Highlights of the IFMSA conference by Gerard Millen
The 57th Annual March Meeting of the International Federation of Medical Students’ Associations (IFMSA) has just finished in Monterrey, Mexico. The theme for this General Assembly was Migration and Health. Gerard Millen, a medical student at Queens University, Northern Ireland was there and gives us a brief report on the main policy events here- Rhona
Migration and health is a huge topic that covers issues as diverse as migration of healthcare workers, disease pandemics, refugee health and the rights of asylum seekers. It is therefore fitting that a series of “theme events” were held on the second day of the General Assembly (GA). Eight different events were held and were attended by up to 200 participants. The type of sessions were very diverse and included talks by leading experts, a movie which was closely linked with the theme, or discussion in smaller groups about the wide ranging implications of migration on health.
My own workshop was on disease pandemics and the easier spread of diseases. This looked at the effect of migration on the ease and frequency with which diseases can spread using the example of tuberculosis. The American Centers for Disease Control and Prevention has a Division of Global Migration and Quarantine with the aim of “reducing morbidity and mortality due to infectious diseases among immigrants, refugees, international travellers, and other mobile populations that cross international borders.” (1) The last statement looks at the heart of the issue - the world is no longer defined by national or even international borders. The sheer volume and affordability of air travel means that it is possible to get from one part of the world to another in less than 24 hours.
One of the other major topics discussed in the theme events was that of healthcare worker migration. This was also the subject of a panel discussion later in the week. The so-called brain drain is not a new issue but one that has troubled developing countries for decades. Health care workers in the developing world often migrate to countries in the developed world for a variety of reasons. These so called push and pull factors are well summarised in an excellent article by Eastwood and coleagues published in the Lancet in 2005. (2)It is clear from looking at the different factors that healthcare worker migration cannot be stopped in the short term. It will take a large, concerted, global effort from both developing and developed countries to slow the leakage of healthcare workers from developing to developed countries. The UK Government has taken steps this year to limit the ability of international graduates to work and train in the UK. (3) This policy is due, not to a sense of duty to those developing countries who have leached graduates to the UK for years, but instead to a desire to be completely self sufficient for our own needs. However, this step by the UK Government will not slow the drain of healthcare workers from developing countries. Instead, it will merely force these graduates to look elsewhere for jobs. They will not have to look far however. The US Government educates approximately 30% less doctors than they require for their health service. (4)
The panel discussion was an interesting overview of the issues involved in healthcare worker migration. However, the panel members were students with an interest in the issues as opposed to experts in the field. For a truly engaging discussion on these issues, health experts such as Paul Farmer would be more suitable. (5)
Towards the end of the week, the discussions at the GA turned to the adoption of policy statements for the IFMSA. A relatively new concept within the IFMSA, Policy Statements allow the organisation to publicly state it’s belief in certain issues. There were six policy statements adopted at the GA, two of which are related to Medical Education. However, it is the other four that I would like to discuss here briefly.
The IFMSA Declaration on Migration of Healthcare Professionals looked at the issue discussed in the Theme Events. The declaration acknowledges the negative impacts that healthcare worker migration can have on a country and sets out ten steps that can be taken by developing and developed countries to try and reduce the frequency and impact of this phenomenon.
The Monterrey Declaration and the Statement on Access to Healthcare for Undocumented Persons both reaffirm the IFMSA’s belief in the concept of health as a human right and that this should not be dependent on social, cultural, or religious beliefs, or on whether the person is residing in a country legally or not. Furthermore, they ask that Government’s should accept that medical need should be the only determinant of health care.
The final policy statement concerns the current situation in Thailand regarding Abbott Pharmaceuticals and the Compulsory licence issued by the Government of Thailand for the anti-retroviral Kaletra. (6) Under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) (7) and the subsequent Doha Declaration, (8) Governments such as Thailand have the right to issue a compulsory license on a patent in the interests of public health i.e. they can break the patent on it and manufacture a generic version of the drug. Abbott have since refused to license any new drugs for use in Thailand in order to punish the Government for their decision. The policy statement calls on the IFMSA to send a letter of support for the decision of the Government of Thailand to the US Trade Representative to Thailand, the Thai Government and the DG of the WHO, Dr Margaret Chan.
At the March Meeting, the new president for the IFMSA was elected, as well as the hosts for the next March Meeting. Melhim Bou Alwan from Lebanon will start his term as president in October of this year whilst Boštjan Berlot from Slovenia will be the new Vice-President for External Affairs. The next March Meeting will see an IFMSA GA come to Tunisia for the first time ever next year.
Overall the GA was a large success with some interesting discussions around the theme of Migration and Health and some very important policy statements being passed. I am grateful to the support of the Lancet without which I would have been unable to attend the March Meeting in Monterrey. Gerard Millen: gerard.millen@googlemail.com
(1) Department of Health and Human Services. Centers for Disease Control and Prevention. Global Migration and Quarantine. http://www.cdc.gov/ncidod/dq/
(2) Eastwood JB, Conroy RE, Naicker S, West PA, Tutt RC, Plange-Rhule J. Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK. The Lancet 2005; 365: 1893-1900
(3) Government News Network. New immigration rules to restrict International Medical Graduates’ access to UK post-graduate medical training. http://www.gnn.gov.uk/environment/fullDetail.asp?ReleaseID=350762&NewsAreaID=2&NavigatedFromDepartment=False
(4) World Health Organization. Migration of health workers. http://www.who.int/mediacentre/factsheets/fs301/en/index.html
(5) Farmer PE. Global health equity. The Lancet 2004; 363: 1832
(6) BBC News. US drug firm blacklists Thailand. http://news.bbc.co.uk/1/hi/world/asia-pacific/6449779.stm
(7) World Trade Organization. Agreement on Trade-Related Aspects of Intellectual Property Rights. http://www.wto.org/english/tratop_e/trips_e/t_agm0_e.htm
(8) World Trade Organization. Doha WTO Ministerial 2001: Ministerial Declaration. http://www.wto.org/English/thewto_e/minist_e/min01_e/mindecl_e.htm
Bookmark on delicious | Digg