Medical Students for SDGs Report 2018-19

1

Report from IFMSA-CIOMS World Health Organization Internship Program 2018

Imprint Executive Board 2018-2019 President Batool Wahdani (Jordan) Vice-President for Activities Nebojsa Nikolic (Serbia) Vice-President for Members Fabrizzio Canaval (Peru) Vice-President for Finance Ahmed Taha (Egypt) Vice-President for External Affairs Marián Sedlák (Slovakia)

IFMSA The International Federation of Medical Students’ Associations

(IFMSA)

is

a

of medical students worldwide. IFMSA was founded in 1951 and currently maintains 133 National Member Organizations from 123 countries across six continents, representing a network of 1.3 million medical students.

IFMSA envisions a world in which medical students unite for global health and are equipped with the knowledge, skills and values to take on health leadership roles locally and globally, so to shape a sustainable and healthy future.

Vice-President for PR & Communication

IFMSA

José Chen Xu (Portugal) Layout Design Simo Gaabouri

non-

governmental organization representing associations

Vice-President for Capacity Building

Georg Schwarzl (Austria)

non-profit,

is

recognized

as

a

nongovernmental

organization within the United Nations’ system and the World Health Organization; and works in collaboration with the World Medical Association.

Publisher

International Federation of Medical Students’ Associations (IFMSA) International Secretariat: c/o IMCC, Norre Allé 14, 2200 Kobenhavn N., Denmark

Email: gs@ifmsa.org Homepage: www.ifmsa.org

Contact Us

vpprc@ifmsa.org 2

This is an IFMSA Publication © 2019 - Only portions of this publication may be reproduced for non political and non profit purposes, provided mentioning the source.

Disclaimer This publication contains the collective views of different contributors, the opinions expressed in this publication are those of the authors and do not necessarily reflect the position of IFMSA. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the IFMSA in preference to others of a similar nature that are not mentioned.

Notice All reasonable precautions have been taken by the IFMSA to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material herein lies with the reader.

Some of the photos and graphics used in this publication are the property of their respective authors. We have taken every consideration not to violate their rights.

Table of Contents

Click on the SDGs wheels to get to your desired section.

Foreword Page 6

Summary Page 7

Introduction Page 9

IFMSA & The SDGs Page 10

Methodology Page 11

Noncommunicable Diseases Page 12

Climate Change and Health Page 17

Migration Page 23

Children’s Health Page 27

Medical Education Page 32

Sexual and Reproductive Health and Rights Page 37

Gender Equality Page 42

Capacity building Page 47

Conclusion Page 51

Discussion Page 51

References Page 52

Annexes Page 53

Acknowledgements Lead author

Sanne de Wit, Coordinator IFMSA United Nations Task Force

Contributors

Alicia Maldonado, External Member IFMSA United Nations Task Force Khaled Abdul Jawad, Internal Member Eastern Mediterranean IFMSA United Nations Task Force Lisa Kelm, Internal Member Europe IFMSA United Nations Task Force Kim van Daalen, External Member IFMSA United Nations Task Force Nishwa Azeem, Internal Member Asia Pacific IFMSA United Nations Task Force Maitê Gadelha, Internal Member the Americas IFMSA United Nations Task Force Marian Sedlak, IFMSA Vice-President for External Affairs Patrick Djabou, Internal Member Africa IFMSA United Nations Task Force All 122 National Member Organization and their representatives that provided their national data and where relevant activity case examples

4

Adonis Wazir, IFMSA Regional Director for Eastern Mediterranean Anouk Nusselder, IFMSA SCORP Development Assistant Catarina Pais Rodrigues, IFMSA Director on Medical Education Charlotte O’Leary, IFMSA Liaison Officer the the World Health Organization Dana Nabulsi, IFMSA SCORA Regional Assistant for EMR Dario Rosini, IFMSA SCORA Regional Assistant for Europe Eglė Janušonytė, IFMSA Liaison Officer for Sexual and Reproductive Health and Rights Issues incl HIV and AIDS Fabrizzio Canaval, IFMSA Vice-President for Members Gabriela Cipriano, IFMSA Regional Director for the Americas Guillermo Young, IFMSA SCORP Regional Assistant for the Americas Hafsa Abduraheem, IFMSA SCORP Regional Assistant for Africa Hiba Ghandour, IFMSA Liaison Officer for Human Rights and Peace Issues Idil Kina, IFMSA Director on Human Rights and Peace Iheb Jemel, IFMSA Director for Sexual and Reproductive Health and Rights incl. HIV and AIDS Jian Feng Sun, IFMSA SCORA Regional Assistant for the Americas Katerina Dima, IFMSA Liaison Officer for Medical Education Issues Katja Čič, IFMSA Director on Public Health Kinsi Ahmed, IFMSA SCORP Regional Assistant for Europe Laura Lalucat García-Valdés, IFMSA SCORA General Assistant Maha Rehman, IFMSA SCORP Regional Assistant for Asia Pacific Mahmood Al-Hamody, IFMSA SCORP General Assistant Maria Krayem, IFMSA SCORP Regional Assistant for Europe Parth Patel, IFMSA Regional Director for Africa Paulina Birula, IFMSA Regional Director for Europe Po-Chin Li, IFMSA Regional Director for Asia Pacific Stephanie McKelvie, IFMSA SCORA Regional Assistant for Asia-Pacific Tadala Ulemu, IFMSA SCORA Regional Assistant for Africa Tarek Ezzine, IFMSA Liaison Officer for Public Health Issues Tatiana Zebrova, IFMSA Director on Professional Exchange Teodor Cristian Blidaru, IFMSA Liaison Officer to Student Organizations Yara Hisham Osman, IFMSA SCORA Development Assistant

Layout and Design

Simo Gaabouri, IFMSA Publications’ Assistant

Disclaimer

To empower medical students and their national & local organizations, the national activity case examples were provided by our National Member Organizations. The IFMSA has been created by its members and relies on its members to work an report on events in line with values of medical professionals - truthfulness and authenticity. Data provided on work done by the National Members Organizations and in national activity case examples are to be recognized as the work of that particular National Member Organization. IFMSA takes no accountability for the information shared in these examples.

Abbreviations

ARM African Regional Meeting CRC Convention on the Rights of a Child CSE Comprehensive Sexuality Education GCM Global Compact for Safe, Orderly and Regular Migration IFMSA International Federation of Medical Students’ Associations IOM International Organization for Migrants LMIC Low and Middle-Income Countries NCDs Noncommunicable Diseases NGO Non-governmental Organization NMO National Member Organization PAHO Pan American Health Organization PHLT Public Health Leadership Training SCORP Standing Committee on Human Rights and Peace SCORA Standing Committee on Sexual and Reproductive Health and Rights incl. HIV and AIDS SDGs Sustainable Development Goals SRHR Sexual and Reproductive Health and Rights STI Sexually Transmitted Infection UDHR United Nations Declaration of Human Rights UN United Nations UNFPA United Nations Population Fund WHA World Health Assembly WHO World Health Organization

5

Foreword

Dear readers, The adoption of the 2030 Agenda on Sustainable Development and its 17 Sustainable Development Goals paved the way to come together and built a better future for everyone, everywhere. It put forward a set of ambitious but clear goals for the world in order to truly leave no one behind.

Youth are the backbone of this future and undoubtedly already agents of positive change around the world. Therefore, we are an essential part of reaching the Sustainable Development Goals. We dare to dream, dare to be different and dare to challenge the current status.

As future healthcare professionals we believe that our duty does not stop at the boundaries of the hospital, but includes providing a healthy environment for communities across the globe. In this spirit, medical students are working effortlessly for the future they believe in.

However, it can be hard to realise the full impact of these combined efforts with just the perspective of your own project. Therefore it is a dream come true to create this report, with the direct and indirect help of all members of the International Federation of Medical Students’ Associations, showing the cumulative impact of local, national and international efforts of medical students globally.

It is my hope that this report both serves to show the world the tremendous contributions of medical students to reach the Sustainable Development Goals by 2030 and to show medical students to be proud of their achievements and serve as an inspiration to keep on moving forward, to keep showing that youth are not just the future, but are already leading today.

Sanne de Wit Coordinator of the IFMSA United Nations Task Force

6

Summary Noncommunicable Diseases

Climate Change and Health - One-third of National Member Organizations contribute to SDG indicators 13.3.1 and/or 12.5.1.

- National capacity building workshops reached over 3000 participants from over 30 countries.

- 92% of National Member Organization contribute to SDG indicators 3.4.1, 3.4.2, 3.5.2 and/or 3.a.1, with almost all working towards multiple targets.

- The most popular topic to work towards among our members is Mental Health.

Children’s Health

- Over one-third of National Member Organizations contribute to SDG indicator 3.2.1 and/or 4.2.1.

- Around two-thirds of National Member Organizations in the Eastern Mediterranean and Asia Pacific regions contribute to these indicators.

Sexual and Reproductive Health and Rights - Three-quarters of National Member Organizations contribute to SDG indicators 3.7.1 and/or 5.6.1.

- 90% of National Member Organization in the African region contribute towards these indicators.

Medical Education

- Almost half of National Member Organizations contribute to SDG indicator 4.5.1.

- More than half of these National Member Organizations looked even further than the indicator alone and focused on overall Social Accountability of their institutions.

Migration

- 21 National Member Organizations contribute to SDG indicator 10.7.2.

Capacity Building

- All responding National Member Organizations organize at least one educational or capacity building event contributing to SDG target 4.7.

- Together all national events reached over 10.000 people in over 115 countries.

Gender Equality

- 87% of National Member Organizations perceive that their organization reached indicators 5.5.2 and 16.7.1.

- Over half of National Member Organizations have more women in leadership positions than men.

This report shows how medical student worldwide contribute greatly to achieving the Sustainable Development Goals by 2030. Figure 1 shows how many IFMSA National Member Organizations work towards each one of our 8 selected topics to report on and below are the key finding of the data presented in this report.

7

Summary

Figure 1. Number of NMOs working on each of the 8 different themes

8

Introduction

In 2015, the General Assembly of the United Nations (UN) adopted a brand-new development agenda with the title Transforming our world: the 2030 agenda for sustainable development.

Within this agenda the UN proposed 17 Sustainable Development Goals over 17 main themes.

Health is an all-encompassing aspect of sustainable development: achieving goal 3 good health and wellbeing will depend on achievements made in all other 16 goals. For example, ending poverty and hunger, promoting educational, economic and gender equality and a sustainable environment.

The International Federation of Medical Students’ Associations (IFMSA) represents, connects and engages with a network of over 1.3 million medical students from 133 National Member Organizations (NMOs) in 123 countries around the globe, divided among 5 regions: Africa, Asia Pacific, Eastern Mediterranean, Europe and the Americas. The IFMSA brings these students together to exchange, discuss and initiate projects to create a healthier world and gives its members the skills and resources to become health leaders, advocating for pressing issues to shape the world.

IFMSA is an officially registered non-governmental organization (NGO) in consultative status with the UN Economic and Social Council since 2003. IFMSA furthermore has special recognition and collaborations with several UN agencies, such as the WHO, UNAIDS and others. Therefore, IFMSA shares, along with all partners, the social responsibility to promote, advocate and achieve the SDGs. The SDGs cannot be achieved without inclusive youth engagement in all levels of development, from local initiatives to policy creation and high-level decision making. To achieve the SDGs and realize its vision, IFMSA has, and will continue to, direct its work to contribute to the realizations of the 17 SDGs. We are committed to motivate our members to work towards the global movement related to the SDGs by relating activities to the key concepts of the SDGs, to provide opportunities such as workshops, exchanges and trainings and to increase education and capacity building around the goals.

