Over these past two weeks after the resumed session of the 73rd World Health Assembly (WHA), I’ve had some conversations with other Canadian youth interested in the Canadian youth delegate role (see application form here) and I’ve been asked some great questions that I realize aren’t made very clear in the application form itself.

Over this past year, I’ve had the privilege of being the Canadian youth delegate to both the 73rd World Health Assembly and the 58th Pan American Health Organization Directing Council meetings. These two meetings are respectively the highest-decision making or ‘governing body’ meetings for the World Health Organization and the Pan American Health Organization – two significant multilateral organizations that the Canada is a Member State for and with. Canada as a Member State sends (or this year attended virtually) a delegation comprised of public servants from the Public Health Agency of Canada, Global Affairs Canada, a Canadian youth delegate, and sometimes a representative from a civil society organization in Canada. Canada attends these meetings to not only receive updates on the work of these multilateral organizations to advance global health priorities and goals, but also to keep these organizations to account in their work and deliverables. The role of the Canadian youth delegate is to provide a youth perspective and lens to the global health issues and topics discussed in advance of these meetings to help strengthen and inform Canada’s positioning and delivery of interventions during these meetings.

These past few months have seen incredible and exceptional attention paid to health and wellbeing of peoples and communities around the world. As a result of the COVID-19 pandemic, the spotlight has been cast on organizations such as the World Health Organization and the Pan American Health Organization and other similar technical organizations that deliver public health guidance and research, crucial for core functions of public health, but certainly during an emergency response to the pandemic of a novel coronavirus. Uniquely, is the role of the World Health Organization, to be seen as a leader in coordination of an international response to the pandemic, including how to ensure similar situations do not repeat themselves again in the future.

The resumed 73rd WHA (virtual) that took place between Nov 9, 2020 and Nov 13, 2020 covered various governance related topics, resolutions not passed over the summer months with a written silence procedure, and an update on covid19 response measures including various review mechanisms for pandemic prevention, preparedness and response. Full details are available here. And a high-level summary prepared by the International Federation of Medical Students’ Associations (IFMSA) can be found here. Many Member States delivered important interventions covering a vast array of topics – in particular, the direct and indirect impacts of the covid19 pandemic on their communities. As well, many Non-State Actors, Intergovernmental Organizations, and Regional Offices of WHO, also provided similarly compelling remarks.

WHO’s Director General, Dr. Tedros, urged that all leaders must prioritize health systems to be better prepared to deliver health services and that strategies will not be successful without the people delivering them (i.e. doctors, nurses, pharmacists, etc.), and thus investments must be made to tackle a global health workforce crisis. Of note, 2021 has been designated as the International Year of Health and Care Workers, to show and demonstrate the essential role of health and care workers during the covid19 pandemic. Dr. Tedros also went on to comment on how over 50 million peoples have been infected with covid19, with 1.2 million deaths, and with more peoples that have died from the disruption of healthcare services. The grief cannot be measured. These statistics do not easily reflect the suffering and the important narratives and stories of individual people and loved ones. The long-term impacts of the covid19 pandemic, both direct and indirect will be enormous, and the type of world inherited by the next generation is hard to imagine.

Dr. Tedros also shared important developments and updates on rapid testing for covid19, the ongoing development of various vaccine candidates, including the COVAX facility (accessible and equitable distribution of vaccine as a global public good) and a covid19 technology access pool. Commendable advancements in public health include the eradication of wild polio virus and the first time the global community has committed to eradicate a particular cancer – cervical cancer. Other updates shared covered the ongoing sustained surveillance for a global response to AMR or antimicrobial resistance. As well as, necessary investments for mental health supports for healthcare workers, tackling a global shortfall of nursing workforce (shortfall of 5.9 million nurses), and bolstering essential public health functions and healthcare services. The issue of sustainable financing for the work of the WHO was also discussed, as the expectations of Member States and the global community on the role of WHO has been disproportionate to what the WHO has been financed to be able to accomplish. And finally, Dr. Tedros ended his remarks that “it is time for the world to heal”, although multiple covid19 vaccine candidates are in development, there is no ‘vaccine’ for poverty, the climate crisis, and inequalities.

