66th World Health Assembly – Day 3

The World Health Assembly is now cruising at its highest speed and day 3 started with the motivation from all that has already been accomplished. Early in the morning, too early for many of us, the delegation met at our new how: the Serpentine’s bar at the United Nations Office in Geneva. Short debriefs were done and soon everyone left towards their own jobs.

Health in the post-2015 agenda: Outcomes of the Global Thematic Consultation, was the main morning discussion, as well as Sexual and reproductive health and rights in the ICPD beyond 2014 and post-2015. Meanwhile, at Committee A, delegates debated on Noncommunicable Diseases and Promotion of Health through the life course.

As soon as main meeting were over, IFMSA delegates had the pressure to run after different ministers, ambassadors and representers of so many institution, to let the know about the work we’re doing and engage them with our opinions. Time flies at the WHA and so much is yet to do, that bustle is the scenario in each corridor, cafeteria or room at the venue. To be at the centre of decision making, where “to change” is not a dream but a reality, where negotiation and advocacy take place at its highest level, is both demanding and fascinating. Delegates are, indeed, putting in practice all skills developed during the Youth Pre-WHA and I take the risk of affirming that not one of the 3,000 people here gathered has not heard about IFMSA’s work.

Workers and universal health coverage. Serving all workers – universal health coverage and productivity

The famous side meetings continued around lunch time. These are actually an extremely important moment as it is in these rooms that a consensus between WHO and Member States is obtained. True real discussions take place, and input from so many different sources always enriches these sessions. Six of these meetings happened simultaneously and IFMSA’s delegates, with the know-how obtained throughout the Pre-WHA and the experience gained on the last few days, had a meaningful participation in discussion on workers and universal health coverage, strengthening palliative care as a component of integrated treatment throughout the life course, addressing inequalities in NCDs: a focus on rheumatic heart disease, gender, equity and human rights: disaggregating data to get the real story, mHEALTH for NCDs: the unique opportunity and challenges, and launch of the WHO Global Alliance for the Care of the Injured.

Quick snacks and coffees were all we had to continue working on the statements yet to conclude: post millennium goals, and human resources in health, will be the two issue to tackle tomorrow, and statements need to be sent 24 hours in advance. Working under a pressure the we no more feel, we all met for one more debrief. Everyone is in a hurry, some arrive late, others leave early, but it is actually amazing to see our group sessions. Should someone have ran into Salle XXIII around 4pm today, the scenario they would encounter was a youth delegation with thirty people coming from all regions, shortly but professionally updating on what they have been doing and where they were heading.

We then headed to the Committee A where Roopa would have the chance to deliver our statement on NCDs, today’s subject of discussion. The meetings on this room tend to be long and complex, with dozens of interventions on specific issues that only well prepared delegates can actually understand. However, having IFMSA’s opinion being read out loud, clearly pointing out problems and suggesting concrete solutions, is indeed empowering youth and being engaged with decision making processes.

IFMSA President Roopa Dhatt addressing WHA Committee A

Before the day would come to an end, we still had ahead of us one last round of meetings and side events. Motivated to both actively listen and participate on these debates, delegates went to sessions on new programme support and policy changes, WHO Global Code of Practice on the International Recruitment of Health Personnel: Stoking up the fire for Code implementation, building systems to address functional decline and dependence in ageing populations, and volunteerism and health coverage.

WHO Global Code of Practice on the International Recruitment of Health Personnel: Stoking up the fire for Code implementation Panel

Sunset was the picture behind us as we left the UN offices after one more amazing day. Everyone is with a mix of feelings, in a healthy equilibrium between huge motivation and a nearly as huge exhaustion. However, the success of the work done, and the will to strike on our goals for the next days, give us the power to continue pursuing our work! Back at the hostel, a final informal debriefing session allowed us to, once again, sit together and keep track on what everyone is doing.

IFMSA’s delegation is doing an amazing job here at the WHA. Engaging Youth in decision making processes is a huge goal, but the commitment of each delegates allows advocacy to happen, having a high quality Youth contribution on where change actually happens: the World Health Assembly.