The report This report serves to show what the outcomes of this work have been on the international, regional, national and local level over the past year, as well as an accountability mechanism for our own actions. Impossible to gather all work done around the globe in one report, 8 main themes related to IFMSA’s priorities were selected to report on: 1. Noncommunicable diseases 2. Climate Change and Health 3. Migration 4. Children’s Health 5. Medical Education 6. Sexual and Reproductive Health and Rights 7. Gender Equality 8. Capacity Building

9

IFMSA and the SDGs In order to reach a better and more sustainable future and to ensure the biggest possible impact of our efforts IFMSA has selected 13 Global Priorities to focus its internal and external work around.

These Global Priorities allow for a streamlined and strategic approach on a global and local level and as guidelines for collaboration. For IFMSA it is important to direct our work to the 2030 agenda and its Sustainable Development Goals, therefore, each of the Global Priorities is linked to one or multiple Sustainable Development Goals as shown in box 1.

IFMSA Global Priorities Noncommunicable diseases

Antimicrobial Resistance

Environment, Climate Change and Health

Refugees’ and Migrants’ Health and Rights

Humanitarian action

Children’s Health and Rights

Social Accountability in Medical Schools

Global Health Workforce

Access to Research and Research Education

Sexual and Reproductive Health and Rights

Meaningful Youth Participation

10

Universal Health Coverage

Global Health Education Box 1. IFMSA Global Priorities and their linkage to the Sustainable Development Goals

Methodology The process of writing this report has been done through the following 4 steps.

1. Selecting indicators and questions

The first step to composing this report was to select the SDG targets and indicators to report on.

This was done through first linking all relevant targets and indicators to our 13 Global Priorities.

After which all IFMSA officials were asked for their input to determine which of these targets would be both most related to our work and attainable for us to measure. This left us with the 14 targets and 14 correspondent indicators divided over 8 main themes incorporated in this report.

2. National data gathering

The next step was to gather data on the contribution of medical students across the globe on the 14 selected targets and indicators. IFMSA biannually sends a mandatory NMO report questionnaire to all NMOs, which is filled out by a representative of the NMO. In the NMO report which had to be completed before February 1st 2019 we incorporated a mix of 16 qualitative and quantitative questions to gather the data to draft this report. The full list of question can be found in annex 1.

The NMO report provided responses to all questions from 121 NMOs and an incomplete response from one NMO.

3. Data analyses

Once the data from the NMO report was shared we cross-referenced this with activities submitted by our NMOs to our activity database to add data that NMOs might have missed to report on. From there we calculated proportions and numbers of NMOs working towards the specific indicators selected for the report overall and by region and the impact these activities had. For calculating our own status on indicator 5.5 we used self-reporting by our NMO representatives and for indicator 16.7 we compared the number of women in leadership within NMOs to the national distribution per gender from the 2017 report of the United Nations. Â

4. Case examples

Last, we asked all IFMSA Officials to share qualitative data on activity case examples conducted in the past year by IFMSA contributing to the selected themes, targets and indicators. Furthermore, we used our activity database and asked a selection of NMOs to provide national activity case examples for the most relevant 6 out of 8 themes.

11

Noncommunicable Diseases Target 3.4: By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease Indicator 3.4.2: Suicide mortality rate

Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol Indicator 3.5.2: Harmful use of alcohol, defined according to the national context as alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol

Target 3.a: Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

Indicator 3.a.1: Age-standardized prevalence of current tobacco use among persons aged 15 years and older

Introduction

Noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, diabetes, chronic respiratory diseases and mental health disorders, account for major morbidity and premature death worldwide. Collectively they are responsible for a major global burden of disease, especially in low- and middle-income countries (LMICs) and the impact of NCDs extends beyond ill-health with major economic consequences worldwide. This makes it crucial to develop effective, context specific interventions.

The rise of NCDs has been largely driven by five risk factors: tobacco use, physical inactivity, harmful use of alcohol, unhealthy diets and air pollution. These risk factors are interrelated and rooted in social, political, economic, cultural, environmental and commercial factors that are often outside of individuals’ control. Underfunding, lack of social mobilization and conflicts of interest with the private sector make NCDs a challenging global public health issue. NCDs’ prevention, control and management is however essential to achieve the SDG target of a one-third reduction in premature NCD deaths by 2030.

The IFMSA affirms the need for urgent global multi-sectoral action on awareness, surveillance, prevention, control and management of NCDs. As NCDs share common risk factors there is an opportunity for comprehensive, coordinated and preventive action to tackle them as a group. The

12

Noncommunicable Diseases

IFMSA therefore called on its NMOs and medical students to: · Promote healthy behavior among themselves and lead by example; · Raise awareness, especially among peers, and advocate towards the reduction of NCDs.

International contributions

IFMSA celebrated World Mental Health Day 2018 with a campaign called “YOUth COUNTs” to promote the topic “Young people and mental health in a changing world” set by the WHO. The campaign consisted of social media posts, Facebook frames for cover and profile pictures, resource database development, infographics and a video of members sharing their impressions.

The overall reach of the campaign was over 23.000 Furthermore, IFMSA collaborated with PAHO to deliver a webinar focused on mental health services in emergency settings to raise awareness of students on the importance of ensuring mental health services to individuals no matter when or where. The webinar also discussed the specifics of offering such services during emergencies and how students could get involved. Furthermore, in the past year a webinar on suicide prevention was held, with methods and tips students would find useful in such situations. The webinar was intended for the knowledge- and capacity-building of members, as well as raising awareness and tackling stigma connected to suicide. Last, a webinar on NCDs was held. The webinar tackled advocacy for NCDs, youth involvement in strategy-making and issues youth around the world is facing in terms of NCDs.

The webinars were viewed over 1000 times

In addition, two manuals were released back to back in order to bring the topics of Cardiovascular Diseases and Ageing closer to IFMSA members. Both manuals introduce the essential aspects of their respective topics, then delve into discussing potential activities and advocacy, and wrapup with an introduction to global stakeholders. In the near future two other manual regarding mental health are planned to be released.

The manuals have been read over 500 times

13

Noncommunicable Diseases Last, a new international workshop was developed that goes into the specifics of mental health and approaches the sensitive topics with varied methodology. This workshop advocates for a psychosocial approach to mental health that treats factors such as a person’s life, working and social environment, as well as purely biological factors as equally important in understanding mental health and well-being. Through this workshop we wish to erase stigma, and raise awareness and understanding that people with mental health disorders should live as full citizens with equal access to opportunities and appropriate services, while at the same time being experts of their lives.

The first workshop was attended by 13 people from 9 countries.

National Contributions

Tackling the burden of noncommunicable diseases is a topic a lot of medical students worldwide work towards. 92% of the 122 NMOs work towards one of the targets mentioned above (figure 2).

Most of them focus on the promotion of mental health, soon followed by the overall reduction of the global burden of NCDs with respectively 96 and 89 NMOs contributing towards these goals.

Working towards prevention of substance abuse such as tobacco prevention is done by 46% of NMOs and alcohol prevention by 21% of NMOs. You can find a complete overview distributed per region in figure 3.

Over 90% of NMOs work on prevention of noncommunicable diseases

Figure 2. Proportion of National Member Organization working towards the reduction of Noncommunicable Diseases

14

Noncommunicable Diseases

Figure 3. Overview of number of National Member Organizations working on Noncommunicable Diseases distributed per Region

National Case Examples ZiMSA, Zimbabwe Health Page 98.4

As one of the countries that were hardest hit by the HIV/AIDS epidemic Zimbabwe’s health resources were channeled into combating sexually transmitted diseases. At the time NCDs weren’t as prevalent in the country, but the number of people suffering from noncommunicable diseases is rising and with that the death toll also climbs with an estimated 31% of deaths in Zimbabwe in 2014 being due to NCDs. Health Page 98.4 aims to address issues regarding NCDs and turned into a mass media campaign that brings about a positive change in health-related behavior across the whole Zimbabwean population constituting of a magazine and a radio show. The health page is published every fortnight during the semester. The health talk is every Wednesday from 19.30 to 20.00 on 98.4 FM Midlands. To start of the discussion a topic is presented for 10 minutes then via the radio station’s WhatsApp platform listeners can ask questions which are then answer and discussed during the course of the show. Usually the content of the show is in synch with the publication released.

The talk show is broadcasted to 1 600 000 people

15

Noncommunicable Diseases IFMSA-Jo, Jordan Here I Am

There are many factors and things that can end a human life: from diseases, to wars, to accidents.

But how sad is it that what could be killing you… is you? Here I Am, a national mental health project sheds light on the mental health of the human being, and tackles one of the biggest problems of our generation: mental health issues and their consequences. By reaching out to those in need to be their hope, voice and light in the darkness and to fight on behalf of every person out there struggling with mental health issues … “Here I am!”

The ongoing project tours all over Jordan, with activities ranging from awareness campaigns in cities and villages, training sessions in schools and universities and workshops pointing out the biggest factors that affect mental health in the society such as drug abuse and mass media and how to tackle such factors. Continuing the work, Here I Am plans to expand its’ outreach to an international level, in hopes of being the light in the darkness for those who need it most.

Over 15 events were organized Swimsa, Switzerland Aufklärung gegen Tabak

Aufklärung gegen Tabak (AGT) is a tobacco prevention program operated by medical students in Berne. Inspired by ideas of AGT in Germany, AGT Berne was founded in 2012. Since then AGT grew continuously and currently counts more than thirty active members. The main goal is to support informed decision-making of adolescents by school-based prevention. As most of the regular smokers start within their teenage years, the project is oriented towards young students in the age of 13 to 15 years and is integrated as a special event in the school program of the students.

The education block of two hours has the following contents: · Information on smoking and all kind of tobacco products; · Demonstration of the risks of tobacco with many experiments linked to everyday life; · Comprehensible visualization of diseases connected to smoking; · Self-experiments by the students to have a direct personal experience on previously given information; · Open and sincere discussion in a room of mutual trust.

The prevention program avoids any prohibition or top-down rules against smoking.

The project reaches almost 500 adolescents per year.

AMSA-Hong Kong, China Mental Health Month

For a long time, mental illness has been stigmatized by the Hong Kong society. Yet, mental health problems and suicides among students have become an increasingly serious concern, with medical students being particularly vulnerable. In March 2018, AMSA Hong Kong organized a series of activities to enhance mental health awareness under the overarching Mental Health Month conveying the message that mental health issues can affect anyone.

First, Dr. Dog Day was held to alleviate stress and provide encouragement for students during exams by inviting dogs to visit students along with professors and faculty counselors to engage with students and learn more about their needs. Secondly, through the Crisis Negotiations Workshop students were equipped with skills on how to communicate with patient suffering from mental health issues.

16

Last, an online campaign was launched with videos interviewing 3 experts and per 50 people from the general public about their understanding of mental health issues and distributing encouraging messages to medical students. Overall the Mental Health Month has effectively increased medical students’ awareness and understanding of mental health issues.

