The emphatic victory of Saima Wazed in the race for the post of Director General World Health Organization’s South East Asia Region (SEAR) not only reflects a generational change in the top leadership of the key body but reaffirms the fact that health has become the latest component of global geopolitics.

Ten of the eleven countries of the WHO SEAR Bangladesh, Bhutan, India, North Korea, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste. The WHO did not give out the voting figures but according to the Bangladesh High Commission press release Saima, a psychologist by training who also worked extensively in the field of autism, polled eight votes while her challenger Shambhu Prasad Acharya, a public health specialist who was Nepal’s candidate got two. Myanmar was barred from casting its vote following its disenfranchisement due to the US sanctions against the country’s military regime.

The contest had acquired a political flavor as Saima is the daughter of Bangladesh Prime Minister Sheikh Hasina and hence perceived as influential. Given the amicable relationship between the Bangladeshi Prime Minister and Prime Minister Narendra Modi, Nepal is concerned that India's vote may not favour their candidate, Acharya, who is a public health specialist with a long experience in the WHO, according to diplomatic sources.

Sources indicate that Saima Wazed is more likely to be favoured by India due to the strategic closeness between New Delhi and Dhaka, while Kathmandu is actively mobilising its diplomatic channels to secure India's vote for their candidate.

The election took place in the backdrop of a high-octane campaign during which the Nepal’s candidate focused on Saima’s lack of qualification in medicine or a PhD. However, diplomatic sources insisted this is not an essential requirement under the WHO’s provisions for such elections. The sources said Bangladesh’s campaign had focused on the need to inject fresh blood and outlook to the functioning of WHO’s SEARO and pointed to Wazed’s work in updating public health-related rules in Bangladesh and her role in enacting the country’s Mental Health Act of 2018 and National Mental Health Strategic Plan of 2020-25. She was also a member of the WHO expert panel on mental health during 2014-22.

In an indication of how the campaign for the election had become high-decibel, a group of 15 distinguished global health experts, including former United Nations officials and public health practitioners issued an “open letter” urging the countries of the WHO SEARO to make a “conscientious and informed choice” when selecting its next Regional Director. The experts also called upon the member-countries to avoid "narrow political manoeuvering" and political quid pro quo. The region’s major power India publicly maintained silence understandably due to its strong ties with its South Asian neighbours Bangladesh and Nepal. Although the voting was by secret ballots, a section of the Indian media speculated that India sided with the Bangladesh candidate.

While the expertise of the candidates in public health was key in the selection of the WHO regional head, strategic affairs experts point out that such elections to multilateral bodies under the United Nations and WHO are often influenced by geopolitical factors. The campaign for such elections often starts well in advance with a country seeking support for its candidate in return for backing other nations in votes at some other UN or WHO agency. It may be recalled that Saima had accompanied her mother to the summits of the BRICS, G20 and ASEAN in recent months.

Soon after the election, Saima in her blog made some interesting comments and outlined her vision as the new chief of a New Delhi-based organization which was the WHO’s first regional office set up in 1948.

Saima acknowledged in her website that “I come from a well-known political family that most are familiar with and incorrectly assume that I have always lived a life of privilege. Despite being born in Bangladesh as the granddaughter of the Father of the Nation, my earliest memories were that of growing up in India as a refugee.” There was no mistaking she was referring to her mother, along with their children, living in New Delhi for a number of years post-assassination of Bangabandhu Sheikh Mujibur Rahman.

Saima said she received her high school and college education in south India but has also lived, studied and worked in the UK, USA, Canada and the UAE, besides Bangladesh. In her written statement for the WHO regional director nomination, she said “I was raised to believe that all religions and cultural practices are part and parcel of the human experience. Our diversity unites us…”  Her remarks are aimed at dispelling suggestions, if made by anyone, that her rise to the WHO SEARO top was due to her family linkage and a sense of entitlement and that she too had gone through rough phases in her life journey.

Articulating her vision for South East Asia facing a myriad of public health issues, she said her objective is to work together to better prepare for the next pandemic after the Covid-19 ravaged the region as well als the rest of the world. “This is extremely important keeping in mind that the World Health Organization is currently working on developing a legally binding pandemic treaty that can ensure equitable access to medical countermeasures such as diagnostics, drugs and vaccines during a health emergency,” she said. Saima also spelt out her priority areas of work as WHO SEARO head would include universal health coverage, community health services, inclusion of mental health under the overarching public health framework, emergency response besides pandemic preparedness, collaboration and partnerships (regional and multi-sectoral), and mental health.
Pointing out how many countries are poorly resourced both from a skilled human resource and infrastructure points of view, she suggested public-private partnership mode, facilitated and supervised by WHO, to ensure the world is “better prepared for the next crisis.” Saima’s leadership of Shuchona Foundation, which is engaged in advocacy, research and capacity building for disabilities, neurodevelopmental disorders and mental health, is part of the story of the importance of civil society in the public health sector in South Asia. “I look forward to building a healthier South-East Asia,” she added.

Public health experts feel Saima takes over at a time when there is a growing demand for redefining the approach of the WHO SEARO. If the South East Asian region is doing better today in some vital health parameters like life expectancy (63.7 years), fastest decline (57%) in maternal mortality ratio since the millennium and reduction in under-five mortality by 78% and a fresh HIV cases by 50%., it is more due to the governments of the member-countries than the WHO. Clearly, a major challenge lies for Saima as she prepares to take on her new assignment.

The writer is a veteran Indian journalist.