Hanan Balkhy is currently juggling numerous responsibilities.
She serves as the director of the World Health Organization’s Eastern Mediterranean region, which encompasses several nations embroiled in the ongoing conflict involving the United States, Israel, and Iran. This situation is affecting not only individual health and safety but also entire healthcare systems, causing her considerable concern.
Balkhy’s name frequently surfaces as a potential candidate for the next director-general of the WHO. The current director-general, Tedros Adhanom Ghebreyesus, will conclude his second and final term in the summer of 2027. The official process to find his successor is set to commence later this month or sometime in May, when Tedros will call for nominations.
The nomination window will shut in September or October, giving Balkhy some time to consider her candidacy. However, she faces a challenging decision that might necessitate taking an administrative leave from her present role amidst significant regional turmoil.
In a recent discussion with STAT, Balkhy shared her thoughts on possibly joining the race, the challenges Washington might present for those seeking the director-general role, and the difficulties her organization, known within WHO as EMRO, faces due to the conflict in Iran and surrounding areas.
To provide some context about Balkhy: she is a pediatrician hailing from Saudi Arabia, educated at King Abdulaziz University. She completed a pediatric residency at Massachusetts General Hospital, followed by a fellowship in pediatric infectious diseases at the Cleveland Clinic Foundation and Case Western Reserve University. Before being elected as the EMRO regional director in early 2024, she spent approximately five years as the WHO’s assistant director-general for antimicrobial resistance.
The interview, conducted prior to the recent ceasefire announcement, has been edited for brevity and clarity.
Could you start by confirming your native country is Saudi Arabia?
Yes, that’s correct.
You studied in the U.S. Do you hold dual citizenship?
Yes, I was born in the U.S., but I am Saudi.
With the selection process for a new WHO director-general beginning soon and your name mentioned as a potential candidate, will you run?
At this moment, I’m not entirely decided. My region demands a lot of attention, and my focus remains on my current responsibilities.
There’s speculation that it might be EMRO’s turn for the director-general position. While not a formal rotation, does this influence your decision?
EMRO and SEARO are the two regions that have never had a director-general. However, this idea is more of a gentleman’s agreement.
Do you have a timeline for deciding? Perhaps by mid-summer, or is it a decision you might make spontaneously?
I think it will be more spontaneous. Given the current situation, the best way to strengthen a candidacy is to excel in my current role.
Experts predict that candidates will likely visit Washington to meet officials, despite the U.S. having withdrawn from the WHO and lacking a vote. What are your thoughts?
The U.S. has been invaluable to global public health, thanks to its talent and scientific prowess. It’s challenging for many of us to see the U.S. step back.
It’s important to visit key locations like Washington and Beijing and maintain open communication. We only stand to lose if we don’t communicate.
We hope the U.S. returns. We want all member states involved. Undoubtedly, every candidate will pursue this, whether they say so or not.
Turning to your region, the global repercussions are significant, but they are most acute in your area. What concerns you the most?
My immediate concern is the potential escalation into nuclear, biological, or chemical warfare. This is a major worry.
We are doing our utmost to ensure we are prepared to support the region’s member states and maintain communication with other regions, as 16 or 17 of the 21 countries involved in the conflict are in EMRO, with a few in the EURO region. [Editor’s note: Despite being in the Middle East, Israel is part of WHO’s European region.]
Another critical concern is attacks on desalination plants, which could be catastrophic. Many countries in the region rely entirely on these plants for water. If compromised, it would lead to severe water shortages.
This could trigger mass migration, leading to overcrowding and displaced populations. Currently, Iran has 3.2 million displaced people, and Lebanon over a million. With a regional population of 750 million, one in seven already requires humanitarian aid.
Our main humanitarian center is in Dubai, where many emergency supplies are routed. The closure of airspace halted millions of dollars in medical supplies, but operations are slowly resuming.
Was the WHO’s emergency supply system completely halted due to closed airspace?
Yes, indeed. We sought alternatives, cooperating with the UAE government to continue flights and find new routes. This, coupled with the Strait of Hormuz closure and rising energy costs, has been my focus recently.
Before we conclude, is there anything else you’d like to address or bring to the spotlight in global health?
As EMRO’s regional director, I’m aware of ongoing discussions about restructuring global health systems to handle both ongoing issues and emergencies.
Building strong systems requires time and investment, even amid humanitarian crises.
