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

The Canadian delegation convened at the Public Health Agency of Canada office building in Ottawa – which is the traditional, unceded, and unsurrendered territory of the Algonquin people.

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 58th 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.

Delivering Canada’s intervention on item #4.1: Report of the End-of-Biennium Assessment of the PAHO Program and Budget 2018-2019/ Final Report of the Implementation of the PAHO Strategic Plan 2014-2019

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.


we ought to prioritize health, wellbeing, and humanity above all else

Sept 20, 2020 – It has been three months since residency training started, and over six months since our local communities have been acutely responding to the COVID-19 pandemic. 

The experiences that so very many have faced and continue to face throughout the public health response to this global pandemic of our times have been exceptional and extraordinary. The resilience that many have demonstrated, the suffering that has been felt, and the difficulties and challenges that continue to lie ahead in uncertain times continue to linger in my mind daily. 

Over these past few months, I’ve tried to make sense of drastically different social norms that we’ve come to embrace as a collective to protect each others’ health and wellbeing – that of wearing non-medical masks in public, physical distancing when possible, and using hand sanitizer countless times in a day. The strangeness of it all is still hard to shake – considering how different things were only a mere 6 months ago. 

The pandemic has affected so many people in different ways and has cut sadly many lives short. The unintended impacts of the public health response to the pandemic have been challenging for many at best and life-threatening at worst. I had met a patient that had come to the clinic in-person and for me to realize that this opportunity of leaving their retirement home has been the first opportunity they’ve been allowed out of their building since the pandemic began – how happy she was to again enjoy the simple things of picking up some groceries and sitting on a park bench to people watch, if only for a short time. I too have learned and relearned of how many things I am incredibly grateful for – taking the time to be fully present and aware, acknowledging my worries, fears, and frustrations. 

The pandemic has acutely and perhaps chronically allowed us as a society to re-examine our priorities and values that prioritize health, wellbeing, and humanity. We have seen health and social inequities widen and worsen. We have seen disproportionate negative impacts of the pandemic and pandemic response on priority populations, including those that are in more vulnerable and marginalized situations. We have seen racism, discrimination, misinformation, and stigma contaminate an effective, collective, and cohesive societal response. And we have seen the inextricable linkages and concurrent climate and ecological crisis that is unfolding more and more each day demonstrating its dire health and social consequences. And we have seen economic impacts, a system created and sustained by communities that will only thrive when communities and people themselves are healthy, well, and thriving. 

We have also seen tremendous acts of heroism, kindness, humanity, and solidarity. 

There is much still to be optimistic about, and as we have seen from these past few months from the response to the global pandemic at all levels, there are certainly means to address social and health inequities rapidly and thoughtfully. These complex systems-level issues can be fought and addressed, but it will take realigning our priorities and values to do so – as the previous system simply was failing too many people in vulnerable situations. The answers and path forward for a strong, just, and equitable recovery and response to the global pandemic lie within communities, and it is up to all of us to listen. We ought to collectively continue to envision communities and a world that priorities health, wellbeing, and humanity above all else. The future of our earth, our communities, and the generations after us depend on it. 

– yipeng