Furthermore, during the resumed 73rd WHA, the various review mechanisms and committees were able to provide updates on the status of their work. Three areas of review mechanisms are currently in place to strengthen the international prevention, preparedness, and response to pandemics and health emergencies. They are the IOAC (Independent Oversight and Advisory Committee for the WHO Emergencies Programme), IHR review committee (Review Committee on the Functioning of the International Health Regulations (2005) during the COVID-19 response), and the IPPR (The Independent Panel for Pandemic Preparedness and Response). While important recommendations continue to flow through various mechanisms and channels for ongoing consideration, improvement, and implementation (such as a traffic light system for pandemic response and risk, sustainable financing for the WHO, ensuring the IHRs are fit for purpose, etc.) – what is clear, is that multilaterialsm is the only approach to global challenges. These review mechanisms may significantly impact global architecture for health security and health and wellbeing post-pandemic. It is also a hope and aim that a humanistic approach is taken to strengthen public health structures, that also strives towards social justice and resilience, in order to address current and future public health emergencies – knowing that structural vulnerability are the fault lines of the pandemic impacts.

The “right to health is the most important right”.

Over the next few weeks, the application period is open for next year’s Canadian youth delegate to the World Health Assembly and Pan American Health Organization Directing Council. The application is available here, and the deadline is December 23, 2020, at 23:59 EST. Please don’t hesitate to reach out if you have questions.

-yipeng

Tomorrow the 73rd WHA (World Health Assembly), the highest-decision making governing body of the World Health Organization, resumes over a span of the week to cover areas of priority that remain unaddressed since the 73rd WHA that took place in May 2020, focusing primarily on the global COVID-19 response and the role of the WHO in this response.

In advance of the resumed 73rd WHA taking place in November 2020, I had an opportunity as Canada’s youth delegate, to gather additional perspectives and ideas to help shape the youth perspective and priorities that helped inform the Canadian delegation’s positioning on various items.

The youth consultations (virtual roundtable discussions, online survey, additional informal one-on-one discussions) were framed around two key questions: 1) how have Canadian youth been impacted by the COVID-19 pandemic? and 2) what is the role of youth in the COVID-19 response?

Canadian youth are a diverse population of students, young people, and professionals that have been contributing to the COVID-19 response through essential work (i.e. in healthcare institutions or in public health units), volunteering (i.e. initiatives to support vulnerable community members, gathering PPE for hospitals/clinics), and advocating for a healthy, green, and just recovery from COVID-19 (i.e. tackling the syndemics of climate crisis, opioid crisis, housing crisis).

Canadian youth have also shown great resilience and flexibility in learning in a virtual means due to the COVID-19 pandemic, but this has also led to significant challenges to accessibility and equity in certain cases, and has impacted how socialization, connection, and mentorship can take place, with important considerations on impacts to mental wellness and building a truer sense of community.

Canadian youth are also very cognizant of the impact of misinformation on our populations/communities and its impact on our compliance with COVID-19 related public health measures. We also have a unique role to play to tackle the ‘infodemic’ in creating scientific communication that is appropriate for youth audiences, that ultimately cuts through the noise and helps provide understanding and facilitates behaviour change.

Many have taken note of the need to concurrently address and utilize the partnerships and collaborations that have allowed an effective and efficient COVID-19 response to date, to also effectively and efficiently respond to the syndemics and intersection between this pandemic and many other crises (i.e., climate, opioids, homelessness, mental health, etc.) and how such crises also disproportionately affect already marginalized and vulnerable populations.

It has been identified that there has been a lack of inclusion of youth in the decisions surrounding the local/provincial COVID-19 responses. The governance structures of decision-making institutions need to reflect meaningful engagement, inclusion, and participation of youth.

