Experiencing Global Health Policy from the Inside: Global Health Fellows, Geneva, 2013

This blog post was contributed by Liz Charles, RN, BSN, MBA (Duke ‘13). 

The 2013 Duke Global Health Fellows

“Nothing ever becomes real 'til it is experienced.”
― John Keats

This summer, funded by SEAD, I participated in Duke’s Global Health Fellows program in Geneva, Switzerland. As part of the fellowship, I interned at the World Health Organization (WHO), took coursework on Global Health Policy and Governance, and met a variety of leaders actively engaged in international health. 

Nearly three years ago I applied to the Health Sector Management program at Duke’s Fuqua School of Business School and wrote in my application essay about my “long-term goal of working with a multinational aid organization, such as the World Health Organization” and how I hoped a Duke education would prepare me for such a role.

You can imagine my excitement, as I boarded a plane for Geneva, Switzerland (home to the World Health Organization) this past spring, only two days after graduating from Duke’s Fuqua School of Business.

As a business student, I had worked with social entrepreneurs and global health projects in Rwanda, India and Ecuador. In these roles, I encountered many international NGOs and their easily identified white, 4X4 vehicles. Previously, as a pediatric nurse, I had looked to the same organizations for advice and guidelines on particular health topics. Nonetheless, my understanding of these large organization’s function and purpose was limited. As I looked to create a career in Global Health, I felt I needed a more comprehensive understanding of global health policy. So, while the rest of my classmates enjoyed post-graduation celebrations, I happily journeyed to Geneva.

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Liz watching proceedings of the WHA

Interning at the WHO:

 I arrived two days before the annual World Health Assembly (WHA) conference during which delegates from every country descend on Geneva to set the WHO’s work agenda for the upcoming year – and, hopefully, follow these mandates with financial donations to cover their cost.

The WHA was an eye-opening experience in diplomacy, negotiation and international relations. Each resolution requires unanimous approval - approval that is usually preceded by long discussions to ensure accurate wording, integrity to political aims, and equity in delivery. The output creates a framework to guide the Secretariat (i.e. WHO employees), ministries of health, and other public health organizations.

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WHA informal negotiations

During the WHA lunch breaks, side meetings and evening events, I enjoyed meeting delegates from all over the world and discussing their countries’ health concerns. One discussion I had was with the US health attaché, Colin McIff. From him I learned about the challenge of making sure all parties in a negotiation have something to show for their effort. Mr. McIff also said that lack of agreement isn’t always a loss, as it provides valuable insight into understanding other’s views.

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The PHI Team

As a WHO intern I worked in the Department of Public Health, Innovation, Intellectual Property and Trade (PHI) on a research synthesis project. I collected documents outlining research priorities from the different departments (32+) across the WHO headquarters. Each document was analyzed according to prioritization method used and criteria applied. Then each priority was analyzed according to type of research (epidemiological, basic science, product development, implementation or evaluation).  

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While initially intended to identify which products (drug, diagnostic, device, vaccine, etc.) were most needed for diseases that predominantly affect the developing world, and for which current market forces have failed to create enough research and development incentive, preliminary results showed greater needs in better data (more recent, more representative of the developing world, more accurate), better understanding of how to get products to patients (implementation, operational and translational research) and better evaluation of which programs and products are cost effective and impactful, and which are not.

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Global Health Policy and Governance Class Week:

For one (very) full week, the 22 Duke Global Health Fellows attended classes arranged by Sanford Professor Anthony So. 

Global Health fellows working through
international crisis scenario

Each morning we were visited by health care leaders addressing hot topics, such as: health financing and universal health coverage; non-communicable diseases; and mental health and violence prevention. Each afternoon we made site visits to leading public health organizations, such as: Doctors Without Borders, the GAVI Alliance, and The Global Fund. The Global Health Fellows showered these organizations’ directors with questions reflective of the cohort’s diversity – i.e. students of law, business, policy, public health, and medicine, and created a ripe learning experience for us all.

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Students chatting with Professor Anthony So (Duke)

During our final day of classes we attended a presentation with the Director Generals of the WHO (Margaret Chan), the World Trade Organization (Pascal Lamy) and World Intellectual Property Organization (Francis Gurry). The meeting was symbolic of the increasing interest in public private partnerships – in this case - public health working with business and trade to solve access and delivery issues. During the presentation Margaret Chan said,  “Finding new business models for public health innovation is something we want.” Working together, these three organizations are seeking for win-win solutions.

Networking in Geneva:

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The interns in my WHO department organized weekly lunch-and-learn meetings with individuals we found interesting. Our luncheons included talks with a consultant for the Bill and Melinda Gates Foundation, a UNAIDS advocate, and an Eli Lilly vice-president, as well as each of the directors in our own department. We received great insight and advice from each luncheon. During one such event, I was introduced to two Department of Tropical Disease Research (TDR) employees looking to research social entrepreneurship’s merits for Public Health. I established a connection to the Social Entrepreneurship Accelerator at Duke (SEAD) and helped write a concept paper on what a future partnership between the two organizations might look like.

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“Don't cry because it's over, smile because it happened.” 
― Dr. Seuss

I gained much more through my WHO experience than I could have ever imagined. As Keats suggested, the experience of working within the World Health Organization made the entire system “real” to me by: exposing the merits and weaknesses of the various international organizations, generating a deeper understanding of global health policy, and introducing a cast of like-minded individuals working to promote health from a variety of vantage points. I thank SEAD and USAID’s Higher Education Solutions Network (HESN) for their support of the Duke Global Health Fellows program and its effort to create future global health leaders.