by Carrie Lee
It is the first day of the World Health Assembly, and all of the delegates are packed into the grand Assembly Hall at the Palais des Nations. I can’t believe I’m here. Looking down from high up in the galleries, we can see rows of tables below occupied by ministers of health. Words from the speakers is playing into my ear from a plastic headpiece – twist the dial and we can hear it played live in Spanish, French, Chinese, Russian, or Japanese. Right at the front of the room is the stage, signified by the well-recognised gold plated emblem of the United Nations.
“Young people should NEVER be viewed as a ‘by the way’. We should be involved and included all the way in decision making, on all agendas!”
The words of 18-year old youth activist from Zambia, Natasha Mwansa, echo across the hall. As she says her first words, she does so with such passion and conviction that everyone in the room wakes up and pays attention. I can hear the exclamation marks in her voice. The moderator amusedly asks her to slow down for the translators, and we all laugh. It is a powerful moment – these precious minutes that a young person, representing young people all around the world, has this platform to speak to world leaders on health. She demonstrates that we are here to make change, and we have something to say.
“Health should not be a tool to get votes, it is a social issue that should be granted to people,” said Natasha. It is our role as young people to hold our leaders accountable. That is what advocacy is about.
As part of a delegation of 60 young health professionals from around the world representing the International federation of Medical Students Associations (IFMSA), youth engagement in global health was on the forefront of our advocacy agenda. We were a diverse group representing medical students, junior doctors, nurses, veterinary students, dental students and chiropractic, from every region of the IFMSA – Asia Pacific, Americas, Europe, Eastern Mediterranean, and Africa.
There’s no denying that young people are hugely involved in global health all around the world, particularly at a grassroots community level. We are idealistic, not yet jaded (hopefully) by the realities of trying to make change. We are passionate and determined, invested in issues that affect our future. We are connected, social media natives, and we know how to harness technology to gather information and bring people together. We need only look at the ever-growing movement of the Climate Marches worldwide, spearheaded by 16 year old Swedish student Greta Thunberg, to realise that young people are a force to be reckoned with.
Attending the WHA also taught me that young people also have a significant role to play, not only in communities, but at a higher decision-making level. It is absolutely vital that our voices are heard in these platforms, where leaders are discussing issues like climate change, universal health coverage, sexual and reproductive health – issues that affect us now, and will do for many years to come.
“We’re not experts with decades of lived experience. But we bring something else: we’re the future,” said Dr Marie Hauerslev, Chair-elect of NCD Child and former Vice-President for External Affairs of the IFMSA.
Throughout the WHA, IFMSA delegates championed youth engagement both directly and indirectly. We met with our country health ministers to discuss pertinent issues related to our respective countries. Some were recognised as official “Youth Delegates” in their country delegations, an important way of recognising young people’s involvement at a country level. We attended side events, participated in discussions, and read advocacy statements at the Committees on topics including health emergencies, universal health coverage, sexual and reproductive health, refugee and migrant health, antimicrobial resistance, health workforce, pandemic influenza, and climate change and health.
We tweeted actively, sharing quotes and moments from side events. Like Lancet Editor-In-Chief Richard Horton’s rousing speech to the Plenary on the first day, declaring his five top priorities for global health to roaring applause, ending with a call to “fully fund the WHO, un-earmarked, no ifs, ands or buts!” Or the candid moment when Professor Wendy Graham gifted a mop to Dr Tedros at an event on the role of access to water, sanitation and hygiene on antimicrobial resistance.
As global health advocates, we need to “walk the talk” too. Several of the delegates tweeted about the abundance of single-use plastics at WHA events – plastic cups, water bottles and the like – calling on the WHO to improve their event sustainability.
As many of us were at the WHA for the very first time, another key theme that we took away was the inherent link between politics and health. In the past when I’ve learnt about the determinants of health, the focus has mostly been on the social determinants, up to a community and population level. The WHA broadened my awareness of the political determinants of health. The way that political agendas, changing policies, and commercial interests affect the health of people and communities.
“Health is a political choice” was a phrase commonly used throughout the WHA. This refers to national leaders – politicians, health ministers – making an active, political choice to prioritise access to health for all people. Leveraging political will is an essential facet to achieve universal health coverage – meaning health for all, of good quality and service coverage, and without causing financial hardship. This is a message that Dr Tedros has been championing.
Coming from the medical profession, our instinct may be to draw away from politics – as if mixing health and politics will discredit our own agenda. But that is not the case. Health providers and policy makers have very different agendas, the key is aligning both to common goals and interests. To make a difference in health, we must understand the perspective that policy-makers are coming from, and to use a similar language of economic investment – demonstrating the benefits of taking action, or warning of the economic costs of inaction.
The WHA is a very unique, almost absurd situation. Once a year, hundreds of people around the world flock to Geneva for a brief but intense encounter, and then go back to their respective countries. How do we ensure that words translate into action at a country level where the majority of the work is done? In the words of Richard Horton, “Health is not created among halls like these or among the pages of journals. Health is created among communities, among people.”
For us as young people, it has been a great privilege to attend the WHA and represent our countries, the health profession, and youth around the world. I have been incredibly inspired by the knowledge, spirit and determination of fellow delegates and friends from around the world. I know that each person will go on to make a significant difference in global health, wherever their interests lie. It goes without saying that the work doesn’t end at the WHA; that we will go back to our communities to raise awareness, run projects, and advocate.
The reality is that official channels for young people to advocate and engage at a decision-making level simply do not exist (yet). At the WHA, we’ve witnessed that health leaders truly acknowledge the importance of youth involvement, but often times it isn’t clear what exactly that will look like. It isn’t enough for us as young people to ask how we can get involved in global health in a broad, general manner. It is also up to us to prove our value by gaining experience and knowledge in specific areas. Show that we are serious stakeholders, and then push to take that to the next level.