The first day of the PreWHA kicked off on a Thursday morning, and you could feel the energy in the room was sky high. One of the first few things we were asked to do was to write down our fears and expectations on post-it cards, and discuss them in groups, then finally stick them on a wall at the end of the room. The main sentiments were almost universal, excitement, hoping to gain valuable knowledge, making a real difference in global health and of course fear of saying something stupid. During the course of the PreWHA, we were divided into 4 streams, or topics, that we would ultimately make a statement on and advocate for during the WHA. The streams were:
- Universal Health Coverage
- Spurious/Substandard/Falsified/Falsely-labeled/Counterfeit medical products
- Nutrition and Non-Communicable Diseases
- Sexual and Reproductive Health Rights
Extremely knowledgeable experts from different areas of expertise came to speak to us about the 4 streams and their place within the WHO and public policy. For the Nutrition and NCDs stream, which is the one I was a part of, Dr. Francesco Branca, (the Director of Nutrition for Health and Development in the WHO) enlightened us on many things including how the WHO is trying to strengthen capacity of organizations to develop guidance on nutrition and how they are instituting effective programs to address the multiple challenges on nutrition.
One of the sessions that we had was a briefing on Health In All Policies, whereby Nathalie Roebbel, a technical officer in the Department of Public Health, Environmental, and Social Determinants of Health (SDH) at the WHO, talked to us about what the social determinants of health and its importance, and thus brings the need for intersectoral collaboration. We were then split into our streams in order to work on an exercise that requires us to solve a health issue using intersectoral collaboration within a government. The example we took was malnutrition in rural areas in a low income country. Throughout the discussion issues kept emerging that really exemplified the complexity of the problem- though it is primarily a health issue and thus the job of the health ministry, it became clear we needed the help of the agriculture ministry to see what land and crops are available, we need the transport ministry in order to transport goods from one area to another, we need the finance ministry in order to fund these projects, among many other things. Decisions that are seemingly unrelated to health, will impact it in a variety of ways, which is really what Health in All Policies is about.
What we also did in our group, was prepare the policy briefs and statements. We decided to focus on 3 main points: Nutrition (with regards to marketing and promotion, advertising, and labelling food products, as well as regulation of food and drink industry), Sugar (implementing a sugar tax, as well as regulation of marketing of sugary drinks), and Breast Feeding (advocating for Member states to immediately comply with the International Code on Promotion & Marketing of Breast-milk Substitutes.)
After learning all we could on global health, public policy, and advocacy, from the best mentors, on the last day we were ready to be set free into the main arena, the World Health Assembly. As we said our farewells to the room that was our home for the past 3 days, I looked over to the wall that still bore the post-its we wrote on the first day. The fears that had once seemed so real and daunting, had started to fade a little bit as the positive energy leading up to the WHA started to take over, and the expectations had slowly started to become a reality.
The first day of the Sixty-ninth World Health Assembly was opened by WHO Director-General, Margaret Chan, in the presence of around 3,500 delegates from WHOs 194 Member States. The first plenary discussion, Transforming our world: the 2030 Agenda for Sustainable Development began with a discussion on WHO reform. This assembly was significant, for the sheer number of agenda items and resolutions member states will need to discuss and agree, which Chan described as record-breaking.
What was important for us as the Nutrition stream, were the important decisions relating to childhood obesity and maternal, child and young child nutrition, and non-communicable diseases. During the opening address, Margaret Chan highlighted that the marketing of unhealthy foods and beverages, especially to children, is now a global phenomenon and that ensuring the quality of the food supply is now much harder when a single meal can contain ingredients from all around the world.
During the course of the assembly, there were many side events taking place that were organized by various member states, which ran concurrently with the plenary and committee meetings. The nutrition team split up into different events in order to gather as much knowledge as possible, and to affirm IFMSA presence in the WHA, when it came time for questions, which were prepared beforehand. One of the highly anticipated events was one titled Accelerating National Progress on Tackling Child Obesity and Child Undernutrition in a Sustainable Way, which was held by the Finnish minister of family affairs and social services; Former President of Namibia; health ministers from Canada, Kenya, Netherlands, UK, and USA; and government representatives from Australia, Bangladesh, Brazil, Mexico, and Zambia, and chair of the Global Nutrition Report, in addition to the Chef and celebrity campaigner Jamie Oliver and none other than Margaret Chan herself.
The country representatives talked about their goals and accomplishments so far, including taxation of sugary drinks, making sure to emphasize making SMART commitments to nutrition (That is, to be Specific, Measurable, Attainable, Relevant and Time-bound). The panelists acknowledged the crisis of child malnutrition, with Jamie Oliver calling for an end to obesity and undernourishment, all over the world.
What was interesting to learn, that the knowledge we attained from the PreWHA, including the health in all policies goal, could be applied to the discussion at hand, whereby it was clear that the interplay between sanitation, climate, education, economy, and agriculture all play a role in governing health.
Author: Rozana R. El-Eid