On our last day at the WHO Executive Board meeting, we re-gather on the floating Genève fondue market where we first met in person. It was a bustling market, warmed by rows of fireplaces against the cold air and filled shoulder to shoulder at every table with locals and visitors alike. Eight medical students tasked with the responsibility of representing 1.3 million medical students from 136 National Member Organizations were among doctors from the World Medical Association, global health vets, and WHO interns met along the way. Our head of delegation said it right, “When you are in Geneva, a week of experience is so rich, it can feel like months. I keep coming back here because it makes me feel so alive, because of the impact I am able to make on others and receive from them, and it is as if I am extending my life.”
Over the past seven days, we have delivered 
9 statements to the WHO Executive Board (EB)expressing IFMSA values and recommendations. We’ve met inspiring leaders at every level of the WHO and UN, discussed issues such as fair internship opportunities with various organizational leaders, and danced, in a combination of laughter and disbelief, alongside the representatives of member states during our physical activity breaks.
We’re not the only student delegation in place. There’s the International Pharmaceutical Students’ Federation, a group of equally motivated people. For the first time, we’ve delivered joint ‘One Health’-oriented statements spanning topics from Antimicrobial Resistance to rabies together with our friends from the International Veterinary Students’ Association. Both are our allies in the World Health Students’ Alliance.
In general, Non-state actors are a strange bunch of people. We can be described as a combination of idealists, activists, opportunists, and realists who believe that we can make a small contribution to the cause. It’s important to highlight that IFMSA is not alone here. We have veterans, like the World Medical Association and Medicins Sans Frontiers, who make powerful statements based on a strong background of knowledge and experience, but also representatives from many other fields such as nurses and community workers. Non-state speakers are usually called upon in groups and wait patiently outside the EB room for their turn to be heard.It’s an interesting atmosphere. A slight nervousness is overcome by discussions with others – some with a lot more experience than you, others with an entirely different point of view on the topic. What unites us is the will to make an impact, even if that only means pushing the giant boulder 1 centimeter forwards.
Through the EB there’s been a strong commitment towards Universal Health Coverage (UHC), but as the Director-General said, “There is no one way. The destination is the same, but roads can be different.” Each country must adapt their health systems in relation to their capacity in order to provide essential care for everyone. WHO has a long history of having targeted communicable diseases such as TB, Malaria, and HIV in “vertical” programs, with less attention spent on directly strengthening health systems. This seems to be changing, with new attention put on the global emerging problem of Non-Communicable Diseases (NCDs): “UHC includes Primary Health Care – for both communicable and NCDs. We need to commit to prevention.” Sexual and reproductive health as a part of UHC cannot be forgotten. This was echoed by IFMSA, Sweden, and France.
Strengthening health systems also means better response to outbreaks. Dr. Tedros said, “When we panic, we give our best. When things are well, we neglect it. Let’s get out of this problematic cycle. We shouldn’t be firefighters”. We completely agree. Peer education and prevention are among our key intervention points in IFMSA.
Little was said about discrimination in healthcare. There’s obviously a wide range of countries represented at the EB meeting, but this topic concerns them all. Some more progressive members, such as Portugal, encouraged WHO to become a more active political factor, and to “strive for the elimination of all forms of discrimination and stigma in healthcare systems.” Other more conservative states, such as the US and Russia, were clear that this is not the mandate of the organization. With the US still being a major donor to the WHO, their words, despite not currently being part of the EB board, resonate heavily within the square walls of the EB room – for better or for worse.
As the meeting draws towards an end, we take some time to reflect on our delegation and on our experience. Just like the execute board, our delegation is made up of people with different backgrounds and views, truly representing medical students worldwide. While our turnover rate is a lot faster, we hope that our small contribution along with what we’ve learned will find a use once we go back home to our respective countries. Since 2007, 15 resolutions have addressed access to medicines without a significant impact. As Thailand wisely said: “Plans without action is a waste of time” – this applies to us too. Just as the actions of the WHO, the real impact of our federation is at a local level and losing touch with local realities inevitably makes our work irrelevant.
The IFMSA pre-WHA and World Health Assembly (WHA) delegation will continue building upon our work in May 2018, with a focus on Universal Health Coverage, NCDs, Antimicrobial Resistance, and ending discrimination in healthcare. Fifty medical students representing regions worldwide will come together to advocate in the highlight of IFMSA efforts at the WHO every year. We look forward to seeing their realizations, lessons, and impact.
The air of Geneva carries a historical significance and spirit of international convention and cooperation like nowhere else in the world. Geneva is a place where countries in opposite ends of conflict may meet at the table to discuss their differences. To our left and right, we see the headquarters of countless organizations ranging from ICRC to the UN High Commissioner for Refugees. This is the place where difficult conversations about the state of the world may be addressed. The voice of youth across these topics hold an important place that reflects the needs and concerns of future generations. We were reminded that our ideas offered refreshing and innovative perspectives. Until we meet again, we travel back to our countries and communities ready to continue striving.
Written by Lerly Luo (Canada) and Martin Plymoth (Italy)
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