Posted by: davidjolson | 05/23/2011

Lessons from global health celebrities: “Be brave”

This guest blog is written by Rachel Irwin, a PhD candidate at the London School of Hygiene and Tropical Medicine and a member of the Global Health Council delegation to the World Health Assembly.

GENEVA — I was sitting in the Serpentine Lounge during a break at the World Health Assembly. The Serpentine Lounge is just outside the rooms where Committees A and B meet. It’s got a coffee shop, lovely views of Lake Geneva and the Alps and is a good spot for meetings and for sighting “global health celebrities.”

Yes, we have celebrities in global health.

I was with some colleagues when I looked over and saw a man two tables over.  He looked a lot like Halfdan Mahler, the director-general of the World Health Organization (WHO) from 1973-1988 but I couldn’t believe he was there.  For about twenty minutes I tried to work up the courage to go over to him when a former WHO assistant director general came over to talk with one of my colleagues and offered to introduce me to Dr Mahler.

Dr. Mahler presided over the WHO during the time of the Alma Ata Declaration, which asserted the importance of primary health care in achieving health for all.  He was there for the Code of Marketing of Breastmilk Substitutes, which highlighted the unacceptable marketing practices of the infant formula producers and for the Essential Medicines List, which presents the minimum list of medicines needed by a country.

I sat with Dr. Mahler for nearly half an hour and talked to him about how the WHO had changed and what it was like when he was the director-general. He talked to me about how antagonistic private industry was during this time – how they fought for the Essential Medicines list and these other agreements and declarations on health.

It was surreal and I appreciate so much the time he took with me.

I also had the opportunity to talk to other global health celebrities over the course of the Assembly and the lesson I learnt from them was to “be brave.”  It’s simplistic to think of the 1970s and 1980s as some heyday of global health – the past is never as perfect as we think.  But I feel there is a certain passion we’ve lost in fighting not only for what we believe, but for the kind of health policies that are clearly supported by independent evidence.

One tricky example has always been the private sector. Certainly, private sector involvement  – with clear and transparent terms of engagement – has lead to achieving some fantastic public health goals – I think always of the strategy in the UK to reduce the amount of salt in processed foods or of how the WHO has negotiated with vaccine producers to obtain funding for pandemic preparedness plans. And diplomacy in health is always a matter of compromise among member states with competing interests and industries.

However, after my discussion with global health celebrities I have to ask just how much are we willing to compromise now?  How much are we really fighting?  If we truly believe that we are right in pushing for a certain policy, are we afraid of standing up because the funding for our salary comes from a funder who is in conflict with this? Do we hide behind the idea that “the issues are just more complicated now?”

During Dr. Mahler’s time there were a lot of people who were brave and fought for global health. Working in global health policy, it’s really easy to forget that there are individuals on the ground and what we decide in Geneva affects them. They’re brave and we need to be brave, too.

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