Pre-World Health Assembly 2018 Report

IFMSA 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) Vice-President for Capacity Building Georg Schwarzl (Austria) Vice-President for PR & Communication José Chen Xu (Portugal)

The International Federation of Medical Students’ Associations (IFMSA) is a non-profit, non-governmental organization representing associations of medical students worldwide. IFMSA was founded in 1951 and currently maintains 135 National Member Organizations from 125 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.

IFMSA 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

Phone: +31 2 05668823 Email: gs@ifmsa.org Homepage: www.ifmsa.org

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Table of Contents Click on the blue circles to go to your desired section

Welcome Message Page 4

Message from the Organizing Committee Page 5

Meet the Organizing Committee Page 6

Acknowledgements Page 7

Introduction to the Pre-WHA

www.ifmsa.org

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Pre-WHA Academic Program Page 10

Steam Reports Page 12

Visibility and Social Media Page 18

Data Evaluation and Outcomes Page 19

Finances Page 21 Photos Credits : - Cover : Copyright WHO/P. Virot

Welcome Message Batool Al-Wahdani IFMSA Vice-President for External Affairs 2017-2018 vpe@ifmsa.org

Dear all, In the fast-growing world we live in, along with all increasing health and global issues, being good healthcare providers requires having a global knowledge, exchanging expertise, and learning from experts about all new global health innovations and initiatives. The PreWHA workshop provides medical, health and other professions students the opportunity to experience all these requirements to become active health advocates in their communities. In addition, it prepares them to participate actively in the World Health Assembly, which is a great opportunity to practice what they have learned through the workshop.

In PreWHA 2018, we were joined by amazing speakers from leading global health organizations and institutions. The speakers tackled important emerging health topics that we face nowadays, shared their experience with the young generation and empowered them to take active roles in these issues. In addition, participants were able to have more in depth knowledge, practice advocacy in specific streams they were interested in, and map down related events and discussions in the World Health Assembly.

It’s important to acknowledge the tremendous efforts of the Organising Committee to make this great event a reality. For more than eight months, those hard working members spared no time in working and preparing for the workshop. With the great leadership by Charlotte O’Leary and Amine Lotfi, the PreWHA workshop has been a great experience for every single participant.

The PreWHA workshop is one of IFMSA’s main events that has been held annually for several years. It is an important capacity building opportunity, in which policy, advocacy, health diplomacy, negotiations, and many other important areas that unfortunately our education systems may not prioritize, are being discussed and addressed. It’s a hub for future leaders, advocates and influencers in the world of global health. I’m very positive of the great impact the workshop has on the participants and looking forward to see how each one of them will utilize the knowledge they gained.

Warm Regards, Batool

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Message from the Organizing Committee Dear Reader, Please find here the report for the Pre-World Health Assembly 2018 that took place before the 71st World Health Assembly. It is our great pleasure to present to you the outcomes of the Federation’s foremost advocacy and external representation event.

The PreWHA is going from strength to strength, and 2018 was no exception. The IFMSA prides itself on diversity and equal opportunity for all members - this year we had a regionally representative, gender-balanced delegation of 52 delegates from 33 countries in attendance. The program had a range of high-level and engaging speakers. Delegates were given the opportunity to put their advocacy and policy skills into practice with a number of interactive workshops.

We (just!) had time to attend the WHO’s inaugural “Walk the Talk” fun run on Sunday 20th May, which was a golden opportunity for our delegates to get outside, get active, and also to show the global health community that we take our health seriously.

We are extremely proud of having the most environmentally sustainable PreWHA yet, with partially carbon offsetting the event (500 Euro), locally sourced and healthy vegetarian meals, PreWHA mugs to reduce the need for disposable cups, minimised printed materials and active transport between hostel and venue. We also not only contributed to the recycling efforts of Geneva, but also to the organic waste initiatives. It is crucial for us to uphold our values as young citizens of the world through the organisation of a sustainable conference.

We would like to thank all those within and outside of our Federation who have helped to bring this event to life. Firstly to our sponsors and partners for this event, without whom we could not have this event. Thank you to our sponsors UNAIDS and the WHO Partnership on Maternal, Newborn and Child Health (PMNCH).. We are ever grateful to the Global Health Centre of the Graduate Institute of International and Development Studies in Geneva for their ongoing support of this event. Secondly to the IFMSA Executive Board and Team of Officials who worked tirelessly to support our every effort and ensure the event was a success, and to allow us to achieve our ambitious goals. Thirdly to the National Member Organisations for their important work that they do at the local and national level, and the input they give in setting the agenda for the IFMSA external representation priorities. We would like to recognize the importance of swimsa who helped us find a free venue. Lastly to the wonderful PreWHA Organising Committee who went above and beyond the call of duty to ensure this event was a success in every way. And of course to our amazing delegates, whose innovative ideas and enthusiasm is the inspiration for this event.

