By Fabrice HUMURA and Ayodeji Matuluko
The World Health Assembly (WHA) is the decision making body of the World Health Organization (WHO) with the main functions of determining the policies of the organization, appointing the Director-General (DG), supervising financial policies, reviewing and approving the proposed programme budget. The WHA occurs annually in Geneva, Switzerland.
For the first time in its history, FIP-YPG attended the 72nd WHA in May 2019, as part of the first official delegation of the International Pharmaceutical Federation (FIP). Diana Ching, Sherly Meilianti, Khalid Garba Mohammed, Ayodeji Matuluko, Acacia Leong and Luisa Quieros were among FIP-YPG delegates and graced us with this interview.
___________________________________________________________________
How was your experience attending the WHA for the first time as a delegate; what opportunities has it created for you?
Ayodeji Matuluko:
Thank you Fabrice for the opportunity to share my experience attending the World Health Assembly with our YPG colleagues.
Attending the WHA for the first time was an unforgettable experience. As a first timer I had done my research in my own little way on previous WHAs, and thanks to the very useful guidance on daily activities provided to delegates by FIP I knew a little of what to expect ahead. However, nothing prepared me for what was an enriching experience and exposure to global health and health policy. What provided an easy transition into the main WHA week we attended with other FIP delegates (20th to 24th May), were the preliminary ‘pre-WHA’ activities comprising the youth event on Saturday the 18th of May, 2019 and the Walk The Talk event on Sunday the 19th of May, 2019. These were followed by the ‘introduction to the WHA briefing’ on Sunday evening which provided a great introduction to the structure and governance of the WHA and highlights of issues to be discussed during the WHA.
Attending the committee meetings during the main WHA week, particularly the Committee A meetings helped me to understand how member states advocate for important agenda items, and how Non-State Actors (of which FIP falls under) can advocate for global health issues to a diverse audience of decision makers and government officials. The plenary meetings, technical briefings and side events were very enlightening and I always left feeling more informed about global health issues.
It was an excellent opportunity to attend with other FIP members, including the FIP President Dominique Jordan and FIP CEO Dr Catherine Duggan. This provided us all the opportunity to get to know each other better and foster friendships towards our shared goal of raising the profile of pharmacy globally. We YPG attendees were given opportunities by the FIP leaders to develop our leadership and communications skills, especially when we acted as facilitators during the High Level Dinner hosted by FIP and the WHO which was aimed at generating solutions to address the projected 18 million global health worker shortfall.
What I find great about the WHA is that although it is a very ‘high-level’ event which ministers and government officials alongside all health care professionals from all walks of life attend, it provides what I will call an informal setting to network with these very important people who you would usually not have access to on a normal day. It is an opportunity you do not want to miss, especially when it allows you to always make a case for pharmacy!
Personally, with respect to my current career, attending the WHA has created a great opportunity for me to understand how my PhD project fits into the global health policy context. Currently, I am undertaking my PhD at Glasgow Caledonian University where I am co-designing and evaluating an intervention to improve antimicrobial stewardship (AMS) in hospitals as part of efforts to tackle the great threat of antimicrobial resistance (AMR). AMS and other key strategies proposed by WHO in the Global Action Plan on AMR were discussed at various meetings and side events with Members States of the WHO highlighting their progress with the development and implementation of National AMR action plans in the Committee A meeting. It was great to understand the progress of work in this area and learn about the substantial work ahead that still needs to be done.
Universal Health Coverage is among the top priorities of WHO and this can’t be achieved without investing in healthcare professionals. How was the discussion at the WHA over this particular subject, with emphasis on the pharmacy workforce?
Diana Ching:
A recurring theme throughout the WHA was that it is imperative that we invest in health workers, which includes pharmacists. Pharmacists play a vital role in many areas, including, but not limited to, immunization, antimicrobial resistance, emergency preparedness, non-communicable disease management, and tobacco cessation education. However, the desired health outcomes cannot be met without other health workers. Collaborative efforts among not only health care professionals, but also outer-disciplinary key stakeholders (eg, employers, policy makers) are necessary to achieve Universal Health Coverage (UHC). With the projected shortfall of 18 million health workers by 2030, we must address pharmacists’ and other health workers’ barriers and concerns. The evidence is there to support the medical and educational interventions for our global citizens, but many of these interventions require financial means. Studies cite that remuneration of services is one of pharmacists’ major barriers to practicing our full scope of practice and knowledge. Therefore, it is crucial, more than ever, to work with individuals beyond the health care sector to help them understand the importance of investing in health care services. There can be no UHC without a strong healthcare workforce.
FIP through a statement that was delivered to ministers at the WHA, advocated for pharmacists to be given access to patients’ medication histories. Why is this paramount and how do you envision its adoption?