A whole month was dedicated to mental health awareness

Climate Change and Health Target 13.3: Improve education, awareness-raising and human and institutional capacity on climate change mitigation, adaptation, impact reduction and early warning

Indicator 13.3.1: Number of countries that have integrated mitigation, adaptation, impact reduction and early warning into primary, secondary and tertiary curricula

Target 12.5: By 2030, substantially reduce waste generation through prevention, reduction, recycling and reuse Indicator 12.5.1: National recycling rate, tons of material recycled

Introduction

Accumulating evidence has shown that climate change puts the lives and wellbeing of billions of people at increased risk. Health impacts can be directly mediated, through weather events, or indirectly mediated, through the effects on economies, access to healthcare, social structure and ecosystems. However, climate change action also offers great opportunities for improving global public health through the so-called co-benefits.

The IFMSA believes that our duty of care not only includes the future of our individual patients, but also that of communities locally, nationally and globally. In light of this, the IFMSA acknowledges i) the direct attribute of human activity to climate change, and ii) the urgent threat climate change poses to global health. IFMSA therefore stresses on the importance of climate change action including the health co-benefits of health mitigation and adaptation strategies and the need for building climate resilient health systems that can protect the promotion and provision of quality healthcare for all. Health must be placed at the center of any negotiations on climate change.

IFMSA therefore called on its NMOs and medical students to:: · Where possible, use the IFMSA recommendations for sustainable and climate-friendly meetings as a guidance to limit the environmental impact of IFMSA and NMO meetings; · Improve the sustainability of NMO and Local Committees; · Take the lead in creating public awareness on climate change and its impact on global health and promote sustainable lifestyle habits;

17

Climate Change and Health · Collaborate with universities and other educational bodies to improve the education on

climate change and its impact on health in medical curricula; · Lead the change by advocating towards key stakeholders, including governments, to take action in climate change mitigation and adaptation; · Lead by example by increasing transparency on and divestment from investments in institutions and organizations associated with the fossil fuel industry.

International contributions

Since its creation in 1951, the IFMSA has grown into a global movement. However, bringing medical students from all corners of the world together to discuss and solve global health problems comes with obvious consequences. Every year, thousands of medical students engaged in IFMSA activities and travel around the globe to participate in internal and external meetings, to do their internships or to take part in various IFMSA exchange programs abroad.

With these challenges, we understood that only our leadership, responsibility and action can lead to the desired outcome – to decrease the effect of IFMSA’s work on the climate and the environment and promote climate change mitigation and adaptation to ensure a healthy planet. In line with these ideas, and to transform our vision into reality, we published the first edition of the IFMSA Recommendations for Sustainable and Climate-friendly Meetings.

The aim of this document is to promote and support green conduct of our international, national and local meetings and to reduce medical students’ contributions to climate change.

Last year, 2 international IFMSA meetings have been completely carbon neutral

Furthermore, we noticed a gap between the impact that the environment as a whole and climate change specifically have on health and the inclusion of the topic into medical curricula, leaving (future) healthcare professionals with insufficient knowledge and skills to address the issue. To change this we launched a global campaign aiming to get climate-health in medical curricula everywhere. The specific goals o the campaign are: 1. To have an element of climate-health included in the curriculum of every medical school by 2020; 2. To have an integration of climate-health in all aspects of medical school life, including research, advocacy, training, and university healthcare systems by 2025.

In order to reach these goals, the campaign will be providing participants with knowledge and tools to advocate to their own medical faculty. Furthermore, a Report Card System is used to assess the status of integration of climate-health in medical curricula of which the outcomes will be brought together in a yearly synthesis report.

The campaign gathered data from over 120 countries on the status of Climate and Health in their Medical Curriculum

Moreover, the Public Health Leadership Training (PHLT) is a standardized workshop to train IFMSA members. The workshop is built on three major pillars – Leadership, Activity Management and Public Health. It equips participants with all the necessary skills needed to become an asset to the Public Health work performed in their country.

18

Climate Change and Health The main priority of a PHLT is to empower future public health leaders and educate individuals to understand the intricate workings of activity management, create powerful activities and track their impact, as well as lead their communities towards better health. Several PHLTs focusing on Climate Change empowered IFMSA members to address the challenges posed by climate change on our health.

The workshops reached over participants

have 60

Last, the theme event of the IFMSA Americas Regional Meeting was Climate Change and Health with the aim to present how much impact climate change has on people’s health and way of living. Two sessions were held: a roundtable which had experts from Universidad del Ecuador that presented the different ways climate change affects populations and a session on Climate Change and its Relationship to SDGs aimed to bring the participants’ perspectives forward on how to work on these topics together.

The theme event was attended by 200 medical students

19

Climate Change and Health National Contributions

Climate Change and Health is a relatively new topic for IFMSA and its NMOs to work on. We however see a steady rise the past years with now one-third of NMOs working towards sustainability, raising awareness and contributing to the topic (figure 4). Capacity building activities on Climate Change and Health are done in a total of 32 NMOs across all regions, reaching more than 3000 participants.

A total of 17 NMOs furthermore try to practice what they preach and are actively working to reduce their own footprint and become more sustainable as an organization. Figure 5 gives an overview of the number of NMOs working on both issues distributed per region. National and local

capacity building events reached over 3000 participants in over 30 countries

Figure 4. Proportion of National Member Organization working towards Climate Change and Health

Figure 5. Overview of number of National Member Organization working on Climate Change and Health distributed per Topic and Region

20

Climate Change and Health National Case Examples AMSA, Australia Code Green

Code Green is the Australian Medical Students’ Association’s (AMSA) national project on climate change and health.

Code Green educates on the health impacts of climate change, advocates for meaningful action against climate change and inspires medical students to get involved.

Code Green has representatives in almost all Australian medical schools, supporting universities to run events that champion climate action and prioritize sustainability. Code Green also organizes collaborative, state-based and national capacity building events that empower students and maximize action. Code Green extends its advocacy work through social media and a monthly newsletter on project progress, opportunities to get involved and a summary of environmental news.

AMSA Code Green outlines four annual priorities: 1. Improve the sustainability of events run by universities and AMSA; 2. Advocate for individuals and organizations to divest from fossil fuels; 3. Lobby hospitals to join the Global Green and Healthy Hospitals program; 4. Leverage Australia’s upcoming federal election to educate peers to make climate change a political priority.

Additionally, AMSA Code Green runs capacity building sessions at national conferences, attends international events and collaborates with other organizations to streamline climate efforts.

Code Green engages 17.000 medical students AEM, Burkina Faso Ouagadougou declaration

on

Climate

Change

and

Health

One of the biggest achievement of AEM was hosting the IFMSA African Regional Meeting (ARM).

The theme of this meeting was Climate change and Health. Over 150 students from all over Africa were gathered in Ouagadougou to discuss the impact of Climate Change on Health. In order to achieve an outcome document, a drafting session happened during two days at the University of Ouagadougou with twenty AEM-Burkina Faso members. After lectures, discussions and sessions, a policy document on Climate Change was finalized and given to the AEM National Assembly for approval. During those days, we highlighted the causes and consequences of Climate Change. This helped us to discuss possible solutions which can be implemented by students and youth. Training and sensitization are conducted since then as follow-up activities.

A national policy document was created and adopted by AEM

21

Climate Change and Health

IFMSA-Quebec, Canada My Planet, My Health

My planet, my health is a 4-week long project addressing issues of air and water pollution as well as food distribution with the goal to foster environmental health education of students in primary schools. It addresses issues of misuse of water and resources, air and land pollution and overall apathy by amplifying environmental health education to inspire students to care for their environment and health. It aims to help the young students in grades 4, 5, or 6 across as many schools as possible to understand the impact of their daily actions on their environment, and thus their health, and the simple things they can do to improve it. To measure the success of the activity during the fourth review session students are quizzed to assess acquired knowledge.

The project provides a 4 week long course IFMSA-Sweden, Sweden The Health and Sustainability Project

The Health and Sustainability Project (Swedish: Hälsa och Hüllbarhetsprojektet) is a newly founded project that aims to address the link between climate change and public health. As medicine students preparing to enter the health sector, it is important to be aware of the impact global gas emissions will have on our future work environment.

The project aims to take climate action by spreading knowledge of the current crisis and working against climate change to prevent a decline in public health. The project is a platform for both concerned and unknowing students to engage in lectures about the problem, participate in workshops and group discussions, attend climate strikes, and much more. Additionally, we are working to incorporate the subject of sustainable development into our education.

The projects targets both concerned and unknowing students

22

Migration

Target 10.7: Facilitate orderly, safe, regular and responsible migration and mobility of people, including through the implementation of planned and well-managed migration policies

Indicator 10.7.2: Number of countries that have implemented well-managed migration policies

Introduction

According to the International Organization for Migration (IOM), migration is defined as the movement of a person or a group of persons, either across an international border, or within a State. It is a population movement, encompassing any kind of movement of people, whatever its length, composition and causes; it includes migration of refugees, displaced persons, economic migrants, and persons moving for other purposes, including family reunification. People on the move are often denied basic human rights, including access to social and health services. Those rights are universal and as such, should be respected and granted regardless of the individual’s legal status.

IFMSA believes that every individual regardless of their legal status has the right to the best attainable standard of health. Accordingly, migrants should be able to access the same standard of health care services as any other person, and proactive measures should be taken to meet the specific health needs of this vulnerable group.

IFMSA therefore called on its NMOs and medical students to: · Actively work on the topic, raise awareness of the current situation of migrants’ health, and invest time and resources into projects and activities on this topic; · Share best practices and projects with other NMOs and reach out to other NMOs to develop advocacy and project collaborations. · Participate in processes to create more equitable health policies for migrants;

International contributions

As a build up for IFMSA’s participation in the Intergovernmental Conference to Adopt the Global Compact for Safe, Orderly and Regular Migration (GCM) in December 2018 in Morocco, a social media campaign was conducted through a series of infographics and pictures. In the campaign the situation of migrants around the world and the challenges they face were highlighted.

Additionally it addressed key points in the GCM such as reducing the vulnerability of migrating populations, providing access to basic services, investment in the development of skills, call for mutual recognition of skills, qualifications and competences and eradicating trafficking.

23

Migration Furthermore, the Muscat Youth Declaration on the Health of Migrant Workers was adopted at the Eastern Mediterranean Regional Meeting in Muscat, Oman. The document sheds light on the current situation of migration in the Eastern Mediterranean Region in addition to the impact migration poses on the occupational health of those migrating.

The Declaration includes a set of guiding principles and a call to action for various stakeholders to collaborate together to implement both the pillars set in the document and the

commitments

of

the

The declaration was adopted by all 12 NMOs of the region.

GCM.

Last, the European National Officers on Human Rights and Peace Weekend 2018 was held with the theme of Youth for Refugees and Migrants: Meaningful Solutions. The weekend represents the perfect opportunity for our members working on human rights and peace to get in touch once a year to discuss global, regional problems, as well as priorities, solutions and tackle the obstacles members may face. In this four-day event, a variety of sessions about migration, the rights and health of refugees and migrants and specific health issues that refugees and migrant face were conducted. The theoretical knowledge was combined with more practical skills on how young people can contribute to refugees’ and migrants’ health and rights and play an active role in advocacy.