We are proud to serve the Federation through developing the skills of the next generation of global health change-makers.

Ever yours, PreWHA Organising Committee

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Meet the Organizing Committee

Charlotte O’Leary, Chair

Amine Lotfi, Programme Coordinator

Elizabeth Peters, Public Relations and Media Coordinator

Sanne de Wit, Noncommunicable Diseases Stream Coordinator

Jonne Juntura, Antimicrobial Resistance Stream Coordinator

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Dominic Schmid, Vice-Chair

Patrick Walker, Universal Health Coverage Stream Coordinator

Jeremy Glasner, Logistics Coordinator

Carles Pericas Escale, Camille Pelletier Vernooy, Ending Discrimination in Treasurer Healthcare Stream Coordinator

Acknowledgements We would like to thank our partners, the Global Health Centre of the Graduate Institute Geneva, the Partnership for Maternal, Newborn and Child Health (The Partnership, PMNCH), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Swiss Medical Students’ Association (swimsa), the City of Geneva and the Geneva Youth Hostel for their continuous support to bring the PreWHA once again to a great success.

Global Health Centre, Graduate Institute Geneva The Graduate Institute is an institution of research and higher education (Master and PhD). Selective and cosmopolitan, it is located in the heart of International Geneva and specialises in the study of the major global, international and transnational challenges facing the contemporary world. It also offers professional development programmes and expertise to international actors from the public, private and non-profit sectors. The Global Health Centre (GHC), established in spring 2008 at the Graduate Institute of International and Development Studies, is unique in Europe as a research centre integrated into an institute of international relations and development. Strategically located in the heart of Geneva, the ‘health capital of the world’, the Centre focuses on combining the practice and analysis of global health at the interface with foreign policy, trade and development. The GHC examines the characteristics and mechanisms of global health governance and multi-stakeholder governance for health at the beginning of the 21st century and engages in capacity building in global health diplomacy. It also builds partnerships with a wide range of actors at international, regional and national levels.

UNAIDS UNAIDS is the leading advocate for global action against HIV/AIDS. Its mission is to guide, strengthen and support worldwide efforts to turn the tide against the epidemic. Such efforts are aimed at: preventing the spread of HIV, providing care and support for those infected and affected by the disease, reducing the vulnerability of individuals and communities to HIV/AIDS and easing the socioeconomic and human impact of the epidemic.

World Health Organization’s Partnership for Maternal, Newborn and Child Health The Partnership for Maternal, Newborn & Child Health (The Partnership, PMNCH) is an alliance of more than 1000 organizations in 77 countries from the sexual, reproductive, maternal, newborn, child and adolescent health communities, as well as health influencing sectors. The Partnership provides a platform for organizations to align objectives, strategies and resources, and agree on interventions to improve maternal, newborn, child and adolescent health.

The Partnership’s role complements the work and accountability processes of its individual members, enabling them to deliver more collectively than they would alone. This Partner-centric approach mobilizes, engages and empowers different implementing partners. It allows them to coordinate their actions and activities, and encourages and promotes mutual accountability.

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Acknowledgements Speakers

We are also eternally grateful to our speakers for supporting our program: Dr. Gaudenz Silberschmidt, Director, Partnerships and Non-State Actors, World Health Organization Dr. Michaela Told, Executive Director, Global Health Centre, Graduate Institute Geneva Dr. Ruediger Krech, Director, Health Systems and Innovation, World Health Organization Dr. Guy Fones, Acting Head, Global Coordination Mechanism on Noncommunicable Diseases, World Health Organization Ms. Diah S. Saminarsih, Director-General’s Advisor for Gender and Youth, World Health Organization Dr. Maria Neira, Director, Department of Public Health, Social and Environmental Determinants of Health, World Health Organization Dr. Diogo Martins, Policy Officer, Wellcome Trust Global Policy Team Ms. Ellie Marsh, Project Manager, Dalberg Dr. Anne Pittet, Paediatrician, MSF and University Hospital of Lausanne Dr. Yassen Tcholakov, Socio-Medical Affairs Officer, World Medical Association Junior Doctors Network Dr. Jim Campbell, Director, Health Workforce Department, World Health Organization Dr. Dudley Tarlton, Program Specialist Health and Development, United Nations Development Programme Ms. Laura Solia Shellaby, City Health Financing Lead, C/CAN 2025, Union for International Cancer Control Dr. Diarmid Campbell-Lendrum, Team Leader Climate Change and Health, Department of Public Health, Social and Environmental Determinants of Health, World Health Organization Dr. Michalina Drejza, Consultant, Reproductive Health and Research Department, World Health Organization.

