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 to 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. Gru Brundtland, current head of WHO and former Prime Minister of Norway, when she leaves early this 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 Belgium. As the incumbent and several of her predecessors came from industrial nations, some feel it may be about time to rotate to the third world. However, the most 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 since 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 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 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.

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 a very influential "ronchero" in nearby Texas. His country's membership in the Security Council where its vote is crucial could bring 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, Monsieur Piot, supported by Brussels is wisely and patiently waiting in the familiar wings.

There is, however, a yet undisclosed scenario which is likely to unfold as the Executive Board prepares to meet later in January. In the absence of an overwhelming candidate, the name of a prominent French Doctor with proven international experience will be introduced. That particular candidate has served in previous governments, participated in U.N. assignments and co-founded a successful international initiative in field medical assistance. French diplomats are experienced in U.N. electoral tactics. Being considerate of the sensitivities of the third world -- and ensure future votes -- the name was not presented earlier. But with a looming deadline a demarche will be appropriately timed.

France has no one in such a senior posting since Michel Camdesus left as head of the International Monetary Fund and recently took over the dossier of an initiative by the French President to help in Lebanon's financial crisis. That may partially explain a lackluster approach, particularly by the Lebanese Prime Minister to the candidacy of his governmental colleague. Dr. Karam's limited prospects may be one of the collaterals of Paris II. Thus, President Chirac would add another feather to his resourceful cap by regaining a senior key post for France and magnanimously placing in it a media-oriented activist politically linked to another party. If he succeeds, the restless doctor would finally find his right niche in his own medical field -- provided he quits smoking.