The weekend was attended by 25 students from 16 different European countries.

24

Migration National Contributions

Migrants’ health and rights is a topic many of our NMOs work on with 21 of these NMOs specifically working towards the implementation of orderly, safe, regular and responsible migration (figure 6). The activities are being held in every region, with most active NMOs in the European Region (figure 7).

Figure 6. Proportion of National Member Organization working on facilitating orderly, safe, regular and responsible migration and mobility of people

Figure 7. Number of National Member Organizations working on the topic of facilitating orderly, safe, regular and responsible migration and mobility of people distributed per region

25

Migration National Case Examples IFMSA Brazil, Brazil The Esperanza Project

Due to the intense migration of Venezuelans and the indigenous Warao to other countries including to Brazil, especially to BelĂŠm, the Esperanza project was created. The project consist of activities divided into 4 days of medical care, in addition to 2 days of capacity building with medical, law and nursing students.

During the 4 days of medical care assistance, juridical services, as well as laboratory and imaging exams were provided. The action was supported by social workers, several doctors, in addition to partnership with the Human Rights Clinic (an NGO linked to one of the Universities of the city); with a laboratory to gathering blood samples, feces and urine and with places that donated some medications. The additional days of capacity building focused on a better understanding of the participants about the situation that they are living in, their origins and customs and their rights in Brazil as refugees.

The project has 200 volunteers who already helped 250 immigrants in the city.

AEM, Guinea International Day of Illegal Immigration

Around the International Day of Illegal Immigration students were by the side of immigrants to prove their support. For this purpose activities were organized during two successive days.

The first day focused on awareness, prevention and screening of diseases. Awareness was raised on the risks of HIV and high blood pressure. After, the medical students participating screened immigrants for high blood pressure and diabetes. On the second day an exhibition was organized to show the consequences of illegal immigration and possible advantages young people might have by staying in their country. The day ended with theater, singing and dancing with which all participants together concluded a common fight against the need for and consequences of illegal immigration.

2 full days of activities were organized SISM, Italy Internships

Migration related activities are present in 36 out of 39 Local Committees in Italy. Twelve of these Local Committees, have started the collaboration with other organizations in the field of social and health assistance for migrants and homeless people (i.e. health centers), providing internships.

These include internships in health centre for asylum seekers and migrants in Genova, Milano, Modena, Rome, Turin, Trieste and Varese. Furthermore, workshops are organised in Novara and a Homeless Project in collaboration with CISOM is being organized.

36 out of 39 Local Committees in SISM Italy work towards the topic

26

Children’s Health

Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births Indicator 3.2.1: Under-five mortality rate

Target 4.2: By 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education

Indicator 4.2.1: Proportion of children under 5 years of age who are developmentally on track in health, learning and psychosocial well-being, by sex

Introduction

All children have the right to opportunities to survive, grow and develop with physical, emotional and social well-being. These rights are defined by the United Nations Universal Declaration of Human rights (UDHR), which applies human rights to all age groups, and the Convention on the Rights of a Child (CRC), which extends special care and protection to address the unique needs of children. A child’s right to health is an inclusive right, which extends not only to health care services, but to a child’s well-being. Therefore, fulfillment of these rights requires that all of the determinants of health are addressed. A child’s right to health must also not be undermined by discrimination or child maltreatment, which contribute to a child’s vulnerability. Preventing children’s rights violations and ensuring the highest attainable standard of inclusive and equitable mental and physical health is a task that must engage all members of society.

The IFMSA believes in all children’s right to opportunities to survive, grow and develop with physical, emotional and social well-being. Therefore, the IFMSA affirms the need to extend special care and protection to address the unique needs of children.

IFMSA therefore called on its NMOs and medical students to: · Participate in and develop awareness and education campaigns and activities on Children Health & Rights related topics, including the causes, implications and consequences and ways of prevention · Acquire evidence-based knowledge pertaining to children’s health and rights; · Acknowledge intersectional and multiple forms of gender inequality present socially and systemically within medical schools and institutions that impacts on child rights and health; · Identify stakeholders and work actively on advocating for topics relating to children’s health and rights.

27

Children’s Health International Contributions

During IFMSA’s March Meeting 2019 a side event was held on the topic of Children’s Health and Rights. The event consisted of a debate called What’s Right when it comes to Children Health and Rights. The participants were divided into six groups, that had to debate for and against 3 different topics. The participants first did research and created arguments about the topics according to the stance they were assigned. Then the debaters from each group conducted their debates followed by an open space discussion. The three debates were: 1. Children with disabilities should get education in separate schools 2. Parents are the final decision making body when its comes to health decision of the child 3. Children should be able to elect their peers to represent them in the parliament

The side event was attended by 60 people from various countries

28

Children’s Health Furthermore, IFMSA addressed Children’s Education in three different campaigns. The Universal Children’s Day 2018 campaign was themed in relation to children’s access to education and safe school environment. Through infographics and articles, the challenges to access education were highlighted with a special focus on gender inequalities. Violence and safe school environment and the forms and drives of violence were additionally addressed.

The second campaign was the celebration of the International Day of Education, where the right to education as a building block for peaceful and productive societies was highlighted.

The third campaign was during International Women’s Day, again stressing the importance of girls’ education and the need for gender-sensitive and safe education environment.

The overall outreach of the campaigns was around 9.000 people

National Contributions

Children’s health and rights is one of the newest IFMSA Global Priorities. However, already over a third of NMOs contribute to decreasing deaths of newborns and children under 5 or promote children’s health and rights otherwise (figure 8). Activities are being organized throughout all regions, but especially frequent in the Eastern Mediterranean and Asia Pacific regions with respectively 60% and 56% of NMOs working towards the topic (figure 9).

29

Children’s Health

Figure 8. Proportion of National Member Organization working on Children’s Health and Rights

Figure 9. Number of National Member Organization working towards Children’s Health distributed per Region

National Case Examples LeMSIC, Lebanon Orphanage Health Day

Around 23000 children are placed in the care of orphanages in Lebanon. A study sadly showed that these children do largely not receive the attentive care and support they need to grow and thrive. In response to this challenge LeMSIC aimed to provide knowledge on healthy lifestyle habits, preventing NCDs and perform appropriate screening for the orphans and Orphanage Health Day was born. Through peer education orphanages were provided with basic awareness session dealing with topic such as hygiene, nutrition, mental health and smoking. In addition basic screening techniques and a full cycle of physical check-ups were provided. Furthermore the project aimed to motive medical students to become advocates for better education and healthcare for orphans across Lebanon.

The project reached over 700 orphans

30

Children’s Health FNESS, Senegal Pediatric Consultations

FNESS Senegal has done a lot of work in order to decrease deaths in newborns and children under 5. One of the most important activities is pediatric consultations and distributing medicines during medical and preventive campaigns that so far ensured mass consultations of more than 6,000 people during 3 days across 3 different cities.

The campaign focused on the following objectives: · Informing and educating the population about diseases like malaria, pneumonia and diarrhea which are frequent in Senegal; · Raising awareness of the importance of breastfeeding and how it enhances the immune system of newborn babies; · Informing the population about the importance of pre-birth care for mothers; · Raising awareness on the national program of vaccination; · Persuading the parents to seek treatment for children when needed and to avoid traditional treatments that can harm children; Aware of the difficulty of finding medicines by default, beside these objectives the associations members of the FNESS donate medicines during these campaigns.

The activity already reached over 6000 people across 3 cities

IFMSA-Pakistan, Pakistan Neonatal Health: Formula versus Breast Milk

In developing countries such as Pakistan, lack of awareness about the difference of synthetic formula milk a natural breast milk causes the masses to accept formulas. The activity, targeting future mothers of our community was based on an awareness campaign that highlighted the differences in Formula Milk vs Breast Milk, in aspects of chemistry and impact on health; both long and short term. For the sake of authenticity and accuracy of the content delivered the Pakistan Food Authority (PFA) was taken on board. With the help of visits to factories manufacturing formula milk and already collected data by PFA in previous years, extensive research was conducted finally yielding enough results to help us understand how the ingredients, and methods used to manufacture formula milk were different and more hazardous than breast milk. Not only this, but the impact of not breastfeeding on maternal health was also addressed. For maximum output of our initiative, presenters ensured the use of easy and comprehensible terminology. At the end of the seminar, response forms were distributed among the audience assess the knowledge which they had gained from the preceding presentation.

The data from the response forms was plotted in graphs and the percentage of people having knowledge about the Infant Formula Milk, its hazards both on the mother and the child, were compared before and after giving the seminar, hence the results of our devoted evaluations revealed a gain of knowledge among the participants.

The activity engaged 120 medical students and reached 400 pregnant women

31

BoHeMSA, Bosnia and Herzegovina My school

My school is a project devoted to preschool and school transition of children with the aim to develop elementary school habits of learning and obligations without parental pressure on a child and prevent a child from developing disorders towards the school. The project was led by a psychologist, who established communication between parents and children in a way that children showed their opinion about the school through drawings after which parents shared what they expected from the children in the school.

The project prepares children for their education

Medical Education Target 4.5: By 2030, eliminate gender disparities in education and ensure equal access to all levels of education and vocational training for the vulnerable, including persons with disabilities, indigenous peoples and children in vulnerable situations

Indicator 4.5.1: Parity indices (female/male, rural/urban, bottom/top wealth quintile and others such as disability status, indigenous peoples and conflict-affected, as data become available) for all education indicators on this list that can be disaggregated.

Introduction

In 1995, the WHO defined Social Accountability (SA) in Medical Schools as the obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve. The 21st century presents medical schools and health systems with an important set of challenges: to assure the quality of healthcare delivery, to promote health equity, to ensure cost-effective use of resources and to build strong relevance between medical education and society. Education institutes are now being called to reduce the mismatch within healthcare delivery; to redefine the roles of health professionals and to produce evidence of positive impact on the people’s health status. An important part of this is that students and teachers reflect the socio-demographic characteristics of the reference population.

IFMSA believes that the ground basis of social accountability for medical schools must involve all stakeholders from health students, community members and physicians to education institutions, health systems and governments. For medical schools to become more socially accountable, this requires improvement and reform of the curricula to respond to current and future health needs and challenges in society, reorient their education, research and service priorities accordingly, strengthen governance and partnerships with other stakeholders, and use evaluation and accreditation to assess performance and impact.

32

Medical Education IFMSA therefore called on its NMOs and medical students to: · Collaborate globally on a national and international level, to give all students worldwide a chance to make a change. · Engage in national and international fora and student organizations in order to exchange ideas on the challenges they face and discover new solutions in partnership with others. · Play an active role in all aspects of quality assurance of Social Accountability. Students should not only be given the opportunity to contribute by providing data, but be included in analysis, interpretation, dissemination and implementation of the results. Students must be included as full members of expert committees involved in accreditation of institutions. · Make fellow students aware of local and international conferences that they can attend, give students a chance to grow in their leadership skills and let them lead working groups and motivate students to take on active roles within student organizations locally and globally. · Create activities to build capacity and raise awareness among medical students in Social Accountability with the ultimate goal of developing more community-based activities and raising public awareness.

