Think Global at March Meeting 2014

Think Global is proud to landscape our achievements from the IFMSA March Meeting 2014, “post 2015, Get Involved!”. We at Think Global with the support of many of the Think Global passionate team certainly did get involved!

Firstly, Think Global is here to stay thanks to your support! The Initiative has been successfully and unanimously re-endorsed for another two years by the plenary. And on the note of elections, Think Global co-coordinator Claudel was elected to next year’s Executive Board as Vice-president for External Affairs.

Back to business; how does one go about creating the next generation of global health leaders? Think Global took every approach we could think of to ensure we were doing just that throughout MM14. Starting with the preGA Think Global was represented in four preGAs spanning global health leadership through to training trainers in advocacy. New Generation of Global Health Leaders participants acted as civil society advocates in the GlobalWHO final day honing their advocacy skills to fight for the advances in global health they feel so passionately about: climate change, health economy, mental health, non communicable diseases and universal health coverage. Cautious not to miss an opportunity, Claudel also ran a session on global health and sustainable development in the exchanges preGA workshop whilst Anya support the advocacy preGA from afar!

Think Global’s name was beginning to seep into the consciousness of those global health minded individuals. Yet more was to come from the team of passionate young global health lovers. The theme of March Meeting 2014 was the post Millenium Development Goals, post 2015 development agenda, suiting Think Global members down to the ground. The topic was introduced through excellent talks from inspiring externals each introducing varying aspects of the post-2015 clearly leading us through what has been a confused and overlapping process. Three subsequent parallel events aimed to educate participants on specific issues within the post2015 agenda. Think Global Coordinators Anya and Claudel facilitated sessions on Health Policies and Sustainable wellbeing respectively, where small group discussions led to excellent debate and intriguing questions to be answered. The need for a health revolution emerged…yet time was insufficient for this to be planned in detail!

Finally the theme event was rounded off with a stimulating interactive session. After being caught up on all the other sessions, a debate on the health aspect of the post-2015 agenda was staged between Mike Kalmus Eliasz (former Think Global coordinator) arguing for Healthy Life Expectancy and Waraguru Wanjau (the IFMSA Liaison Officer to the WHO) arguing for Universal Health Coverage. With IFMSA President implementing his SCORA upbringing and getting the whole room got involved, enraged and subsequently contributed to the creation of the Hammamet Resolution. A truly collaborative document clearly articulating the global views of medical students regarding the future development agenda.

Think Global representatives at the meeting didn’t stop there, there was more work to be done! During the joint Standing Committee sessions we twice ran a session on “Global Health Education – what, why and how?” In total around 60 participants explored the concept of global health and how to tackle their universities to include more of it in the curricula. This showcases the IFMSA at it’s best, where we can all share our experiences to develop the achievements of others and will be carried forward for the next couple of months in order to develop an international guiding document. In addition, you may have already heard that the IFMSA is working to develop a standardised Global Health Advocacy Training; a three day workshop which can be implemented worldwide empowering youth to make change, work is continuing and all will soon be revealed.

We also collaborated on IFMSA policy statements which were successfully adopted, including one on trade and health and one the future development goals. Plus, we have helped increasing the knowledge and interest regarding the Trans-pacific and Trans-atlantic trade agreements. We were also able to meeting with many members of the Team of Officials, specifically including the standing committee directors with whom we met and pledged to improve our communication to facilitate united activities for an even better IFMSA.

Finally, for us as Think Global coordinators meeting some of our inspirational team members face-to-face was a highlight of the conference. There is no amount of words that can thank you all for the hard work you do around the world.

If you are interested in getting involved with us for the rest of the term, please fill out this form. We are very much looking forward your bright ideas and meaningful input!

On behalf of the International Think Global Team,

Claudel & Anya
thinkglobal@ifmsa.org

Advocacy and the physician in training moving forward from March Meeting 2013?

