IFMSA Asia-Pacific Regional Meeting on September 2012 in Malaysia – Join us!!!

This coming September 13-16, 2012, the Asia-Pacific region of IFMSA will be holding its annual Regional Meeting in the city of Penang, Malaysia. It will be hosted by the Society of Malaysian Medical Association Medical Students (SMMAMS), one of IFMSA’s active member organizations. More than 300 medical students from all over Asia-Pacific will gather in the beautiful UNESCO World Heritage Site to engage in dynamic and fruitful discussions, learn from outstanding leaders in medicine and public health in the region, and participate in cultural and knowledge exchange beyond the four walls of medical school.

The theme for this year’s regional meeting is “Transitions 2012: Doctors-in-training changing the global health landscape of Asia-Pacific.” 

Asia-Pacific is a rapidly evolving and changing region. And so do its health care systems, which are as diverse and unique as its many cultures and populations. Countries in the region are now striving hard to transform their health systems, adopt new medical technologies, address emerging health threats, and reduce lingering health inequities. Indeed, the entire Asia-Pacific region is in itself a health system in transition.

The region’s medical students should also join this massive transformation. Now more than ever, we need a new generation of doctors with a deep understanding of the complex changes happening in global health, both in the region and in the world at large. Furthermore, the 21^st century Asia-Pacific doctor must be in the forefront of action in addressing these transitions, committed to achieving a global health future that we all profoundly want and truly deserve.

PROGRAM HIGHLIGHTS

 

Keynote Lecture

The first night of the APRM will be opened by Dr. Tikki Pang, former Director for Research Policy & Cooperation at the World Health Organization in Switzerland and currently Visiting Professor at the Lee Kwan Yew School of Public Policy at the National University of Singapore.

 

Global Health Debate

This year’s APRM will inaugurate the first-ever Global Health Debate in the whole of IFMSA. In this competition, two teams composed of members from various NMOs of the Asia-Pacific region will engage in a highly-charged discussion on a specific pressing health issue that is currently facing the region. The debate hopes to deepen mutual dialogue and critical thinking among participants, as well as to contribute new insights to the selected issue that will certainly shape the future of Asia-Pacific’s health.

 

Student Panel on Comparative Global Health

This panel will allow medical students to give a presentation about their respective health care systems, raise issues that are shared by the different countries, and identify features that are unique to the diverse country settings.

 

Global Health Film Festival

Soon to evolve as the “Asian Oscars of Global Health,” this event will enable participants to watch thought-provoking films covering different health themes and issues. The show will be followed by a moderated discussion, hoping to synthesize global health lessons gained from the movies.

 

Asia-Pacific Global Health Fair

This global health fair will showcase the best projects, campaigns, and other activities of the various NMOs of the Asia-Pacific region. Each NMO will also install an exhibit of the country’s health system, trends, and determinants. Sponsors and partners such as nongovernmental organizations and UN agencies will also be invited to set up a booth and present various global health work opportunities for the participants.

 

Democracy as a Path to Health for All

International Day of Democracy at the Asia-Pacific Regional Meeting 2012

This coming September 15, 2012, the world will commemorate the International Day of Democracy. As the third day of the Asia-Pacific Regional Meeting of the International Federation of Medical Students’ Associations falls on the same date, we medical students from across the region plan to organize an afternoon of public gathering as our way of celebrating democracy and educating the local people about the gifts and ways of democracy.

The United Nations define democracy as a “universal value based on the freely expressed will of people to determine their own political, economic, social and cultural systems and their full participation in all aspects of their lives.” The Asia-Pacific countries represented in IFMSA, including the host country Malaysia, all share a common desire to enhance people’s participation in everyday governance.

As doctors-in-training, we acknowledge the role of democracy toward achieving the vision of health for all. In 1978, the Alma Ata Declaration recognized the value of people’s participation in health care. The 2008 Commission on Social Determinants of Health under WHO also called for the creation of spaces for enhanced participation of individuals, communities, and civil society groups in the shaping of health systems and addressing of various health determinants. The timing of the conference vis-à-vis the International Day of Democracy is perfect, as now we see a great transition in the global health landscape in Asia-Pacific – health is now gradually being put in the hands of the people at last.

