World Health Organization chief Tedros Adhanom Ghebreyesus is all but guaranteed a second term after a procedural vote Tuesday made him the sole nominee ahead of a leadership election in May.
The first African leader of the UN health agency said he was "very grateful for the renewed support", after the WHO's executive board held a secret-ballot vote approving his nomination as the only candidate for the post.
Tedros, one of the most recognisable figures of the global battle against Covid-19, acknowledged that his first five-year term had been "challenging and difficult", and said it was a "great honour" to be given the opportunity to continue the battle.
The former Ethiopian minister of health and foreign affairs is thus expected to be a shoo-in for re-election when all 194 WHO member states cast their ballots for the next director-general in May.
Since Covid-19 burst onto the global stage more than two years ago, the 56-year-old malaria specialist has received much praise for the way he has steered the WHO through the crisis.
African countries in particular have been pleased at the attention paid to the continent and at his relentless campaign for poorer nations to get their fair share of Covid vaccines.
Ethiopia criticism
The main source of opposition meanwhile has come from Tedros's own country.
Ethiopia's government has slammed his comments about the humanitarian situation in his home region of Tigray, in the grip of a 14-month conflict.
After Tedros earlier this month described the conditions there as "hell" and accused the government of preventing medicines and other life-saving aid from reaching desperate locals, Addis Ababa demanded he be investigated for "misconduct and violation of his professional and legal responsibility".
Ethiopia does not, however, appear to have much support in its criticism.
"He has indeed expressed himself forcefully, but what he is saying corresponds to facts observed by the heads of all the humanitarian agencies," a Western diplomatic source told AFP on the condition of anonymity.
"There was no misconduct."
Addis Ababa blocked the African Union from unanimously backing Tedros's nomination, but several African countries, including Kenya and Rwanda, figure among the 28 mainly European nations that officially put his name forward.
Zero tolerance' for abuse
The United States is also now largely supportive of the WHO chief.
That marks a major about-face from the start of the pandemic, when former president Donald Trump's administration began pulling the United States out of the WHO, accusing it of being Beijing's puppet and helping cover up the initial outbreak.
Trump's successor Joe Biden halted the withdrawal, and Washington has voiced stronger support for Tedros as he has taken a sterner tone with China, demanding greater transparency around the origins of the outbreak.
Beijing has rebuked the WHO chief for some of those comments, but still says it supports his candidacy.
Beyond the pandemic, Tedros has faced a barrage of criticism, including from nations supporting his second term bid, over his handling of devastating allegations of rape and sexual assault by humanitarian workers, among them 21 WHO employees tackling Ebola in the Democratic Republic of Congo between 2018 and 2020.
Tedros told the board he had been "horrified" by those reports, insisting the WHO had "zero tolerance for sexual exploitation, abuse and harassment".
Significant reform
Tedros's second term will likely be dominated by the towering task of strengthening the WHO, the weaknesses of which have been laid bare as the pandemic lashed the planet.
Many countries are demanding significant reforms, but the extent and shape of the changes has yet to be defined, with some nations wary that a stronger WHO might encroach on their sovereignty.
Tedros is also calling for a vast reform of WHO financing, warning it does not have the funding needed to respond to the numerous crises it is asked to respond to around the globe.