Sherly Meilianti:
The overall goal of the WHO’s Medication Safety Challenge is to reduce medication errors and medication-related harm by 50% in the next five years, worldwide. As a medicines expert, pharmacists have a vital role in reducing medication errors and improving medication safety. In delivering our service, we are the professionals who ensure the medication safety throughout the medication process, from the moment a medicine reaches the patient, through administration, treatment monitoring and follow up, to safe disposal. In many countries, pharmacists even provide medication reconciliation services that are not only able to optimise medication-related care, but also minimise risks and prevent errors. Having access to patients medication histories would enhance the responsibility of pharmacists in improving patient safety. Pharmacists have therefore been able to be one of the barriers to reducing medication-related harm. By advocating pharmacists to the higher level, which in this case, the WHO, we hope that the member states could incorporate into their policy, which will improve the responsibility of pharmacists.
FIP signed a historic Memorandum of Understanding (MoU) with WHO to elevate joint action on the 18 million health worker shortfall. How is this going to address health challenges globally?
Khalid Garba Mohammed:
Thank you for this question, first of all, let me start by congratulating the FIP and WHO for the successful joint high-level dinner during the just concluded WHA72. It was indeed a great honor and privileged that I witnessed the event, and served as one of the facilitators where momentum was gathered from different international health professional associations, health worker unions, youth organizations, professional alliances and member states across the globe to bring ideas on addressing the WHO projected shortfall of 18 million health workforce by 2030, particularly in low-and lower-middle income countries in order to accelerate universal health coverage (UHC). Indeed, the FIP, WHO, healthcare professional associations and youth organizations including International Pharmaceutical Federation Young Pharmacist Group (FIP-YPG) set the following 6 key action plans to address the shortfall of 18 million health workforce by 2023 [1]:
1. Join forces across professions to move together
Health professional associations will join forces to catalyze interprofessional collaboration by connecting their members, building capacity for collaboration, and working collectively rather than in parallel to mobilize a multisectoral strategy for a sustainable workforce, greater job satisfaction, and better outcomes.
2. Invest in health worker jobs for UHC and inclusive growth
Work towards a sustainable health workforce with health, labour, education, and finance ministries to drive data, policy dialogue, decision making and action to maximize the potential of the available workforce and invest in education, skills, and jobs that deliver efficient health impact.
3. Ensure decent work and eliminate discrimination
Develop and implement national health workforce strategies for decent and quality jobs for all health workers, including their safety, remuneration, elimination of all types of discrimination especially through gender-transformative change, social protection, social dialogue, and positive practice environments.
4. Implement what works
Apply and scale identified solutions and best practices, while focusing on quality, primary health care, community engagement, self-care, and people-centered approaches.
5. Activate the power of youth
Address workforce challenges by tapping into the potential of youth in the health and social workforce through their engagement in identifying and implementing strategies.
6. Harness technology to maximize impact
Utilize technologies to support health workers and build their competencies, strengthen health promotion and health outcomes.
Finally, with the our FIP CEO as the current Chairperson of the World Health Professions Alliance (WHPA), which brings together global pharmacists, dentists, physicians, and nurses from the International Pharmaceutical Federation, the FDI World Dental Federation, the World Medical Association and the International Council of Nurses, I am convinced that the set goals are achievable within the time frame. However, I would like to emphasize on engaging youths in addressing this shortfall, because the lack of available health workers takes several dimensions, especially in low-and lower-middle income countries. For instance, in some developing countries, there are many young promising healthcare professional graduates who are struggling to secure jobs. Unfortunately, the healthcare system needs their expertise dearly, but some government policies do not warrant their immediate absorption into the system due to the lack of priority on public health, and ultimately this hinders the health for all and the universal health coverage targets.
[1] World Health Organization (WHO). Addressing the 18 million health worker shortfall — 35 concrete actions and 6 key messages, available at: https://www.who.int/hrh/news/2019/addressing-18million-hw-shortfall-6-key-messages/en/ (accessed June 7th, 2019)
Acacia, you have attended the WHA twice previously, and you were part of the FIP-YPG delegation this year. How would you say that attending the WHA has impacted on you professionally and personally since the first time you attended?