Mr. Mo Barry, Global Network of Young People Living with HIV Mr. Souvik Pyne, YP Foundation Ms. Monique Long, Jamaican Youth Advocacy Network Ms. Hayley Gleeson, International Planned Parenthood Federation Mr. Michel SibidĂŠ, Executive Director, UNAIDS Mr. Marc Sprenger, Director, WHO AMR Secretariat Mr. Joseph Kutzin, Coordinator, Health Financing Policy, World Health Organization Dr. Nandita Murukutla, Vice President, Policy Advocacy and Communication, Vital Strategies Dr. Mariangela Simao, Assistant Director-General for Drug Access, Vaccines and Pharmaceuticals Dr. Otmar Kloiber, Secretary-General, World Medical Association Dr. Akihito Watabe, Health Financing Officer, World Health Organization Mr. Okiki Badejo, Public Health Researcher, Institute of Tropical Medicine in Antwerp Mr. Mirfin Mpundu, Head of ReAct Africa Ms. Lucica Ditiu, Executive Director, StopTB Dr. Roopa Dhatt, Co-Founder & Executive Director, Women in Global Health Dr. Mychelle Farmer, Chair, NCD Child and Pediatrician, American Academy of Pediatrics Dr. Ishu Kataria, Global Coordinator, Young Professionals Chronic Disease Network Ms. Jessica Renzella, Strategic Development Coordinator, NCDFREE Dr. Robert Yates, Senior Fellow and Director of the UHC Policy Forum, Chatham House Mr. Charles Antoine Barbeau, Youth Delegate, Canada Ms. Anne de Boer, Youth Delegate, Netherlands Prof. Amanda Howe, President, World Organization of Family Doctors Ms. Helga Fogstad, Executive Director of the Partnership for Maternal Newborn and Child Health.

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Introduction to the Pre-WHA

For the past 60 years, IFMSA has been engaging with the World Health Organization to promote youth engagement in global health governance.

One of the most significant events is the annual World Health Assembly (WHA), serving as the main arena for health discussions among member states and civil society.

Foster of a sense of community amongst youth coming from a variety of different, social, cultural and geographic backgrounds; Promote joint advocacy and project ideas pertaining to global health issues at local, national and international levels between various youth organizations.

Started in 2013, the Youth Pre-World Health Assembly Workshop has become an important event for the IFMSA and the broader youth community engaged in health. The event aims to educate and empower future leaders in health while developing a collaborative approach to youth participation at the World Health Assembly. Specifically, the PreWorld Health Assembly aims to:

In 2018, the PreWHA event ran from the 17th until the 20th of May, for 4 days before the World Health Assembly in Geneva. The 52 participants from all five IFMSA regions met at the Salle de Faubourg in Geneva. The overarching theme was global health diplomacy, governance and leadership, with focused streams on Noncommunicable Diseases (NCDs), Antimicrobial Resistance (AMR), Universal Health Coverage (UHC) and Ending Discrimination in Healthcare. Working together, the participants created advocacy strategies for their stream before putting their training into action at the WHA.

- Increase visibility and impact of youth participation and collaboration at the World Health Assembly by facilitating coordination of youth organizations, civil society, the WHO and its Member States; - Provide youth with a better understanding of global health governance and diplomacy, and its importance at national and global levels; - Develop skills in advocacy, health care leadership, and policy engagement towards action on global health within youth;

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Pre-WHA Academic Program May 16th was the arrival day, with a welcome dinner featuring an informal keynote address by Dr. Gaudenz Silberschmidt (Director, Partnerships and Non-State Actors, World Health Organization). The program was grouped into sessions focusing on overarching global health issues, stream-specific issues, and skills-oriented capacity-building.

Sessions on Overarching Issues: Our first session was “Introduction to Global Health Diplomacy and Governance”. Dr. Michaela Told (Executive Director of the Global Health Centre, Graduate Institute Geneva) presented and discussed the academic aspects of global health diplomacy.

Ms. Diah S. Saminarsih (Director-General’s Advisor for Gender and Youth, WHO) presented the new approach from WHO to promote meaningful youth and gender participation in global health and proceeded with inviting the participants to the first ever Youth Town Hall held in WHO’s history.

The Careers in Global Health session allowed participants to focus on themselves and their futures in global health. Delegates were joined by interns from the WHO for discussion with distinguished global health leaders Dr Maria Neira (Director, Public Health and the Environment Department, WHO), Dr Diogo Martins (Policy Officer, Wellcome Trust Global Policy Team), Dr Anne Pittet (Paediatrician, MSF and University Hospital of Lausanne) and Ms Ellie Marsh (Project Manager, Dalberg).

Dr. Roopa Dhatt (Co-Founder & Executive Director, Women in Global Health) introduced the gender gap in global health and discussed its scope and relevance to the IFMSA’s work. She also presented the approach taken by Women in Global Health to address the issue, with concrete examples.

