High-Level Dialogue on Health in the Post-2015 Development Agenda concludes in Botswana

IFMSA Interventions at the Global Thematic Consultation on Health in the Post-2015 Development Agenda, delivered by IFMSA President Roopa Dhatt

March 3-5, 2013 in Botswana

Intervention #1—Importance of YP in the Development Agenda, Health in All Policies, and Getting to the Root Cause

Young people are a large population. Health issues (such as mental health, violence, injuries, child marriages, unprotected sex, early pregnancy and childbirth, sexual coercion, HIV) and social issues (such as employment, environment, education) continue to challenge their ability to meaningfully participate in achieving their future. We urge the post MDG framework to increase young people’s analysis, perspective and participation. We also urge the post MDG to consider forgotten voices of marginalized and vulnerable groups regardless of political, religion, social, racial, national, sexual, gender, national, sexual or any discrimination.   Not only are young people the future, but also they will be responsible for sustaining the efforts that are set now. We should engage with young people early on about healthy lifestyles, sexual reproductive health, and career planning and use them as a vehicle for social change, specifically in increasing the shortage in human resources for health.

We also feel that health should be placed in other policy agendas beyond the development agenda and the sustainable development. We urge the creation of more health indicators that are context specific, age-specific, and population specific in evaluating policies.

We encourage the global community to seek and address the root cause of inequity and the determinants that challenge health and well-being, especially in empowering young people early on.

Intervention #2—Political Language and Health in all Policies

1. We need a political language that is universal–understood and useful across sectors, so we can have more meaningful dialogue on setting the development agenda, especially if we are aiming for a more integrated approach.

We have heard a great deal about Human Security as potential framework that is emerging in some other non-health settings. It is a framework that focuses on development, human rights and state security. It is focused on the needs of people, multi-sectorial, integrated, and focused on both protections and empowerment.  It is a tool for both design and evaluation.  We need to consider such frameworks.

2. We need to keep our approach multi-sectorial, focused on sustainable efforts, addressing root determinants of health, bridging gaps, and integrating at the local level.

3. The how still needs to be answered, as we focus on these efforts.                                                       

Intervention #3—Human Resources for Health/Health Workers

 

When we talk about setting the health priorities for post-2015, we have to ask ourselves several questions.

• Who are the targets of these priorities?
• Who will be central to responding to the health priorities? Human resources for health or Human resources for development.
• If these are health workers or similar groups, how do we plan to engage with them and include them in setting in the post-2015 agenda?
• What will be their health literacy?
  • Will this include?
    • Multi-sectorial approach
    • Social Determinant of Health/ Determinants of Well-being
    • Sustainable development
    • Global heath
    • E-Health
    • Addressing the needs of target, marginalized and vulnerable groups
• How do we plan to build their capacities and make sure quality is

 

As a future health care provider, answering these questions are essential to setting the future development agenda and insuring that health priorities that are set are achieved.

 

Intervention #4—Specific Target Groups and An overarching goal on adolescents and young people

 

While we support universality of the goals that are set in the next development agenda, we want to highlight the importance of outreach to specific target group, like marginalized and vulnerable populations, especially adolescents.  While we do support the notion of age-specific, life cycle or other similar groupings for an over arching goal, we want to make sure that specific target groups are emphasized.

 Moreover, we would like to propose to the health community, about considering another additional overarching goal. We have heard in the room these past days a lot of mention of young people and their engagement, involvement, and access to health services, especially sexual reproductive health services. We also have been hearing at the UN level, at the WHO, the Rio+20 and other thematic consultations the importance of investing in young people as an emerging theme.

 

We have been discussing about the future…

The many health issues we discussed are most pertinent to young people, especially adolescents…(topics such as sexual reproductive health, mental health, violence, child brides, even health lifestyles and NCDs apply)

Young People are the future…

So why don’t we put adolescent health on the global development agenda, as an overarching goal?

Such a goal would be universal, sellable, and compelling.

Such a goal appeals to sustainable development (green economies, future generation)

Such a goal has the potential to be multi-sectorial (job employment, education, environment, nutrition)

Social determinants of health are a reality for young people, especially adolescents’ future.

Young people are innovators of social media, new technologies, tools and approaches.

