Most people don't even know that the World Health Organization (WHO) is part of the United Nations system. Together with the International Labour Office (ILO), the Food and Agricultural Organization (FAO), UNESCO, and the World Bank Group, they are the big five in the galaxy of over thirty programmes, funds and agencies that meet regularly and hopefully co-ordinate their work in the field. They are not exactly like the big five members of the Security Council, but internally they seem to carry similar weight.

In dealing with their executive directors, the Secretary General treads softly; they have their own governing bodies drawing their own priorities. That is partly why there is special interest in who will take over from Dr. Brundtland, current head of WHO and former Prime Minister of Norway, when she leaves early next year.

By now, there are nine official candidates with no clear front runner, eight from the developing countries and one, Peter Piot who heads the UNAIDS programme, from France. As the incumbent and several of her predecessors came from industrial nations, it maybe about time to rotate to the third world. However, the only senior official amongst them is the Prime Minister of Mozambique, Pascoal Manuel Mocumbi, who seems to have a good chance. The Senegalese Health Minister could be counted out as a compatriot of his is already heading FAO in Rome.

Another African, "Sir" Djamil Fereed of Mauritius, must be joking or bargaining; he is presented as an "adviser" to his country's health minister -- a surely daunting task in that idyllic island -- but not a serious qualification to oversee international health. The chances of Dr. Joseph Williams Cook of Cook Islands -- a former Australian colony -- are slightly better, but not by much. South Korean Dr. Jong Wook Lee who heads the WHO programme against tuberculosis has done a credible job in his field, but he is perceived mainly as a technician; besides another Far East Asian, a Japanese, heads UNESCO in Paris.

The Arab group is embarrassingly caught between two competitors: a former Egyptian health minister who had left his post under a cloud of media accusations and Lebanese Tourism Minister, former Health Minister Karam Karam, a distinguished medical doctor who is well known in Beirut and Damascus, but does not seem to have a visibly ongoing campaign. With only six weeks to go, it is regrettable that someone so professionally and politically qualified should be plunged into an international competition without serious organisation or adequate preparation. The first step could have been to obtain the endorsement of the Arab League as the Egyptian candidate has no chance whatsoever; not only is he handicapped by a negative reputation, but there is already another Egyptian who heads an international agency -- Dr. Mohammed El-Baradei, Executive Director of the International Atomic Energy Agency in Vienna. Furthermore, the grapevine has it that the Arab League office in Geneva has not been helpful; some claim it is pushing for the former colleague of its Secretary General.

There remains Dr. Julius Frank, Mexico's Health Minister. In addition to his medical background, he could be greatly helped through personal phone calls from President Vincente Fox to very influential "ronchero" in nearby Texas. His country's membership in the Security Council where its vote is crucial and could lend him key support. Although another Latino from Chile heads ILO in Geneva, a suitable arrangement -- if he is favoured by the powers that be -- is to designate Mexico in precise geographical terms: that is, as part of Central America and the Caribbean. Otherwise, the selection could go to Monsieur Piot, who is wisely and patiently waiting in the familiar wings. That would explain a lackluster approach by the Lebanese government to that campaign. Dr. Karam's candidacy may be one of the collaterals to Paris II initiative by the French President to help cover Lebanon's financial crisis.

Meanwhile, advocates of gender equality among senior international officers, are lamenting the loss of yet another post occupied by women. When the High Commissioner for Refugees Ms. Sadako Ogata left, she was replaced by a man. When the High Commissioner for Human Rights Ms. Mary Robinson left, she was replaced by a man. Now that Dr. Brundtland is leaving WHO, a man is most likely to take over. Some question where have all the good women gone? Others ask more pointedly: where are all the good men that are confident enough to nominate a qualified woman?