Charles Antoine Barbeau (Youth Delegate, Canada) and Anne de Boer (Youth Delegate, The Netherlands) gave a session on Youth Delegate Programs and-related issues. They introduced the concept, and discussed challenges facing young people seeking to start such programs in their home countries.

The PreWHA ended with the traditional “Introduction to the WHA: A briefing for New Delegates”, hosted and organised by the Graduate Institute and open to the public. This event was supported by the United Nations Foundation and had many renowned speakers, which gave a context to the new delegates about the fundamental topics that would be discussed during the WHA.

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Keynote speeches: Michel SidibĂŠ: The UNAIDS Executive Director joined us for an inspiring keynote speech in which he highlighted the role that medical students and other future healthcare providers play to end AIDS by 2030, as well as how we can get more involved in the Global Compact for Non-Discrimination.

Helga Fogstad: The Executive Director of PMNCH delivered a keynote speech which covered the different aspects: - Why UHC is critical for the achievement of the Sustainable Development Goals ?

- How adolescent health and wellbeing links with UHC ?

- What PMNCH does and how the Adolescent and Youth Constituency members are engaged ?

- Delivered some guidance for IFMSA’s engagement for the World Health Assembly.

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Stream reports:

Noncommunicable Diseases Stream Coordinator: Sanne de Wit, IFMSA Liaison Officer for Public Health Issues Stream Participants: Ahmed Elshaer (Egypt), Alja Špicar (Slovenia), Ayilkin Çelik (Turkey), Brian Li Han Wong (Canada), Danielle Wiesner (Canada), Dominic Schmid (Switzerland), Maroun Bou Zerdan (Jordan), Michelle Houde (Canada), Paula Reges (Brazil), Rannei Hosar (Norway), Rose Adjei-Bempah (Ghana), Soha Ahmed Ibrahim Ahmed (Sudan) Noncommunicable diseases (NCDs) represent the largest proportion of the global burden of disease.

In addition to their mortality burden, NCDs commonly lead to significant morbidity, and have major economic consequences worldwide. Premature deaths from NCDs are largely preventable, and many are mainly driven by four big risk factors: physical inactivity, unhealthy diets, tobacco use, and harmful use of alcohol. These risk factors are interrelated, and rooted in social, political, economic, cultural, and commercial factors that often lie outside of individuals’ control. Youth are specifically vulnerable to these risk factors as 70% are started during adolescence.

Underfunding, lack of social mobilization, and conflicts of interest with the private sector make this a challenging public health space, but also present an exciting opportunity for coordinated action.

While it is agreed by world leaders that the global burden of NCDs represents one of the major health challenges of our times, we will not be able to reach Sustainable Development Goal target 3.4 (to reduce premature mortality from NCDs by onethird through prevention and treatment by 2030), based on the current rate of decline in premature mortality from the four main NCDs. This year the third UN High-Level Meeting on NCDs will commence, a critical opportunity to enhance action, which can be only reached through high-level political commitment, a multi-sectoral approach and an ambitious outcome.

The NCDs stream therefore aimed to step out of the silos and explore tackling the burden of NCDs from different angles, such as addressing the commercial determinants of health, NCDs as a developmental issue and how to bring stakeholders

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together. The stream started with a keynote speech from Dr Guy Fones, the acting head of the WHO Global Coordination Mechanism on NCDs, who gave the participants an introduction to NCDs. He specifically focused on challenges faced in implementing the needed ambitious action against NCDs and relevant discussions around the topic during the WHA and beyond. After the introduction the participants were ready to dive deeper in some of the challenges surrounding NCD action implementation with a session on the commercial determinants of health, given by Dr Nandita Murukutla, where she showed some key strategies the industry uses to counter action and how to tackle these strategies. Later in the day it was time to look into additional sectors to engage with, outside of health, to make action against NCDs meaningful and effective. In a panel the participants heard from Dr Diarmid Campbell Lendrum about how the environment and climate change impacts the burden of NCDs, from Dr Dudley Tarlton why NCDs are not just an health issue, but also a development issue, and from Laura Solia Shellaby what we can do to bring these different stakeholders around the table and why that is important. wEquipped with the information from the previous sessions the last session of the stream was aimed for the participants to see what, we as young people could do in the battle against NCDs. Guided

by Dr Mychelle Farmer, Dr Ishu Kataria and Jessica Renzella, 3 groups of participants respectively made plans on how addressing human resources for health and health systems for NCDs could contribute to universal and equitable access to NCD prevention and care across the life course, how we can mobilize youth to advocate for NCD financing, and how we can design an effective campaign to raise awareness among children, adolescents and young people. This left participants not only ready for the WHA, but also equipped with ideas to take back home after.