International contributions

The IFMSA General Assembly August Meeting 2018 focused on Social Accountability as its theme, bringing together several experts from various areas together in two panel discussions, spread over two days. Participants had the chance to hear about the interlinkage between social accountability and research, accreditation, university service activities, curriculum planning and how student organizations such as IFMSA can advance social accountability in medical schools. During the second event, participants also had the opportunity to work in small groups and draft IFMSA’s 2018/2020 Action Plan on Social Accountability, the guiding document for the Federation in this field.

Reaching around a 1000 medical students’ from 100 countries

33

Medical Education Second, the Social Accountability workshop was organized for the first time in August 2018 and consisted of 3 full working days. Participants learned and discussed about the basics & values of social accountability, why we need to widen access to medical & health professions education and what methods can contribute towards this. Participants also identified how to make university curricula more socially accountable towards societies and contribute towards Universal Health Coverage. The workshop resulted in the IFMSA Social Accountability Pledge.

11 participants from 6 countries participated in the pilot version.

Last, in 2017, IFMSA together with the Training for Health Equity Network (THEnet) prepared free, online platform for young advocates to support them in their work on social accountability. The platform includes resources such as training materials, infographics, advocacy letters, an informative video as well an assessment tool for faculties. As of 2019, the toolkit has now been translated into 3 more languages: Spanish, French and Arabic and the Federation is already working on more versions, to make sure the toolkit reaches every corner the world.

The toolkit languages

34

is

available

in

4

a

as

o f

Medical Education National Contributions

Almost half of NMOs contribute specifically towards ensuring equal access to (medical) education or towards broader social accountability of their institutions (Figure 10). 27 NMOs work towards the first and 34 NMOs towards the latter. While all regions have activities contributing to the topic, proportionally the most active NMOs are situated in the Americas and Eastern Mediterranean regions (figure 11).

Figure 10. Â Proportion of National Member Organization working on Social Accountability and/or equal access to Medical Education

Figure 11. Number of National Member Organizations working on Medical Education distributed per Topic and Region

35

Medical Education National Case Examples JAMSA, Jamaica

The Jamaican Medical Students’ Association (JAMSA) launched its programme in Social Accountability in 2017 with a series of student volunteer interprofessional health fairs in rural and underserved Jamaica. An abstract on the qualitative analysis of participants was presented at Beyond Flexner 2018 and The Network: Towards Unity For Health 2018 conferences. The National Officer on Medical Education was sponsored to attend IFMSA’s inaugural workshop on Social Accountability and was a Theme panelist at the General Assembly. In 2018 a research project was initiated to survey JAMSA members using the IFMSA Social Accountability toolkit and the National Officer was invited by the medical school Dean of the UWI Mona Campus to present to the admissions committee on ‘Socially Accountable Admissions Policy’. Interprofessional student health fairs continue and future plans include collaborating with the Trinidad and Tobago Medical Student Association on the role of Social Accountability in addressing Global Health Workforce issues in the Caribbean Community.

The project was presented at two conferences IFMSA-Peru, Peru

Last year, in the National General Assembly of IFMSA Peru, a session about Social Accountability took place. This event brought medical students from different universities across Peru together.

The training helped the participants to understand the importance of Social Accountability and the deficiencies that are seen at the national level. It motivated the participants to become active in social accountability, beginning at the local level in their own faculties by introducing this topic to their respective authorities. Follow up plans from these session are to be executed in the following months.

The session involved 32 participants from 11 universities

36

Sexual and Reproductive Health and Rights Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes

Indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods

Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences Indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care

Introduction

The Universal Declaration of Human Rights describes health as a core human right, and that an intrinsic principle of health is autonomy. Reproductive health is an important aspect of health and wellbeing. It is a woman’s human right to have full autonomy over decisions relating to when and how many children to have. It is our collective priority to ensure that there will be safe avenues for her to enact this choice. Effective access to sexual and reproductive health care helps to reduce millions of unintended pregnancies and ensures access to safe abortion.

Comprehensive Sexuality Education (CSE) is a curriculum-based and age-appropriate process of teaching and learning about sexualit, including cognitive, emotional, physical and social aspects.

The aim of CSE is to equip students - especially children and adolescents - with knowledge, attitudes, skills and values empowering them to realize and actively take care of their health, well-being and dignity. It aims to develop social and sexual relationships based on respect, raise awareness on the impact of own choices on both own and others’ well-being, as well as to ensure protection of their rights throughout their lives.

The IFMSA acknowledges the relevance of Comprehensive Sexuality Education for ensuring the respect to sexual and reproductive rights in the different stages of the life cycle. IFMSA believes the inclusion of CSE in the national curricula will help youth to have a healthier sexual and reproductive lives, free from stigma and discrimination.

37

Sexual and Reproductive Health and Rights IFMSA therefore called on its NMOs and medical students to: · Reaffirm their commitment and belief that all women should have full access and autonomy over the range of their reproductive and sexual rights, including safe abortion services. These services should be affordable, legal and free of stigma and discrimination; · Advocate for and work towards full access and autonomy for reproductive health and rights; · Educate themselves by providing evidence-based resources on the benefits of CSE and its provision for young people; · Encourage, advocate for and develop student-led peer education programs and projects that are evidence based, have sex positive, human rights based and empowering approach, are age appropriate, delivered by trained facilitators and, whenever applicable, follow local, national or international guidelines on CSE provision.

International Contributions

As a collective effort between Ipas and IFMSA that aims to increase IFMSA members’ awareness of, experiences with and ability to effectively advocate for women and adolescents reproductive health, especially safe abortion a strategy on women’s and adolescents’ reproductive health and safe abortion was created. A main part of this strategy is to deliver international workshops to IFMSA members.

The focus of this workshop is to advance the development of a network of safe abortion advocates within the federation. The training covers several related topics; for example: human, sexual and reproductive rights; abortion laws and policies; barriers to access care, including stigma; safe abortion methods; and identification and referral of women with abortion-related complications. The curriculum also includes information and activities on values clarification for abortion attitude transformation, as well as youth participation and leadership.

The workshops were held in 4 regions and during one IFMSA General Assembly with a total of 52 participants

Moreover, for International Sexual and Reproductive Health and Rights (SRHR) Awareness Day IFMSA organized an international campaign. The campaign was focused on raising awareness towards SRHR both as an IFMSA priority and as a relevant global health topic. For everyone, simple infographics were created, which had the purpose to explain what SRHR is, to show how it can impact people’s life on a global level and to describe the actions made so far by IFMSA, its members and its biggest partners as the WHO, UNFPA and Ipas. Furthermore, one of the infographic was made to have interactive feedbacks from IFMSA members commenting with SRHR-related facts in their country.

38

Sexual and Reproductive Health and Rights Additionally a set of different Facebook profile pictures frames were provided, each one containing a way SRHR can impact our daily life to increase participation. Finally, to give adequate conclusion to the campaign, a webinar on SRHR was delivered.

Around 1000 profile pictures were created

Last, IFMSA organizes SCORA Xchange: a unilateral exchange program for IFMSA members focused on Sexual and Reproductive Health and Rights. The goal of this program is to provide the participants with information about the social and health care situation and strategies of the hosting country on the previously mentioned topics; emphasizing on the importance of global health as well as encouraging the intercultural exchange and discussions between them.

SCORA X-change involved 90 participants and 92 organizing members last year National Contributions

Three quarters of NMOs work towards the promotion and access to Sexual and Reproductive Health and rights (figure 12). Of those 91 NMOs a great majority of 75 NMOs specifically work towards target 5.6 and indicator 5.6.1 organizing activities to empower women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care. All regions are very active on the topic, but especially the African region with almost 90% of its NMOs working on this topic (figure 13).

Figure 12. Proportion of National Member Organizations working on Sexual and Reproductive Health and Rights

39

Sexual and Reproductive Health and Rights

Figure 13. Number of National Member Organizations working towards Sexual and Reproductive Health and Rights distributed per Region

National Case Examples MSAKE, Kenya and IMCC, Denmark Project Respect

Project RESPEKT aims to ensure increased awareness of and education on SRHR amongst teenagers in Kenya and other relevant stakeholders, such as NGO’s. The main health challenge that this project addresses is inadequate and unequal access to SRHR education amongst the Kenyan youth. The project applies a rights-based approach in combating the harmful cultural practices, gender–based violence, and lack of relevant and accurate information on SRHR among the targeted youth in Kenya. The primary target group is boys and girls aged 13-19 in secondary schools located in the Local Committee areas of MSAKE and the other areas of Kenya will have virtual access through the project website.

The project has the following objectives: · Create and deliver an evidence-based curriculum that divides SRHR into specific units to improve levels of knowledge on SHRH and gender-related issues among targeted Kanyan teenagers; · Create a webpage that offers a larger outreach and more interactive approach towards SRHR education, counseling and access to services; · Develop and execute an advocacy strategy.

This project is a collaboration between 2 NMOs from different regions

40

Sexual and Reproductive Health and Rights IFMSA-Japan, Japan The Peer Education Project

IFMSA Japan has three activities for keeping access to sexual and reproductive health and rights. Firstly, we visit many schools in Japan and learn together with students about sexual topics including Sexually Transmitted Infections (STIs), pregnancy and abortion. The target group ranges from elementary school to high school. In total 13 schools were visited last year in which a total of 2600 students were given a lecture. After some of the lectures a before and after questionnaire revealed that almost 90% of students not only improved, but even answered almost all questions correctly in the after questionnaire.

Secondly, we have participated in the Tokyo Rainbow Pride for 7 years. Lastly, we started project for preventing STIs because the number of STI patients is increasing now in Japan, but many Japanese people don’t have enough knowledge about the disease. To improve that condition, we make card games so that young people can learn easily about the disease.

The projects reached around 2600 students across Japan

Associa-Med, Tunisia Comprehensive Sexuality Education

Caught between strong family ties, religious values and exposure to sexual content through television, the majority of adolescents lack the accurate knowledge required to make decisions related to their sexual responsibility, leaving them vulnerable to coercion, STIs and unintended pregnancy. In Tunisia, the latest studies have estimated that only 19,1% of girls aged between 15 and 24 are informed about HIV knowing that the age of the first-time sex is around 17 which is an alarming situation that pushes us to take action as soon as possible.

Based on a peer-to-peer youth education that uses a combination of experiential learning methods, ‘edutainment’ and social media, this workshop consists of delivering one or a series of sessions in different high/middle schools around the country to teenagers aged between 15 and 20 years old about maternal health and access to safe abortion, gender based violence, and STIs, including HIV to enable young people to exercise their sexual and reproductive rights.

Objectives of this project were set as follows: · Provide young people with the tools to make reasonable decisions and build healthy relationships · Help youth delay onset of sexual activity, reduce the frequency of unprotected sexual activities and increase condom and contraceptive use. · Foster respect for human rights and diversity as a way to reduce stigma and discrimination · Communicate a positive, life-cycle approach to sexuality · Help strengthen communication skills and decision-making abilities through including participatory teaching methods · Provide honest, effective sex education – not ineffective, shame-based abstinence-only programs that usually create a distance between the educator and the young people in order to rebuild trust in sex education.