Pedro Correia de Miranda

PorMSIC – Portuguese Medical Students International Committee

Reflection from Pre-WHA Youth Workshop: Negotiating for better global health

“Not just training for the future, but participating in the present” were the words of Dr Wilson, President of the World Medical Association, at the Closing Ceremony of the recent Pre- World Health Assembly (WHA) youth workshop, organised by the IFMSA. In many ways, his words reflected exactly what we were doing in this three-day workshop, which involved over 30 young people interested in health advocacy. With students from all over the world gathered in Geneva, covering disciplines such as medicine, pharmacy, dentistry, law, and public health, we had come together to prepare for the upcoming WHA.

The workshop involved a combination of keynote addresses, expert panels on five important WHA agenda topics, and small working groups on these issues for advocacy preparation. These five topics were non-communicable diseases (NCDs), human resources for health (HRH), maternal and child health (MCH) and sexual and reproductive health (SRH), the post-2015 agenda, and research and development (R&D). Throughout the three days, we split into groups to prepare focus points and briefing papers on these issues, which we would use throughout the WHA to discuss with member states, and interventions, which we would submit for presentation to the Plenary.

Group Photo of the participants on the Pre-WHA Youth Workshop

But first, we had a range of excellent introductory lectures. The opening address was given by the wonderful Dr Sigrun Møgedal, who spoke about the importance of youth involvement in global health. She inspired us all by promoting the key differences youth can have in this field, most particularly, by being able to take risks, be strong, and demand change. We talked about the difficulties in defining global health, but ultimately the one that resonated with me the most was simple: “global health means…we’re all in this together!” This was followed by a lecture on global health diplomacy, given by Professor Ilona Kickbusch of the Graduate Institute of International and Development Studies. She gave an excellent overview of the current global health agenda, and the need for global governance for health. An introduction to the World Health Organisation (WHO) was provided by Dr Mihály Kökény, former Chairman of the Executive Board, and Dr Andrew Cassels, current Director of Strategy. Dr Cassels spoke about WHO reform and highlighted the fact that one of the WHO’s key roles in creating normative standards and public goods is often not recognised, resulting in criticisms of the organisation as a whole. Dr Kökény shared the lessons he learnt while at the WHO, including the importance of preparing for all scenarios, consulting with experts on topics, and discovering the vested interests of those you are working with.

Workshop days two and three were made up of panel sessions for each of our focus areas. An attempt at brevity prevents me from going into detail about the speakers and issues discussed in each, but we were fortunate to have interesting and experienced panellists who were able to provide new perspectives on each topic. A highlight was to hear from Dr Lola Dare, of CHESTRAD, who spoke about the need for reform in medical education, and emphasised the need for social accountability as a component of training for all health workers. Similarly, Carlos Dora, of the WHO Department of Public Health and Environment, spoke about the importance of health in the post-2015 agenda – as he pointed out, “health is central to development; as a precondition, beneficiary, and indicator.” Perhaps the most useful session of the workshop however was an advocacy simulation exercise, coordinated by representatives from the Graduate Institute, World Vision and Save the Children. This forced us to play various roles in the WHA process – member states, non-governmental organisations, and the WHO Secretariat – in order to understand how the lobbying process works at the assembly and think more critically about our role as an NGO agitating for change within the system.

So, after three long days, we concluded the pre-WHA workshop with a greater understanding of the issues on the agenda, a renewed focus on interdisciplinary collaboration in health, and concrete goals for our advocacy throughout the assembly itself. The inaugural pre-WHA workshop was most definitely a success, and will no doubt see an improved recognition of the role for informed and coordinated youth involvement in global health.

By Freya Langham

66th World Health Assembly – Day 2

Breakfast at 6:30 is something one simply doesn’t like, but in WHA that is exactly how it works. The sun was still rising when the first delegates left to the UN Office in Geneva for another full, tiring but exciting day at the centre of decision making: the WHA.

Whilst logistics were being sorted, documents printed, task distributed, and agenda organised, some delegates attended a breakfast on Post 2015 Consultation on Global Health and Diplomacy, at the Intercontinental Hotel. With the presence of minsters of health from the all over the world and WHO ambassadors, the purpose was top advance on discussion around the post-MDG development framework, broaden the discussion of the post-MDG framework to include the diplomatic community, private sector, academics, other private donors in global health and other development stakeholders as part of an on-going consultative process, and begin to outline the health-related principles and goals for a post-MDG development framework.

