Nomination Form for WHO South-East Asia Regional Award for Public Health Champion 2026

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Important instructions (please read carefully)

  • This form must be completed by the person nominating. Self-nominations are not permitted.
  • Only work conducted within the WHO South-East Asia Region will be considered.
  • All six sections must be completed. Incomplete applications will not be reviewed.
  • You may resume your application at any time by selecting the “Resume later” option available at the end of each section on subsequent pages. This option is located on the left side, below the “Previous” button.
  • Responses must adhere to the specified word limits.
  • Supporting documents providing verifiable evidence of impact are mandatory.
  • Before initiating the application, please ensure you have PDF versions (maximum 25 MB each) of the following documents:
  1. Letter of nomination
  2. Curriculum vitae of the nominee (or Institutional Profile for institutional nominations)
  3. Evidence of impact (at least one document, such as data reports, evaluations, or publications demonstrating measurable outcomes)
  4. Endorsements/letters of support from relevant institutions or stakeholders

Note: For any technical help on form, please contact on email id: guptaan@who.int

There are 30 questions in this survey.

Eligibility checklist (Mandatory). 

  • The nominee is not a WHO staff member
  • This is not a self-nomination
  • The work demonstrates measurable public health impact
  • The work has been conducted in the WHO South-East Asia Region