41

MEDSAR, Rwanda World AIDS Day Training

A lack of knowledge of how HIV/AIDS can be prevented in the native language, how to advocate for HIV/AIDS prevention and how to use condoms and existing laws and rights on sexual and reproductive health by health care related students was noticed. Therefore, a capacity building training was organized for university students to be able to go out there and teach about how to use condoms and prevent HIV/AIDS and other STIs. The main auditorium of the school of medicine and pharmacy was used for the workshop and discussions, demonstrations and group talks were used to make the workshop productive and more enjoyable. The follow-up data witnessed many volunteers being empowered afterwards and went on teaching on HIV/AIDS prevention and condom use in their native languages.

The capacity building workshop reached 250 students

Gender Equality

Target 5.5: Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life

Indicator 5.5.2: Proportion of women in managerial positions

Target 16.7: Ensure responsive, inclusive, participatory and representative decisionmaking at all levels

Indicator 16.7.1: Proportions of positions (by sex, age, persons with disabilities and population groups) in public institutions (national and local legislatures, public service, and judiciary) compared to national distributions

42

Gender Equality Introduction

According to the current understanding, gender is an umbrella term for norms and roles determining which characteristics and behaviours are perceived masculine or feminine and hence considered appropriate for men or women according to societal beliefs. Contrary to our biological sex - male or female - gender is a social construct that varies across societies and changes with time.

While gender inequality refers to the undeniable differences between the variety of sexes and genders, gender inequity is an unfair inequality, an obstacle to a person’s enjoyment of rights and opportunities based on their gender identity or expression. Moreover, individuals who do not follow established gender norms and women often face severe stigma and discrimination and are more vulnerable to gender inequity. Gender inequity exists in the social determinants of health, including levels of exposure to disease and injury; investment in nutrition, care and education as well as access to and utilisation of health services. Gender-based social exclusion and discrimination also have direct adverse effects on physical, social and psychological health. Improving gender equity in health is therefore one of the most direct and potent ways to reduce health inequalities and ensure effective use of health resources. Since the health impacts of gender relations are multidimensional, they cannot be addressed through a traditional binary male-female approach.

This further calls for both healthcare systems and societies to aim for an inclusive, sensitive and non-binary perception of gender identities.

IFMSA emphasises gender equity as an essential factor to ensure the human right to health: this includes one’s freedom to control one’s health and body and the entitlement to a health system that protects and grants equal opportunities to everyone. As future healthcare providers, we are committed to supporting gender equity within and outside of medicine as it is a prerequisite to fulfilling The Universal Declaration of Human Rights which stipulates that everyone is entitled to human rights “without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.”

IFMSA therefore called on its NMOs and medical students to:: · Promote awareness on the health impacts of gender inequity at both individual and collective levels. · Promote awareness on the consequences of gender inequity in the medical profession, especially for women, and non-cisgender people. · Develop strategies that actively promote educational and leadership opportunities for all medical students, irrespective of their gender. · Promote the usage of gender inclusive language and pronouns in all internal processes and reform official documents in order for them to be entirely gender sensitive. · Actively engage in peer education programs to increase their competences on gender related issues.

43

Gender Equality International contributions

The IFMSA Gender Representation Strategy 2018-2019 aims to provide a robust and comprehensive analysis of the representation of people of different genders within the IFMSA, at a national, regional and international level. Activities undertaken as part of the Gender Representation Strategy include collecting data about the gender distribution of leadership at the national level and performing ‘gender watches’ at meetings to assess the speaking time of people from different genders, countries and regions. This year-long analysis will inform the development of targeted interventions to improve representation and participation of people from different genders, countries and regions within the IFMSA. Data has been collected at 3 Regional Meetings and one General Assembly so far. Data will be collected at a further two more Regional Meetings and one more General Assembly.

Data from 1600 meeting attendees and 124 NMOs has been collected

Additionally, IFMSA’s General Assemblies always have a theme to which the academic part of the program relates to. To advance our work on Gender Equality and related SDGs, we have decided to conduct the Theme event of our March Meeting 2019 on the topic of ‘’Gender & Health’’. Two events in form of a panel discussion and a debate took place in Portorož, Slovenia, featuring highlevel experts from the WHO, Women in Global Health, and academic & community leaders in the area of gender & health. Medical students were extremely interested in discussions around gender equality, the role of gender in healthcare settings, discrimination and counter-solutions for transgender and other non-binary communities. We have witnessed several proposals for concrete actions on national and local levels and relevant IFMSA Officials do closely follow up on these developments.

The theme event reached around 1000 medical students from 100 countries

44

Gender Equality Furthermore, for International Women’s Day a team of 10 medical students from 4 different regions worked on training session outlines, an argumentation Package “The Right to Equality”, infographics, a vídeo for a social media campaign among other actions in order to raise awareness among medical students of gender inequalities in the medical fields, gender as a Social Determinant of Health and understand its relation with other social determinants of Health. They aim to create a capacity building space for students to gain knowledge and skills to work against the gender inequalities that exist, both on interpersonal and structural level with an intersectional approach.

15 social media posts with a reach of over +20k have been created

National contributions

Over 85% of our NMOs either agree or strongly agree that their organisation adheres to target 5.5 in terms of equal opportunities for leadership (figure 14). Just around 40% of NMOs implemented measures such as policy documents to reach this and 15% even specifically mentioned that equal opportunities were reached without the need of an intervention in their organisation (figure 15).

When looking at the number of women in leadership within NMOs in comparison to the national distribution it interestingly shows that the leadership of over 30 NMOs resembles the national gender distribution and that in over half of NMOs there are relatively more women in leadership than their proportion in the country (figure 16).

45

Figure 14. Attitudes of National Member Organizations towards equal opportunities within their own organizations.

Figure 15. Proportion of NMOs actively working towards Equal Opportunities within their NMOs

Figure 16. Distribution of gender in leadership in National Member Organization in comparison to the national distribution plotted from the perspective of women in leadership positions in percentages.

46

Capacity Building Target 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development.

Introduction

Youth, as one of the biggest demographics on earth, are undoubtedly an important agent of positive change in the world. They are the backbone of the future and the new leaders of tomorrow.

Through active participation, youth are empowered to play a vital role in their own development as well as in that of their communities. They offer refreshing and innovative ideas reflecting the need and concerns of future generations. Throughout the years, they have been calling out for more civic, economic, political and social involvement. However, worldwide, youth face multiple challenges in terms of access to equal opportunities and involvement in decision making processes which affect their lives and future. These challenge withholds them to participate in a meaningful way, which requires that individuals are entitled to participate in the decisions that directly affect them, including design, implementation, and monitoring of interventions. This is often a result of lacking the proper tools, education, employment and resources to participate effectively.

IFMSA therefore called on its NMOs and medical students to: · Develop the necessary skills and acquire the knowledge which enables them to take an active role as youth and positively influence the meaningful contribution of youth in their communities. · Equip IFMSA members with the appropriate knowledge of SDGs, through activities such as capacity building workshops, webinars, volunteer or internship opportunities, and through social media and communication platforms with infographics and other forms of promotions, and create meaningful youth networks;

International contributions

One of the biggest global health capacity building and advocacy events of the year is the IFMSA Youth Pre World Health Assembly Workshop (PreWHA). This event is held in the four days prior to the World Health Assembly, the World Health Organization’s annual meeting. At the PreWHA, 50-60 young global health advocates from around the world come together to develop their knowledge on important global health topics, and their skills in effective advocacy. These topics include sustainable lifestyles, human rights and gender equality among others. Delegates are then well equipped to attend the WHA and to deliver the key messages of youth directly to government representatives from around the world.

47

Capacity Building

In 2018 the PreWHA was attended by 55 students from 32 countries

Moreover, the Advanced Training for IFMSA Global Health Advocates Workshop is a workshop that gives IFMSA members advanced skills to perform external representation at high level meetings and advocate actively for the Sustainable Development Goals. The agenda includes topics such as policy making, UN system, external representation at the global and regional level, as well as to apply this tools in a national level. On the last day of the workshop, a simulation takes place where the participants simulate to be in a high level meeting advocating for a specific topic related to the SDGs, and they put into practice all the skills learnt.

The workshop has been held before in 3 General Assemblies and 3 Regional Meetings reaching over 70 members from over 40 countries

48

Capacity Building

Last, the appreciation of cultures is a recurrent topic in all of our Exchanges. Regularly exchanges organize trainings on Intercultural learning. The training aims to educate Exchange officer and active members of exchanges teams on how cultural differences may often bring to misunderstanding and conflicts between people. During the training, we educate students on how to overcome those barriers, how to look broader and become more tolerant and understandable, and how to prevent possible conflicts based on cultural differences.

IFMSA facilitates over 13.000 exchanges ever y year

National Contributions

All 121 NMOs that answered the question have at least done one educational or capacity building activity on the topics mentioned in target 4.7 (figure 17). The most popular across all regions is Human Rights with over two-thirds of NMOs holding an activity to build capacity on the topic.

Gender equity follows with activities in 53 NMOs. Sustainable Development, the Promotion of a Culture of Peace and Non-Violence and the Appreciation of Cultural Diversity have activities in around 40 NMOs (figure 18).

All national educational or capacity building activities reached over 10.000 participants worldwide.

Figure 17. Proportion of National Member Organization holding at least on Capacity Building activity on the topics mentioned in target 4.7

49

Capacity Building

Figure 18. Number of National Member Organization holding Capacity Building activities distributed per Topic and Region

50

Conclusion and Discussion Conclusion

Our Federation is composed of medical students, and we are not necessarily taught about the Sustainable Development Goals, but our interest and passion for global health moved us to work actively on them in many areas, from campaigns at the local level to international workshops. As a youth-led organization, we have demonstrated commitment towards the 2030 Agenda and we strongly believe that youth are prepared to lead changes in their societies to ensure no one is left behind.

This report summarizes the efforts of IFMSA from the local to the international level to achieve the SDGs. The combined efforts have reached many people and we are continuously encouraging members to exchange ideas and collaborate to create new activities. Our Global Priorities have helped us to shape our efforts in order to contribute to the SDGs.

Discussion

While this report gives a good overview of the contributions of medical students worldwide towards the SDGs, it has some limitations. The NMO report was only answered by one person per NMO and this may not reflect the whole work and activities done by the NMOs either nationally or locally. Moreover, sometimes our members do not realise they are contributing to a specific SDG and as a consequence do not report it. This both leads to underreporting of activities. Additionally, some targets and indicators are very specific and while our members have great impact on the overarching topic they address, their efforts were not applicable to the specific target and indicator set in the 2030 agenda.

One of the lessons learned therefore is that medical students need to be made more aware of the SDG indicators that are most related to their work, to be able to focus their activities’ objectives towards them, as well as the need for more training on impact assessment to determine the reach of these activities.

Overall, despite the limitations, this report demonstrates the wide variety of activities done by medical students to reach the SDGs at the international, regional, national and local level. As IFMSA, we have a clear stance to call our members to work towards the SDGs, and we will continue encouraging and helping them to exchange, develop, execute and report their activities to be young active advocates for the 2030 Agenda.

51

References

· Boelen C, Heck JE. Defining and measuring the social accountability of medical schools

Geneva:WHO; 1995; Available at: http://whqlibdoc.who.int/hq/1995/WHO_HRH_95.7.pdf.

· Oberoi, P., Sotomayor, J., Pace, P., Weekers, J. and Walilegne, Y.T. International migration,

health and human rights. 2013. International Organization for Migration (IOM).