The following questions and discussion items summarize and/or quote excerpts that summarize the discussions and inputs that took place on these guiding questions.

How have you as a youth, student, or young professional been impacted by the COVID-19 pandemic?

• Education: The loss of opportunities for learning, and job/volunteer opportunities, online learning, and working environments – more difficult to connect socially and develop networks.
• Mental wellness: Presence of screen/’Zoom’ fatigue, familial stress, not having the optimal environment at home for studying/learning – other siblings, parents that work from home, etc. (unsafe home environments for certain youth).
• Finances: The gaps in social assistance for young people – transitions in jobs over these past few months, leaving a job for another job set up (only to find this job has been cancelled), and left under/unemployed.
• Relationships: Feeling of being more isolated for those aged 18-30 (formative years of building relationships, personal and professional networks, and socialization), and family responsibilities – informal caregiver to others (older adults at home, younger siblings).
• Social determinants of health: Acknowledging privilege of having food, shelter, supportive families, etc. (not all youth have such privileges). “Increased reflection about my privilege as someone who has a supportive family dynamic at home, having shelter, access to nutrition, ability to social distance, to continue my studies”.

From your perspective, what do you think is the role of youth in the COVID-19 response at the level of the WHO?

• Communication: Youth should be more involved in creating youth friendly and specific messaging on various social media platforms (Twitter, Instagram, TikTok etc.) – relatable and accurate content. And youth have a critical role in tackling the ‘infodemic’.
• Advocacy: Acknowledging and advocating on health and social inequities, youth perspectives when it comes to equity, inclusivity, diversity and a just recovery. “Advocating for better social support system, for communities disproportionally affected by COVID (economically but also in terms of mental health, access to care, social isolation, etc.) and most importantly advocating for the climate justice and imminent urgent response to climate change”.
• Youth voice and decision-making: Advocating for mental health services and creative community building, ideas for building resilience, resources on navigating difficult relationships in close circles, including employment concerns, learning and mentorship concerns, and safety of youth. Youth to be more included in decision making, especially for the decisions relating to us that directly impact our lives.
• Sharing wise-practices: Providing recommendations on how youth have contributed to COVID-19 response in various parts of Canada.
• Educating for prevention: “Create a youth culture of preventative, protective, and proactive medical actions through habit creation and behaviour change to stop the spread of COVID. And, most importantly, connect with each other through formal and informal networks to support each other in creating the post-COVID-19 world we want to see, as outlined by a just COVID recovery for all (https://justrecoveryforall.ca/), and be financially supported by local governments to kick start and complete such initiatives. In this process, we will create the jobs we not only seek, but that our world needs”.

How has the COVID-19 pandemic affected your vision of the future in terms of health equity and climate justice?

• Widened gaps in health inequities and other social determinants of health: Women’s health (domestic violence, ongoing access to birth control, childcare & working at home causing heavier burden on women’s mental health), health of the racialized, urban poor communities who need to be physically present for essential jobs & at higher risk of exposure. It has also shown some ways forward in how workplaces can be more accommodating to working women with a family and provides a strong case for a universal minimum income.
• Reducing environmental impacts: Climate change is not only an environmental issue but also a health, economical, and social issue which needs to be urgently addressed. “I worry that climate justice will be forgotten while we ramp up single-use plastic use, single-use PPE, and disposable cleaning products during this pandemic which in theory will exacerbate climate change. I was hopeful meaningful climate reforms would be considered prior to this pandemic and now I worry our priorities are shifted so completely away from it that we will not get back to this topic for months, if not years – when months and years are incredibly important at this critical time for climate change”.
• Collective well-being: This pandemic has exacerbated pre-existing inequities and have made these inequities more visible to the general public. “Further highlights to me that global health isn’t about national boundaries or different countries, but really about finding ways for all of us to thrive in this inextricably linked global community”.

With hope and hard work, let us re-imagine building a better world that is ultimately better than before the COVID-19 pandemic began – putting health and wellbeing of people and communities as the highest priority.

-yipeng