Last month, Tedros Adhanom Ghebreyesus, director-general of the World Health Organisation, met President Xi Jinping in Beijing to discuss what China’s leader called “the devil virus”.
Dr Tedros, an Ethiopian who in 2017 became the first African to head the Geneva-based institution, has been thrust into the maelstrom created by the coronavirus, which by Friday had infected 31,000 people in China, killed 636 and spread to two dozen countries.
Following the meeting, state media reported comments from Dr Tedros praising China’s handling of an outbreak that has become the biggest crisis either he or Mr Xi have faced. “China’s speed, China’s scale and China’s efficiency . . . is the advantage of China’s system,” he was quoted as saying.
Critics picked up on his remarks as evidence that the WHO was pandering to China’s dictatorship. Media outlets, including the Financial Times, have reported allegations that, in Wuhan — the city at the epicentre of the outbreak — officials were slow to report the virus’s spread, or even actively covered it up. To detractors, Dr Tedros is guilty of praising a state whose controlling instincts may have helped the virus multiply.
Many health experts, however, have leapt to his defence, arguing that Dr Tedros had nothing to gain from criticising China openly. “I think he’s doing amazingly well,” said David Nabarro, a former special adviser to the UN secretary-general.
“He has to work with the Chinese . . . He can’t just start slagging them off,” said Dr Nabarro, who lost out to Dr Tedros for the top WHO job. “Tedros is trying bloody hard to get it right.”
In an interview with the Financial Times on Thursday after another crushingly long day, Dr Tedros defended himself strongly, saying people should not rush to guess what China knew.
“Nobody knows for sure if they were hiding [anything],” he said, adding that, if they had, the virus would have spread earlier to neighbouring countries. “The logic doesn’t support the idea [of a cover up]. It’s wrong to jump to conclusions.”
China, he said, deserved “tailored and qualified” praise. “They identified the pathogen and shared the sequence immediately,” he said, helping other countries to quick diagnoses. They quarantined huge cities such as Wuhan. “Can’t you appreciate that? They should be thanked for hammering the epicentre. They are actually protecting the rest of the world.”
He also praised Mr Xi. “I was stunned by the knowledge he had. He was personally living it. That’s good leadership.”
It was under another forceful leader, Ethiopia’s former prime minister, Meles Zenawi, that Dr Tedros became health minister in 2005. Meles’s vision of a “development state” has been credited with transforming a country once associated with famine into one of Africa’s most promising prospects.
Under Meles, Dr Tedros cut cases of malaria, HIV, tuberculosis, maternal and child mortality, first in Tigray province and later, as health minister, across much of Ethiopia. He trained 40,000 female community health workers and increased the number of medical school graduates tenfold.
His strong belief in primary healthcare, he said, resulted from the death of his younger brother when he was seven and growing up in Asmara, capital of Eritrea, the son of a soldier. “I have been very committed to universal health coverage since,” he said.
Arkebe Oqubay, a former mayor of Addis Ababa, has known Dr Tedros for 25 years. “He transformed the health system in Tigray by building prevention systems,” he said, adding that he remembers him constantly reading management books and had rarely seen him angry. As foreign minister from 2012, he had what Mr Arkebe described as a hierarchy-flattening open-door policy.
At the WHO, Dr Tedros inherited an organisation heavy on turf wars but stretched for funding. He narrowed the organisation’s priorities: universal healthcare, prepare for health emergencies, focus on women’s and children’s health, and address the health impacts of climate change.
Peter Piot, director of the London School of Hygiene & Tropical Medicine, where Dr Tedros studied in the 1990s, has known him since his Tigray days. “I was always impressed by how connected he is to people on the ground,” he said, citing his numerous visits as director-general to the Democratic Republic of Congo during the recent Ebola outbreak.
“My suspicion is that he is happier going to Beni than sitting in executive board meetings,” said Mr Piot, referring to the city, prone to militia attack, at the epicentre of an Ebola crisis that is now waning.
Dr Tedros’s tenure has not been without mishap. Early on, he appointed Robert Mugabe, the late Zimbabwean dictator, as goodwill ambassador, a decision he reversed under a barrage of criticism.
Lawrence Gostin, professor of health law at Georgetown University, was a past critic, alleging that, as health minister, Dr Tedros covered up three cholera epidemics in Ethiopia, categorising them as “acute watery diarrhoea”. Dr Tedros strenuously denies this.
Yet even Mr Gostin has become a fan. “He’s fighting public health crises on two continents — Ebola in DRC and coronavirus in China — and I think he’s doing a damn good job.” With Beijing, he said, “he was walking on a tightrope because he wants to coax China to become a good international actor”.
Dr Tedros, who has launched a $675m coronavirus appeal, insisted that, with concerted action, the outbreak could be defeated. “We need to bring this virus out into the light so we can attack it properly,” he said.
“The virus is a common enemy,” he added. “Let’s not play politics here.”