Report from IFMSA: 1000 young global health leaders meet in North Africa
Vice President Global Health, Canadian Federation of Medical Students
Last week I travelled to Tunisia from my childhood hometown on the Labrador coast, joining Danielle Chard (McGill), Siqi Xue (Toronto), Zia Saleh (Alberta) and 1000 other global health leaders from all over the world. It was a humbling and inspiring experience – with brilliant peers from over 100 countries, we worked to build solutions for some of the world’s greatest global health challenges.
Through the Canadian Federation of Medical Students (CFMS), Canada is a member of the International Federation of Medical Students’ Associations (IFMSA), the voice of the world’s 1.3 million medical students to international organizations including the World Medical Association, WHO, UNESCO, and the World Health Assembly, among others.
It was an incredible chance to rub shoulders with global health leaders like Dr. Eugenio Villar (Coordinator of the WHO’s Department of Equity, Poverty and Social Determinants of Health), Dr. Allessandro Demaio, co-founder of NCDFree (a global social movement to reduce the rate of non-communicable diseases and advance health equity), and Dr. Margeret Mungherera, President of the World Medical Association. But even more inspiring than this was the chance to work and learn alongside colleagues from every corner of the planet.
Working with Canadian medical students to connect with so many inspiring people from across the Americas, Africa, Asia, the Middle East, and Europe is a huge honour. Together, we shared training in advocacy and policy writing, attended workshops on a range of topics related to health and social justice, and navigated some of the most tricky questions in global health. It was friendships built during workshops, training sessions, plenaries, and over lunch, in the hallways, and on the dance floor that built the foundation for more more delicate and serious policy discussions. For me, this global health diplomacy was by far the most humbling, inspiring, and exciting part of the meetings.
With this in mind, I’m uniquely thankful to everyone who worked to write and win progressive policies on behalf of 1.3 million medical students from 117 countries, on trade and health, ending discrimination on the basis of gender identity, abortion access, conscientious objection, humanitarian access in Syria, and the post-2015 development agenda.
Trade and Health
The CFMS delegation worked closely with colleagues from every region of the world to win consensus on a new policy on trade and health, calling for trade agreements to respect public health, and opposing the Trans Pacific Partnership (TPP), which Medicines Sans Frontiers (MSF) has called “the most destructive trade agreement for access to medicines in history.” This policy statement won unanimous support on the floor of the general assembly, and is not only a big win at the international level, but a useful example for the CFMS as we write our own policy statement on trade and health for our upcoming Spring General Meeting in Ottawa.
Access to Induced Abortion
Building on CFMS’s work improving access to induced abortion in Canada, we worked with countries from all regions to advance a policy statement written by Medsin-UK and AMSA-Australia supporting women’s right to access safe, timely, and voluntary therapeutic abortions, which won by a impressive margin (48 countries in favour, 11 against, 3 abstentions), a truly remarkable achievement in a culturally diverse global health forum.
Ending Discrimination to Improve LGBTQ Health
IFMSA also passed a very strong statement calling for an end to discrimination to better the health of LGBTQ people (with 48 in favour, 15 against, and 5 abstentions). Countries at the WHO and WHA have been unable to reach agreement on this, making the IFMSA the first international health organization to take such a strong position. In a unique moment, the delegation from Uganda spoke of the plurality of cultural, political, and legal settings that medical students from the African continent work and organize in, and chose to abstain from the vote. Thinking of the ease of armchair morality and the challenge of navigating realpolitik in the search for social justice, I have come to think that this choice to abstain (rather than vote against) was itself perhaps an act of political courage, a small step in the right direction. In any case, this policy win left me feeling proud of the IFMSA, and looking forward to continue to work with our international neighbours to help advance health for all, regardless of sex, gender, or place.
Conscientious Objection and Access to Care
Balancing a physician’s right to conscientious objection with patient’s rights to access essential care inspired healthy debate on the floor of the general assembly. The policy, proposed by AMSA-Australia and Seconded by Medsin-UK, states that physicians holding a conscientious objection to the provision of medical treatment must declare such objections to their patients, and provide timely and effective referral to another health practitioner who does not hold such an objection. In response, NMSA-Norway issued a statement expressing concern that there are settings in which conscientious objection may essentially hinder timely and effective access to care, and that a physicians moral convictions must not restrict a patients right to access essential health care. In the end, the policy passed with strong support and lingering questions about how best to articulate reasonable boundaries to conscientious objection that protect access to care.
Access to Humanitarian Aid in Syria
As we met in Tunisia, the UNHCR estimates that there are 9.3 million people in need of humanitarian assistance in Syria, and 2.3 million refugees – 1 million of these children – seeking protection as a result of the Syrian civil war. International Rescue Committee President and Former British Foreign Secretary David Miliband has described the international response to the crisis as “the defining collective failure of this century so far.” With this humanitarian crisis unfolding, the IFMSA issued a strong and nuanced policy statement (written by Medsin-UK, IFMSA-Jordon, and IFMSA-Iraq) calling for massive international solidarity to support suffering Syrians and countries that have welcomed refugees.
Post-2015 Development Agenda
With the Millennium Development Goals reaching their evaluation milestone in 2015, IFMSA is actively joining negotiations to define post-2015 future development goals. While progress towards the MDGs has been impressive, transformative steps are still needed to win a sustainable and healthy future for all. As the IFMSA continues contributing to the global conversation on the post-2015 development goals, we will be working to ensure that Universal Health Coverage and a commitment to health equity are at the centre of any future health goals. The IFMSA Policy Statement on Post-2015 Future Development Goals (proposed by IFMSA Quebec and Seconded by Medsin-UK) and the Hammamet Declaration on Health Post-2015 (signed by all national member organizations of the IFMSA) reflect these priorities, and will be useful reference points as Canadian medical students continue contributing to the post-2015 development process.
From Tunisia to Taiwan: CFMS and the IFMSA
I left feeling more sure than ever that there is a role for a strong Canadian voice at these meetings, and that there is a special need at IFMSA for the skills and interest in global health that so many Canadian medical students share.
I also left with a clearer sense than ever before that Canada and CFMS have much to gain from nurturing our relationships with our international neighbours. Around the world, medical students are tackling similar problems – access to care in rural and remote areas, health human resource management, the influence of pharmaceutical companies on medical education, intellectual property rights and drug prices, the health of migrant and refugee populations, and action to advance the social determinants of health. We have so much to learn from each other, and so much to gain from sharing our lessons and accomplishments. The IFMSA represents a unique forum for this kind of exchange. With this in mind, I am excited to encourage Canadian medical students to join us for the 63rd General Assembly August Meeting of the IFMSA in Taiwan, August 5th to 11th (with pre- and post-GA events from August 1st to 16th). We’ll be sending a call out this week, so stay tuned!
And as always, please get in touch with questions or ideas about how we can better work together to build a more fair and healthy Canada that works with our neighbours to win a more just and healthy world for all.
Sending all my best from the Labrador coast,
Andrew Bresnahan (McMaster University)
Vice President Global Health, Canadian Federation of Medical Students