The World Health Assembly in Geneva is impressive in just about every way. It is hosted by a stunning and ancient city, housed by a palace constructed for the League of Nations in the 1930’s (Palais des Nations), and filled with important representatives from 184 member states. We have eaten lunch with the chief of staff for the Ebola response team, taken pictures with the WHO Director General, and listened to Chancellor Angela Merkel urge for reform in the wake of several public health emergencies. Such a setting can be daunting for a 22-year-old student, but the lessons I’ve learned will stay with me for my entire public health career.
The first lesson I’ll take away is the distinction between access and quality. Access to health services provides an essential step toward adequate care, but it is the quality of those services will determine the final outcomes. This principle also applies to the World Health Assembly itself. The WHA provides invaluable access to shared knowledge by bringing the world’s health ministers together, but the quality of discussions and impact is has left a few of us frustrated. I personally would love to see more sharing of best practices. The WHA should facilitate a transfer of knowledge that highlights the best of what may be happening in a country like Uruguay so that a country like Nigeria could adapt those programs for its own people. Only in the technical briefings did we see some ministers of health sharing what they’ve accomplished to a limited degree.
The second lesson comes in the form of a phrase used in many of the sessions on persons with disability: “Nothing about us without us.” That is to say, a person living with blindness should be in the room if that is the issue being discussed. Beyond just disabilities, people living with AIDS or survivors of Ebola should be on the panels along with health experts and government officials. I saw this idea carried out twice in the sessions I attended; first was a dementia patient who presented on mental health and noncommunicable diseases (NCDs), and second was a Tanzanian boy with albinism who was brought to the Global Citizen meeting on disabilities. In both cases, the people with the disease or disability were the highlight of session, connecting with the audience on an emotional level and drawing the most applause after speaking. Putting a face to the illnesses we speak about in a sterile and distant environment such as the Palais des Nations makes an enormous difference in how inspired I am to work on solutions for the problems that exist.
Finally, I learned the value of prevention over treatment. This topic has come up both in discussions of resilience against outbreaks and reducing the burden of noncommunicable diseases. In terms of emergencies such as the Ebola outbreak, it was the weak health care systems in the affected countries of West Africa that made the virus so difficult to contain. In terms of NCD’s, we heard many discussions about the importance of investing in preventive measures and health promotion instead of dealing with the high costs of chronic diseases such as obesity or diabetes further down the road. This type of dialogue represents a change of approach from reactive to preemptive measures. In light of the Sustainable Development Goals that are soon to be adopted, the health community is realizing that dealing with emergencies and diseases as they continue to crop up is NOT sustainable. We must anticipate future issues and work to mitigate them ahead of time as much as possible.
I have two suggestions for the World Health Assembly that stem from each of the lessons learned: first, treat the Assembly a bit more like an award show instead of merely an administrative meeting. Use videos and other media to place a spotlight on high-performing programs or ministries of health from around the world. Disseminate documents with a list of best practices from around the world over the past year. Second, use communication technology such as Skype or a recorded video message to include the voices of the doctors, health care workers, and patients from the field in the areas that are being discussed, whether it is West Africa or Southeast Asia. A more proactive stance on sharing public health successes so that they can be modified and replicated, as well as bringing more humanity to the World Health Assembly might serve to inform and inspire health ministers, NGO attendees, or even public health students even more in the future.