In 2017, the World Health Organisation (WHO) appointed Dr Tedros Adhanom Ghebreyesus as its director general. He's the first African and the first person from the global south to occupy this high office.
His election process was equally historic: a secret ballot that gave equal voting opportunity to all member states for the first time in WHO's 70-year history. The post had been filled previously by a vote of the executive board. Tedros - as he is popularly known - got an overwhelming two-thirds majority.
This triggered great jubilation in his home country of Ethiopia that he had served with distinction as health and foreign minister. But now, the mood in Addis Ababa has turned toxic. As Tedros stood poised to renew his mandate at WHO, the Ethiopian government launched a blistering attack on him, accusing him of gross misconduct by interfering in the country's internal affairs.
Ethiopia's endorsement is not needed to re-elect Tedros as his first-term performance stands on its own merits, and no candidates oppose him. Nevertheless, Ethiopia is determined to embarrass him, as a distracting political manoeuvre on the global stage.
What has drawn such ire? Addis was acutely embarrassed when Tedros drew attention to the catastrophic health and humanitarian situation in Tigray: a "hell" that is an "insult to humanity".
The civil war includes ethnically-directed war crimes against civilians and a blockade on medicines and food into Tigray. The egregious violations of international humanitarian law and human rights conventions have been likened to genocide.
Colouring the picture is Tedros's own Tigrayan identity and history as a prominent member of Ethiopia's previous administration dominated by the Tigray People's Liberation Front. This is now the bitter enemy of current Prime Minister Abiy Ahmed.
Tedros's own family and friends have been targeted in the conflict. This is quite unprecedented for a UN agency head but not unknown among other senior staff. I was myself subjected to death threats as head of the United Nations in Sudan for speaking against its government committing crimes against humanity in Darfur. The intimidation touched my family, and continued even after I left Khartoum for the relatively safe haven of Geneva.
Tedros is well-known worldwide because of his strong health leadership, especially in relation to Ebola and COVID-19. As a prominent global influencer, what he says matters.
Speak up or stay silent?
The vilification of the elected head of a United Nations agency raises disturbing wider issues. Should the leaders of international organisations speak up or stay silent when they see gross abuses by member states against agreed norms and laws they are duty-bound to uphold?
The WHO is a multilateral development agency but its health work is substantially humanitarian. And never more so than in our pandemic age. Tedros's dilemma is well-known to all humanitarians. They are damned by governments if they speak up for victims of their abuse or oppression. They are also damned by rights advocates if they don't, because giving "voice to the voiceless" is a cardinal element of their mission.
But what should be voiced loudly and what can only be whispered privately? They are allowed to beg for resources for the hungry and sick, but not to challenge the inhumanities that generate suffering. Because that violates the bedrock humanitarian principles of "neutrality" and "impartiality". And in the case of multilaterals, it trespasses into the no-go zone of national sovereignty, the last defence of states violating the international norms they have signed.
Old rules don't work
The defence shield of a multilateral system of frameworks and institutions such as the UN Security Council, Human Rights Council, International Criminal Court or the African Union and African Court on Human and People's Rights is punctured by the geopolitics of powerful states with impunity to disregard or undermine them.
Idealists hold on to the myth that humanitarianism is a non-political enterprise. Yet it is shamelessly manipulated and blatantly shackled to partisan objectives, as graphically shown by current Afghanistan and Ethiopian experiences. The political economy of humanitarian work is undergoing a tectonic shift as authoritarian superpowers and their dependent client states in Africa, Eastern Europe and Asia challenge the dispensations of a retreating liberal order.
Humanitarian bodies - multilateral and civil society - don't know how to respond to the wicked new world. Ethiopia provides a telling illustration. Before Dr Tedros put his head above the parapet, Addis had already suspended humanitarian agencies such as the Norwegian Refugee Council, MSF and Al Maktoum Foundation, and expelled UN humanitarian staff.
Nowadays, humanitarians may only operate in Ethiopia if they submit to the will of the national authorities. The new rules are "see no evil, hear no evil, speak of no evil". Even this could be swallowed if it meant that the desperate victims of famine and disease received help. But that is not happening and, instead, humanitarians risk getting co-opted into the total war on Tigray through their enforced passivity.
In past difficult circumstances, aid workers took inspiration from the Red Cross Red Crescent Movement that includes the International Committee of the Red Cross (ICRC), International Federation of Red Cross (IFRC) and Red Crescent Societies, and national societies in almost every country. They pioneered the modern humanitarian enterprise, giving us the Geneva Conventions and the fundamental humanitarian principles. But their collective impact shrinks worldwide as their noble vision collides with the realities of a harsher world.
Perhaps this explains why, unlike the voices of courageous leaders of some UN agencies such as OCHA, UNICEF and OHCHR that have rung out over Ethiopia, the leaders of ICRC and IFRC are strangely muted. The Ethiopian Red Cross, which once championed humanity through many previous cycles of violence, is heavily constrained by its controlling government. Despite their self-restraint, there is little to suggest that the Red Cross in Ethiopia has any privileged access to the most needy and vulnerable, especially in Tigray.
Under such circumstances, if speaking up or not doesn't make a difference to whether or not humanitarians can succour the vulnerable, what should they do? The question should be posed to the recipients. Research is limited but experience indicates that potential beneficiaries of humanitarian assistance are not naive.
They are aware of what agencies cannot do if they are denied access by vengeful or cruel authorities. Under such circumstances, they are desperate not to be abandoned or forgotten, even if they can't be practically helped. They still get huge comfort and courage when caring people of influence speak up because they can't speak for themselves or won't be heeded.
Tedros found himself between the devil of a situation in Tigray and the deep blue sea of his constraints as a top international civil servant. His compassion and conscience provided the rock from which he spoke for humanity, without fear or favour. Other leaders in responsible positions must do the same. Over the longer term, that may perhaps save more lives and even humanitarianism itself.
Author: Mukesh Kapila - Professor Emeritus in Global Health & Humanitarian Affairs, University of Manchester