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A few reflections on the World Health Summit 2018 in Berlin

By Kristof Decoster
on October 19, 2018

Both of us recently attended the World Health Summit (WHS) organized in Berlin from 14-16th October, as some of the “over 2000 delegates and 300 speakers from around 100 countries”. The WHS celebrated its 10th Anniversary this year, among others with the launch of a “Global Action Plan for healthy lives and wellbeing for all” in which 11 key global organisations signed a commitment to unite for collective action towards achieving the health related SDG goals & targets, by working in partnership rather than in silos. Supported by UN Secretary General Antonio Guterres and presented by WHO DG Dr. Tedros, the Global Action Plan adopted a framework organised under three strategic approaches: ‘Align (efforts to avoid duplication), Accelerate (the progress towards global health goals – 7 cross-cutting areas were identified where more innovative, synergistic efforts can significantly accelerate progress in global health) and Account (for these goals by linking investments to results). With the first stage of this new action plan, which came into being at the explicit request of Angela Merkel (and a few other leaders), Germany’s increased financial commitment to WHO (to the tune of 115million Euros for the next 4 years), with Germany also being a key player in the fight against Anti-Microbial Resistance (AMR), and  many global health institutes and actors currently setting up branches and offices in Berlin, the German Health Minister Jens Spahn rightly highlighted Germany’s growing role in global health at the opening plenary. Spahn also announced the establishment of a new hub for Global Health in early December, and emphasised the shared responsibilities and the need for ‘multilateral peaceful collaboration to bring health to everybody on this earth as a human right’. Merkel would  do so even more forcefully  at a joint (WHS/Grand Challenges) keynote event later in the week where she was cheered on almost like a rock star. On a side note: Jens Spahn provided the ultimate reason why we should ditch the term ‘non-communicable diseases’ altogether: Germans just can’t pronounce it 🙂

Coming to the WHS straight from Liverpool after attending the global Health Systems Research (HSR) Symposium there, we could see some stark differences in the agendas of both events, the way they were organised and the kind of participation they displayed. At the HSR Symposium, young researchers from the Global South were involved in engaging and diverse plenary discussions, and also in most of the other sessions, diversity & inclusion were certainly not empty words, even if there’s always room for improvement. Inclusiveness has been a key objective of the symposium since its beginning (including of the Emerging Voices venture), and it was good to see that goal being achieved in Liverpool.

In contrast, we found the World Health Summit (still) largely dominated by people from the Global North and global elites. In spite of the organisers’ efforts, still too many of the panels were #manels (i.e. male panels) or male-dominated. Panels (certainly in the main plenaries) were, moreover, often comprised of leaders and key decision makers of big funding organisations like the Bill & Melinda Gates Foundation, GAVI and The Global Fund; and CEOs from pharma companies like Pfizer and Merck. There was very little representation from (more radical) civil society and young voices of the global south. The absence of these key actors – civil society organisations and communities for whom the policies are actually being issued and implemented (for example in the session on global health security) was consistently pointed out by the audience during panel discussions as well as on Twitter. Apparently, some civil society actors are considering engaging more in the future which would be great for the Summit. True, there were lots of young global health & medical students from Germany, Holland, and other European countries, but with only 10 New Voices in Global Health, 20 young physician leaders and 10 entrepreneurs from the start-up track being officially included in the Summit programme to showcase their work, in an audience of over 2000 delegates, there is still a huge gap to bridge between the ‘high-level’ (and occasionally stratospheric or even outer space) policy level discussions and on-the ground realities.

Although the theme of the summit was Science, Innovation & Policies and how they can (and should) be synergized to address the global health issues across the world – the phrase “together we are strong”  was reiterated multiple times throughout the summit, including by Dr. “Partnership” Tedros –   there was more emphasis on science, innovation, development of new vaccines, AMR and global health security, with a focus on multi-stakeholder partnerships and “getting the incentives right” for big pharma companies and donor agencies to get them engaged and invested for the long term; rather than on what it actually takes to implement these partnerships and policies on the ground and address inequities. Yes, partnerships are very important in our complex times in which we face many wicked challenges, and for sure “together we are strong(er)” but somehow the people selected to discuss all this on stage were surprisingly kind to each other. Big Pharma CEOs didn’t get many questions on their tax optimisation ‘best practices’, for example.

In line with some of the major global health challenges of our times, core topics at this WHS were Pandemic Preparedness, the SDGs, Health in All Policies, Access to Essential Medicines, Health Systems Strengthening, AMR, and The Digital Healthcare Revolution. At the start of the Summit, the M8 Alliance, the academic think tank and backbone of the WHS, issued its Berlin Declaration 2018 stressing the central role of health as a driving force for the United Nations’ SDGs. “We strongly advocate a holistic and science driven approach to solving the global health challenges. Public and global health funding needs to increase”, Detlev Ganten, the WHS’s “eminence grise”, said.

With the launch of the SDG3 Global Action plan and participation from some of the most influential leaders and politicians in the field of global health, including Bill Gates, Dr. Tedros, state leaders and ministers from Norway, Ghana & Germany, and WHO’s Afro lead, Matshidiso Moeti, this year’s WHS and coinciding Grand Challenges meeting were used as a platform for positioning Germany as a key emerging Global Health hub for the coming years. In this respect, the week was certainly successful, and the love for multilateralism was all around. Few asked the question though, why multilateralism and global solidarity are in such trouble nowadays.

Hopefully, with more regional meetings planned in the coming years, among others in Makerere in 2020, the WHS will also start bringing more evidence “from the ground” to the global policy level, ideally basing it more on public health needs than on (geo?-)political, economic, and still somewhat Northern dominated interests.

One last remark: for now, the World Health Summit still remains firmly in the ‘global health’ mode, it appears. With a few exceptions (Anders Nordström for example), the Planetary Health paradigm hasn’t really sunk in yet. So here’s a plea to invite Naomi Klein and other Jason Hickels in the coming years to change that. It’ll make the WHS even better!


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