The World Health Organization’s (WHO) members re-elected Tedros Adhanom Ghebreyesus as director general by a strong majority for another five years, the president of the World Health Assembly said on Tuesday.

The vote by secret ballot, announced by Ahmed Robleh Abdilleh from Djibouti at a major annual meeting, was seen as a formality since Tedros was the only candidate running.

Ministers and delegates took turns to shake hands and hug Tedros, a former health minister from Ethiopia, who has steered the U.N. agency through a turbulent period dominated by the COVID-19 pandemic. The president had to use a gavel several times to interrupt the applause.

German Health Minister Karl Lauterbach tweeted on Tuesday: “Just re-elected as Director General of #WHO: @DrTedros. 155/160 votes, spectacular result. Congratulations, fully deserved.”

Germany recently overtook the United States as the U.N. health agency’s top donor.

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