Officials in London and Washington said they expected their Geneva missions to be instructed to adopt a more robust line in dealing with WHO from now on. The main donor nations are working to co-ordinate a timetable of reforms for the Director-General. "We shall hold him to account for the results of this work," a Foreign Office spokesman in London said. "If he doesn't meet that timetable then his position will have to be looked at again," another official added.
Dr Nakajima came in for unprecedented public abuse by health ministers at yesterday's session of the World Health Assembly in Geneva, when Zimbabwe's minister, Timothy Stamps, called him "politically astute and well connected but mortally wounded in terms of credibility and the capability of effecting change".
Three African ministers said WHO's management had failed. and an African- sponsored resolution calling on Dr Nakajima to step down over allegations of racism and mismanagement was withdrawn after several ministers had risen to make their points.
It was thought to be the first time the head of a UN agency has faced such withering ministerial criticism in public.
Diplomats and UN officials were privately questioning whether Dr Nakajima could expect to serve out his full term until 1998. Most thought prospects for a third term were dead. "It's hard to see him getting any real support for this," the Foreign Office spokesman said.
The African resolution was the latest in a series of scandals to beset WHO since Dr Nakajima won a bitterly contested second term in office two years ago.
The British Auditor-General, Sir John Bourn, has refused to continue working with WHO because he said trust and co-operation between his auditors and the organisation's leadership had broken down.
Sir John published a devastating report this week which detailed waste, corruption and fraud at WHO's regional office in the Congo.