[WHA68] IFMSA Statement on Recruitment of Health Personnel

Statement made on May 22nd 2015 during the 68th World Health Assembly on Item 17.2: WHO Global Code of Practice on the International Recruitment of Health Personnel

IFMSA welcomes the document A68/32 addressing the implementation of the code.

Whilst applauding the efforts of Member States and WHO, we, as future health professionals, raise a concern that current Code is mainly focused on regulating the migration of health personnels.

It is fundamental that member states apply Code article 3.6 and tackle fundamental factors that cause the migration such as poor or unsafe practice environments, poor education and excessive workload, sometimes over 100 hours per week.

We are facing mental and physical strains, harming our practice, decreasing patient safety and exponentially increasing the costs of healthcare systems, and sometimes even leading to suicide. Health workers and students must be protected from violence, discrimination and exploitation in the workplace, and be allowed to operate within a positive practice environment that guarantees occupational safety and health.

We urgently need evidence-based data on core factors leading to migration such as poor education, working environment, equitable distribution and retention of health workforce. We urge member states to increase the engagement of health workers, educators and students in the process of data collection and creation of national implementation strategies.

We highlight the problems in the efficient implementation of the Code as stated in the report and we urge the WHO Secretariat to acknowledge the value of the input from stakeholders in enforcing accountability in accordance with article 9.4.

Health in the emerging post-2015 development framework will remain aspirational unless accompanied by strategies involving transformational efforts on health workforce capability that don’t only focus on developing countries.

IFMSA commits to participate in the discussions related to the creation of a Global Strategy on Human Resources for Health and we encourage member states to have a more comprehensive discussion on dimensions of current health workforce crisis.

Without motivated health workers, there is no health care.

[WHA68] Thoughts on Day 1

The Pre-WHA: Global Advocacy programme and the United Nations Introduction to the WHA for New Delegates was an engaging epilogue to the intentions and efforts our 35+ IFMSA delegates in the week ahead for the World Health Assembly, held at the Palais De Nations, Geneva. Despite being filled to the brim with infographics, strategic buzzwords and conversant Politikspeak, many of us were besieged by the hubbub of delegates and the relentless stream of knowledge conveyed by parallel events by Member States, WHO departments and NGOs.

The brunt our delegation come from a medical background where technical detail is our bread and butter– this week we will be thrown from our niche into an mutisectorial environment to engage the politicians, journalists and social workers of the world. The accrued efforts of our delegates elucidates the validity of a youth voice in topics of global health intervention, and we hope for a crescendo of discussions and support on the health agendas we are fighting for in the coming week. I have been inspired from Day 1, and I can only hope to inspire others as a future leader. Read on for an update of the main events the IFMSA delegation has attended.

The IFMSA Induction in the WHA
The Ebola crisis shook the foundations and greatly humbled international organizations in 2014, and we had anticipated that the agenda points would be attuned to how the WHO modifies its response to global health emergencies, surveillance for disasters and communicable diseases (and in particular, neglected tropical diseases), and antimicrobial resistance in relation to intellectual property and health financing. My fellow delegates and I are excited to have an overview on the proposal of 17 Sustainable Development Goals as an extension (and they reiterate “extension, not replacement”) of the Millennium Development Goals which expire in 2015.

The effort of externals to IFMSA from legal, education and political sectors among our delegates, compounded with the impressive resume of varied advocacy work our delegates possess, shone through with the preparation within each stream (namely 1) Antimicrobial Resistance, 2) Child and Adolescent Health, 3) Climate Change and Health and 4) Human Resources for Health). With tracking documents, an updated list of delegates from member states, we were scampering between the Salles armed with our advocacy strategies, to attend the first Plenary Session (the more determined advocates among us waste no time in camping in the hallways to corner relevant delegates to our streams, an impressive feat at 8am on a Monday morning).

Plenary and Committee A
Upon the opening of the Health Assembly, Shri Jagat Prakash Nadda, Minister of Health & Family Welfare of India is sworn in as President of the 68th World Health Assembly to preside over plenary events, and it is evident from his speech that health financing is all the rage among the Member States for this Assembly. He cites exciting funding efforts for the proposed WHO contingency fund, implantation of the Consultative Expert Working Group framework and the Member State Mechanism on SSFFC medical products, to the applause of the delegates.

Similarly, German Chancellor Angela Merkel touched upon the necessary resilience of health systems and requested the 192 member states and observers to reflect on the deep grooves left by the devastation of the Ebola crisis. Accountability among all parties was of recurrent mention as she illustrated the responsibility of G7 to the global health agenda. A particular focus of her speech was on the dire import of the phenomenon antimicrobial resistance and the Global Action Plan in response, on par with what our IFMSA delegates advocating for in a policy statement.

In the afternoon, the well-humored and succinct Margaret Chen, Director-General of the World Health Organization addressed five key points for the direction of the WHO in future. Her points spanned creating a unified programme for health emergencies with performance metrics for an appropriate response time frame. Particularly groundbreaking was her call for 100billion USD contingency fund for emergencies in the wake of the delay in Ebola response, citing her belief that “Ebola shot our organization to the core”. Congratulations were in order for the PAHO to be the first rubella-free region, and the increasing engagement of women in healthcare.  

