Posted by: davidjolson | 05/19/2010

No help from State Dept. on health personnel code

This guest blog was written by Dr. Amy Hagopian, assistant professor of global health at the University of Washington; senior health workforce policy advisor at Health Alliance International; and member of the international section of the American Public Health Association. Dr. Hagopian is a member of the Global Health Council delegation to the World Health Assembly in Geneva May 17-21.

GENEVA, Switzerland – The Health Workforce Advocacy Initiative hosted a rousing side event at the World Health Assembly Tuesday to raise enthusiasm for the Code of Practice on the International Recruitment of Health Personnel.

Meanwhile, the U.S. State Department delegation tried to derail the code. The Honorable Mary Robinson, president of Realizing Rights and the former U.N. High Commissioner for Human Rights and president of Ireland, led a spirited pep rally for the Code of Practice tonight in the Palais des Nations (U.N. headquarters). The event was organized by the Health Workforce Advocacy Initiative and its partner organizations, originally in hopes that the code would have passed the Assembly on Tuesday and we would be discussing how to implement it.

 Sadly, while we were talking about how great it would be to have a code, a “drafting committee” of WHA delegates was meeting two doors down to discuss the code in a session that had bogged down completely. Delegates were nitpicking definitions of “ethical” and what it means to balance the right to migrate with the right to health.

(We understand from informal reports the U.S. delegation, headed by State Department attorney Ann Blackwood, were fairly consistently obfuscatory; for example, one of their objections to the use of the word “ethical” in the code is that the word was “unnecessarily stigmatizing.”)

Speakers at the code’s side event included Mary Robinson (“Shall we lock them in until they do the right thing?”), Mubashar Sheikh, director of the WHO’s Global Health Workforce Alliance (“Millions of health workers need our help!”), Peggy Clark of Realizing Rights/the Aspen Institute (“The brain drain first came before the U.N. General Assembly in 1968”), and Francis Omaswa of the African Centre for Global Health and Social Transformation and formerly GHWA director (“The future belongs to civil society.”). Ibadat Dhillon, also of Realizing Rights, spoke about his new guidebook on bilateral agreements that could serve to support code implementation. I spoke on the panel about how research needs to support code implementation.

Perhaps most moving was Anneleis Allain, of the UK’s International Baby Food Action Network, who spoke about the year the World Health Assembly voted to adopt its FIRST and LAST voluntary code: The Code of Marketing of Breast-milk Substitutes. She reminded us the vote on that Code was 118 to one, with 3 abstentions. (Can you guess who the ONE no vote was??) But it took many years to get the World Health Assembly to get to that vote, and she encouraged us to be persistent. She said the advocates work to pass a resolution every two years to keep the code current with science and marketing practices, and the use the important power of SHAMING to call out industry practices that are inconsistent with the admittedly voluntary code. (Perhaps that is what the world’s largest country involved in importing health workers from poor countries is worried about?).

The drafting committee met until 11 pm Tuesday night, and plans to reconvene at 9 am on Wednesday. I’ll be hanging around outside hoping for stories to leak out of the room. While Francis Omaswa may believe the future belongs to civil society, we are still not allowed in the room while the code sausage is being made. More on Wednesday!


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