China’s nomination of Chinese national Song Li to lead the World Health Organization has been filed under the wrong heading.
Most of the coverage treats it as a chapter in a bigger story: Washington has walked out, Beijing has stepped in and Geneva must now pick a side. That story is tidy. It is also a bad way to hire someone to run a crucial, technical agency.
Start with what is known. Song is a maternal and child health specialist with some twenty years in the field, including the SARS, bird flu and Covid-19 responses, who until recently ran the women’s and children’s health department at China’s National Health Commission.
In 2023, China put her forward for the WHO’s Western Pacific regional directorship, and the region’s governments chose Tonga’s Saia Ma’u Piukala instead. If the World Health Assembly elects her next May, she would be the first person from mainland China to run the agency, and the second Chinese national after Margaret Chan, who led it from 2007 to 2017.
Those facts belong in the file but they are not the job description. Indeed, the job will be narrower and harder than the speeches around it.
Tedros Adhanom Ghebreyesus’s second term ends in August 2027, and the rules bar him from a third. The Executive Board will cut the field to three early next year, and the Assembly will decide by secret ballot in May.
Whoever wins takes over an organization that has already cut its two-year budget by 22%, to US$4.2 billion, and has shed roughly a quarter of its jobs after the US withdrawal and a wider squeeze on aid.
The money is where the debate gets most confused. Voluntary contributions, most of them earmarked by donors for projects of their choosing, still make up more than three-quarters of WHO’s financing.
Assessed dues, the membership fees every country owes, are the smaller and more predictable slice. With the United States gone, China is now the largest state payer of those dues.
Its projected $320 million for 2026-27 comes mostly through that channel, yet it still ranks only fourth among all funders once the Gates Foundation, the European Commission and the World Bank are counted.
Neither Beijing’s critics nor its defenders like to dwell on this, but for more than a decade every WHO reform plan has asked for exactly this kind of money: dues paid in full and not tied to a donor’s pet project.
One can worry about the clout of a big assessed payer and still admit that the agency has spent years encouraging precisely that behavior. Either way, a director-general does not inherit the treasury of the government that nominated her. She inherits a gap.
That distinction should discipline the campaign. It is fair to ask what each nomination says about the government that made it, Song’s included.
But the same question applies to the other six: Qatar’s former health minister, Indonesia’s sitting health minister Budi Gunadi Sadikin, Botswana’s nominee, and three candidates who are current or recently retired WHO officials, among them two serving regional directors. Every name on that list is there because a government proposed it.
Independence has never been a matter of passport. It is a willingness to publish findings a capital would rather bury, to press one’s own government for data and access, and to refuse the trade in which programs follow the loudest check. Member states should apply that test once, in public, to the whole field.
Two anxieties deserve a hearing. The first is concentration. Chan’s decade at WHO, and the fact that a Chinese national, Qu Dongyu, now runs the Food and Agriculture Organization, give members a fair reason to ask whether another specialized agency should go the same way.
Rotation exists so that no country treats a post as its reserved seat. But the norm loses its meaning if it is invoked only when the nominee is Chinese and forgotten when the nominee comes from a capital already well represented in Geneva.
Asia in particular has reason not to flatten this race into a referendum on China. The Western Pacific’s 2023 vote for a Tongan surgeon over Song showed that governments in the region do not vote as a bloc. They should not be asked to now.
The second anxiety is memory. Covid-19 left unresolved arguments about early reporting, access for investigators and the limits of WHO’s authority over sovereign states. Those arguments will follow any candidate associated with Beijing.
They should not be waved away, and they should not be treated as a disqualification unique to one person. The next director-general will need outbreak data from governments that would rather not share it, and sooner or later one of them will be the candidate’s own.
So put the same question to every candidate, in public: what will you do, in the first crisis, when the government that nominated you is the one WHO has to challenge?
Then ask for the answer in writing: fixed timelines for public statements under the International Health Regulations, protection for WHO staff who raise concerns, and rules for stepping aside when a home country’s interests collide with the agency’s.
None of this guarantees independence, but it makes independence something members can measure, and it asks no more than WHO’s own constitution already does: the director-general and staff may not take instructions from any government, and governments undertake not to give them.
There is a better reason to take Song’s candidacy seriously, and it has little to do with flags. WHO’s hardest task over the next five years will be deciding what a smaller agency still does well. Maternal and child health is often treated as the soft annex of global health security. It is not.
Keeping antenatal care, skilled delivery and immunization running during an outbreak tests the same systems that detect and contain one. A director-general whose career was built on that continuity might stop WHO from splitting “health security” and “primary care” into rival camps.
She might also prove too narrow for a job that now includes a broken funding model, a skeptical membership and a United States whose vote at the 2027 Assembly is in doubt over some $281 million in unpaid dues. The campaign exists to find out which description is true.
The US withdrawal and the habit of reading every candidacy through it have left the institution fragile. Fragility argues for a duller election, not a louder one. Members should ask every candidate what the WHO will stop doing and how it will widen flexible funding beyond a handful of donors, and then hold the winner to the answers.
Song Li’s nomination is a fact of this race. It does not have to be its subject.
Y. Tony Yang is an endowed professor at the George Washington University in Washington, D.C.