 

Other Activities

Standing Committee Sessions

Training Sessions

Penang Heritage Walk Tour

Penang Hawker Festival

National Food and Drinks Party and Cultural Night

 

with Pre-APRM Workshops on September 10-12, 2012 in Kuala Lumpur, Malaysia

on Social Determinants of Health, Projects Management, Advocacy and Policy, and Training New Trainers (TNT)

 

Everyone is invited! Special rates for non-Asia-Pacific medical students are available.

For more information about the meeting, you may visit http://www.aprm2012.org/.

 

After Rio, where to?

The IFMSA delegation at the World Conference on Social Determinants of Health

In this commentary, Renzo Guinto analyzes the aftermath of the World Conference on Social Determinants of Health held last October 19-21, 2011 in Rio de Janeiro, Brazil, and reminds all stakeholders, including IFMSA, that we cannot fail the second time around. More articles about “Youth and the Social Determinants of Health” in Medical Students International 25: http://issuu.com/ifmsa/docs/msi25_onlinedistribution/1

 

Ramon Lorenzo Luis R. Guinto

The road, or rather the flight to Rio de Janeiro, Brazil is the longest I ever took. Two days to the destination, two days on the way back, but at the end of the nine-day sojourn, I can say it was all worth it. As someone who lives in Asia, you only get to South America once in a blue moon. I feel blessed because this trip was not just my first to the continent, but the main object was historic and inspirational.

For three days, more than a thousand public health experts coming from governments, UN agencies, academia, and civil society gathered at the World Conference on Social Determinants of Health to discuss how global health equity can be achieved. Unfortunately, the road towards it is not as smooth as my flight to the land of samba.

To illustrate the gravity of the situation, I turned to my reference materials. In Southeast Asia alone, glaring inequalities in maternal mortality rates can be noted: 339 out of 100,000 mothers in Laos, 229 in Indonesia, 84 in the Philippines, and only 16 in Singapore (1). On the other hand, when referring to inequities within countries, the classic example in social determinants literature is that of Glasgow in Scotland. Despite it being a city in a rich industrialized country, there exists a 30-year gap in life expectancy between the city’s most and least advantaged communities (2).

Clearly, there are forces that shape these inequities, and biomedicine realized that genetic and other individual factors have little to do with these gross inequalities at the population level. Two hundred years ago, the German physician Rudolf Virchow (3), who is regarded as the Father of Social Medicine, had already hit the nail at the head when he asked: “Do we not always find the diseases of the populace traceable to defects in society?”

It is therefore with this background that the World Conference was organized, with the intent of engaging “high level political support to make progress on national policies to address social determinants of health to reduce health inequities” (4). Moreover, the conference is an off-shoot of the 2008 report of the World Health Organization (WHO) Commission on Social Determinants of Health (5), which synthesized evidence from around the world illustrating how social determinants of health (SDH) – the conditions in which people are born, grow, live, work and age – bring about avoidable health inequities within and between countries.

The Commission, headed by renowned British social epidemiologist Professor Sir Michael Marmot, also listed down proposals for action on social determinants, which were summarized into three overarching recommendations: 1) the improvement of daily living conditions; 2) tackling the inequitable distribution of money, power, and resources; and 3) measuring and understanding the problem and assessing the impact of action.

Mixed views

The overall outcome of the conference itself can be described as equivocal, as it has drawn mixed views from different sectors. Some saw the conference as a major step towards renewing the global health equity debate, even being tagged as the new “Alma Ata,” in reference to the landmark 1978 Alma Ata Declaration on Primary Health Care (6). Although not explicitly using the phrase “social determinants of health,” the Declaration was the first international document that recognized gross health inequities as “politically, socially, and economically unacceptable” and which had called for intersectoral action and international collaboration towards the achievement of “health for all by the year 2000.”

