Robert Mugabe as WHO goodwill ambassador – what went wrong?

Under his watch rampant hyperinflation and gross mismanagement has devastated the economy in the country once referred to as “the breadbasket of Africa”.

The health system in Zimbabwe has collapsed under his rule and he does not trust his own hospitals, flying to Singapore for medical care three times since January.

In total he spent US$53m on foreign trips last year – an amount equal to a fifth of the entire health budget.

On paper, the health system is well designed – built on the principles of universal access, health promotion, and strong primary care.

However, by the WHO’s own assessment chronic underfunding has led to poor outcomes (Zimbabwe comes 180th out of 193 countries for life expectancy – a dismal 59 years).

On October 18th Tedros made the following announcemt mid-way through his speech: “Today I am also honoured to announce that President Mugabe has agreed to serve as a goodwill ambassador on NCDs for Africa to influence his peers in his region to prioritise NCDs” .

I work as a consultant for the WHO Global Coordination Mechanism on NCDs, based at the HQ in Geneva.

This unit instigated the conference.

It does not seem that the Director General shared his intention with any senior WHO staff; my colleagues were as dumbfounded as the international community.

There also isn’t any evidence to suggest that the decision was anything more than a terrible and uncharacteristic political misstep.

But there is past precedent to help explain what he might have been thinking.

Tedros built his platform on universal health coverage: encouraging countries to extend an increasing range of health services to a greater proportion of the population while improving financial protection for people, for example through health insurance, when they fall ill.

His focus on universal health coverage is microcosmic – he has also championed a more universal vision of global health and has put real effort into inviting all members of the global community to support his goals.

During his candidacy he visited a huge number of member states, and an article in the China Daily is indicative of his efforts to court all countries regardless of their political record.

His years of experience pragmatically overseeing significant health improvements within an oppressive government may explain his willingness to engage with other unsavoury regimes.

This is a difficult line to tread.

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