A Chinese woman at the helm of global health: how Beijing is setting its sights on the WHO following the US’s withdrawal

China has announced the nomination of its own representative to head the World Health Organisation (WHO). Beijing is proposing Song Li, an expert in maternal health, for the top post at the UN health agency, as stated by the Foreign Ministry spokesperson, Mao Ning, during a press briefing. This move could increase China’s influence over the international body following the United States’ withdrawal, scheduled for this year. After all, President Donald Trump’s decision to withdraw from the WHO is just another piece in the massive global chess game between China and the US, which ranges from artificial intelligence to tensions in the Pacific. And this nomination by China appears to be precisely a new move in this never-ending chess game. China’s bid, however, is by no means straightforward for various reasons, starting with the fact that there are no fewer than seven candidates vying to lead the Geneva-based organisation that governs global health – a role that has not been without controversy, particularly in the wake of the Covid pandemic.

The announcement by the Asian giant comes after the 24 September deadline for the submission of nominations for this role. Song Li will be competing against a shortlist of six candidates – three men and three women – nominated by Qatar, Saudi Arabia, Belgium, Spain, Indonesia and Botswana – to succeed the current Director-General Tedros Adhanom Ghebreyesus, whose term of office expires in August 2027. The current outgoing Director-General cannot stand for re-election due to the two-term limit. Specifically, the six candidates nominated so far are: Hanan Mohammed Al-Kuwar proposed by Qatar, Hanan Balkhy proposed by Saudi Arabia, Hans Henri P. Kluge (who served as WHO Regional Director for Europe) proposed by Belgium, María P. Neira nominated by Spain, Budi Gunadi Sadikin nominated by Indonesia, and Gevorg Tamamyan nominated by Botswana. The nomination “demonstrates China’s firm support for multilateralism”, said the spokesperson, and “will help ensure that the organisation plays a more active role in improving the health and well-being of all humanity”. According to WHO data, Song heads the Department of Women’s and Children’s Health at the Chinese National Health Commission and has a career spanning twenty years. Song has been involved in drafting or organising various laws relating to women’s and children’s health, including areas such as prenatal diagnosis and assisted reproductive technologies. If elected, Song would be the second Chinese national to lead the WHO after Margaret Chan, who headed the organisation between 2007 and 2017.

“The Chinese candidacy is somewhat surprising and perhaps unexpected,” points out Gianni Rezza, extraordinary professor of Hygiene at the Vita-Salute San Raffaele University in Milan, who previously worked at the WHO. “It is difficult to say, at least for now, which of the seven candidates stands the best chance. Among the two Europeans vying for the post are the Spanish candidate, who may hold a certain appeal for South American countries, whilst Kluge, the Belgian, has already served as Regional Director for the European Region; then there are two from the Arabian Peninsula, with the Saudis strongly backing their candidate – who also holds an American passport – but she faces competition from a Qatari. And finally, there is an Indonesian and an Armenian, the latter also from the European Region but nominated by an African state”. According to Rezza, “the Chinese candidate could face a double disadvantage, given that even before Tedros, the WHO was headed by Chang, who came from Hong Kong – which is now effectively Chinese – and the current Director-General of the FAO is also Chinese. The signal, however, is a strong one. Following the US withdrawal – although the US will still be campaigning to some extent – China is likely aiming to gain more influence within the organisation, and this could also mean increased investment in global health. In terms of soft power, China, for example, is already strong in the African region and beyond. “So the battle for the leadership of the WHO,” concludes Rezza, “will be a difficult one, but not an impossible one; yet this candidacy means a great deal, regardless of the final outcome, in terms of China’s commitment, especially following the US’s withdrawal.”

According to the analysis, the initiative offers Beijing the opportunity to fill the void left after US President Donald Trump withdrew the United States from the organisation following his re-election in January. Trump has long accused the WHO of being a “puppet of China”, particularly during the Covid-19 pandemic. China, for its part, had previously accused Trump of trying to “shift the blame” onto the WHO. In particular, the US President has not forgotten the pandemic that struck during the final year of his first term as President, and in some ways his handling of it may even have jeopardised his re-election. Even back then, the WHO came under fire from Trump, who accused it, amongst other things, of ‘covering up’ for China regarding the origins of the Covid virus that brought the world to its knees for three years; and whilst signing the order to withdraw from theGeneva-based organisation in front of the cameras, he pointed out that China allocates far less money to the WHO – in fact, about a tenth – than the US does, despite having a population of 1.4 billion. The United States has always been the main contributor, providing over 15 per cent of the total funding – $1.3 billion for the 2022–2023 biennium and $958 million budgeted for 2024–2025 out of a total WHO budget of $6.5–6.8 billion – and by providing offices, databases and researchers. Now, however, the US withdrawal from the WHO coincides with China’s pledge to increase its funding to $500 million.