Stream reports:

Ending Discrimination in Healthcare Stream Coordinator: Carles Pericas Escalé, IFMSA Liaison Officer for Sexual and Reproductive Health issues including HIV and AIDS. Stream Participants: Lam Tin Kei (Hong Kong), Wong Gabriel Chun Hei (Hong Kong), Anshruta Raodeo (India), Isabel Jiménez Camps (Spain), Eliza Kluckow (Australia), Elliot Chong Yeung (Singapore), Sara Esameldin Adam Nagi (Sudan), Naomi van Veen (The Netherlands), Emma Joanna Lengle (Norway), Jérémy Glasner (Switzerland)

Discrimination in healthcare settings faced by people living with and most affected by HIV and other key populations has shown to be a major impediment to health. Discriminatory patterns in healthcare systems affect the efficacy of preventive strategies, the utilisation of testing methods, the enrolment in and adherence to treatment and the frequency of medical consultation in general. Studies conducted for the HIV Stigma Index revealed for example that a quarter of people living with HIV reported to have experienced some form of discrimination in healthcare. It has also been shown that people who perceive high levels of HIV-related stigma are 2.4 times more likely to delay enrolment in care until they are very ill. Examples of faced discriminatory situations or concepts are: - Limitation of access to comprehensive sexuality education and to prevention methods for key populations due to paucity of needs-related offers, - Denial of treatment and other health services such as maternal care, dental care or family planning services,

- Restriction of the patient’s autonomy in clinical settings, e.g. undergoing coerced abortion or sterilisation, - Violation of privacy and confidentiality by disclosing a patient’s HIV sero-status to family members or hospital employees without authorisation, - Demands for additional payment for infection control, - Conduction of unnecessary precaution procedures, e.g. health providers isolating and minimising contact with the patients, - Prejudgement of people living with HIV, e.g. believing that people acquired HIV because they have engaged in irresponsible behaviour, - Provision of antiretroviral therapy made dependent on the use of contraception or people’s sexual behaviours.

- Provision of a poorer quality of care to people living with HIV compared to other patients.

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This results in an overall impairment of HIV-related care provided by individuals, institutions and systems: It leads to an increased likelihood for key populations to be exposed to a risk of an HIV transmission and to poor health outcomes for people that have acquired HIV. Hence, the end of AIDS cannot be reached unless discrimination is adequately addressed and eliminated from all clinical settings.

This can only be attained when health workers, as the core of healthcare provision, are made aware of their responsibility in this issue and are taught rights-based, people-centred and non-stigmatising healthcare provision.

The main objectives the stream were: 1- How does HIV-related discrimination in healthcare affect the health outcomes of people living with HIV and key populations ?

2- What are the specific needs of (young) key populations when receiving healthcare ?

3- What are the challenges and missteps to carry out interventions that aim at protecting people living with HIV and key populations from discriminatory attitudes ?

4- How can we influence stakeholders during World Health Assembly and push forward the Zero Discrimination Agenda ?

The following sessions were delivered: 1- Introduction to the Adolescent Health Stream: This short presentation was part of the Streams Introduction Session and served to present the topic and the announce the relevant WHA processes around it 2- How does discrimination affects health ? An HIV related insight: This session in the form of three round-tables covered the following aspects: - External factors related to discrimination that prevent people living with HIV and key population from seeking healthcare and adhere to treatment.

- Examples of discriminatory patterns that people living with HIV and key populations face in healthcare systems.

- Discrimination and its relation to poorer health outcomes of people living with HIV and key populations in all aspects of health.

3- Discussion panel: The panel, moderated by the stream coordinator aimed at giving a broader perspective and first-hand experiences on what key populations and people living with HIV face in healthcare settings.

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Stream reports:

Antimicrobial Resistance Stream Coordinator: Jonne Juntura, IFMSA Liaison Officer to Student Organizations.

Stream Participants: Soykaina Baladi (Morocco), Rosie Herrington (UK), Aamr Hammani (Morocco), Saniya Sahasrabudhe (India), Isaac Florence (UK), Kareem Makkawi (Egypt), Navrikan Bains (US), Pablo Estrella (Ecuador) Antimicrobial Resistance (AMR) is one of gravest threats to human health in the history of medicine. It is estimated that if nothing is done, the mortality due to AMR will continue its steep rise and by 2050, lead to more deaths than cancer today (10 million and 7 million, respectively). What more, it will have devastating effects on the global economy, especially those in low and middle income countries where health systems are already fragile. According to a recent report by World Bank, the effect of AMR on the global economy will equal the financial crisis of 2008-09, with the exception that the effect of AMR will be sustained for many years to come. The threat of AMR has been long recognized inside the health sector. Yet, it is only during the past few years that steps have been taken to tackle AMR on a global scale. In 2015, a Global Action Plan on AMR was adopted by the World Health Assembly. This was followed by an opportunity rarely granted to health topics: a High-Level Meeting was held on AMR at the United Nations General Assembly (UNGA) in 2016. Currently, the Interagency Coordination Group on AMR is preparing a final report on the global situation on AMR to be delivered to the UN Secretary-General in June 2019.