However, others noted the diminished ambition of this event, especially of its main product – the Rio Political Declaration on Social Determinants of Health (7). This new document laid out commitments and recommendations from the over 100 governments present, capturing the five themes of the conference – governance, participation, the role of the health sector, alignment of global priorities, and monitoring of progress (8). However, other groups, especially civil society, criticized the document as being silent about some fundamental and crucial subjects such as trade as a social determinant of health, the links between social determinants of health, climate change, and sustainable development, and ultimately the redistribution of power, money, and resources, which has been the clarion call of the Commission’s Report since its publication.

Despite the document stepping on middle ground, there are still reasons to celebrate. The World Conference provided a venue for academics and civil society to gather and combine their voices for the revival of the health equity debate. In recent years, especially since the failure of Alma Ata in 2000, international networks such as the People’s Health Movement (9) have created their own platforms for global discussion on health equity and social justice, but none of these are either initiated or actively participated in by the WHO or any other intergovernmental agency.

The Rio conference, on the other hand, was the brainchild of WHO as requested by Member States through a World Health Assembly resolution in 2008 (10). Thus, this event served as an opportunity for meaningful dialogue between governments and UN agencies on one hand and civil society and academia on the other. Civil society groups were even allowed to organize their own side events, which further contributed to the solidifying of existing international and regional networks.

The People’s Health Movement (PHM) in particular also made use of this rare chance to concretize their dismay towards the Rio Political Declaration. Considered as the largest network of health activists calling for the revival of Alma Ata principles and of the vision of “health for all,” PHM came up with its own “Alternative Rio Declaration” (11). In this document, PHM listed down specific and concrete measures to address global health inequities such as the use of progressive taxation, reducing the clout of financial capital, use of health impact assessments in trade agreements, reconceptualization of development aid as an international obligation, and democratization of global governance, to name a few. The group’s statement somehow reflects the dissatisfaction towards the status quo, embodied by the ongoing Occupy protests which have spread from Wall Street to across the globe (12).

PHM and civil society at large even infiltrated the closing panel of the conference in a grand manner. One of its members, Dr. David Sanders from the University of Western Cape in South Africa, lambasted the Rio Declaration’s silence on unfair trade in food production and the “brain robbery” of health workers by Northern countries. Such fearless statements triggered the only standing ovation during the three-day conference.

Speaking the SDH Language

Another positive sign that we have observed during the conference is that some governments are now starting to speak the language of social determinants. Before the World Conference, I have previously attended a few meetings on social determinants. It is evident that despite the publication of the Commission’s Report and the wide availability of resources on social determinants, there remains diversity in understanding of the concept, ranging from promoting healthy lifestyle among local politicians (hoping that their good health will translate into good policies) to addressing global determinants such as climate change and the financial crisis.

In Rio, it seemed that some countries have already grasped the idea, while a few were actually fairly advanced in their understanding and implementation of action on social determinants. For example, South Australia boasts its “Health in all Policies” approach which enables other departments beyond the health sector to apply a “health lens analysis” to their policies and projects (13). Thailand instituted a National Health Assembly in an attempt to democratize health governance and allow participation from all sectors in priority setting and decision making (14). Finland even went on by declaring the welfare state as the best medicine against growing health inequities (15).

Despite this, albeit minor, victory, it is important to keep in mind that no matter what ministers of health declare in international conferences like this, most of the crucial decisions governing social determinants of health are under the jurisdiction of other domestic leaders such as ministers of finance or labor or even the prime ministers and presidents themselves, none of whom are present in the conference (16). The same can be said of the international arena – key actors such as the United Nations, World Bank, and World Trade Organization were also absent in Rio. Expressing a commitment during the World Conference is just half the battle – advocating for action to other sectors at home still remains the major formidable task.

Consistency is key

Even after the World Conference, health equity activists should also keep an eye at the World Health Organization. Observers of global health history clearly understand WHO’s tendency to switch themes from time to time, depending on the tune of some donor countries, influential NGOs and academic think tanks, and even private donors.  If WHO is really serious about “closing the gap in our generation” as the Commission’s Report’s title says, then the organization should remain consistent in its policy pronouncements from the Director-General to its country offices, and the SDH framework should be reflected in all its implemented programs, whether on HIV-AIDS to NCDs.

