Reflections from Canada’s Youth Delegate to the 58th Pan American Health Organization Directing Council (PAHO DC) Meeting

Overall, the 2 full days of meetings on 28-29 September 2020 that covered 22 agenda items and 9 resolutions were very positive, productive, forward-looking, and constructive. Substantial areas of work and progress were made on PAHO governance reform and the successful informal negotiations of the adopted item on COVID-19 Pandemic in the Region of the Americas. Some politicization of the public health response and issues were seen, similar to the politicization of public health issues seen earlier in the virtual 73rd World Health Assembly that took place in May 2020.

In advance of the 58^th PAHO DC, as the youth delegate, I provided feedback on items #4.2 (COVID-19 Pandemic in the Region of the Americas) and #3.2 (Annual Report of the Director of the Pan American Sanitary Bureau) – this feedback was supported by additional comments and reflections from youth, students, and young professionals across Canada that have been involved throughout my term as the youth delegate. I was also really pleased to see the incorporation of unique considerations on the impact of COVID-19 on youth into Canada’s intervention for item #4.2; “Canada would like to invite PAHO to incorporate a greater analysis in PAHO’s COVID-19 response on how to address the needs of impacted vulnerable youth and young people. We value the unique youth perspective and thank the Youth delegate in Canada’s Delegation to the 58th Directing Council for raising this important issue.”

The COVID-19 pandemic has impacted the region in extraordinary ways including how member states conduct the governing body meetings, such as PAHO DC, including how the youth delegate traditionally in previous years has engaged in the PAHO DC itself as well. In some ways, this has allowed for inclusion and engagement of the youth delegate with the OIA/PHAC team in more integrated and meaningful ways, providing substantial insight and learning on the intricacies of global health governance and diplomacy during a global health emergency and pandemic of unprecedented proportions.

In moving towards a virtual format for the first time in the organization of PAHO’s history, providing a truly unique opportunity to be a witness to the strong calibre of expertise of the OIA/PHAC team with regards to governance-related accountability and transparency for which the Canadian delegation plays a critical role in. Uniquely, this allowed for gaining insight into particular granular details related to the organization’s financial matters of regulations, rules, and reports of the director and external auditor. This also included the opportunity to witness informal negotiations between PAHO member states on the COVID-19 related item as previously mentioned.

High-level opening remarks during the first day of meetings set the foundation for a productive agenda that focused on the need for national unity, global solidarity, and investing in multilateral organizations such as PAHO which happens to be the first multilateral organization in the world at the time of its creation. It was acknowledged that the Americas region at the time of the meeting, is the global epicentre of the COVID-19 pandemic due to the steep rise in the incidence of cases.

There were important remarks shared on the disproportionate impacts of the COVID-19 pandemic on more vulnerable peoples and populations (i.e., Black and Indigenous peoples of colour) and the pre-existing inequalities from gaps in social determinants of health (i.e., peoples with informal jobs, housing conditions that are incompatible with physical distancing, older age above age 60, and people with underlying medical conditions such as non-communicable diseases).

In particular, the hurricane season was described as the ‘heart attack of the climate crisis’, recognizing that the disproportionate impacts of climate change on human health affect peoples in the Americas region in different ways (i.e., forest fires causing asthma/lung disease, weather change and natural disasters causing displacement/migration/injury, mental health impacts, and among many other impacts). It is a critical moment to consider, address, and respond to the impacts of the climate crisis as now more than ever, we are focusing more on an economy of wellbeing to support people and communities with social and economic policy to protect and promote health in the context of the COVID-19 pandemic. Recognizing that preparedness and response to the ongoing climate crisis is both a necessary and critical investment for global health outcomes and strengthening the concurrent response to the COVID-19 pandemic.

In summary, as well put by Dr. Carissa Etienne (Director of the Pan American Sanitary Bureau), “there can be no competition between the health and economy, a healthy nation is a wealthy nation…health is a public good”. And similarly, as commented by Dr. Tedros Adhanom Ghebreyesus (Director-General of the World Health Organization), “investing in health is not just the right thing to do, it is the smart thing to do”. This opportunity to meaningfully engage so very uniquely in global health diplomacy and governance processes during a global pandemic and health emergency has provided an immeasurable and invaluable learning experience that has been profoundly insightful and humbling.

In closing, upon reflecting on the informal discussions with other youth representatives and leaders around the world in the area of global health governance, I have yet to come across another youth delegate or representative that has had an experience comparable possibly due to reduced engagement with youth in the context of the need for nimble and timely decision making for the COVID-19 pandemic; in contrast, this is arguably more important than ever provided the circumstances and the particular impacts on an entire generation of youth living through drastically unimaginable times in their lives thus far.

The COVID-19 pandemic has inflicted tremendous negative impacts on peoples and communities around the world, both in direct and indirect ways. It has been a time of great suffering, but also a true demonstration of the adaptability and resiliency of the human spirit. We are more interconnected and interdependent than ever on one another’s successes and failures in the pandemic response – let us never forget the importance of investing in prevention and preparedness through holding the health and wellbeing of all peoples and communities to the highest possible standards and values.

-yipeng