The objectives of the stream were: 1. What is AMR and why is it a challenge? Participants understand what is meant by AMR and they have the basic technical knowledge related to it.

2. AMR and One Health - Why working multi sectorally is the only plausible solution? Participants understand the need for multiprofessional collaboration 3. AMR in 2018 - what are the UN & WHO processes to follow? Participants understand the most relevant processes related to AMR in the recent past and future 4. AMR- What are the Member States doing? Participants understand the role of the Member States and how they can advocate for AMR in their respective countries.

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The following sessions were delivered: - Introduction to the AMR Stream: The objective of the session was to give the participants the basic understanding of the current AMR policy landscape, the main policy processes related to it and the most important stakeholders - AMR, WHO and the UN: The road that took us here (Marc Sprenger, Director of WHO AMR Secretariat): This session intended to give a more detailed perspective on the challenges of AMR. This included the need for multisectoral approaches and the role of animal health. The session was delivered by Marc Sprenger, the Director of WHO AMR Secretariat.

- The role of civil society and grass-root action in tackling AMR (Mirfin Mpundu, ReAct Africa; Jeremy Know, Advocacy Lead at Wellcome Trust): Civil society action is important in all health policy. What makes AMR an interesting topic in this regard is the fact that AMR does not yet have broad civil society engagement. The objective of the session was to have a panel discussion with two experts working on engaging the civil society on AMR and through this, have a vivid discussion on the current challenges and opportunities for engagement.

- Preparations for the upcoming High-Level Meeting on TB at UNGA (Lucica Ditiu, StopTB): This session aimed to broaden the understanding of the participants on the important link between the AMR and Tuberculosis agenda.

The sessions was delivered by the Executive Director of Stop TB partnership, Lucica Ditiu. On September the 26th, there will be a High-Level Meeting on TB organized as part of the UNGA. This occasion will provide an important opportunity to further advocate for AMR and the its inclusion in the TB agenda.

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Stream reports:

Universal Health Coverage Stream Coordinator: Patrick Walker (Australia) Stream Participants: Adonis Wazir (Lebanon), Ankit Raj (India), Ave Pold (Estonia), Balkiss Abdelmoula (Tunisia), Chris Samaras (Greece), Daniel D’Hotman (Australia), Eman O’Suliman (Sudan), Gemma Wyatt (UK), Hana Lucev (Croatia), Jorge Cardoso (Portugal), Tarek Turk (Syria) Universal health coverage (UHC) is a term that describes the ability of people – no matter their background or situation – to access the healthcare services they need, when they need them. It is a key challenge that must be overcome if we are to improve global health, and is integral to the work of governments, health services, and civil society organisations around the world. Due to its important nature, it has been adopted by WHO Director-General, Dr Tedros Ghebreyesus, as the primary focus of WHO. As he wrote in July 2017, ‘all roads lead to universal health coverage.’

Despite dramatic improvements in healthcare and health technologies in the past century, more than 400 million people have no access to essential health services, and almost half the world’s population lack basic social protections. 800 million people are forced to pay more than 10% of their household budget to pay for healthcare, putting them at significant risk of being pushed into extreme poverty - and all its associated challenges. Clearly, UHC must be urgently prioritised if we are to achieve improvements in global health. So, as the Organizing Committee, we were thrilled to be able to put together a stream on the topic for this year’s Pre-WHA. The UHC stream was specifically designed to cover some of the most important key aspects of UHC - health financing, health workforce, ensuring quality of services, access to essential medicines and health products, amidst others. This can all seem overwhelming, but to contextualise the stream we were fortunate to hear from Dr Ruediger Krech, Director of Health Systems and Innovation at WHO. This session gave delegates a taster of what to come, and importantly an insight into WHO’s role in ensuring health coverage around the world. Following from this, we enjoyed two keynote talks on health financing and health workforce, given by Dr Joseph Kutzin, Coordinator of Health Financing Policy at WHO, and Dr Jim Campbell, Director of WHO’s Health Workforce department, respectively. These sessions offered a chance to delve a little deeper into these individual aspects of UHC, and equipped us with a more comprehensive knowledge of these complicated topics.

By this stage, delegates were starting to understand what UHC really meant, and fascinating and challenging discussions were beginning to spark among little huddles around the conference room. This was encouraging, especially as it was now time to integrate what we had learnt, which I aimed to facilitate through the final two sessions of the stream. The first of these was a panel discussion on the challenges to achieving UHC. This session gave us the opportunity to integrate the different facets of UHC which we had been discussing, and put it all together to determine what the barriers were to improving health coverage. Most striking here was the sheer variety in challenges seen between and within countries. Importantly, we also discussed the idea that UHC is not something to be ‘achieved’; every country can improve coverage in some way - be it increasing the number of people covered, increasing the services available, or decreasing the out-of-pocket costs patients are forced to pay. We can all improve, regardless of where we sit.