Acacia Leong:
I would say I have grown in both aspects. As I develop professionally, I can see where my role as a pharmacist fits in the grand picture of global health, at the same time, with each WHA, I find that I am able to reflect more and more on my practice locally and identify the little steps that can be taken to push the public health agenda to benefit patients within the local community. Pharmacist play such a vital role in public health whether they realise it or not and it is in the little efforts that help grow in numbers and contribute towards addressing a global health issue. For example, one of the major topics addressed at WHA is antimicrobial resistance (AMR), having the pharmacist counsel patient on taking their antibiotics effectively and finishing the course is already a step towards tackling AMR. In my practice, I would always advise patients to bring back any excess or remaining antibiotics and stress not to throw it down the sink. Other topics that have made me reflect on my practice is vaccinations and I consistently try to break down barriers to patients receiving vaccination. Non-communicable disease (NCDs) is also another topic which pharmacist play a vital role in being able to provide patient centred services and helps me keep the focus on the patient and address their needs rather than tell them what they need, and I believe that shift in focus has been a growing theme over the last WHAs. Patient safety is a new topic this year but is not a new concept in a pharmacist’s everyday practice. Having this topic addressed at the WHA adds value to the importance of prioritising patient safety especially in a pharmacist’s daily practice. I do feel very privilege to be able to relate these topics to my own practice and continuously improve on them, I do realise this may not be reflective of the daily tasks for different pharmacy practice across the globe and so I believe it is important that we are advocating for the empowerment and utilisation of pharmacist in these health agendas.
In terms of how the last few WHA has impacted me personally, I believe it has inspired me to take a greater interest in public and global health. The WHA consistently reminds me to think of my actions not just professional but in everyday life on how that impacts public health and the SDGs even with simple things such as recycling, think about sustainable solutions rather than a temporary fix, water usage, encouraging education and transfer of knowledge and believing in equality.
At the ‘Engaging Youth in the Global Health Agenda Event’ organised by the youth delegation to the WHA, The WHO Director General (DG) Dr Tedros Adhanom Ghebreyesus, charged youth to first of all invest in their health and to be advocates for universal health coverage starting from their communities. What do you recommend young professionals do to ensure that their zeal to make an impact in global health is effectively put to work?
Luisa Queiros:
I believe getting into the right mindset is a good start. Many youths are inspired at the WHA as it is a good global platform but may not know how to take that inspiration and turn it into local action. ‘Think globally, act locally’ was something a keynote speaker once said, and I believe that is true. Bit by bit in their roles, youths can address public health challenges in their own ways, whether it is addressing a recycling problem that contributes to climate change which then ultimately impacts health or running public health campaigns to raise awareness on a disease topic or public health agenda, approaching schools and universities to include public health in the education and training curricular and many more, the list is endless. Being involved in youth organisations that champion youths’ involvement in public health by approaching the government to include youths in the country delegation was also a growing movement seen in some countries. Seeking and gathering youth’s opinion in vital public health matters and producing evidence-based reports or responses is a tangible outcome that can be used in policy statements. Being part of a global youth organisation or getting involved in public health associations that is dedicated to the global health agenda and motivating, spreading the message and impact to others to take an interest in the public health agenda also channels youth’s passion for global health in the right direction.
Diana Ching:
Make your voices heard! Engage more with your community through service. Learn more about how you can advocate for pharmacists to your local and national legislative bodies. There are 1.8 billion young individuals in the world and we are the future leaders. Therefore, we need to be involved in shared decision making processes. In order to advocate for the role of pharmacists, we must have a presence in sectors beyond just the pharmacy network. Do not be afraid to step out of your comfort zone!
What was your most favorite part of the WHA, and your final comments as we conclude?
Diana Ching:
The energy and passion by the youth! There were several side-events hosted by young professional organisations to share experiences, ideas, concerns, and calls to action. It has also been an eye-opening experience seeing the shift of focusing on women and youth as a main part of the solution to addressing the 18 million health worker shortage and to achieve universal health coverage.
Acacia Leong:
There were so many favourite parts of WHA that it is hard to narrow it down to one favourite. One of the highlights I would have to say is the high level dinner organised by FIP on Addressing Health Workforce shortage. This event brought together such a diverse range of stakeholders all in positions of influence to be able to start a movement. It was very motivating to have different representatives of various organisations bring their expertise to the table and put their heads together to address the challenges affecting health workforce and come up with tangible goals to bring to the technical seminar on Investing in Jobs and Health for all as well as reflect on their own roles and how they can achieve these goals in their own organisations. A key favourite for me during the WHA is being able to humbly represent our professional organisation and advocate for the role of pharmacist in global health agenda. Being able to have thought-provoking discussions with other like-minded inspiring youths passionate about global health and being able to have fruitful discussion in addressing global health topics such as NCDs, youth’s role in health workforce and primary health etc reinforces my motivation to continuously improve my practice embed the public health advocacy culture in my daily role. WHA was a great opportunity for those who attended, but even without attending the WHA, everyone still has a vital role to play in achieving the global health agenda in their own way, so maybe it is time for us to ask ourselves when thinking about tackling the challenges to public and global health, ‘If not now, when? If not me, who?’