Side Events
I personally attended the Global Health Security Agenda: From the Ebola Epidemic to Measurable IHR Implementation side event, facilitated by Dr. Anarfi Asamoa-Baah, the Deputy Director-General of the WHO. Representatives from the USA, Uganda, the Kingdom of Saudi Arabia among others discussed the concept of ”What Gets Measured Gets Done”, fighting for improvement of assessment tools and indicators for sustainable capacity on specimens transport and disease surveillance systems. Of particular interest was the fact that 75% of emerging diseases have a zoonotic focus, as indicated by Norway, who also introduced a Twinning model to connect member states beyond the political bubble. Collaboration is again emphasized, but between more and less developing nations as they have finally thrown  out the North-South model of health inequity.

In the afternoon, we further split for side events, with a significant portionof our delegates sitting for the “ From Commitment to Action: Delivering on NCDs and Health in the Post-2015 Era” at the Intercontinental hotel where Global Surgery, the topic of a SWG from within the IFMSA was heavily mentioned, inadvertently endorsing the work of our attending delegates. I had attended “The Political Commitment and accomplishment on Neglected Tropical Diseases” back at the Palais, and had the pleasure of learning about sleeping sickness from a timeline video on the WHO effort to eradicate the disease (our health officials do seem to love their infographics), and discussion of how far member states such as Malawi and The Gambia have reached  in the fight against pathogens such as lymphatic filariasis and schistosomiasis.  A particular historical moment was a woman, one of few being treated for Guinea-worm in attendance, a reminder to the delegates in the room that it is not naive to invest hope in the eradication of stubborn neglected communicable diseases in future. “Childhood cancer: universal access to treatment, care and support from a Global perspective” at the Geneva Press Club also had our delegates in attendance.  

A Final Thought
Despite the pittance of time permitted for our delegates to ease into our advocacy strategies, we had great success stories in attracting member states to our cause, tracking the delegations of our member states for a particular health issue or just for the acknowledgement of the presence of a youth voice, with some such as the delegation of the Philippines being so supportive as to share our statements with their allied states It is not difficut to see that the reach of our delegation is extending beyond the Assembly, with the office of the DNDi and with the WMA among other successful connections.

Whisperings of new policy statements are popping up (such as on youth involvement in delegations), some as a result of new connections with delegates and others issues which had always been at the back of our  minds that needed the final push of diverse input from other students—a true testament to the importance of collaboration, whether it be among students, delegates or member states.

Entry written by Zareen Chiba, IFMSA Delegation to World Health Assembly 68

[WHA68] IFMSA Intervention at Climate Change & Health Briefing

Intervention made on May 20th 2015 during the 68th World Health Assembly Technical Briefing on Climate Change and Health 

Link to IFMSA Policy Brief on Climate Change and Health, a global call to action: http://issuu.com/ifmsa/docs/cch_policy_brief

We thank WHO for opportunity to speak today, and more generally to the place the organization is giving to youth and health students.

We take note of the air pollution resolution released this morning and strongly welcome references to climate change throughout the text.

For several years now, IFMSA has been present at the several UNFCCC processes and meetings,  with the objective of making sure that health was not left out of the climate change discussions. As the doctors of tomorrow, we are deeply concerned about the unhealthy environments in which our future patients are most likely to live in, if no ambitious actions are taken today.

As of now, we feel health is not represented enough. As health students we demand more, for ourselves, for our patients and for the future generations that are yet to be born. We demand that decision makers negotiate for policy measures which address health and well-being.

As said by Dr Neira recalld it, we saw great health outcomes at COP20, where the concept of health cobenefits has been integrated to the call for action. In ADP session last February, we have continued in that direction.

Now ahead of ADP Session of June, starting in only a few days from now, we are asking to make sure health is not left out of the discussion. There are incredible opportunities for health to be integrated into the text on the way to Paris, so that its importance is not forgotten. The time is ticking, and we are inviting you to strengthen the climate health nexus within the  UNFCCC process. Cross and trans sectorial collaboration between the ministries is much needed.

In the coming weeks, the Global Climate and Health Alliance, of which IFMSA is a founding member, together with the WHO, will launch a global international communications campaign titled Our Climate , Our Health. We aim to mobilize the health community and the general public to act on climate change in the run up to COP21. We hope your voice will join ours.

We will be facing the consequences of the decisions taken today and the policies that are being implemented. As such, it is our moral obligation to speak up, our duty to act and our responsibility to reach out to policy-makers.

Our priorities, as future health professionals, on the road to Paris are:

    • To ensure that health and health cobenefits are key consideration in all climate change discussions and policies, particularly nationally in the INCDs and internationally at the UNFCCC negotiations towards and beyond COP21.
    • To have strategies to reduce the use and dependence on fossil fuels, and for institutions and the health sector to take a stronger stance on divestment.
    • To create training opportunities for a well educated, informed and prepared youth

As young people we are hopeful of a greener, healthier future, but we need your political will to make this happen. If we keep falling behind our mandate, it will be impossible for us to fulfill our responsibilities as health professionals and to protect populations’ health. We look forward continuing collaborating with you to shape this green, resilient, sustainable and healthy future.

Link to IFMSA Policy Brief on Climate Change and Health, a global call to action: http://issuu.com/ifmsa/docs/cch_policy_brief