Young people are already in some cases acting as human resources for health. 

Young people are engaging already on claiming their future and investing into it.

 

Discussion Points on Round Table during the meeting

 

GOAL: Universal Health Coverage

• The goal as is comprehendible, sellable, and universal.
•  The message should be more universal health access versus universal health coverage.
• We should make sure that such a goal, also has a specific mention for target groups, especially vulnerable and marginalized groups like migrant, rural, indigenous, young people.
• We should take the time to incorporate more sustainable development concepts in the goal, including sustainable practices.
• The goal should prepare health systems for a dynamic environment and not only the health issues of now, but for the future.
• Human resources for health (health workers) are an essential aspect of achieving this goal, so greater emphasis should be placed on targets for this workforce in the development agenda.
• When we talk about prevention, we should talk about health literacy and what competencies are we aiming for in UHC.
• There also needs to be emphasis on quality and therefore, quality indicators created, no only indicators on service coverage and protection.

 

 

 

GOAL: Maximizing Health Life Expectancy

• The goal is hard to understand and is not very sellable, but universal.
• We recommended changing the language to promoting a more understandable message and one beyond health, as a larger over arching goal (either well-being, healthy planet, maximizing human potential).

• We recommended age-specific targets, but making sure that there is a special mention of target groups, especially adolescents, marginalized and vulnerable populations.
• We should avoid in this setting creating silos and emphasize the multi-sectorial possibilities with other sectors such as education, green economies, environment, and nutrition.
• Additionally, there is potential to make this a larger goal.
• The possibility exists to keep the healthy life expectancy as an indicator.
• We should also integrate more sustainable development concepts and language into this goal—include education, green economies and the environment.

Written by Roopa Dhatt, IFMSA President 2012/13

28th Pan American Sanitary Conference: [Day 2] “Health in the Americas”

A fresh and cloudy morning welcomed us as we headed to 525 Twenty-third Street. Walking was the best morning energizer to positively start our second day of work at the 28^th Pan American Sanitary Conference in Washington D.C. A promising day to actively participate and speak out for our Federation with the intervention regarding the NDC’s regional strategic plan.

The agenda started with the PAHO program and budget 2010-2011, the presentation of the PAHO Budget Policy and continued with the release of the report on “Health in the Americas” (link).

Average life expectancy in Latin America and the Caribbean rose from 29 years in 1900 to 74 years in 2010, and today 98% of children live to see their first birthday, while 100 years ago only 75% did. However, inequalities persist among and within countries, according to the 2012 edition of Health in the Americas. As Dr. Mirta Roses Periago, director of the PAHO, said: “Each country is a mosaic of situations, places, and communities, and every number, every piece of information, and every statistic represents the face, life, health, and hopes of a single, unique individual, each face has a voice, each voice expresses a need, and each need calls for action.”

We therefore welcomed this report which we think represents our best opportunity to advocate for the renewal of the commitment to construct a sustainable and evidence based post MDG agenda.

IFMSA, representing medical students from more than 100 countries worldwide, advocates locally and globally to build a post-MDG agenda where Health Equity For All is built on a shared vision of development across the lifecourse and achieved through:

A)Policy integration,

We acknowledge the effort that has been made towards poverty eradication and development but outline the limited progress made in bringing together the historically independent social, economic and environmental policy at both national and international levels. The macroeconomic approach to solving poverty-related disease is simply insufficient to meet the demand of countries. We need to utilize the current momentum to keep the efforts and achieve cross- sectorial integration.

B)Partnerships,

Recognizing WHO’s considerable increasing work in this area – especially with NGOs, who we believe have a great capacity to positively influence the direction of the Organization. We call for cooperation and collaboration between organizations and countries working towards the same goals to address the unfinished agenda of unnecessary, preventable deaths of mothers, children, and other vulnerable population groups and to continue and renew efforts to sustain achievements in health.

C)Engagement of young people.

Youth comprise nearly 30% of the world’s population. Youth have the greatest at stake in our quest for a sustainable after 2015 agenda.