· Watts N, Adger WN, Ayeb-Karlsson S, Bai Y, Byass P, Campbell-Lendrum D, Colbourn T, Cox

·

· ·

· · · ·

· ·

· · ·

52

P, Davies M, Depledge M, Depoux A. The Lancet Countdown: tracking progress on health and climate change. The Lancet. 2017 Mar 18;389(10074):1151-64.

World Health Organization. Global Health Observatory (GHO) data; Top 10 causes of death. 2017; Available at: http://www.who.int/gho/mortality_burden_disease/causes_ death/top_10/en/ World Health Organization. Global Health Observatory Data; Risk Factors. 2017. Available at: http://www.who.int/gho/ncd/risk_factors/en/ [accessed May 2019] World Health Organization. Global status report on noncommunicable diseases. 2014; Available at: http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf?ua=1 WHO. Gender, equity and human rights. 2017; Available from: http://www.who.int/gender-equity-right/en/ World Health Organization. Women’s Health. 2013; Available at: http://www.who.int/mediacentre/factsheets/fs334/en/ United Nations. Report of the Secretary-General on Policies and programmes involving youth. 2019 (E/CN.5/2019/5) UNESCO. Emerging Evidence, Lessons And Practice In Comprehensive Sexuality Education - A Global Review. United Nations Educational, Scientific And Cultural Organization (UNESCO), Paris, 2015; Available at: https://www.unfpa.org/sites/default/files/pub-pdf/CSE_Global_Review_2015.pdf.

UNESCO. Left behind. 2017; Available at: http://uis.unesco.org/apps/visualisations/no-girlleft-behind/#lastmile-1 United Nations Department of Economic and Social Affairs. Population Division. World Population Prospects 2017. 2017; Available at: https://population.un.org/wpp/Download/ Standard/Population/ United Nations General Assembly, Transforming our world : the 2030 Agenda for Sustainable Development, 21 October 2015, A/RES/70/1 United Nations General Assembly. Convention on the Rights of the Child. 20 November 1989 United Nations General Assembly. Universal Declaration of Human Rights. 10 December 1948

Annex 1. Overview of question asked in the NMO report Target or Indicator to measure

Question

I n d i ca t o r s 3.4.1, 3.4.2, Has your NMO worked on reducing the burden of 3.5.2 and noncommunicable diseases (cardiovascular disease, 3.1.1 cancer, diabetes and/or chronic respiratory disease) and/or the promotion of mental health in the past year by having at least one activity, capacity building event or advocacy effort?

Please give a short description of the activities, capacity building or advocacy efforts mentioned above, if any.

I n d i ca t o r s 13.3.1 and 12.5.1

Indicator 10.7.2

I n d i ca t o r s 3.2.1 and 4.2.1 Indicator 4.5.1

I n d i ca t o r s 3.7.1 and 5.6.1

53

Answer options

· My NMO does not work on this topic · My NMO works on the reduction of noncommunicable diseases

· My NMO works on mental health promotion

· My NMO works on alcohol prevention · My NMO works on tobacco prevention · Short paragraph · No, my NMO does not work on this topic · Yes, my NMO had at least one capacity

building event on climate change Has your NMO worked towards education, awareness · Yes, my NMO had at least one other activity of advocacy effort on climate change and/or capacity building on climate change in the past year by having at least one activity, capacity building · Yes, my NMO works towards improving our own sustainability event or advocacy effort?

If your NMO had a capacity building event on climate · Number change, please indicate the number of participants · No, my NMO does not work on this topic Has your NMO worked on ensuring the implementation · Yes, my NMO has worked on ensuring of orderly, safe, regular and responsible migration orderly, safe, regular and responsible policies in the past year by having at least one activity, migration capacity building event or advocacy effort?

Has your NMO worked on decreasing deaths of · No, my NMO does not work on this topic newborns and children under 5 or otherwise promoting · Yes, my NMO has worked on promoting health for children under 5 children’s health in the past year by at least one activity, capacity building event of advocacy effort? · No, my NMO does not work on this topic · Yes, my NMO has worked on Social Accountability, but has not specifically worked towards ensuring equal access Has your NMO worked on Social Accountability in Medical Schools, specifically focussing on ensuring · Yes, my NMO has specifically worked towards ensuring equal access to equal access to education, in the past year by at least education one activity, capacity building eent or advocacy effort? · No, my NMO does not work on this topic · Yes, my NMO has worked on enabling woman aged 15-49 to make informed decisions regarding sexual relations, Has your NMO worked on the promotion of and contraceptive use and reproductive care access to sexual and reproductive health and rights by enabling woman aged 15-49 to make informed · Yes, my NMO has worked on sexual and reproductive health and right in other decisions regarding sexual relations, contraceptive use ways than mentioned in b and reproductive health care in the past year by at least · Both option 2 and 3 one activity or advocacy effort?

Please give a short description of the activities, capacity building or advocacy efforts mentioned above, if any. · Short paragraph

Annex 1. Overview of question asked in the NMO report · · · · ·

Target 4.7

Has your NMO worked on education or capacity building in the following topics in the past year? Check all that apply. · Please indicate how many participants you had in the education or capacity building mentioned in the previous question. · Indicators 5.5.2 and 16.7.1

54

Sustainable development Sustainable lifestyles Human rights Gender equality Promotion of a culture of peace and non-violence Appreciation of cultural diversity Number

What percentage of the current leadership group of your NMO, including national officers (if your NMO has them), identify as women?

· Number from 0-100

Does your NMO have a policy document on gender equity/ representation?

· Yes · No

Does your NMO have specific policies (in e.g. its Constitution or Bylaws) with measures to promote gender equity

· Yes · No

In addition to the above two questions, has your NMO addressed gender representation/equity in other ways?

Please describe.

· Short paragraph

To what extent do you agree with this statement: In my NMO, all people, regardless of their gender, have the same opportunity to have leadership positions.

