For most of its 46-year history, the World Health Organization was considered the most effective U.N. agency, which was not hard given the quality of the others.

Based in Geneva, WHO led the successful worldwide struggle to eradicate smallpox in the 1970s. More recently, it has coordinated the fight against AIDS and other public health scourges.During the past five years, the organization has been under a strange director-general, Dr. Hiroshi Nakajima of Japan, and unfortunately its work has deteriorated.

According to a State Department briefing paper and officials, Nakajima is a poor leader, incompetent manager and fuzzy communicator.

He is not fluent in English and French, key WHO languages, and some who deal with him say his thoughts are hard to follow.

He is autocratic with his staff, which depresses morale. The good doctor travels more than half the year, often without telling regional directors that he is coming. This upsets them and leaves headquarters rudderless.

Not surprisingly, some of WHO's best experts began leaving.

For instance, Dr. Jonathan Mann quit as head of the agency's global AIDS program in 1990 and later hit Nakajima's leadership in the battle with the disease.

Last summer most of WHO's big contributors - the United States, Canada and the European Community - decided that Nakajima, 63, should be denied a second five-year term. They got behind his well-regarded deputy, Dr. Mohammed Abdelmoumene of Algeria, whom Nakajima promptly fired.

The Japanese government is proud of and attached to Nakajima, the first Japanese citizen elected to head a U.N. agency. Tokyo thought it would lose face if he failed to gain re-election.

After Nakajima took over, Japan opened its checkbook to the WHO, doubling its contribution to $43.5 million in 1990-91 and even more since then. It began to hint that its largess would shrink without Nakajima in Geneva.

The State Department says Tokyo opened an "aggressive" campaign of threats and vote-buying. Among the threats: no more fish imports from the Maldives, no more coffee from Jamaica, no $250 million Export-Import loan to Algeria.

Also, insiders say, Third World delegates on WHO's executive board were offered first-class airline tickets to Japan, $14,000 in walking-around money and $50,000 grants to their personal research projects.

For the record, Japanese officials deny all charges.

How should we judge their denials? Perhaps in light of Japan's many unkept pledges to reduce its trade surplus and open its market wide to foreign goods.

View Comments

In any case, on Jan. 20 the executive board voted 18-13 to give another term to Japan's man. All major donor's except Japan opposed him. The (unbribed?) Third World put him over.

Dr. Donald Henderson, who led WHO's anti-smallpox drive, said, "This was not an election based on merit of the two candidates and record of performance. . . . There were clearly a great many countries that voted after having been wined and dined and promised many things by the Japanese government."

All 181 WHO members will get a chance to affirm or reject Nakajima at the group's annual assembly in May. No executive board choice has ever been defeated, and the United States and the European allies must decide whether to undertake the uphill effort.

They should. Proper direction of WHO, which is the Third World's health department, is more important than pleasing Tokyo.

Join the Conversation
Looking for comments?
Find comments in their new home! Click the buttons at the top or within the article to view them — or use the button below for quick access.