IFMSA is already working to shape the future health and sustainability agenda; we are agents of change and catalysts of development in our countries. The need for more meaningful opportunities of youth involvement in policy and implementation work is one of our major interests as representatives and voice of medical students worldwide so that together with our governments we can find and implement equitable solutions to improve the health and lives of people worldwide.

The agenda went on with the Strategy and plan of action on noncommunicable diseases. In the context of the epidemiological transition the growing importance of noncommunicable diseases as a cause of mortality is not new. What has changed is the recognition of the enormity of the social and economic consequences of a failure to act on this knowledge. It is evident that sums in the order of US$ 11 billion spent now on cost-effective interventions can prevent over US$ 40 trillion-worth of future damage to the world’s economies. Nevertheless, there remains a significant gap between rhetoric and reality when it comes to concrete action and the allocation of resources.1

Where Sachalee Campbell (IFMSA Jamaica) gave an outstanding intervention (http://psc28.wordpress.com/2012/09/18/civil-society-representatives-support-ncd-strategy/) that highlighted our concern about the proposed strategies. The intervention remarked that :

1. 1.     The NCD crisis is about equity.

Multi-sectoral strategies to reduce the imbalance of social determinants of health must be integrated with efforts to control NCDs as further social inequity will only exacerbate the crisis.

1. 2.     NCDs are a cross-sectoral issue.

NCDs are closely linked to all three pillars of sustainable development – economic growth, social equity, and environmental protection. The WHO and member states have a powerful voice in this debate and can highlight the potential of sustainable development policies to tackle NCDs. We therefore ask if member-states have consider the implications of both bilateral and multi-lateral free trade agreements such as the Trans-Pacific Partnership Agreement that includes multiple countries in the Americas on access to affordable treatments for NCDs and the potential threat to sustainable development policies including access to nutritious food, clean energy, and healthy environments?

1. 3.     Progress should be measured by both health and non-health indicators.

In order to accurately evaluate the effectiveness of integrating sustainable development policies to control NCDs.

1. 4.     Young people should be involved.

Young people in the Americas and worldwide are interested in improving the health statuses of their countries. It is important that we recognize that young people are able to influence development in our region.

We as IFMSA represent medical students from more than one hundred countries – young people who also suffer from NCDs. As the health professionals of tomorrow, we are committed to combating this major health challenge of our generation.

As Zac Ephron (High School Musical) said “We are all in this together”!

Hugs from Washington,

Altagracia Mares

Moving Ahead IFMSA, What our members are saying?

Building Blocks of IFMSA—Vision and Mission

As IFMSA takes on greater societal challenges in the second decade of the 21^st Century, IFMSA, a federation of more than sixty years is taking on an internal review of values, principles and objectives.

IFMSA is aiming to create a new vision and a review of the mission statement.  Over the past years, IFMSA has expanded its priorities to include societal issues such as climate change, universal health care, social determinants of health, global health education, health systems, discrimination, non-communicable diseases, mental health and many more to address those issues that challenge achieving quality, accessible health for all.

IFMSA remains as committed to its standing committees and Initiatives:

• Public Health
• Sexual and Reproductive Health, including HIV/AIDS
• Medical Education
• Human Rights and Peace
• Professional and Research Exchanges
• ThinkGlobal
• Global Health Equity

The words and thoughts that inspire our members….

(These are the direct thoughts of IFMSA members from the year 2011/12…with many more thoughts to come in the year 2012/13).

IFMSA experience provided through IFMSA:

Fun/exciting/Interesting/enjoyment; Educational/Knowledge/Learning/informative; Training/ Experience/ skills; Challenging; Inspiring; Life changing; Motivating/motivation; Opportunity; Fantastic; Empowerment/Enabling; Energetic/ Enthusiastic; Friends/family/belonging/team/cooperative; Unity/unifying; Collaboration/ cooperation; Progressive/progress; Broaden thinking/open minded; Leadership

The organizational behavior/direction/activities/values:

Development oriented/development/professional development; Social/meeting/sharing/ to all; Projects; Integrity; Networking/partnerships/connections; Visionary/vision/ dream; Friends/family/belonging/team/ cooperative; Interactive/active; Exchange; Ambitious; Diversity/ accept difference; Collaboration/ cooperation; Unity/unifying; Medicine/health (public health)/Doctors/future of health care; Broaden thinking/open minded; Peace; Professional/practical; Making difference/impact/change/global impact; Community focused; Advocacy/intervene/influence; Initiative Responsibility 

