A leading candidate to head the WHO was accused last week of covering up three cholera epidemics in his home nation, Ethiopia, when he was health minister — a charge that could seriously undermine his campaign to run the agency.
The accusation against Tedros Adhanom Ghebreyesus was made by a prominent global health expert who is also an informal adviser to David Nabarro, a rival candidate in the race for WHO director-general.
Tedros, who uses his first name in his campaign, denied the cover-up accusation and said he was “not surprised at all, but quite disappointed” that Nabarro’s camp — which he said included high-ranking British health officials — had switched to running what he called a “last-minute smear campaign.”
The vote for the WHO director-general is to take place at a weeklong meeting of the world’s health ministers in Geneva, Switzerland, beginning on Monday next week.
Nabarro, reached by telephone on Saturday in China, said he knew of the accusations — especially because world health officials believe Ethiopia is suffering a cholera outbreak even now, while still denying it — but he insisted that he had not authorized their release.
“I absolutely did not know,” Nabarro said.
His adviser, Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University, called attention to Ethiopia’s long history of denying cholera outbreaks even as aid agencies scramble to contain them.
Some of those outbreaks occurred on Tedros’ watch.
Gostin said he acted without consulting Nabarro and did so because he believed the WHO “might lose its legitimacy” if it is run by a representative of a nation that itself covers up epidemics.
“Dr Tedros is a compassionate and highly competent public health official,” Gostin said. “But he had a duty to speak truth to power and to honestly identify and report verified cholera outbreaks over an extended period.”
In an interview, Tedros, who was the Ethiopian minister of health from 2005 to 2012 and remains highly regarded for his accomplishments then, denied covering up cholera.
Outbreaks occurring in 2006, 2009 and 2011 were only “acute watery diarrhea” in remote areas where laboratory testing “is difficult,” he said.
That is what the Ethiopian government said then and is saying now about an outbreak that began in January.
WHO officials have complained privately that Ethiopian officials are not telling the truth about these outbreaks. Testing for Vibrio cholerae bacteria, which cause cholera, is simple and takes less than two days.
During earlier outbreaks, various news organizations, including the Guardian and the Washington Post, reported that unnamed Ethiopian officials were pressuring aid agencies to avoid using the word “cholera” and not to report the number of people affected.
However, cholera bacteria were found in stool samples smuggled out of the country. As soon as severe diarrhea began appearing in neighboring countries, the cause was identified as cholera.
UN officials said more aid could have been delivered to Ethiopia had the truth been told.
Somalia is battling a large cholera outbreak, and a new vaccine is being deployed there. Aid officials believe cholera is also circulating in the neighboring regions of Ethiopia, but without confirmation, they cannot release the vaccine.
The Ethiopian Ministry of Health is still calling it “acute watery diarrhea” and told Voice of America News last month that it would not change that report without laboratory confirmation, which it said it did not have.
Under the International Health Regulations, which apply to all WHO members, nations must accurately report disease outbreaks, but the WHO can officially report only what nations say.
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