Access Denied: IFMSA Addresses Health Care Inequity

Posted on November 3, 2007
Filed Under Health Care Policy and the Student Doctor, News

International Federation of Medical Students’ Associations
Reprinted with Permission

Almost 1,000 medical students from over 90 different countries gathered in Canterbury this August to tackle inequities in health care across the globe. The 56th August Meeting of the International Federation of Medical Students Associations returned to the UK with the theme, “Access to Essential Medicines.” It proved to be a fascinating, tumultuous, and at times controversial week.

The IFMSA is the largest student body in the world, founded in 1952 to provide a cohesive voice for medical students across the globe. Its biannual general assemblies aim to educate and inspire its members to take action on international health issues, each centered around a chosen theme. The decision by the UK to focus on “Access to Essential Medicines” (AEM) was taken in light of its key relevance to both the developed and developing worlds. More than 10 million deaths each year can be attributed to lack of access to life-giving medications, in direct contravention of the Universal Declaration of Human Rights, entitling every citizen the right to “health and well-being of himself and his family, including … medical care and necessary social services”.  

The Assembly was opened, with customary vigor, by Dr. Richard Horton, chief editor of the Lancet. He spoke of the “collective failure” of medical institutions to produce doctors engaged with society, both domestically and globally. Increasing inequality in access to health care, he argued, demands that the moral contract between the medical profession and society be rewritten such that doctors come to see the assertion of justice as a fundamental part of their duty. It requires that doctors and medical students are prepared constantly to “disagree and quarrel with, object to, dissent from and disapprove of, resist, disbelieve, refuse, oppose, challenge, contradict and defy (their) governments” as and when the need arises. Justice in health, he concluded, should be paramount to all medical practice: “The social pathology of globalization, inequity and epidemic human misery that we face today demands nothing less.”

The spirit of revolt continued throughout seven days with a series of lively debates, speeches and seminars from experts as diverse as Hans Hogerzeil (director of Department of Medicines Policy and Standards, WHO), Parveen Kumar (chairman of the BMA), Richard Smith (CEO of United Health Europe and former editor of BMJ) and Richard Barker (chairman of Association of British Pharmaceutical Industries).

Informal lunchtime sessions on “Systems,” “Activism” and “How Students Relate to the Pharma Industry” encouraged students to take a personal stand. Videos on AEM ran throughout the week and computer-assisted learning packages provided real and well-argued evidence to back the rhetoric. Representatives from a range of non-governmental organizations, including Medecins Sans Frontieres and Oxfam, attended, tirelessly explaining their work and encouraging hundreds of medical students to consider work overseas. For, as Prof. John Yudkin (former director of the International Health Medical Education Centre) observes in the AEM film, “It is not just about access to drugs, it is about access to people who can prescribe and safely deliver those drugs.”

Record numbers of travel bursaries to the UK were distributed to students from economically-less developed countries who would have been otherwise unable to attend the Assembly. The sheer number and diversity of students encouraged a variety of viewpoints, and debates could be heard echoing through the corridors long after the speakers had finished. Projects and campaigns were coordinated from opposite sides of the world and many exchange schemes initiated.

The week culminated in the creation of “The Canterbury Declaration” and its formal adoption by the IFMSA. The Declaration supports the WHO Access Framework and, while recognizing the need for trade-related intellectual property rights legislation, advocates for countries making full use of its flexibilities. Importantly, its adoption lends the IFMSA a clear and consistent voice on the matter of “Access to Essential Medicines.” The Declaration encourages student protest and pledges support to all campaigns aimed at increasing governmental spending on AEM, challenging cases where essential medicines are priced beyond the reach of the poor and promoting transparency within the pharmaceutical industry.

The voice of the IFMSA is a powerful one and has in the past informed both national and, through its affiliation with the World Health Organisation, international policy. Its work is mainly directed into five main areas, recognised as peripheral to core medical curricula but central to the reality of health care. These are reproductive health (including AIDS), human rights and peace, public health, professional and research exchange, and medical education.

The UK branch of the IFMSA, Medsin-UK, is especially active and has branches in 28 different medical schools across the country, involving hundreds of health care students in its projects, campaigns and educational events. Its network aims to connect innovative projects and enthusiastic students to work together in addressing the broader determinants of health.

If you would like to know more about the IFMSA or Medsin-UK, or to get involved in the campaign for Access to Essential Medicines please see www.ifmsa.org or www.medsin.org

Comments

2 Responses to “Access Denied: IFMSA Addresses Health Care Inequity”

  1. Dr. Red Vines on November 4th, 2007 5:18 pm

    I think that the reason why there is a

    >>

    “collective failure” of medical institutions to produce doctors engaged with society, both domestically and globally.

    >>

    is in large part due to how U.S. medical schools are run on the stateside of this equation. In the 1960’s there was a wave of volunteerism and interest in domestic issues, this gave way in the late 1990’s and early 21st Century to a medical culture where obtaining the most specialized. high-paying, and well regarded training position, such as a cardiologist or dermatologist, became the goal of most medical students. As a medical student in school fellow classmates would often give me a funny look when I talked about going abroad for a significant amount of time, often with disparaging remarks about the poor conditions in developing countries. However, I think that the biggest obstacle to student’s optimistic plans about pursuing global health lies in how medical students are taught in the cllinical years. Often, due to increased patient loads medical students more and more and being expected to manage more than six patients, in terms of scheduling radiographic procedures, monitoring labs and vitals with equipment more outdated than a modern supermarket, and also must “know their patients better than the intern, residents, and attending.” In addition, the pressure that attendings who grew up as residents in the Me Generation of the 1980s who are upset with lower than expected average earnings and increased workloads often results in medical student abuse, and this leads to depression and loss in interest in serving mankind abroad, and more interest in surviving the week at “school.” I think the model of the imperfect baby boomer is Bill Clinton, who while developed an interest in HIV/AIDS post-office to improve his presidential “legacy” also complained about his low presidential salary and dedicated himself to high-paying jobs post-presidency. I would wholeheartedly agree that there is a collective failure of medical schools to promote awareness of domestic issues, secondary to viewing medical students these days as cheap labor and not a resource for the immediate future needs of citizens everywhere.

  2. Real World Doctor on December 29th, 2007 12:13 am

    The third party payment system in the US is the largest driver of inequality in the US. Medical students are wasting their time being taught the same idealistic and outdated BS in the medical school. Once out in the real world, they’ll realize that they entire healthcare system is against them. Some realize this in 4th year of medical school and go into limited patient responsibility specialties like radiology and dermatology.

    Medical school should revise their old-school ways of reaching that only leads to handicapped doctors that become slaves of corporate interests and government entities.

    This is NO JOKE.

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