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RIP global health conference (air) travel

By Kristof Decoster
on August 10, 2015

This morning the article “Have tenured academic position, will travel (frequently)” in the Sydney Morning Herald caught my attention via Twitter. The issues pointed out in the article, summarized aptly in the introductory paragraph as ‘Academics’ travel to overseas conferences is expensive and environmentally damaging but many see it as a perk of their job’ (the article focused on senior academics) do also ring a bell in the global health & HPSR community, perhaps even more so than for the average scientist in some respects. There are also clear differences, though.

I reflected a bit more on this thorny issue, as it has long annoyed me that my own institute does have a policy on limiting printing paper for reasons of sustainability, but a “frequent flyer” policy is still nowhere to be seen (at least not one for ecological reasons), even if I’m aware that there are other and bigger sources of greenhouse emissions than air travel. (PS: anyone who has seen me “navigating” at a braai in South Africa knows that my carbon footprint is sky high (regardless of the plane travelling involved to get to Cape Town in the first place);  I’m working on my meat consumption, but it’s a work in progress, I hate to admit…)

But to come back on plane travel, as long as (commercial) planes don’t fly on solar energy, and substantial carbon taxes  are not put in place “to let the market work its magic” it’s an issue the global health community cannot avoid, just like any other scientist or other people, in the not too distant future (in Belgium, a stand-up comedian, with a background in bio-engineering, sticks to a a rule to only fly once a year, maximum).

In the new SDG era, that will be even more the case. Planetary health is about to become a key concept in the world of global health.  Yet, for the time being, plane travel is still embarrassingly common. There are reasons for this, of course, and some are even good reasons.

Nevertheless, let’s brainstorm a bit on ‘ways forward’. I hope the HPSR community will have a thorough discussion on this issue in Vancouver next year.

In trademark global health fashion, let me already suggest here a proper three letter-acronym to take this important agenda forward: RIP.

The ‘R’ could stand for ‘rotation’  (after all, many successful football coaches rotate quite a bit with their star players, so why on earth do Tim Evans, Richard Horton and other Margaret Chans have to be (almost) everywhere, even if for representative purposes?). But the letter stands even more for ‘rationing’, I’d say. If we believe in planetary health and in boosting planetary resilience as a key approach to deal with the enormous challenges in this century, among others we’ll also have to ration our plane travel, seniors and juniors alike. Of course, the issue is more relevant for senior voices and other top dogs in the field, as their plane travel tends to be the most resilient – put more bluntly, many see it as their God-given right to fly … wherever. But some of the young & already well-connected love to post jolly pictures on Instagram too, every time they board a plane!

No doubt, global health requires many of these people to be there. If Hans Rosling goes to Liberia to help out for several months, we can only applaud this and thank him for his sacrifice. His added value there is obvious. Many global health leaders have similar incredibly important tasks to fulfill, especially in global health crises. This is why some of the issues raised in the article only go that far for the world of global health.

But having said that, it’s clear that for conferences and the like their presence is sometimes less required, even if I (and many others) enjoy the razor sharp intellect & excellent moderating skills of Tim Evans, the highbrow lamenting & manifesto style of Richard Horton, or the blunt (or sometimes shrewd) answers from Margaret on tricky questions. So rationing seems the right thing to do in the post-2015 era, also for exemplary reasons.

Why not for example dedicate a ‘plane travel through the lifecourse’ budget to all people in the world? Clearly, I’d love to start with The Donald and O’Leary (not to mention Big Pharma CEOs and other frequent flyer cadres in corporate circles), but the global health community should first lead by example. Allowing for some family related plane travel – global health scholars often have foreign spouses –  professional air traveling should be constrained to where people really are required and provide ‘value for money’. And budgeted. At the height of their career, scholars should perhaps be allowed to travel a little bit more, whereas the dinosaurs would probably have used up all their ‘flying credit’ and happily stay home, enjoying the company of their grandchildren. Young and ‘emerging’ voices would also be allowed to fly a bit more, as the name implies, as they tend to benefit the most from the exposure to new ideas and networking at conferences, need to get relevant field experience, build their cv, etc. Let’s aim for a global health air travel ‘bell curve’, so to say.

