Elections for the presidency of the World Heart Federation (WHF) rarely attract attention beyond specialist circles. This year, however, the contest carries particular significance. The World Heart Federation—the world's largest international organization dedicated to combating cardiovascular disease—will choose the leader responsible for shaping the global strategy against the leading cause of death worldwide.

The WHF Nominations Committee has narrowed the race to two candidates for President-Elect: Chinese cardiologist Junbo Ge and Spanish cardiologist José Ramón González Juanatey, nominated by the European Society of Cardiology and officially included on the committee's final recommended slate.

This is more than a contest between two distinguished scientific careers. It also represents two different visions of international leadership for an organization that brings together hundreds of scientific societies and cardiovascular foundations across the globe. Juanatey seeks to improve cardiovascular health among the world's most vulnerable populations with a clear objective: to move toward a world free of rheumatic heart disease, free of Chagas disease, and with hypertension under control so that it no longer remains the world's leading cardiovascular killer.

More Than an Outstanding Cardiologist

Dr. Juanatey needs little introduction within Spanish cardiology. A Professor of Medicine at the University of Santiago de Compostela since 2000, Director of Cardiology at the Santiago University Clinical Hospital since 2007, former President of the Spanish Society of Cardiology, and a member of the World Heart Federation Board for two consecutive terms, he brings together a rare combination of clinical practice, biomedical research, healthcare management, academic leadership, and international institutional experience.

"What is not measured cannot be improved": this statement encapsulates a philosophy rooted in continuous evaluation and measurable outcomes

Under his leadership, his department has been recognized for more than a decade as one of Spain's leading cardiology services based on objective quality indicators, while his research group ranks among the country's most productive in cardiovascular science.

Yet perhaps the most compelling aspect of his candidacy is not his remarkable résumé, but the consistency between what he has accomplished over decades and what he now proposes to achieve on the global stage.

A Candidacy Built Around One Central Idea: Reducing Inequalities

One striking feature of González Juanatey's platform is that it devotes relatively little attention to bureaucratic or institutional matters. Instead, it begins with an undeniable reality: cardiovascular disease remains the world's leading cause of death, but its burden is distributed profoundly unequally.

Low- and middle-income countries bear the greatest burden of cardiovascular disease while facing major barriers to early diagnosis, treatment, and prevention. His proposal places these disparities at the very heart of the World Heart Federation's future agenda.

His priority is to strengthen cardiovascular prevention through health education, screening programs, digital transformation, and artificial intelligence tools, always guided by one essential principle: technology must reduce inequalities rather than widen them.

This is not simply aspirational rhetoric. Throughout his career, Juanatey has promoted international cooperation projects in Latin America focused on heart attack response systems, Chagas disease, and rheumatic heart disease—conditions that have become rare in Europe but continue to devastate many parts of the world.

Health as a Social Issue

During his recent appearance on the MUNDIARIO Podcast, Juanatey returned to an idea that has shaped his entire professional career.

More than 80 percent of myocardial infarctions occur among the most socioeconomically disadvantaged populations.

This observation challenges conventional thinking. Building excellent hospitals is not enough. Nor is investing exclusively in cutting-edge medical technology.

Cardiovascular health begins long before hospital admission. It starts with education, nutrition, air quality, neighborhood conditions, access to physical activity, and even the economic stability of families.

This vision aligns almost perfectly with the platform he has presented for the WHF presidency, where equity repeatedly emerges as the guiding principle behind every strategic decision.

Prevention as the Most Powerful Health Policy

For decades, medicine has often measured success through technological sophistication and increasingly advanced treatments. Yet the greatest healthcare revolution of the twenty-first century may not come from a new machine or breakthrough drug, but from preventing millions of people from becoming ill in the first place.

When Mónica Martínez interviewed him on the MUNDIARIO Podcast about healthy aging, Juanatey did not recommend miracle products, dietary fads, or nutritional supplements.

Instead, his answer was both simple and demanding: regular physical exercise, balanced nutrition, and healthy lifestyles.

Scientific evidence continues to support this straightforward prescription over any commercial trend.

It is therefore no coincidence that much of his international program focuses on strengthening health education and promoting healthy habits from childhood onward.

Transparency: Measuring to Improve

Perhaps one of the defining characteristics of Juanatey's healthcare philosophy is his unwavering commitment to objective evaluation.

"What is not measured cannot be improved."

This principle summarizes a management model based on transparent and verifiable indicators.

In Spain, he has consistently advocated for publishing performance data on heart attack mortality, cardiac surgery outcomes, treatment times, and hospital quality—not to create competition between institutions, but to encourage collective learning and continuous improvement.

He now proposes extending this same philosophy internationally through the creation of a Global Cardiovascular Health Observatory, capable of guiding public policy through comparable data and scientific evidence.

At a time when misinformation increasingly affects public health, such a commitment to evidence-based decision-making carries particular significance.

Science, Diplomacy, and International Cooperation

Leading an organization such as the World Heart Federation requires much more than medical expertise.

It means negotiating with governments, international organizations, scientific societies, private foundations, universities, and multilateral institutions.

Juanatey's platform fully reflects this broader diplomatic dimension.

Health equity—particularly in low- and middle-income countries—forms the backbone of his project

He proposes strengthening collaboration with the World Health Organization, the United Nations, leading international scientific societies, and ministries of health to place cardiovascular disease firmly at the center of public policy.

His agenda also includes expanding the Emerging Leaders program, creating an international campus for continuing cardiovascular education, and developing long-term partnerships capable of ensuring the Federation's financial sustainability while preserving its scientific independence.

These proposals are not theoretical. During his presidency of the Spanish Society of Cardiology, he implemented a comparable strategy built on institutional partnerships, accredited education, digital innovation, and stronger integration of nurses, primary care professionals, and patient organizations.

Defending Public Healthcare

Another element that gives coherence to his candidacy is his clear defense of publicly funded healthcare.

In his conversation with MUNDIARIO, Juanatey described Spain's public health system as "the country's greatest social achievement" and warned of the growing loss of physicians and nurses to other sectors.

This is not an ideological position.

Rather, it reflects a conclusion strongly supported by international scientific evidence: accessible, universal, and well-funded healthcare systems consistently produce better population health outcomes, particularly in chronic diseases such as cardiovascular conditions.

This same commitment to equity is clearly reflected throughout his international platform.

An Election with Global Consequences

Ultimately, the members of the World Heart Federation will decide who they believe is best prepared to lead the organization in the years ahead.

Junbo Ge also represents an outstanding scientific career, and the international cardiovascular community will assess both candidates on their merits.

Regardless of the final outcome, however, José Ramón González Juanatey's nomination already represents extraordinary recognition for a career built over decades through clinical medicine, academic leadership at the historic University of Santiago de Compostela, scientific research, and healthcare management.

It is rare for a Spanish physician to compete for the presidency of an international organization of this scale.

Perhaps the greatest strength of his candidacy lies precisely in its ability to combine scientific excellence with social justice.

At a time when medicine is increasingly captivated by artificial intelligence, precision medicine, and technological innovation, González Juanatey reminds us of something fundamental: genuine progress in healthcare means ensuring that no one suffers a heart attack—or dies from cardiovascular disease—because of where they were born, their family's income, or their lack of access to effective prevention.

That vision transforms his candidacy into something greater than a personal ambition.

It represents a model of leadership for an organization whose central mission has remained unchanged since its foundation: ensuring that a person's postcode or economic circumstances no longer determine their chances of surviving cardiovascular disease. @J_L_Gomez in @mundiario