Physicians in training advocate for access to education in Quebec (2012)

The theme of the IFMSA General Assembly in March 2013, “Advocacy and the Physician in training,” acknowledged that advocacy and medicine are inseparably intertwined. Discussions at international conferences such as the “World Health Summit” and reports by eminent organisations such as the Royal College of Physicians UK have also highlighted the ever evolving awareness of the need for physicians to be equipped with advocacy skills. Yet standard medical school education in no way prepares future physicians for this role.

Physicians as advocates is not a new concept. Historically, physicians were known to be those that advocated on behalf of their patients, their communities and stood up for those without a voice. In a climate where social determinants of health are increasingly considered, the advocating physician is required to engage politically, to debate policy and to battle for funding. Currently, to ensure that you are prepared for this role requires extra-curricular involvement and significant time investment. To teach such skills in medical school isn’t to say that all physicians would go on to use them, but it would be the first step to creating a generation of empowered advocates.

To begin considering how advocacy could be incorporated into medical curricula the recent emergence of global health education onto medical curricula could provide a basis. Linking the teaching of advocacy to global health education may promote a culture of linking problem identification to action. In that sense, incorporating advocacy skills into medical education could provide a new culture of thought in which the skills for tackling issues which arise within medical training are provided.

Physicians in training advocate for access to education in Quebec (2012)

Physicians in training advocate for access to education in Quebec (2012)

Within the International Federation of Medical Students Associations (IFMSA) and many of its member organisations, advocacy training and global health education workshops are commonplace and ever-growing. Feedback is consistently positive, and an increasing base of evidence demonstrates the success of these workshops in empowering participants. This year, the Think Global initiative within the IFMSA will aim to continue and broaden the provision of global health education and advocacy skills in order to produce a generation of medical students equipped to change the world!

Current projects include the development of a standardised Global Health Advocacy Training which will be piloted locally in Quebec and at a meeting of the IFMSA in Tunisia. The Think Global project is also in the process of collating resources for this training; all contributions would be welcome at thinkglobal@ifmsa.org.

In the near future we hope to develop this training, disseminating plans and empowering more global health advocates worldwide.

Anya Gopfert & Claudel P-Desrosiers
Think Global Coordinators 2013-2014
thinkglobal@ifmsa.org

IFMSA Delegation to the 5th OWG on Sustainable Development Goals

The IFMSA delegation to the fifth session of the open working group on sustainable development goals, 25-27th November 2013, part of the United Nation Major Group of Children Youth.

Sustainable Development Goals: Realizing the World We Want

The UN Open Working Group (OWG) on Sustainable Development Goals (SDGs) was created to allow for a global conversation around a new development agenda for post-2015. SDGs are based upon the Millennium Development Goals (MDGs) established in 2000 which has guided the development agenda for the past fifteen years. The process of developing SDGs, which started in March 2013, includes a set of eleven multi-stakeholder thematic consultations involving delegates from members’ states, United Nations Groups, and the civil society.

Health in the Development of a Sustainable Development Framework

Health is a “precondition for, an outcome of, and an indicator of all three dimensions of sustainable development”[i] : social, economy and environment. Therefore, it needs to be a crosscutting issue in the post-2015 SDGs. The protection and the promotion of health and wellbeing of all people of all ages can be part of all potential SDGs. Proposed goals and targets should include health-sensitive indicators.

The framework needs to promote action to achieve human development and promotes human health and wellbeing through the following[ii] :

  • Universal, equitable, rights-based, and human security approach
  • Inclusion of existing and future health issues : MDGs priorities, and emerging global health challenges (NCDs, mental health, infectious diseases)
  • Promotion of human rights for all, by ensuring enabling environments for the protection of human rights
  • A focus on the poorest and most vulnerable and marginalized populations: sexual minorities, older people, people with disabilities, NDCs and migrants.
  • Promotion of policies and programs supporting health and development throughout the life course, and ensuring access to services to minimize the social and economic impacts of experiencing a health condition
  • Active and meaningful engagement with nongovernmental organizations and civil society
  • Clear and strong accountability mechanisms, with adequate and sustainable financing


Fifth Session: Health as a Sustainable and Inclusive Economic Issue

“There is a sense of urgency.” “The Social Agenda has to be a strong consensus. Goals must be few, measurable, and easy to communicate.” “We must leave no one behind.” Macharia Kamau opens the fifth working group session. On Monday morning, co-chairs Körösi and Kamau lead the session on sustained and inclusive economic growth, macroeconomic policy questions (including international trade, international system and external debt sustainability), infrastructure development and industrialization.