It is saddening that “social determinants” or “health equity” is not mentioned in the candidature current WHO Director-General Dr. Margaret Chan, who is now seeking another five-year term (17). Surely, as the only candidate for the post, she will be given another chance to lead WHO and to push forward the health equity agenda. Not only will it complement her agenda towards stronger health systems and a reformed WHO, this work on social determinants, and not her present focus on NCDs or any other vertical disease-oriented program, could also become her enduring legacy to global health.

Finally, again speaking of consistency, governments should start realizing – and realizing through the hard way – that business as usual is not an option for our global health future.

Health equity at the heart of IFMSA

Finally, this commentary will not end without looking at the role of the International Federation of Medical Students’ Associations (IFMSA) in this ongoing global debate. In 2011, IFMSA made health equity and social determinants of health a key policy focus (16), commencing with the passing of a policy statement on the matter in Jakarta (18). For months, the Small Working Group on Health Inequities under the Standing Committee on Public Health energized the discussions, both online and in actual meetings and consultations, which then culminated in a magnetic presence in all standing committee and regional sessions, and an overwhelmingly-attended forum with Sir Michael Marmot during our 60^th anniversary conference. During that week, “SDH” became the mantra of Copenhagen.

Now, after Rio comes Accra, Ghana, which hosts IFMSA’s March Meeting this 2012, revolving around the theme of social determinants of health. This assembly is accompanied with a pre-General Assembly workshop on SDH and a presentation to the plenary on the proposed Global Health Equity Initiative. All these, I believe, will set the tone for IFMSA’s future.

This “SDH” capital that has been amassed in 2011 should not be put to waste, and I hope the future generations of IFMSA leaders and members will not cease talking about it and doing something about it. I recall someone telling me, “There should be no SDH-related activity in future meetings after Ghana.” I beg to disagree – the discussions should continue beyond Accra – as we already triumphantly did from Jakarta to Copenhagen to Rio.

We should remember that for every missed opportunity to discuss and to act on this crucial issue of our times, someone has to pay the price. Global health equity is not merely a theme for a conference, but a real global challenge that a truly global and truly health-committed organization should tackle in the 21^st century.

Our aim is to create a global movement, not to make it a topic for a session. Every General Assembly has a new breed emerging, and therefore every General Assembly should not stop sowing the seeds of health equity into each IFMSA generation.

Medical students as social determinants of health

Looking at particular social determinants, I hope to see IFMSA spark a discussion about the management of human resources for health, including medical students who will soon become physicians, as an important global social determinant of health (19). I already mentioned about the “brain robbery” of health workers by developed countries from developing countries being a hot topic in Rio. It cannot be denied that medical students and young doctors play a vital part in this ongoing process.

As an international federation of medical students, it is our obligation to look into this issue, not just in medical education, which is only one segment of the whole health human resource production process, but also in the recruitment, certification, deployment, quality assurance, and compensation of physicians and health workers. These processes, in turn, are inextricably intertwined with issues concerning global trade, human migration, and global health governance, to name a few.

For example, a closer look into our professional exchange programs would enable us to understand if such programs actually promote global health learning for meeting local needs, or instead lead to global health inequalities by encouraging young physicians to move from their places of origin and training to new locations, which are often more lucrative but where they are needed least. I am sure many of our members will feel uncomfortable about this matter, but if we truly want to close the health gap, this one cannot be ignored.

Time to Become Revolutionary Doctors

Sometimes, no matter how well-informed, updated, and passionate I am about the issue of social determinants and health equity, I feel that I still do not have the exact answers. But also I think what is important now is that we medical students have already started talking about it – that we condemn the inequalities in health, that we understand the root causes of ill health and health inequities, and that we seek for ways to change the status quo. The members of the IFMSA delegation even expressed this desire and optimism in a statement distributed during the final day of the World Conference:

“We medical students commit ourselves to continue engaging with all sectors involved in the work towards global health equity, spreading awareness of the social dimensions of health to our fellow young people, mobilizing them to take action in their respective communities and countries, doing our part, little by little, but with courage, constancy, and conviction.” (20)

We therefore invite every member of this Federation to embrace this commitment, now as medical students, and beyond, when we become doctors of the future, until we see the day when, in the words of former UN secretary-general Kofi Anan, “health will finally be seen not as a blessing to be wished for, but as a human right to be fought for.”