The ‘I’, then. This is global health, so this letter can only refer to ‘Innovation’. As much as I love Margaret Chan, I think a fancy video with Margaret would sometimes suffice (and here you can hire a few Hollywood blockbuster whizzkids to add some flashy visual effects; then we can all put on our 3-D glasses to enjoy Margaret, Richard, Tim, … everywhere in the room; call it the global health ‘Jurassic World’ experience). We could even include the occasional roar. So the entertainment value and global health celebrity watching  that some of us indulge in at times (myself included) at global health conferences, would still be guaranteed. Sometimes these video performances already happen, but they should become far more common.

As for schemes to offset plane emissions, they already exist for a while, too, but there’s still much room for improvement. Not only do they set the wrong example, morally speaking (if you have your mouth full of planetary health, at least). But we should also be far more creative. We all love ‘targeting’ in global health, so why not set up schemes at institutional (or discipline) level that would subsidize young voices & the marginalized’s attendance at global health conferences and conversely heavily penalize Julio Frenk and other already fairly well-connected global health voices as soon as they try to board a plane? Or an institutional level carbon tax (as long as we’re still waiting for global consensus on such a tax) which would have a very steep slope – as the level of seniority goes up, the tax would rise exponentially after a certain age ?

If you have a baby, you’d be allowed somewhat shorter visits abroad, but your colleagues with older children or no kids would have to stay at least three or four weeks abroad every time they fly. Well, just an example. I’m sure the health economists can come up with far more intricate schemes. The World Bank could even make a special scheme to send marginalized people to a conference, instead of Tim Evans or Jim Kim. The Global Airlifting Facility. Obviously, everybody subscribing to the planetary health manifesto wouldn’t even need such a scheme to constrain his/her air travel, they’d do so naturally. They know all too well that for them, the excuse “Wir haben es nicht gewusst” just doesn’t fly, even they’re about to save humanity.

Senior people would still be allowed to attend the occasional high-level conference, but no more than once a year, ideally the main highlight of the year in their field (Jeff can go to a few more, as he publishes in all 17 SDG areas), and one face to face teaching task (again for a considerable period of time, not hopping from one teaching job to another). As for the others, conference, teaching, setting up research in remote areas and in consortia, … they could use all kinds of virtual tools, or let themselves represent by their staff (equally rationed though). Would also be good from a ‘Switching the poles’ perspective, and smart to prevent burn-outs too among staff.

This brings us to the last letter of the acronym: the ‘P’ of ‘Pooling’. At departmental level and/or in unit teams, (air) travelling should be pooled. Global health activities, pledging conferences and conferences should also be pooled, more than is already the case now (like around the World Health Assembly). Why not have a Geneva global health “jamboree” for two months (or as long as it takes to deal with the numerous and neverending global health challenges in the world) and let the key people fly in and stay there for the entire period of time? They’d be “on a mission” like in the old colonial days when fathers and nuns left for years, sometimes decades, before they came back home for a short visit. For in-between meetings in Geneva, institutions could still send scholars to high-level meetings, but only by train (instead of using Easyjet and other low budget airlines). Again, a substantial carbon tax would make some of these suggestions redundant, but as long as such a tax is not in place, nobody says we can’t already move ahead.

Of course, this all requires some transformative restructuring of the incentive systems for academics and centres of excellence. On the individual level, a virtual keynote speech would have to count just the same as a real keynote; the same would go for junior voices with abstracts accepted but who already used up their flying credit for that year – enter virtual presentations; …. This would be quite good from a democratic point of view too, as researchers from the Global South often have trouble to finance conference participation, even after fee waiving.

Institutions and organizations all want to set up their own ‘high-level’ global health conference and event these days, preferably with as many Leaders in the field as possible, among others to prove their continuing relevance or as a ‘deliverable’ for donors,  but  perhaps it’s time to be a bit more selective and look for synergies? Not every world city and world class institution needs its own global health event every year…. so pooling & rotating could be an option here too. Or do we want ‘Global Health Conferences … wherever)’, post-2015?

In short, the global health community should lead by example in the post-2015 era of planetary health and SDGs.

The Time is Now to Ration, Innovate & Pool global health (conference) travel!

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