Post 2015 Consultation on Global Health and Diplomacy

Back at the WHA, a short debrief was the point of start of the day. While discussion in the Assembly Hall continued on NCDs, Committee A discussed the programme and budget matters. This was followed by the main subject of the day: the WHO Reform. Member States gave their input on the main changes that should take place within WHO, and Renzo had the opportunity to address the delegates on the importance of Youth engagement on the decision making processes.

Day 2 – Morning Delegation Debriefing 

Some of our delegates then headed to a luncheon seminar organised by the World Medical Association addressing the “Low Level of Immunization Rates among Health Care Professionals”. Dr. Cecil Wilson, President of WMA, explained that flu, commonly regarded as harmless infection that everyone gets, is in fact a global health threat that causes around 500,000 deaths every year. The importance of immunising physicians was the main idea of the speech, as this represents a standard of quality care.

Meanwhile, other meetings kept taking place and our delegation was distributed in order to attend as many different discussions as possible. Autism spectrum disorders, the ePORTUGUESe Programme under South-South cooperation, antibiotic resistance as a threat to global health security, and effectively countering the NCD epidemic were the topics under debate. These sessions are an amazing experience as delegates get both the chance to enrich their own knowledge on so interesting matters, but also the opportunity to chase, speak, discuss and learn with monsters, ambassadors and NGO representatives.

ePORTUGUESe Programme under South-South cooperation meeting

The awaited 10 minutes to grab a sandwich and get a coffee eventually happened, but everyone had to rush as Dr. Jim Yong Kim, President of the World Bank, would soon start his speech, during the fifth plenary session of the WHA. Dr. Kim’s main points were that healthcare financing reforms should be universal, transforming healthcare, not only at a tertiary level. Social justice was defined as essential and the need of concrete plans and metrics for outcomes of Alma-Ata Declaration was emphasised. According to Dr. Kim, access, quality and affordability should be the ground rules of universal healthcare. As main goal, we should strike on ending absolute poverty by 2030: all citizens need, deserve and have the right to access quality affordable healthcare. Together with this, closing the coverage gap in the 40% poorest countries by building capacities and reducing economic inequality through employment should be a priority. Finally, Dr. Kim defined 5 specific areas that the World Bank will support: health systems, millennium development goals 4 and 5, strengthening the measurement of work done related to UHC, the science delivery, and the improvement on capacity for sanitation and women empowerment. This amazing speech ended with the idea that we have to demand the end of the deadly fragmentation that has hindered our health systems for so long. “We must be the generation that delivers Universal Health Care”.

World Bank President Dr. Jim Yong Kim Speech

The delegation then had the chance to meet, with enough time to make a full debrief and update on main points. Evolution on policy briefs and interventions, update on which delegations have been addressed, and organisation of the following meetings and events were all done.

Day 2 – Afternoon Delegation Debriefing 

This happened quickly enough to head to a meeting under the tittle “From global declarations to local actions: health promotion beyond 2015″, organised by the Alliance for Health Promotion-A4HP jointly with the Regional Psycosocial Support Initiative – REPSSI, South Africa. After two speeches on social determinants of health and health promotion, and Psyco-social support implementation at regional and country level, Roopa was invited to make a presentation on medical education and health promotion beyond 2015. It was extremely motivational for all of us to see the audience’s interest on youth’s opinion and there desire to commit on engaging youth within decision making processes. The presentations were followed by an informal networking event offered by the Alliance for Health Promotion-A4HP. We are very happy to have received the invitation for this event, and to have had the chance to continue advocating on youth engagement among the participants.

IFMSA President Dr. Roopa Dhatt presentation at “From global declarations to local actions: health promotion beyond 2015″ meeting

The day closed with one more round of meetings: the pharmaceutical manufacturing capacity of Uganda, securing health and development through scaling up nutrition, strengthening pharma-vigilance for better regulatory functions in low- and middle-income countries, and an update on Influenza A situation were the issues addressed.

Finally gathered again at the Hostel, everyone had the opportunity to chill and work at the same time. Delegates are starting to feel tired, but motivation is huge, and striking on the goal of engaging youth at the decision making center that WHO is, is indeed the goal that will, in a couple of hours, wake up each and everyone of us.

Pedro Correia de Miranda

PorMSIC – Portuguese Medical Student International Committee