Three Days in Geneva

Lack of internet has made my posting a little delayed, but I wanted to take this opportunity to summarize three packed days in Geneva, the first stop of our semester-long trip. In those three days we visited a number of intergovernmental organizations with a role in global health: WHO, IOM, ICRC (red cross), UNAIDS, and the UN (You can look up those acronyms if you are really curious), culminating in a lunch with the health minister of India atop the roof of the UN building, overlooking a gorgeous Swiss landscape (yeah I know it’s not an opportunity we secured by merit in any way, but it’s still pretty exciting).

It’s both exhilarating and daunting to get a sense of the scope of decisions made here, by people who suddenly seem like human beings rather than fancy titles you read in published literature. It’s admirable to know these people have devoted their lives to the ideal of health for all. There’s just something so refreshing about the ideals of the ICRC, whose commitment to remaining a neutral, independent provider of healthcare to any person affected by armed conflict was personified so strongly by our guest Dr. S. That man is an unbelievable inspiration if you could hear him speak. Unfortunately, according to our professor, even the Red Cross is not immune from internal political power struggles.

That brings me to my second, more critical perspective. The global health landscape is facing some sweeping changes, changes that institutions such as the WHO must keep up with. There is a shift toward chronic lifestyle diseases such as diabetes and hypertension, even as global health seems myopically preoccupied with single diseases and short-term targets (As Dr. Chan pointed out, investing in health systems is not “sexy”). Investing in health systems is crucial to not only develop long-term self-reliance but also to ensure the success of disease-oriented programs such as those to combat HIV.

Perhaps the most striking part of these three days was not the grand buildings and the photo ops, but two stories we were told by our professor. The first is about cars. Whenever a new official is promoted to work in the WHO, you can usually find them by looking for the shiniest BMW. The second is about education. A year of elementary education at one of the greatest international schools in the world costs around $25K a year—good thing that it’s covered by the UN for its employees.

It’s stories like these that make you wonder at which point a grand dream for the world turns into a way for the powerful to spread their ideas while treating themselves. I’m not yet ready to agree with a statement as cynical as that. But as pointed out to me by those with far more experience, Dr. Chan’s was painfully honest in her recognition that the WHO is reaching a funding plateau and in her demand that it downsize to reduce organizational disarray and excess.

(Will post pics later, having a laptop crisis)

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