The next WHO director-general is Tedros Adhanom Ghebreyesus

The long wait is over: Tedros Adhanom Ghebreyesus has been elected as the World Health Organization’s new director-general by the World Health Assembly.

The former minister of health of Ethiopia beat two other finalists in the race — the U.K.’s David Nabarro and Pakistan’s Sania Nishtar — with a final vote of 133 out of a possible 186.The vote in Geneva on Tuesday 23rd May took almost five hours, including pre-vote statements from each of the finalists.Voting took place in three rounds. Tedros won the first round of voting with 95 votes, while Nabarro came in second with 52 votes. In accordance with the electoral rules, Nishtar was eliminated after finishing in third place with 38 votes.

Despite a huge lead, Tedros would have needed two-thirds of the vote to be considered as having a “clear and strong majority,” avoiding further rounds of voting.He took 121 votes in the second round, against Nabarro’s 62. The final round saw Tedros secure 133 votes, and Nabarro 50.The election concludes a year-long process that was unprecedented in the history of the U.N. health agency — the first time all member states have been given the opportunity to choose the next WHO leader.

The election is just the start of a long journey for Tedros, who will need to navigate his way in a challenging fiscal environment for the WHO and the wider global health community, with funding cuts looming among key donors such as the U.S.He will also bear the task of making the case for the WHO’s relevance, an issue outgoing director-general Margaret Chan underscored in her opening address — and her last speech — at the World Health Assembly.

Dr Tedros Adhanom Ghebreyesus was nominated by the Government of Ethiopia, and will begin his five-year term on 1 July 2017.Prior to his election as WHO’s next Director-General, Dr Tedros Adhanom Ghebreyesus served as Minister of Foreign Affairs, Ethiopia from 2012–2016 and as Minister of Health, Ethiopia from 2005–2012. He has also served as chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria; as chair of the Roll Back Malaria (RBM) Partnership Board; and as co-chair of the Board of the Partnership for Maternal, Newborn and Child Health.

As Minister of Health, Ethiopia, Dr Tedros Adhanom Ghebreyesus led a comprehensive reform effort of the country's health system, including the expansion of the country’s health infrastructure, creating 3500 health centres and 16 000 health posts; expanded the health workforce by 38 000 health extension workers; and initiated financing mechanisms to expand health insurance coverage. As Minister of Foreign Affairs, he led the effort to negotiate the Addis Ababa Action Agenda, in which 193 countries committed to the financing necessary to achieve the Sustainable Development Goals.

As Chair of the Global Fund and of RBM, Dr Tedros Adhanom Ghebreyesus secured record funding for the two organizations and created the Global Malaria Action Plan, which expanded RBM’s reach beyond Africa to Asia and Latin America.

Dr Tedros Adhanom Ghebreyesus will succeed Dr Margaret Chan, who has been WHO’s Director-General since 1 January 2007.