· · · · ·

Strongly disagree Disagree Neutral Agree Strongly agree

Annex 2. Overview of activities per National Member Organization

Country, NMO

Ragion

Noncommunicable diseases

Indicator 3.4.1 Reducing the burden

Inidcator 3.4.2 Mental Health

Algeria, Le Souk

Eastern Mediterranean

x

x

Argentina, IFMSA-Argentina

the Americas

x

x

Aruba, IFMSA-Aruba

the Americas

Australia, AMSA

Asia Pacific

Climate Change Migration and Health

Indicator 3.4.2 Alcohol prevention

Indicator 3.a.1 Tobacco prevention

x

Europe Europe

x

Bangladesh, BMSS

Asia Pacific

x

Belgium, BeMSA

Europe

Bolivia, IFMSA-Bolivia

the Americas

Bosnia and Herzegovina, BoHeMSA

Europe

x

x

x

x

x

x x

x

x

x

x

x

x

x

Brazil, DENEM

the Americas

Bulgaria, AMSB

Europe

x

Burkina Faso, AEM

Africa

x

Burundi, ABEM

Africa

x

Cameroon, CAMSA

Africa

Canada, CFMS

the Americas

x x

x

x

x

China, IFMSA-China

Asia Pacific

x

x

China - Hong Kong, AMSAHK

Asia Pacific

x

the Americas the Americas

x

x

Europe

x

x

Cyprus, CyMSA

Europe

x

x

x

Europe

x

x

the Americas

x

x

Ecuador, AEMPPI

the Americas

x

x

Egypt, IFMSA-Egypt

Eastern Mediterranean

x

x

El Salvador, IFMSA-El Salvador

the Americas

x

x

Estonia, EstMSA

Europe

x

x

Finland, FiMSIC

Europe

Ghana, FGMSA

Africa

x

Greece, HelMSIC

Europe

x

the Americas

Guatemale, IFMSA-Guatemala

the Americas

Guinea, AEM

Africa

Guyana, GuMSA

the Americas

Haiti, AHEM

the Americas the Americas

x

Europe

x

Europe

x

x

x

x

x

x

x x

x x

x

x

x

x

x x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

2.7

28

-22.2

x

Korea, KMSA

Asia Pacific

Kosovo - Serbia, KOMS

Europe

x

x

Kuwait, KuMSA

Eastern Mediterranean

x

x

Europe

x

x

x

Eastern Mediterranean

x

x

x

x

x

Lithuania, LiMSA

Europe

Luxembourg, ALEM

Europe

x

Malawi, UMMSA

Africa

x

x

Malaysia, SMMAMS

Asia Pacific

x

x

x

x

Mali, APS

Africa

x

x

x

x

x

x

x

Europe

x

x

x

x

x

x

x

Eastern Mediterranean

x

x

x

Asia Pacific

x

x

x

Europe

x

Nigeria, NiMSA

Africa

x

Norway, NMSA

Europe

x x

x x

Oman, MedSCo

Eastern Mediterranean

x

x

Pakistan, IFMSA-Pakistan

Asia Pacific

x

x

x

Panama, IFMSA-Panama

the Americas

x

x

x

x

Philipines, AMSA-Philipines

Asia Pacific

x

x

Poland, IFMSA-Poland

Europe

x

Portugal, ANEM

Europe

Qatar, QMSA

Eastern Mediterranean

x

x

x

x

x

x

x x

x

x

x

x

x

x

x

x

x

x x

x

x x

x

x

x

Republic of North Macedonia, MMSA

Europe

x

x

x

Romania, FASMR

Europe

x

x

x

Russian Federation, HCCM

Europe

x

x

x

x

x

x

x

x

x

Sierra Leone, SLEMSA

Africa

x

Singapore, SiMSA

Asia Pacific

x

Slovakia, SloMSA

Europe

x

Slovenia, SloMSIC

Europe

x

x

South Africa, SAMSA

Africa

x

x

x

x x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x

x x

x

Asia Pacific

x

x

x

Thailand, IFMSA-Thailand

Asia Pacific

Togo, AEMP

Africa

Trinidad and Tobago, TTMSA

the Americas

Tunisia, Associa-Med

Eastern Mediterranean

x

x

Turkey, TurkMSIC

Europe

x

x

Turkey - Northern Cyprus, MSANC

Europe

x

x x

x

x

x

x

x

x

Africa

x x

x

United Kingdom of Great Britain and Norther Ireland, SfGH

Europe

x

United States of America, AMSAUSA the Americas Asia Pacific the Americas

x

Eastern Mediterranean

x

Zimbabwe, ZIMSA

Africa

x

x

x x

x x

x

x

x

x

x

x

x

x

x

x x

x x x

x

x

x

x

x

x

x

x

x

x

x

x

x x

x

x

x x

x

x

x

x

x

x

x

70

16.4

x

66

12.5

42

x

x

x

x

9

30

-21

50

-1.1

20

-30.5 -0.6 8.6 -0.9

53

2.1

x

x

32

-18

x

x

83

33

71

20.5

x

57

7.6

x

47

-3

30

-19.7

x

70

18.8

x

56

5.8

32

-18.7

35

-15.6

44

-6.8

x x

x

x

53 x

x

x

10 60

x

x

x x x

-9

60

50

x

x x

-2

x

x

x

25.4

x x

x

x

4.4

50

22.6

x

x

x

7.3

57

x

x

x

-15 19.4

73

x

x

35 69 59

x x

x

x

3.8 13.1

-6

x

x

x

x

4.8

52 63

60

x

x

x x

20.3

9.5

x

x x

24.7 -24.3

50

x

x

75 25 70

44

x x

x

-13.5 -20.5

61

x

x

x

13.3

37 31

50

x

x

-5.8 -8.2

40

x x

x

x

Venezuela, FEVESOCEM

x

x

x

x

Yemen, NAMS

x

x

x

x

x

-17

44 42 64 x

x

x

Europe

x

x

x

x

Ukraine, UMSA

x

x

x

x

x

Uganda, FUMSA

x

x

x

x

x

-18.3

x

x

x

x

-0.5

30 33

x

x

-13.8

50

x

x

x

38.1

36

x

x

x

-4.8

92

x

x

x

35.9

x

x

x

90

x

x

x

8.9 3.4

x

x

x

x

x

0.1

46

x

x

x

Africa

x

x

x

Europe

x

60

45

x

x

x x

x

x

x x

50

x

x

x

Sudan, MedSIN

Asia Pacific

13.7

x

x

Taiwan - China, FMS

15.4

x

x

x

x x

x

x

Tajikistan, TJMSA

-32.3

64

x

x

Sweden, IFMSA-Sweden

x

x

x

x

x x

x

x

x

Russian Federation - Republic of Tartastan, TaMSA Europe

17 67

x

x

x x

x x

x

x

x

x

6.6

x

x

x

x

x

-0,4

x

x

x

x

10.6

x

x

x

x x

-17.4

18.7

x

x

32 60

70

x

x

-21.7

x

x

x

x

0.4

28

5.8

x

x

16.8

-1.1

x x

65 50

56

x

x

50.2

50

x

x

27.5

x

x

x

Morocco, IFMSA-Morocco Nepal, NMSS

-3.1

80

57

x

x

47 100

50

x

x

x

29.5

x

x x

80

x

x

x

33.4

x

x x

5.1

83

x

x

x

x

x

7.2

55

x

x

x x

the Americas

x

x

x

-5.8 23.2

x

x x

45 73

x

x

Latvia, LaMSA

Malta, MMSA

x

x

Lebanon, LeMSIC

Mexico, AMMEF-Mexico

x

1.1

x

x

x

no data

x

x

x

x

no data

x

x

x

x

18.2

12.2

x

x

x

x

x

17.8

69 52

x

no data

x

2

71

63

x

x

x

x x

x

x x

x x

x

x x

x

55

55

x

x

-36.4

58

x

no data

7

13

x

x x

x

24.7 29.8

57

x

x

x

75 80

x

x

x

x

Uzbekistan, Phenomenon

x

x

x

no data

x

Syrian Arab Republic, SMSA

x

x

x

x

x

Europe

x

x x

x

x

x

no data

x

Eastern Mediterranean

x

x

x

Switzerland, swimsa

x

x

x

Europe

x x

x

x

Spain, IFMSA-Spain

x

x

x

x x

no data

x

Europe

x

x

x

x

Serbia, IFMSA-Serbia

x

x

x

Africa

x

x

Asia Pacific

Senegal, FNESS

x

no data

Africa

Africa

x

x

Kazakhstan, KazMSA

the Americas

x

x

Kenya, MSAKE

Rwanda, MEDSAR

x

x

x

-0.8

-10.9

x x

x

x

50

40

x x

x

x

Saint Lucia, IFMSA-Saint Lucia

28.2

x

x

x

Europe

18.5

82 x

x

x

x

Republic of Moldova, ASRM

-4.5

67

3

x

x

34.6 28.1

x

x

x

the Americas

x

85 79 46

x

x

no data

3.2

0.1

x

x

-5.2

50

x

x

20.6

45

x

x x

49.2

72

x

x

x

100

x

x

x

7.2

17.2

x

x

-5.9

69

x

x

3.1

45 58

53

x

x

24.1

54

x

x

x

x

14.2

74

x

x

x

65

54

x

x

x

x

17.5

10

x

x

67

-3.4

x

x

29.8

47

x

x

1

80

x

x

x

9.8

52

60

x

x

60

x

x

x

x

x

x

x

x

Peru, IFMSA-Peru

x

x

x

x

x

x

x

x

Netherlands, IFMSA-NL

x

x

x

x

x

x

Europe

x

x

x

x

x

x

x

x

x

Montenegro, MoMSIC

x

x

x

x x

x

Eastern Mediterranean

Jordan, IFMSA-Jo

x x x

x

Iraq, IFMSA-Iraq

Asia Pacific

x x

x x

Iraq - Kurdistan, IFMSAKurdistan

the Americas

x

x

x

Eastern Mediterranean

Eastern Mediterranean

x x

x

Asia Pacific

Japan, IFMSA-Japan

x

x

Iran, IMSA

Jamaica, JAMSA

x

x

Asia Pacific

Europe

x

x

Eastern Mediterranean

Italy, SISM

x x

x

Indonesia, CIMSA-ISMKI

Europe

x

x x x

x

Honduras, IFMSA-Honduras

Europe

x

x

Iceland, IMSA

Ireland, AMSI

x

x x

x

Hungary, HurMSIC

Israel, FIMS

x

x x

x

x

x

x

x x

Grenada, IFMSA-Grenada

India, MSAI

x

x

Europe Europe Europe

x

x

x

Denmark, IMCC Dominican Republic, ODEM

18.9 -22.5

x

x

x

-13.5

x

x

x

36 30

x

x

x

Costa Rica, ACEM Croatia, CroMSIC

x

70

x

x

Europe

x

Indicator 16.17.1

x x

x

x

x

the Americas

France, ANEMF

x

x

Catalonia - Spain, AECS

Promotion of a Appreciation of Indicator 5.5.2 culture of peace cultural diversity % woman in and nonleadership, violence

x

x

x

x

x

Gender equility

x x

x

Chile, IFMSA-Chile

Georgia, GMSA

x

x

x

x

Human rights

x

x

x

Europe

Germany, bvmd

x

x x

Gender equality

Sustainable lifestyles

x

x

the Americas

Europe

Capacity building

Sustainable development

x

Bosnia and Herzegovina Republic of Srpska, SaMSIC

Czech Repulbic, IFMSA-CZ

SRHR

Indicator 3.7.1 and 5.6.1

Indicator 4.5.1

x

x

Brazil, IFMSA-Brazil

Colombia, ASCEMCOL

Medical Education

Social Accountability

x

x

Austria, AMSA

the Americas

Childrens' Health

Indicator 10.7.2 Indicator 3.2.1 and 4.2.1

x

Azarbaijan, AzerMDS

Canada - Québec, IFMSAQuébec

Indicator 3.9.1

x

x

2.2 -40.3 6.2

61

10.3

69

18.5

63

12.8

50

-0.2

25

-24.5

45

-6.3

IFMSA

International Federation of Medical Students’ Associations

Algeria (Le Souk)

Dominican Republic (ODEM)

Lebanon (LeMSIC) Libya (LMSA)

Senegal (FNESS)

Ecuador (AEMPPI)

Lithuania (LiMSA)

Serbia (IFMSA-Serbia)

Egypt (IFMSA-Egypt)

Luxembourg (ALEM)

Sierra Leone (SLEMSA)

Malawi (UMMSA)

Singapore (SiMSA)

Aruba (IFMSA-Aruba)

El Salvador (IFMSA-El Salvador)

Malaysia (SMMAMS)

Slovakia (SloMSA)

Australia (AMSA)

Estonia (EstMSA)

Mali (APS)

Slovenia (SloMSIC)

Austria (AMSA)

Ethiopia (EMSA)

Malta (MMSA)

South Africa (SAMSA)

Azerbaijan (AzerMDS)

Finland (FiMSIC)

Mexico (AMMEF-Mexico)

Spain (IFMSA-Spain)

Bangladesh (BMSS)

France (ANEMF)

Montenegro (MoMSIC)

Sudan (MedSIN)

Belgium (BeMSA)

Georgia (GMSA)

Sweden (IFMSA-Sweden)

Bolivia (IFMSA-Bolivia)

Germany (bvmd)

Morocco (IFMSAMorocco)

Bosnia & Herzegovina (BoHeMSA)

Ghana (FGMSA)

Nepal (NMSS)

Greece (HelMSIC)

The Netherlands

Syrian Arab Republic (SMSA)

Grenada (IFMSAGrenada)

(IFMSA NL)

Taiwan - China (FMS)

Nigeria (NiMSA)

Tajikistan (TJMSA)

Norway (NMSA)

Thailand (IFMSAThailand)

Argentina (IFMSAArgentina) Armenia (AMSP)

Bosnia & Herzegovina – Republic of Srpska (SaMSIC) Brazil (DENEM)

Guatemala (IFMSAGuatemala)

Brazil (IFMSA-Brazil)

Guinea (AEM)

Bulgaria (AMSB)

Guyana (GuMSA)

Burkina Faso (AEM)

Haiti (AHEM)

Burundi (ABEM) Cameroon (CAMSA)

Honduras (IFMSAHonduras)

Canada (CFMS)

Oman (MedSCo)

Switzerland (swimsa)

Pakistan (IFMSAPakistan)

Tanzania (TaMSA)

Panama (IFMSAPanama)

Trinidad and Tobago (TTMSA)

Paraguay (IFMSAParaguay)

Tunisia (Associa-Med)

Hungary (HuMSIRC)

Canada – Québec (IFMSA-Québec)

Iceland (IMSA)

Peru (IFMSA-Peru)

India (MSAI)

Peru (APEMH)

Turkey – Northern Cyprus (MSANC)

Catalonia - Spain (AECS)

Indonesia (CIMSA-ISMKI) Iran (IMSA)

Philippines (AMSAPhilippines)

Uganda (FUMSA)

Chile (IFMSA-Chile) China (IFMSA-China)

Iraq (IFMSA-Iraq)

Poland (IFMSA-Poland)

China – Hong Kong (AMSAHK)

Iraq – Kurdistan (IFMSAKurdistan)

Portugal (ANEM)

United Arab Emirates (EMSS)

Colombia (ASCEMCOL)

Ireland (AMSI)

Costa Rica (ACEM)

Israel (FIMS)

Republic of Moldova (ASRM)

United Kingdom of Great Britain and Northern Ireland (SfGH)

Croatia (CroMSIC)

Italy (SISM)

Cyprus (CyMSA)

Jamaica (JAMSA)

Republic of North Macedonia (MMSA)

United States of America (AMSA-USA)

Czech Republic (IFMSACZ)

Japan (IFMSA-Japan)

Romania (FASMR)

Jordan (IFMSA-Jo)

Democratic Republic of the Congo (MSA-DRC)

Kazakhstan (KazMSA)

Russian Federation (HCCM)

Uruguay (IFMSAUruguay)

Denmark (IMCC)

Korea (KMSA)

Dominica (IFMSA Commonwealth of Dominica)

Kosovo - Serbia (KOMS)

Kenya (MSAKE)

Kuwait (KuMSA) Latvia (LaMSA)

Qatar (QMSA)

Togo (AEMP)

Turkey (TurkMSIC)

Ukraine (UMSA)

Uzbekistan (Phenomenon)

Russian Federation – Republic of Tatarstan (TaMSA)

Venezuela (FEVESOCEM)

Rwanda (MEDSAR)

Zambia (ZaMSA)

Saint Lucia (IFMSA-Saint Lucia)

Zimbabwe (ZIMSA)

www.ifmsa.org

Yemen (NAMS)

medical students worldwide