcome of the Third International Conference for Financing for Development, which was held in Addis Ababa, Ethiopia, on 13–16 July 2015. He was responsible for the organization of the ''Addis Ababa Action Agenda (AAAA)'' document in which the attending countries committed to financing for the Sustainable Development Goals. He played a key role in saving the Forum from collapse by bringing polarized positions closer. The outcome document, the ''Addis Ababa Action Agenda (AAAA)'', set policy actions by Member States, which draw upon all sources of finance, technology, innovation, trade, and data to support the implementation of the Sustainable Development Goals. The Conference was criticized by a few observers for failing to come up with new money for implementing the SDGs while a follow-up April 2016 report by the Economic and Social Council Forum was much more optimistic and provided the framework to monitor the commitments. Tedros served as a member of the High Level Task Force for innovative financing for Health Systems chaired by former World Bank President and U.K. Prime Minister Gordon Brown.

Agenda 2063 of Africa Union

As Chair of the Executive Council of the AU in 2014, Tedros highlighted the need for a paradigm shift in Africa's political and socio-economic governance and development 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. He also helped achieve the agreement between the Federal Government of Somalia and Jubaland Political Actors, which played a role in improving the delivery of health services and protecting the safety and security of Somali citizens.

West Africa Ebola Crises

As Minister of Foreign Affairs, Tedros played a pivotal leadership role in the Africa Union's response to the 2013–2016 Western African Ebola virus 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. He also promptly mobilised 200 Ethiopian health workers highly trained in management of public health emergencies and surveillance (by an initiative he created when he was the Minister of Health) to join the African Union response team.

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. At that time, the dam was more than 22 percent complete and expected to produce 6,000 megawatts, making it Africa's largest hydroelectric power plant. The dam was expected to have a reservoir of around 70 billion cubic meters, which was scheduled to start filling in 2014. Egypt, Ethiopia and Sudan established an International Panel of Experts to review and assess the study reports on the dam. The panel consisted 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. 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. 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 the Egyptian government, the report found that the dimensions and size of the dam should be changed.

On 3 June 2013, while discussing the International Panel of Experts report with President Mohammad Morsi

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