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The last day posed perhaps the greatest challenge to delegates: after hearing from others for 3 days, now it was their turn. With the expert help of Dr Robert Yates, Senior Fellow and Director of the UHC Policy Forum at Chatham House, we put delegates in the shoes of two lower-middle income countries, Nigeria and Lao PDR, to brainstorm ways of improving health coverage in their allocated country. This was a wonderful chance for delegates to put the skills and knowledge they had gained thus far into practice, and it was a true pleasure seeing the extremely high quality of interventions that groups came up with. Every single one was reasonable, well-targeted, well backed-up by evidence, and innovative. An ideal way to end an ideal stream, and help delegates jump into the Assembly with the skills and knowledge needed to carry out their plan and influence country delegations to lead by example and improve health coverage as a matter of urgency.

Visibility and Social Media Merchandise For this year’s PreWHA we decided to ensure our merchandise was as sustainable as possible, hence we chose to have PreWHA Mugs made which cut down the use of plastic cups during the event. In addition, we also had PreWHA Notepads, pins and for the OC we had optional PreWHA T-Shirts made. Lastly, we had an undated PreWHA Banner made which will be able to be passed in to future PreWHA Organizing Committees and prevent having the banner as a recurring cost.

Social Media and Advocacy For the past few years, the IFMSA has sent a large delegation to the World Health Assembly; this year has been no different. Our core reason for this is to amplify the voice of the youth in global health governance. As young people in an era fused with increased information access, we had to come up with a comprehensive visibility strategy so that both stakeholders and actors in and outside of the WHA are made aware of and are able to follow our activities and advocacy priorities. A presentation was delivered by the Social Media and Public Relations Coordinator regarding social media and advocacy to the Youth Pre-WHA delegates. The goals of this presentation were to help delegates: 1) Recognize social media as a useful and effective advocacy tool; 2) Analyze cases where social media has been utilized for advocacy purposes; 3) Encourage participation in IFMSA preWHA 2018 social media advocacy efforts; 4) Supply tips for effective social media use for advocacy and awareness.

A copy of the Presentation can be found here.

Visibility of IFMSA at the preWHA and WHA71 All participants were encouraged to use #yWHA71 and #WHA71 throughout the duration of the preWHA and WHA event. In summary, IFMSA as a student group dominated the hashtag #yWHA71 according to Brand24, a renown social media analytical tool, we produced a whopping 1281 tweets, ensuring high visibility of our activity at the PreWHA. IFMSA was tagged in tweets from @Michel Sidibe the current Executive Director of UNAIDS. See key IFMSA tweets here and further analytics here.9

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Data Evaluation and Outcomes: To evaluate the impact of both PreWHA and WHA, we used questionnaires sent to all selected participants before and after the event. We evaluated self-reported levels of knowledge and skills.

Participants were asked to rate their knowledge/skill on a numerical scale from 1 to 5 scale. We used the same questions in the pre- and post-event surveys. Next to mandatory questions, participants were also able to provide free feedback.

General Outcomes We measured participants’ knowledge on the World Health Organisation and the World Health Assembly in General, as well as the roles and interests of different WHA participants in general. Furthermore, we inquired how comfortable participants felt to approach these stakeholders at the WHA. All parameters showed a score increase.

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Advocacy Skills We asked participants to rate their proficiency in different advocacy techniques that were addressed in PreWHA sessions. Please note that PreWHA and WHA were regarded as one capacity building opportunity, so part of the change in scores maybe due to experiences made at the WHA. The biggest increase was found in stakeholder mapping, which is probably due to the fact that an entire session was devoted to it.

Streams Next, we looked at the four different streams. For each one, we analyzed participants’ general knowledge, the confidence to discuss the topics with peers and key stakeholders and their proficiency in advocating in the area.

For reasons of clarity, the graph shows the difference between pre- and post-event scores (all of them are positive values, indicating an increase from before to after the PreWHA). We also calculated the average of all differences per stream.

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Finances Financing the PreWHA remains a very challenging activity, as Geneva has a very high price of living. Ultimately, it is of utmost importance that every effort is made to reduce registration fees for IFMSA members, recognising the financial barriers many people face to attending external meetings. We are proud to have kept the registration fees comparatively low this year and will strive to ensure this continues into the future. This year we also had a strong focus on sustainability, so prioritised a partial carbon-offset of the event in the budget and we aimed to support local producers by buying fruits directly from the farmers. .

We are very pleased with the financial report of this year’s PreWHA. We would like to thank all those that contributed to ensuring the financial sustainability of this event in 2018, especially our financial sponsors the PMNCH and UNAIDS, and other partner organisations that have facilitated free and discounted facilities for our use in Geneva, particularly swimsa, the City of Geneva and Geneva Youth Hostel.

