Notes from the World Health Summit: Days 2-3

By Jenna T. Nakagawa
October 27, 2011

Today I listened to the Director of Médicins Sans Frontières (MSF, Doctors without Borders), Switzerland call out the Global Program Team Director of Novartis, one of the world’s leading pharmaceutical companies: “How can you say you are working toward social responsibility when Novartis is suing the Indian government for trying to make generic drugs more available?” Doctors without Borders v. Big Pharma—what could be better than this? I sat in my seat, practically falling out of it, with a big, beaming smile and never once did I stop snapping my fingers—that’s the way I felt, at least.

Things over here are getting interesting. Between yesterday (day two) and today, I attended seminars addressing: disaster preparedness with special attention to nuclear safety (oxymoron?); the impact of climate change on urban environmental health; new policies in the United Nations, the World Health Organization (WHO), and leading humanitarian agencies such as MSF to address the challenges of climate change; and partnership- and market-based models for increased access to health services in middle- and low-income countries. I’ve spoken to others who attended other seminars and panel discussions, and we’ve all agreed that people are becoming more courageous. Perhaps as we become comfortable with the format of the summit, and as jet-lag subsides, we find the energy and tenacity to speak on the issues that are important to us. Call it pride, or ego—either way, the summit is taking on a democratic tone that I can only describe as refreshingly Ancient Roman. (I don’t know anything about the Ancient Romans, of course, but I imagine that, much like us, they sat comfortably in their forum, all clad in nice garments, while people served them little bites to eat and they haughtily chuckled at big words.)

We do have a long way to go before these discussions are actually fruitful, however. For every good point brought up there is another not addressed.

  • Experts from the Johns Hopkins School of Public Health discussed the health consequences of increased air pollution, unsafe drinking water and poor sanitation services, but mentioned nothing of holding accountable the industries responsible for emissions, and the governments neglectful of widespread public health hazards.
  • The mayor of São Paulo, Brazil described the flooding, structural damage, and rise of infectious disease in his city as a result of climate change, but mentioned nothing of how these disasters are actually being addressed. (When asked, he spoke exclusively in the future tense, “We need to create international partnerships,” and called it a day.)
  • Diplomats in energy policy reminded us of the horrors of nuclear pollution and the necessity of disaster preparedness, but mentioned nothing about the promotion of alternative energies so that these disasters do not occur in the first place. A man representing the International Atomic Energy Agency shifted uncomfortably in his seat and said they “are not responsible for making ethical judgments on the use of nuclear energy.” The only man on the panel who could say “we are not interested in nuclear energy” was a diplomat from Japan, and even he was not convinced.
  • Novartis and non-profit pharmaceutical partners promoted new, innovative drugs, but mentioned nothing of the services communities won’t be able to afford once they are forced to purchase these drugs. When confronted, they merely repeated their companies’ missions statements.

The term “social responsibility” and the phrase “we need to create global partnerships” stand alone by themselves, as if they were self-explanatory—as if “responsibility” did not necessarily mean action and “partnerships” did not mean planning. These arguments are informative, and maybe even compelling, but they are not complete. This is tragedy of the commons on a global scale.

The President of MSF described the current state of humanitarian aid as, ironically, a state of emergency; military endorsement of soldiers posing as humanitarians, increased conflict in low-access areas in the Middle East and Africa, and pharmaceutical companies fighting for patents on drugs that should be readily available have created a hostile environment for medical relief. When describing these challenges, he was not informing; he was pleading. The rest of the world is waiting—whole populations starving, reaching out from flooded waters and warfare, suffering, and ever-growing—while we tap our nice shoes up granite steps, eat miniature sandwiches and drink spritzer water, strategizing policy the way a thesaurus strategizes word choice.

On a very positive note, I am proud to report that students have played a major part in facilitating more action-oriented discussion. The presentations move quickly, but despite not much time allotted for asking questions students have managed to make our presence at the summit very apparent. In fact, attending the World Health Summit was worth the travel, even if just to witness a student scolding a room full of politicians, another rendering a group of diplomats speechless, and another turning a government official’s silence into “I will try.” Attending the World Health Summit was worth it for the applause—the applause from people and groups like MSF who want to move mountains and understand that young professionals are at the base.

Admittedly, the World Health Summit was never meant to be a call for action—it was meant to be a call for networking. Networking is powerful, especially when we put high-ranking officials from the WHO, the Global Fund, UNITAIDS, MSF, and all forms of industry together in the same room. While agreeing on the “what,” however, we cannot forget to ask “why,” and even more importantly, “how.” I believe that answering these more important questions is our generation of professionals’ responsibility—really, we don’t have a choice.

Jenna T. Nakagawa
MD/MPH Term 1
St. George’s University, Grenada

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