Organizational structure:

International/universal/global/worldwide; Collaboration/ cooperation;  Biggest students run NGO in the world/leading students organization

Things to improve in IFMSA for the next 10 years:

Health for all

Good communications between Local Committees

More Research

More Legal Recognition

New S.C on new technologies

Leadership Globally

Social Recognition

More career guidance and counseling

General Secretariat Office

More collaboration between Medical Students and other healthcare professions

Seeing IFMSA SCs goals coming to reality locally in the KCs

IFMSA African Bilateral Exchanges

100% participation of African NMOs 

More African Officials

More African Meetings (GAs, SRTs, RMs)

100% representation

Integrated Policy Making

Second Languages

Medical Educations quality world wide

Bigger Organization

IFMSA Alumni in governments

Direct impact on the community

More researches

More projects

Big Topics to focus on the next 10 years:

Maternal and infant mortality

The right to health

Cancer awareness

Malaria Eradication

Health insurance scheme

Ways to reduce HIV

Reduction of communicable diseases in Africa

Female Genital Mutilation

Effect of corruption on the health sector in Africa

Water supply

Solar energy

Attitude of health workers in health care delivery

Point to consider:

Education/awareness

Political will

Culture and traditional ethics

Partnerships

Strategic Cooperation

On Local level: (how we want it after 10 years)

More support for local efforts focused on transnational projects

Common goal for local efforts, doesn’t need same structure

Connected to local communities

Every member should understand what IFMSA is.

Identify and partner with other local organizations + fundraising opportunities 

Translate IFMSA objective into a local context

Seek exposure via local media

Bringing organizational decisions down to local chapters, specially policy statements

National level: (how we want it after 10 years)

Representation in every nation with medical schools

Official recognition of all exchanges for school credit

Reaching more (or better 100%) students in Medical schools in each country

More tangible projects with public health influence (significant impact on society)

International: (how we want it after 10 years)

Global health Education framework for all students

Total representation (100% countries and schools worldwide)

Leader of change in global issues: SDH, Pharma, Tobacco, Climate change, Human Rights

IFMSA Office (Head Quarters)

International platform for collaboration

Be the voice of all Medical Students worldwide

Our values and principles

IFMSA was created to impact the world and to empower its members in taking their vision and ideas, and making them a reality. IFMSA has inspired generations of medical students to develop the leadership abilities and skills to take on challenges and to improve the world around them in a crucial period of their career. Engaging in IFMSA encourages both professional and personal collaborations irrespective of geographical, social, cultural, religious, racial, sexual and political differences. As a result, future doctors are becoming more culturally aware and sensitive physicians.

Principles (The IFMSA Constitution)

3.1  The federation pursues its aims without political, religious, social, racial, national, sexual or any other discrimination

3.2  The federation promotes humanitarian ideals among medical students and so seeks to contribute to the creation of responsible future physicians

3.3  The federation respects the autonomy of its members.

Objectives (The IFMSA Constitution)

4.1 The goal of the federation is to serve society and medical students all over the world through its member organizations by:

a)    Empowering medical students in using their knowledge and capacities for the benefit of society.

b)    Providing a forum for medical students throughout the world to discuss topics related to individual and community health, education and science and to formulate policies from such discussions.

c)    Promoting and facilitating professional and scientific exchanges as well as projects and extracurricular training for medical students, thereby sensitising them to other cultures and societies and their health problems.

d)    Providing a link between members, medical students’ associations and international organizations, and to encourage the cooperation between them for the ultimate benefit of society.

Mission Statement (IFMSA Bylaws):

The mission of IFMSA is to offer future physicians a comprehensive introduction to global health issues. Through our programs and opportunities, we develop culturally sensitive students of medicine, intent on influencing the transnational inequalities that shape the health of our planet.