If you or your organisation is interested in financially supporting the PreWHA in 2019, and contributing to the growth of global health leaders, please contact the Liaison Officer to the World Health Organization at lwho@ifmsa.org

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Finances

Expenses

Budget

FINAL

10

Materials

€ 480.00

€453.33

20

Travel expenses

€ 1,243.00

€1,216.34

30

Food and accommodation

€ 25,467.66

€22,600.73

40

Remuneration

€258.00

€196.34

50

Carbon Offsets

€500.00

€500.00

Subtotal

€ 27,448.66

€ 24,966.73

100

Budget margin (4% of subtotal)

€1,097.95

€998.67

110

Administration (4% of subtotal)

€1,097.95

€998.67

Total

€ 29,644.55

€ 26,964.07

Incomes

Budget

FINAL

200

Registration fees from 44 participants for pre-WHA

€11,000.00

€11,000.00

210

Registration fees VPE pre-WHA and WHA

€250.00

€250.00

215

Penalty Fees

€300.00

€250.00

220

Fees for WHA accommodation for 41 participants

€9,875.00

€10,124.00

230

Partners

€5,100.00

€2,593.58

240

Budget margin from pre-WHA 2017

€3,200.00

€3,200.00

€60.00

€60.00

250

OC T-shirts Debt from participant (56 euro) + from 2 OC members (12 euro) for 251 t-shirts

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€68.00

Total

€ 29,785.00

€ 27,545.58

Net Balance

€ 2,336.34

€ 2,578.85

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El Salvador (IFMSA-El Salvador) Estonia (EstMSA) Ethiopia (EMSA) Finland (FiMSIC) France (ANEMF) Gambia (UniGaMSA) Georgia (GMSA) Germany (bvmd) Ghana (FGMSA) Greece (HelMSIC) Grenada (IFMSAGrenada) Guatemala (IFMSAGuatemala) Guinea (AEM) Guyana (GuMSA) Haiti (AHEM) Honduras (IFMSAHonduras) Hungary (HuMSIRC) Iceland (IMSA) India (MSAI) Indonesia (CIMSA-ISMKI) Iran (IMSA) Iraq (IFMSA-Iraq) Iraq – Kurdistan (IFMSAKurdistan) Ireland (AMSI) Israel (FIMS) Italy (SISM) Jamaica (JAMSA) Japan (IFMSA-Japan) Jordan (IFMSA-Jo) Kazakhstan (KazMSA) Kenya (MSAKE) Korea (KMSA) Kosovo - Serbia (KOMS) Kuwait (KuMSA) Latvia (LaMSA) Lebanon (LeMSIC) Libya (LMSA)

Lithuania (LiMSA) Luxembourg (ALEM) Malawi (UMMSA) Malaysia (SMMAMS) Mali (APS) Malta (MMSA) Mexico (AMMEF) Montenegro (MoMSIC) Morocco (IFMSAMorocco) Nepal (NMSS) The Netherlands (IFMSA NL) Nicaragua (IFMSANicaragua) Nigeria (NiMSA) Norway (NMSA) Oman (MedSCo) Pakistan (IFMSA-Pakistan) Palestine (IFMSA-Palestine) Panama (IFMSA-Panama) Paraguay (IFMSAParaguay) Peru (IFMSA-Peru) Peru (APEMH) Philippines (AMSAPhilippines) Poland (IFMSA-Poland) Portugal (ANEM) Qatar (QMSA) Republic of Moldova (ASRM) Romania (FASMR) Russian Federation (HCCM) Russian Federation – Republic of Tatarstan (TaMSA) Rwanda (MEDSAR) Saint Lucia (IFMSA-Saint Lucia) Senegal (FNESS)

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medical students worldwide

Serbia (IFMSA-Serbia) Sierra Leone (SLEMSA) Singapore (AMSASingapore) Slovakia (SloMSA) Slovenia (SloMSIC) South Africa (SAMSA) Spain (IFMSA-Spain) Sudan (MedSIN) Sweden (IFMSA-Sweden) Switzerland (swimsa) Syrian Arab Republic (SMSA) Taiwan - China (FMS) Tajikistan (TJMSA) Thailand (IFMSA-Thailand) The Former Yugoslav Republic of Macedonia (MMSA) Tanzania (TaMSA) Togo (AEMP) Trinidad and Tobago (TTMSA) Tunisia (Associa-Med) Turkey (TurkMSIC) Turkey – Northern Cyprus (MSANC) Uganda (FUMSA) Ukraine (UMSA) United Arab Emirates (EMSS) United Kingdom of Great Britain and Northern Ireland (SfGH) United States of America (AMSA-USA) Uruguay (IFMSAUruguay) Uzbekistan (Phenomenon) Venezuela (FEVESOCEM) Yemen (NAMS) Zambia (ZaMSA) Zimbabwe (ZIMSA)