Stephen Hawking, not really at the World Health Assembly

This week the Sixty-sixth World Health Assembly is taking place from 20 to 28 May. Officials from 194 Member States have begun their annual review of the activities of the World Health Organisation and will set new priorities. Many NGOs and industry representatives are present attempting to influence them and around 3000 people try to find their way in the vast premises of the Palais des Nations in Geneva. I used to be there as member of the Dutch delegation, busy to keep high civil servants and sometimes even the minister happy with their programmes, meanwhile trying to follow all agenda topics and meeting friends from the global health community. But this year I was more relaxed and could look from the other perspective as staff member of the World Health Organisation

The Health Assembly discusses many health topics like specific diseases, health coverage, women and children’s health, as well as the budget and management matters of WHO. The official opening of the assembly is bombastic, in a huge plenary hall and with much formal ceremony. After that the delegates split in two still very big rooms to discuss proposed resolutions. There are also many side events during breakfast, lunch and late afternoon sessions. I did organise one myself on Wednesday evening about the outcomes of the long-term care meeting in The Hague. With so many people around it is possible to compose great panels and we had a well visited session with among others high level representatives from the USA (assistant secretary), Brazil (vice minister) and Japan. Even better, they had good stories.

There are always impressive moments during the Assembly. Negotiations on important topics can be tough and can last till deep in the night. I still remember 2008 when I was once from 8 in the morning till 4 in the night at the palais. A small drafting group was composed when the big group with all countries could not find a compromise and had to go on with the other items on the agenda. The drafting group was working the whole week to find an acceptable text for everybody and I had to be there on the last difficult evening before closure of the assembly. The topic concerned was very political: how to make medicines affordable to everybody but also ensure that pharmaceutical companies have enough incentives to innovate (and to make profits).

Also interesting are the guest speakers on Tuesday. In previous years I have listened to Desmond Tutu, Bill Gates and Queen Noor, to name a few. This year they invited the president of the World Bank Jim Yong Kim. His speech was rather impressive, calling to end poverty by 2030. Bringing effective health services to all people is one essential element to achieve that. He concluded by saying that we face a moment of decision and that the question is not whether the coming decades will bring sweeping change in global health, development and the fundamental conditions of our life on this planet, but that the only question is what direction that change will take: Toward climate disaster or environmental sanity; toward economic polarization or shared prosperity; and toward fatal exclusion or health equity.

The point of health equity (no big differences in health due to your income or social status) is not just something for poor countries. Remarkably, it was the United States in the session on universal coverage that stated that health care is a right and fundamental in the next development agenda (now being prepared for the period after 2015). They also admitted that they have much to learn from the successes of other countries and that they are late in the progress. Despite of Obamacare many Americans do not have health insurance and can be ruined by catastrophic health expenditures when they fall ill.

Another touching moment was the session on disability. There are 1 billion people in the world with some form of disability and almost everybody will experience some form of impairment during their lives. People with disabilities have the same health care needs as others, but are 4 times more likely to be treated badly and 3 times more likely to be denied health care. Half of them cannot even afford health care. Of the 70 million people in the world that need a wheelchair only 10% have access to one. Staggering figures and it is good that there will be a special session during the UN General Assembly on disability on 23 September 2013.

But it became even more staggering when concrete people explained how they dealt with their disability. First Stephen Hawking, the famous physicist, spoke in a video address about his motor neuron disease but how he could still be successful in his work and personal live. But also that he realised that he was very lucky guy !!! as he had access to first class medical care and the resources to have all kinds of support. Many millions of people do not have that and are denied access to health rehabilitation, support, education and employment. They never get the chance to shine.

But shining did the next speaker, Alexandre Jollien, a rather unknown young Swiss philosopher with a disability. He had a moving story about that at home he does not really feel disabled but that as soon as he moves out of the house he is confronted with his disability and everybody considers him a disabled person. He explained, as only French speaking philosophers can do; a disabled person is not a disabled person and that is why we call him disabled. But we change from day to day and that is also the case for the disabled. He concluded by thanking The Director General sitting next to him, Margareth Chan, who is not Margareth Chan and that is why we call her Margareth Chan for the chance of speaking here and by saying that having a disability is nothing to be ashamed of.

The World Health Assembly can be crippling as well for its participants. Long days of sitting together with many people in a cramped room, sleeping in dusty hotel rooms, rich diners but also long intervals without any food & drinks. This year was a of course a bit better for me although flying home now I do not completely feel like Fred Lafeber anymore, who is not Fred Lafeber anyhow.