world health assembly

So I haven't updated in awhile but I have become (marginally) more productive in the past week. This has entailed not actually showing up to the WHO, where I have a ridiculously slow, old computer without a USB drive and little to no monitoring.

Instead of going to the WHO, I have been attending some parts of the World Health Assembly, which is usually less interesting than one might assume (or at least less interesting than I assumed it might be…it seems that there has to be a better, more efficient way to run things rather than having everyone who wants to speak/offer commentary/read a report) do so before voting or discussing resolutions. To give you all a little background on the WHA, it's basically an annual weeklong meeting held every year at the UN (the WHO is too small to hold all the delegates) where countries send delegates (generally ministers of public health; the US delegation head is the director of health and human services, Leavitt) to review current programming and discuss policy and priorities for the WHO. I think countries sit in alphabetical order according to their names in French, but haven't totally figured it out. The public is allowed in this seating gallery/balcony, which has two rows of maybe 20 seats or so. At each seat, there is an earpiece that covers your ear, and controls for volume and language. There is simultaneous translation available in Chinese, Spanish, French, English, Arabic, and Russian, and you just turn the dial to what language you want to listen to. This is also available at all the plenary sessions, so it's kinda interesting.

The most interesting and educational part of the WHA for me so far has been the technical briefings. These are generally 90 minute meetings with a panel of speakers organized by either a department at WHO or an NGO like Consumer Project on Technology (aka CP-Tech) or Medicins sans Frontieres (Doctors without Borders, or MSF). A big topic being debated right now is a resolution proposed by Kenya and Brazil to establish a global framework for essential health research and development (aka R&D), which would basically create an intergovernmental working group to address issues of how to fund and devote resources to diagnostics, treatment, and monitoring for 'neglected diseases' (TB, sleeping sickness, onchocerciasis, other infectious diseases). It would also make neglected diseases a priority. Interestingly, it has been shown that less than 1% of the pharmaceutical industry/new innovations registered in the US for the past 10-plus years have been related to neglected diseases, which make up 12% of the world's disease burden.

Some of the topics people have discussed during briefings I've attended include alternative R&D schemes that don't necessarily involve the current system of patents and intellectual property rights (example: the Medical Innovation Prize Fund, currently the subject of a House Resolution in the US), access to second-line antiretrovirals for HIV/AIDS, the breakdown of pricing on medicines in developing countries (from manufacture to retail to end patient price), open access/ data sharing mechanisms used during the Human Genome Project and how that can relate to the advancement of scientific knowledge in general, counterfeit drugs, and more. I've also met some people, but generally feel 'out of the loop' or unwelcome regarding the NGO crowd, even though I really respect and am interested in what they do. Some of the NGO's working on the R&D resolution include MSF, Drugs for Neglected Diseases Initiative (DnDi - I got a cool offer to work with them this summer but decided I wanted the experience of working in a huge multinational organization instead…I sometimes wonder what my experience would be like there), Third World Network, CP-Tech, and others. Today I had a really awkward moment where I went to say hi to this woman who is an advocate and activist that my really good friend in Thailand had introduced me to over email. She was (unsurprisingly) standing in the area where the NGO community had set up camp in the coffee bar area of the WHA (basically a big area with tables, chairs, a coffee bar in the corner…mostly for people to meet). I said hi to her, thought she probably didn’t remember me, and she went to get coffee. I remained standing and the head of MSF came and started talking about the resolution that was still being worked on in the drafting group (originally there were two resolutions and I think they're merging them into one; there were also questions about all the 'brackets' or debatable language in the resolution). I hung out because I was kinda interested and she has insider info, but then felt awkward as I was standing outside this circle and they were huddling closer. I moved to the side and started looking at a document discussing the new language of the resolution and then looked up to see the head of the MSF Campaign for Access to Medicines giving me a semi-dirty look. I was really embarrassed and wanted to introduce myself but then thought, what if they didn't want anyone from the WHO here, or what if they think I'm some kind of weird spy, or whatever. I ended up leaving and feeling really crappy about the whole NGO scene. It's not like these people haven't seen me at every single briefing they hold or sat next to me in some meeting.

There is one NGO guy that has been very welcoming and nice though, and I really appreciate it. He says hi to me when he runs into me at the WHA and tries to keep me up-to-date re: what's going on or what I might be interested in. I am really grateful for anyone who opens up at all to give me direction as I don't feel like most people care about some random Asian American med student, including the person my friend introduced me to over email. This is disappointing to me because I'm one of the younger people around, and it seems like you would want to spark interest in the following generation.

In any case, I've also been enjoying my time in Geneva and been spending time with Kim, Columbia law and public policy student. We went to the medicine pricing briefing together Wed. night and then stopped by the Geneva Intern Network Pub Night at Mr. Pickwick's but didn't really meet a ton of other interns, but we did hang out with Govind, Iris, two roommates (Alpena and this white girl whose name we can't remember), and Laura, a new addition to the Global Health Fellow crew. During dinner, which we grabbed at Ali's, this döner kebab place, the white girl told hilarious stories about how she only ate organic food but used to drink like six espressos a day. Last night we also met up for dinner and drinks at Café Artes and had good times talking about random people we knew, how people made the decision to be super into materialistic goods as a definition of success, college, living abroad, and other fun topics. Our waitress, who was Chinese, later asked me if I spoke Chinese when I went inside to pay the bill and was impressed that I could speak (really horribly) considering that I learned it in college. I was kinda embarrassed since I felt that my Chinese TOTALLY sucked (esp compared to what it used to be) but she was really nice and said we would practice if I saw her again. That was fun (and random, like when the guy I bought my cell phone from spoke Thai to me) and makes me miss speaking other languages.

Last thought. I do miss college, but when I meet people here in college, I think, thank god I'm not premed anymore. Those people are crazy and I don't think most of them understand what going to med school is all about. Not that I know all the answers, but I'm happy that I took some time to see what it was I was trying to accomplish by going. OK, that's it for now. Chris is coming tomorrow!!! :)