What is sustainable and inclusive industrialization? It is national economic growth and policies that take under consideration social issues such as public health, food security, gender equity and decent employment, as well as taking environmental issues into consideration.

As a medical student, engaged citizen, and on behalf of the UN Major Group of Children and Youth, I believe that it is essential to promote health in the SDG framework on future and re-negotiated trade and investment agreements. Therefore, international trade agreements must not undermine public health, and should address tobacco control, access to medicine, and technology access. Inclusive economic growth is directly linked to poverty, inequalities, and determinants of health.

I recommend the inclusion of policies that ensure allocation of resources to support the implementation of universal health coverage (UHC) and access. I recommend targets to promote measures to decrease indoor and outdoor air pollution as the use of accessible, active and public transport. I recommend a target to increase national tax revenues and economic capacity through taxation on products that contributes to poor health outcome. Fiscal policy is a powerful tool for encouraging health-promotion behaviours.

Those recommendations were to be discussed with the delegates. One of our goals was to talk to the representatives from member states about health issues. To accomplish this, we were tracking, which means to write what each delegate was saying in short key points. After the sessions, we therefore approached them in one-on-one fashion according to our knowledge and ties to individual countries. Engaging discussion on health issues linked to energy or macroeconomics allowed for inspiring discussions with some delegates as well as for the sharing of our position.

During the sessions, the question of financial stability was repetitive. It requires transformation at an international level. Unfortunately, we did not hear concrete propositions about how the financial system can be transformed to support sustainable initiatives; therefore, fiscal policies to support countries in their sustainable efforts are necessary. Calls for donors to reaffirm their goals to allocate 0.7 % of the gross domestic product to foreign aid and to allocate funds especially for improving health outcomes according to current epidemiological trends are strongly voiced. [iii]

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Fifth Session: Health as an Energy Issue

The second half of the working group was devote to Energy issue. “Energy is the golden thread that connects economic growth, social equity, and environmental sustainability” Ban Ki-Moon, UN Secretary-General. We believe that the inclusion of indicators to measure the health equity impacts of energy policies can benefit from access to energy. We also support indicators to measure indoor and outdoor air pollution exposure, according to WHO’s assessment of ambient air pollution concentrations[iv]. Some countries talked about the interlinkages between energy and health, as well as interlinkages with many other issues like gender, economy and poverty. Energy, especially renewable energy, is a strong promoter of health.

Sustainable Economy on Health Outcomes
- National Taxation of tobacco or other unhealthy products
- Interdiction of non-therapeutic use of antibiotics in livestock production, as this contributes to increasing resistance in humans
- Support eradication of malaria, AIDS and tuberculosis
- Support to reduce tropical diseases and non-communicable diseases
- Support free-smoke decent job
- Policy to protect sexual and reproductive health and rights of women and adolescent girls

4 million people die per year as a result of exposure to smoke (cook stoves or open fires). 3, 3 million people die each year from exposure to outdoor air pollution. [v]

Those statistics were mentioned not only by UN major groups, but also by delegates from varied continents. Everybody agreed: energy access for all is essential to the achievement of the post-2015 agenda. However, a major question remains unanswered: how do we address energy when access for all and equity is needed as well as a transformation of energy systems to green energy alternatives?