This year and beyond, we, IFMSA, must keep reminding the global health world that we, medical students and young people at large, are not mere observers or beneficiaries, but are key players in this global movement. We will inherit this current global health regime sooner rather than later, and so we must exhaust all the platforms within our reach not tomorrow but now.

So, after Rio, where to? For IFMSA and medical students worldwide, it is time to, quoting from a new book entitled Revolutionary Doctors, “combine the humanitarian mission of medicine with the creation of a just society” (21). Realizing this requires an unwavering commitment to social determinants and “health for all.”

About the Author

A final year medical student at the University of the Philippines Manila, Ramon Lorenzo Luis R. Guinto (Renzo) is the facilitator of the SCOPH Small Working Group on Health Inequities and head of the IFMSA delegation in the World Conference on Social Determinants of Health. He is also the Regional Coordinator for the Asia-Pacific of IFMSA and immediate past president of the Asian Medical Students’ Association-Philippines, the IFMSA NMO in the Philippines.

 

 

References

1. Chongsuvivatwong V, et al.  Health and health-care systems in Southeast Asia: diversity and transitions. Lancet 2011; 377: 429–37. Available from: doi:10.1016/S0140-6736(10)61507-3.
2. Hanlon P, Walsh D & Whyte B. Let Glasgow flourish. Glasgow: Glasgow Centre for Population Health, 2006.
3. Virchow R. Collected Essays on Public Health and Epidemiology. Cambridge: Science History Publications; 1848/1985.
4. World Health Organization Department of Ethics, Equity, Trade, and Human Rights. Concept Paper for the World Conference on Social Determinants of Health [Online]. Geneva: World Health Organization, 2010. Available from: http://www.who.int/social_determinants/draft_concept_paper_september_2010.pdf. [Accessed 10^th January 2012].
5. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization, 2008.
6. WHO, UNICEF. Declaration of Alma-Ata. Alma-Ata, USSR, 1978. Available from: http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf.  [Accessed 26^th October 2011].
7. World Health Organization. Rio Political Declaration on Social Determinants of Health. Rio de Janeiro, Brazil, 2011. Available from: http://www.who.int/sdhconference/declaration/Rio_political_declaration.pdf.  [Accessed 21^st October 2011].
8. Closing the gap: policy into practice on social determinants of health: discussion paper for the World Conference on Social Determinants of Health. Geneva: World Health Organization, 2008.
9. People’s Health Movement. Available from: phmovement.org [Accessed 10^th January 2012].
10. Resolution WHA 62.14. Reducing health inequities through action on the social determinants of health. Geneva: World Health Organization, 2009. Available from: http://apps.who.int/gb/ebwha/pdf_files/A62/A62_R14-en.pdf.  [Accessed 26^th September 2011].
11. Protecting the right to health through action on the social determinants of health: a declaration by public interest civil society organizations and social movements. Rio de Janeiro, Brazil, 2011. Available from: http://www.phmovement.org/sites/www.phmovement.org/files/AlternativeCivilSocietyDeclaration20Sep.pdf.  [Accessed 29^th October 2011].
12. Occupy Wall Street. Available from: http://occupywallst.org/. [Accessed 10^th January 2012].
13. Kickbusch I. Health in all policies: The evolution of the concept of horizontal health governance. In: Kickbusch I, Buckett K. (eds.) Implementing Health in All Policies: Adelaide 2010. Adelaide: Department of Health, Government of South Australia, 2010: pp. 11-23.
14. Rasanathan, K, Posayanonda, T, Birmingham, M. and Tangcharoensathien, V. Innovation and participation for healthy public policy: the first National Health Assembly in Thailand. Health Expectations, February 1, 2011. Available from: doi: 10.1111/j.1369-7625.2010.00656.x
15. Ministry of Social Affairs and Health, Finland. Minister Guzenina-Richardson: The welfare state is the best medicine against growing health inequalities. [Online]. Available from:  www.stm.fi/tiedotteet/tiedote/view/1569646#en.  [Accessed 3^rd December 2011].
16. Guinto, R, et al. Students’ perspective on rooting out causes of health injustice. [Online] Lancet, October 20, 2011. Available from: doi:10.1016/S0140-6736(11)61628-0. [Accessed 20^th October 2011].
17. Chan, M. Dr. Chan’s vision on WHO priorities and strategies [Online]. Geneva: World Health Organization, 2011. Available from: http://www.who.int/mediacentre/events/governance/dgelection/2012/CV_Chan_2011.pdf. [Accessed 25^th December 2011].
18. International Federation of Medical Students’ Associations. Policy statement on health inequity and the social determinants of health. Jakarta, Indonesia, 60th March General Assembly of the International Federation of Medical Students’ Associations. March, 2011. Available from: http://www.ifmsa.org [Accessed 26^th September 2011].
19. Globalization and Health Knowledge Network. Towards health-equitable globalisation: rights, regulation and redistribution. Final report of the Globalisation Knowledge Network of the Commission on Social Determinants of Health. Geneva: World Health Organization, 2007.
20. International Federation of Medical Students’ Associations. Medical Students’ Perspective on the Rio Declaration. October 21, 2011. Available from: ifmsa.wordpress.com [Accessed 21^st October 2011].
21. Brouwer, S. Revolutionary Doctors: How Venezuela and Cuba are changing the world’s conception of health care. New York: Monthly Press Review, 2011.

