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

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

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Protecting and Promoting Health in the Face of Climate Change

Climate change is already having profound effects on health, with the WHO estimating it to directly cause over 200,000 deaths annually. If we continue along the same path, this will escalate dramatically fast. One of the most terrifying things about climate change is that it will affect the most vulnerable people, those living in the poorest countries. They, who are the least responsible for climate change, will bear a far larger burden than citizens from the richest countries. Inequalities in social and economic development, education, accessibility and quality of basic health care, infrastructures and public policy, will play a crucial part in determining the national impact of climate change. Once again, the poorest populations will be hit the hardest.   

Climate change will affect health in many ways:

  • Increased frequency and severity of extreme weather events (heatwaves, hurricanes, cyclones, massive floods)

  • Famine, drought and malnutrition, threatening food supply of millions and causing mortality and damaging child growth and development

  • Mass migration, with recent estimations indicating over 200 millions climate change refugees by 2050.

  • Infectious diseases, especially diseases transmitted by mosquitoes (malaria, dengue, yellow fever, West Nile Virus, etc) spreading to new territories

  • Air pollution, increasing the incidence notably of lung cancers, asthma and chronic obstructive pulmonary diseases.

Climate change has important health impacts and given the inequitable distribution of its consequences, it is contributing to increasing health disparities between developing and developed countries. (1,2) Quantitatively, climate change was estimated to be responsible for “154 000 (0.3%) deaths and the attributable burden was 5.5 million (0.4%) DALYs” in 2000.(3). The World Bank estimates, in a recent report, that a 4 oC warmer world is so different from the current one that it comes with high uncertainty and new risks that threaten our ability to anticipate and plan for future adaptation needs. Isn’t that scary ?

In only a few days, thousands will gather in Warsaw (Poland) for the 19th meeting of the Conferences of Parties (COP19) for the UN Framework Convention on Climate Change (UNFCCC). This intergovernmental process has been operating since 1994, and serves as the international forum for negotiations and discussions on global action to combat climate change. The conference will see over 10,000 experts in climate change, sustainability, and development come together for two weeks from November 11 – 22 to piece together the initial building blocks of a new global (hopefully binding) agreement, to be delivered in 2015 at COP21 in Paris. You can find all information about COP19 on the official website: http://www.cop19.gov.pl/.

In the past years, IFMSA has been one of the leading NGOs, delivering powerful interventions, organizing massive mobilisation, leading youth efforts, and above all, advocating for a bigger health consideration in the COPs negotiations. It also works together as part of the Global Climate and Health Alliance (GCHA) to advocate for policies which promote human health and protect the planet. The Alliance is managed by a number of leading, international environment and health organisations, coordinating their international policy and communications strategy at the UNFCCC.

We need to bring the two agendas of health equity and climate change together” – WHO Commission on Social Determinants of Health

At this years climate talks, IFMSA will have a delegation consisting of five people from all over the world, led by Charlotte Holm-Hansen from IMCC-Denmark. The delegation will mainly focus on promotion of the second Global Climate and Health Summit, youth participation and how health should not be seen isolated but how health co-benefits can strengthen other issues. The delegation will be blogging daily, and can be followed on Facebook and Twitter (using the hashtag #IFMSACOP19).

On the 16th of November (in parallel with COP19), the GCHA is holding the second Global Climate and Health Summit, which will develop a road-map for the international health community to mobilise around in the lead up to COP21 in 2015. If you’re in Poland at the time, you can register for the Summit here.

We, as young people and as medical students, have no choice but to act. As the WHO Commission on Social Determinants of Health states, “we need to bring the two agendas of health equity and climate change together”. If you are interested in getting more involved in IFMSA climate health efforts, join our Think Global Team (call is open until November 24th!); set up IFMSA project “Healthy Planet International” at home; follow the Federation’s delegation to COP19 (on twitter: #IFMSACOP19); sign the Climate & Health Council Pledge; look at Global Climate & Health Alliance resources; and email us for more ideas right here at thinkglobal@ifmsa.org.  

Claudel P-Desrosiers, Chalotte Holm-Hansen, Yassen Tcholakov, Nick Watts
IFMSA Think Global Initiative | thinkglobal@ifmsa.org  

References:
1. Climate Change 2007: Impacts, Adaptation and Vulnerability. United Kingdom and New York, NY, USA: Intergovernmental Panel on Climate Change, 2007 4.
2.Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, et al. Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet. 2009 May 16;373(9676):1693-733.
3. World Health Organization. The World health report : 2002 : Reducing the risks, promoting healthy life. Geneva: World Health Organization; 2002. 248 p.

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