Things we found missing in the discussions

Growth, growth, growth
Although the need for growth is understandable for development, this cannot be the single target of macroeconomic policies. Growth must most importantly be managed in a sustainable manner within planetary boundaries. How about mentioning an economist’s worst nightmare: managed economic compression in regions / economic areas that are highly unsustainable in their practices instead of only managed growth. The closest we came to hearing such bold ideas was through discussions of increased energy efficiency.

Growth is not the direct equivalence of development. Actually, these two terms refer to quite opposite concepts. Growth can be defined by the unique expansion of something such as the economy, and this is not necessarily good. Development on the other hand refers to a constant evolution toward something better.

Youth presence 
MGCY certainly had a strong delegation and there were a few UN interns present as well, but we found low youth participation. We were told by MGCY representatives that youth participation in this session was significantly lower than usual and indeed, the IFMSA delegation represented more than half of the MGCY members present at any single point in time. An important way to ensure intergenerational equity in major UN discussions is by involving youth in official member state delegation; this is something that we would like to see both in future OWG session and in other international forums.

Youth voice to promote health and equity in the post-2015 agenda is essential. Youth must be engaged in this process. Monday afternoon, Professor Jeffrey Sachs, Director of the UN Sustainable Development Solutions Network and Director of The Earth Institute, exclaims that we are running out of time and of safe space, that the work of these SDGs is essential and that it needs to inspire the world, and most important, SDGs post-post 2015 must “Empower the young people”.

Concluding Thoughts

The MDGs were without a doubt historic and monumental, but regardless, were riddled with problems and short-failings. However, the spirit at OWG5 is impressively positive and constructive in this regard. Although the group in general seems to recognize the failings of MDGs, they are regardless looking forward with bold optimism. Lessons learned from the MDGs center around sustainability, multi-dimensional targets and statistical indicators. Conversations, without a doubt, emphasize that although MDGs highlighted social needs in a unified context, these social and humanitarian goals cannot be achieved without the economic development, and consequent public capital, to spend on social avenues. Secondly, the problem of silo-ing in the MDGs occurred by the creation of single-facet goals (ie: one goal for education, one goal for health, etc.). However, this compartmentalization does not reflect reality. Issues are intertwined and networked in complex fashions, which needs to be reflected in new SDGs and their respective targets.

Although this has been discussed at the OWG5, our lobbying efforts have noticed some resilience in taking a fully integrative approach. As soon as health seems to be mentioned, economy-focussed ears and minds close up. This is the goal of our lobbying efforts this week: to try and persuade delegates that health is a multi-dimensional goal, and is necessary but not sufficient for sustainable economic development. New indicators that measure human well-being and health must be used to evaluate economic progress in the future. Although the final outcomes of our advocacy efforts will not be seen for years to come, it has been monumental to be part of these constructively critical conversations that will set a new development precedent for history.

Jennifer Walker, Mathieu Hains, Stéphanie Lanthier-Labonté, Yassen Tcholakov
IFMSA Delegation to the 5th UN OWG on SDGs

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[i] UN. The Future We Want. June 2012. http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/66/288&Lang=E. Accessed 18 November 2013.

[ii] UNDESA UN, Mr. Nikhil Seth. The Health PerspectiveFifth Session of the Open Working Group on Sustainable Development Goals (OWG 5).  http://sustainabledevelopment.un.org/index.php?page=view&type=9500&menu=[%menu_nr%]&nr=1459. Accessed 21 November 2013.

[iii] UNDESA UN, Mr. Nikhil Seth. The Health PerspectiveFifth Session of the Open Working Group on Sustainable Development Goals (OWG 5).  http://sustainabledevelopment.un.org/index.php?page=view&type=9500&menu=[%menu_nr%]&nr=1459. Accessed 21 November 2013.

[iv] WHO. Health indicators for sustainable development: Energy: http://www.who.int/hia/green_economy/indicators_energy2.pdf Accessed 21 November 2013.

[v] WHO. Health in the green economy: Household energy in developing countrieshttp://www.who.int/hia/hgebrief_henergy.pdf Accessed 21 November 2013.