Post-WPRO Meeting: On WHO budget and NCDs (Day 2)

Renzo, Maria, and Kyle at the 62nd session of the WHO Regional Committee for the Western Pacific

October has been a jampacked month for international conferences and meetings. Now we return to one of the recent engagements of IFMSA – the 62^nd session of the WHO Regional Committee for the Western Pacific held in Manila last October 10-14, 2011. In this blog entry, Kai-Yuan Cheng (Kyle) from Taiwan and Maria Lioni Kusuma Tatang from Indonesia share their thoughts about the second day of the meeting, which focused on the WHO regional budget and non-communicable diseases. At the end of the vignettes is the intervention on NCDs which was drafted by the IFMSA team and distributed to all participants of the meeting.

 

Kyle’s thoughts:

Following yesterday’s intensive discussion on WHO reform, the committee discussed today the budget of the previous and the next bienniums. It is not surprising that some of the points raised during the discussion on WHO reform were re-mentioned, since one of the purposes of the reform is to reduce unnecessary costs in operations.

The afternoon session is rather unique. There are several governmental officials and social activists who shared about successful programmes on NCD control and prevention. One of the inspiring projects came from the World Heart Foundation. WHF is one of the four international organizations that established the NCD alliance, which advocated the inclusion of NCDs in the global health agenda. The alliance also worked on tackling NCDs in partnership with industry players. Such a successful case of cooperation between NGOs and industries has interested several national representatives in WPRO.

One of the speakers in the panel gave a reminder: “Private sectors should have no role in policy decision, but they can have big roles in policy implementation.” This poses a challenge to governments, as they strive in building intimate alliances with the private sector while they struggle in maintaining their neutrality and staying away from potential conflicts of interests.

Reflecting on my country’s experience on NCDs, I can say that as of now, Taiwan has not yet been doing pioneering work. We have several prestigious enterprises which I believe possess the capability as well as the awareness to contribute to solving health issues such as NCDs. I hope my country will maximize the potential of cooperation between the public and the private sectors as we combat the forces that lead to NCD morbidity and mortality.

 

Maria’s thoughts:

The second day of 62^nd Session of WHO WPRO Regional Committee has indulged me with extremely important discussions. The morning session allowed us to see how budgeting is conducted and implemented in WHO Regional office.

The WHO Regional Secretariat explained that lack of technical expertise in managing the budget as well as the earmarking of voluntary contributions by some Member States and other donors remain as some of the challenges in the financing of WHO. Currently, only 20% of the money comes from Member State contributions, while the rest relies on earmarked voluntary donations from some Member States, health foundations, and private enterprises.