Aims:

• To expose all medical students to humanitarian and health issues, providing them with the opportunity to education themselves and their peers;
• To facilitate partnerships between the physician in training community and international organization working on health, education and social issues;
• To give all medical students the opportunity to take part in clinical and research exchange around the world;
• To provide a network that links active medical students across the globe, including student leaders, project managers and activists, so that they can learn from and be motivated by each other;
• To provide an international framework in which medical student projects can be realized;
• To empower and train medical students to become advocates in leading social change.

Our structure

IFMSA is a federation that is run by student volunteers and aims to promote collaboration across borders. The Executive Board governs the organization, the liaison offers build external relations, and the standing committees, initiatives, support divisions and regions lead the programming of the organization. The national member organizations (NMOs) are the official decision making body, where members from each national member organization meet bi-annually to vote on IFMSA’s policies and elect the team of officials.

Our Membership

Our values in IFMSA align with reaching out to members around the globe and increasing opportunities for exchange, capacity building and fostering relations beyond borders.

 

While one of the world’s oldest and largest independent organization representing associations of medical students internationally, IFMSA’s family continues to grow—with more representation from underrepresented regions. IFMSA’s family over the years has grown.

At the 61^st General Assembly, August Meeting 2012, we reached an astounding 114 NMOs in 107 countries. We also have 14 African countries being represented in IFMSA after this General Assembly. We welcomed IFMSA-SKN, Saint Kitts and Nevis, OMA-Albania, ODEM-Dominican Republic, SLMSA-Sri Lanka, SLEMSA-Sierra Leone, ZAMSA-Zambia, and IFMSA-Morocco at our past General Assembly.

Our General Assemblies and Regional Meetings

IFMSA General Assemblies take us around the globe and strive to explore topics in medicine that are important to the global health community and the future of health professionals.  In the past years, IFMSA has taken on several themes at the General Assemblies:

• Universal Health Care (AM2012—Mumbai, India)
• Youth and Social Determinants of Health (MM2012–Accra, Ghana)
• Health and the Future (AM2011—Copenhagen, Denmark)
• Health Equality and Disparity among the MDGs (MM2011—Jakarta, Indonesia)
• Health and the City (AM2010—Montreal, Canada)
• Complementary and Alternative Medicine (MM2010—Bangkok Thailand)
• Investing in Health of Children and Youth (AM2009—Ohrid, Macedonia)
• Conflicts and Health (MM2009—Hammamet, Tunisa) and many more.

Through our General Assembly themes our members get an opportunity to learn from experts and locals alike about social and health issues. The national hosting organization work with IFMSA to create theme events that not only address international hot topics, but also personalize it with having as much as possible locally, based panelists from the host-country.

Our Outreach

IFMSA works both globally and locally. While our roots have always been think globally and work locally, in the past years, we have shifted away from that to reaching and working at levels—internally, regionally, nationally and locally.

Our members are active through their National Member Organizations (NMOs) at the local level—working on projects, going into the community and directly improving their communities through education, public health outreach and increasing awareness on key health topics ranging from Breast Cancer Awareness to Environmental Issues to Road Safety.

At the regional and international level, our members are building the international medical student platform on social and health issues. We advocate for patients, focus on access to essential medicines, support reforms to address climate change, participate in the sustainable development consultation process, raise attention to social determinants of health, shed light to youth issues, especially on reproductive health and sexual rights, but most importantly, we approach the training of becoming a doctor with a broader perspective.

The meetings we have attended over the year include high-level meetings to NGO sessions to student networks. Some of the meetings this year include:

• International UN related:
  • WHOs EB Meetings, Regional Meetings, WHAs
  • UNCSD
  • UNDP Summit
  • UNESCO
  • World Conference on Social Determinants of Health (WHO)
  • COP 17, UNFCC and Bonn Meeting, UNFCC
  • UNAIDS
  • UNHCR
  • Rio+20, Sustainable Development
• Student Networks
  • IFISO
  • World Health Student Symposium
• Professional Groups
  • World Federation of Neurology
  • World Medical Association (WMA)
• Special Interests
  • World Health Summit
  • International AIDS Conference

IFMSA has done a great deal over the years through the collaborative efforts of its National Member Organizations and inspired, motivated members around the world.  However, there are still many more challenges for IFMSA to continue to strive to reach.

-Written by: Roopa Dhatt, IFMSA VPE 2011/12 and President 2012/13