Next big agenda for the second day is non-communicable diseases. The segment started with an address from the Regional Director, reminding the participants about the profound urgency of shifting commitments to NCD control and prevention into tangible actions. The Malaysian Ministry of Health then gave a presentation about their approach to NCDs.

The discussions emphasized that continuous monitoring and surveillance, together with consideration of social determinants of NCDs, are critical issues that WHO has been trying to address at the global level. Advocacy and partnerships related to NCDs within the health sector and with other non-health agencies are also of vital importance. It is essential to note that most NCDs occur in low and middle-income countries, and therefore leadership, funding, and alliance-building for action on NCDs should be focused on these countries. Another critical aspect of NCDs that must be tackled carefully is the ethical relationship of NCD actors with the private sector.

I realized that we medical students can and should take an active part in the prevention and control of NCDs. IFMSA can contribute in building the evidence base for action, as well as in allowing transfer of best practices from successful countries and communities to others that are still struggling with the NCD burden. Every deed, big or small, counts!

Medical Students’ Perspective on

Item 13. Non-communicable diseases

The evidence on the global burden of non-communicable diseases (NCDs) cannot be ignored. Two of three deaths each year are attributable to NCDs, while four-fifths of these deaths are in low-income and middle-income countries. A new report from the World Economic Forum and Harvard School of Public Health estimated the cumulative output loss due to NCDs at US$ 47 trillion, representing 75% of global GDP in 2010.

The Western Pacific Region cannot turn a blind eye on NCDs. One report from WPRO stated that around 25,000 people die every day from NCDs in the region. Recently, a Lancet article reported that NCDs accounted for nearly 60% of the total deaths in Southeast Asia.

We laud the WHO Western Pacific Regional Office for its efforts in creating regional collaboration for action on NCDs. Such a regional strategy is needed now more than ever, as NCDs are a challenge not just of some countries, but of all nations. But we also hope to see WHO’s leadership in inspiring action on NCDs from other sectors aside from government, including civil society, private enterprise, and the academia. NCDs cannot be truly addressed if we do not tackle the sources of food we eat, the availability of open spaces for exercise, and the regulation and ultimately eradication of tobacco products, to name a few.

The IFMSA is also committed to combat this major health challenge of our generation. For the past sixty years, our Federation, a unique network of 106 medical students’ associations from 99 countries, has been teaching communities about diabetes prevention, holding events that promote physical activity, and giving comfort to cancer patients of all ages.

Last September 19, coinciding with the United Nations High-Level Meeting on the Prevention and Control of Non-communicable Diseases, our Federation commemorated the “IFMSA Day of NCDs.” During this event, medical students from around the world organized roundtable discussions, educational fora, and community activities, as well as utilized social media such as Facebook and Twitter in spreading awareness of the global burden of NCDs to the general public.

Finally, we remind the WHO and Member States to not isolate NCDs from the more encompassing discussion on health systems strengthening, health equity, and action on social determinants of health. For example, evidence shows that it is the world’s poor that are more susceptible to smoking behavior, and therefore smoking-related disease and death. A WPRO report on the link between poverty and NCDs showed that more severe outcomes for the poor from NCDs are not only caused by greater risk behaviors and increased incidence of disease, but also from their inability to access or afford preventative services and treatment.

It is very timely that after the UN Summit on NCDs, the next important global health meeting will be the WHO World Conference on Social Determinants of Health. Next week, IFMSA will also be present in Rio to remind the global health community that action on social determinants of health will not just provide us protection from NCDs, but from all diseases as well.

A world that is safe from NCDs, infectious disease, pollution, poverty, and social inequities – that is a healthy world.

Prepared by

Ramon Lorenzo Luis R. Guinto (Regional Coordinator for the Asia-Pacific), Maria Lioni Kusuma Tatang, and Kai-Yuan Cheng in behalf of the International Federation of Medical Students’ Associations (IFMSA) on the occasion of the 62^nd session of the WHO Regional Committee for the Western Pacific, October 10-14, 2011, Manila, Philippines