The Global Health Landscape Symposium: Revitalizing the Global Health Advocacy Agenda (#GHLS18) was a moment as well as a meeting: to gather leaders in global health policy, programming, education, implementation, and beyond. On November 30, nearly 200 attendees from 110 organizations came together in Washington, DC to engage with the state of global health from a distinctly intersectoral perspective. The 2018 Symposium is part of GHC’s global health leadership series.
After initial introductions from GHC Board Chair Kate Dodson (UN Foundation), the day was begun by opening the floor to jump-start the conversation with commentary by attendees. Despite panel moderator Raj Kumar of Devex launching into this discussion at 9:00 AM (on a Friday morning!), participants all over the room stood up to contribute ideas about the global health concerns, priorities, goals, achievements, positioning, and perspectives. I, meanwhile, was blearily scribbling their words down, while taking quick breaks to sip my heavily caffeinated black tea. Luckily, even as questions formed in my head, others in the room were expressing the same thoughts in focused statements.
Representatives from PATH, the American Heart Association, UN Foundation, Global Health Corps fellows, RESULTS, NCD Child, the Global Health Technologies Coalition, Save the Children, and many more offered their perspectives on some necessary first steps for a discussion about global health, benchmarked at the end of the year 2018.
The audience began by bringing up needs for:
Phew. Did you get all that? Spoiler alert, the audience was incredibly prescient with their initial commentary. And, I repeat, at 9:00 AM in the morning. This boded well for the rest of the conference.
Indeed, in the first of what would prove to be a day of well-balanced panels, Jen Kates (Kaiser Family Foundation), Keifer Buckingham (Open Society Foundations), and Charles Holmes (Center for Global Health and Quality, Georgetown University Medical Center) discussed the above ideas, hearing opportunities and concerns and posing the question: what next? Financing and accountability were key topics of the day, as resource mobilization and the question of “who is responsible?” are organizationally important to consider for policy advocates and implementers alike. Panelists discussed the effects of positive versus negative messaging and what it means to keep up the pressure on certain diseases while also managing to draw attention and resources to more neglected areas of health.
Meanwhile, as resource mobilization efforts and needs vary between contexts, panelists called for each organization to make and share clear statements on the added value of their work. They recognized the importance of formal structures and high-level meetings but noted that action is what is ultimately required. The panel concluded that health advocacy requires making a solid case for why taxpayer dollars should be allocated in particular areas, as donors (public and private) demands increasingly rigorous attribution and results.
Universal Health Coverage as a unifying goal
In a brief recorded message, World Health Organization (WHO) Director General Dr. Tedros Adhanom Ghebreyesus welcomed GHLS18 attendees and reminded everyone that the basis of global health work is that health is a human right. Those who do not have access to health and healthcare are actively deprived of their foundational rights and that the pursuit of universal health coverage (UHC) aims to resolve this global disparity.
What a prestigious lead-in to the next panel on, “Achieving Universal Health Coverage and Primary Health Care for All,” moderated by Roopa Dhatt of Women in Global Health. Panelists nodded to Dr. Tedros’ reminder and wasted no time in jumping in to a discussion on access to health as the first priority. This in turn requires thinking about the distinct policy environments where implementation takes place. Elisha Dunn-Georgiou (PAI) repeatedly brought us back to practicality as she noted how we constantly see commitments, signatures, and action plans; but “whether these turn into implementation is a different story.” She noted that civil society must be included in all of these decisions because they are both the voice of the community and the ones who hold governments to account in reaching the most marginalized. Participatory design from the very beginning is the only way.
It’s unique to be at a conference where every panel is the rockstar panel. Discussants brought up the need to reach beyond health to advocacy and grassroots movements in other sectors. If we are truly intending to reach the most vulnerable this must be addressed. Roopa summed up much of the conversation by remarking that the “usual people around the table means the usual solutions”. James Fitzgerald, Director of Health Systems and Services at the Pan-American Health Organization (PAHO), succinctly dismantled false dichotomies of organizational structure that distract from the point: a focus on priorities, health needs, how the systems can deliver them, and people. Mic drop.
Applied advocacy – learning from experience & strategizing for a changing political environment
Eight breakout sessions, divided into four topic areas, gave space for attendees to participate in smaller group discussions that brought experiences, critiques, and suggestions for solutions to bear on the topics of the day – primarily how to effectively tailor global health advocacy for impact.
- Session A: U.S. Perspective on Universal Health Coverage
- Session B: Universal Health Coverage in a Multilateral Context
- Session C: Transforming Advocacy through Messaging
- Session D: Transforming Advocacy through Mobilizing
Some key takeaways are that advocates need to step outside their respective bubbles to translate global health priorities into language (and have I mentioned messaging?) that policymakers who have a constituency to report to would resonate with. UHC goals are more easily understand in their unpacked components and building blocks (strengthening community health systems, the journey to self-reliance, access to basic services, and so much more) rather than represented as three simple letters we assume are clear to all. In the second group of sessions, participants were invited to come up with transformational strategies based on past experience and future goals. Small groups brainstormed messaging strategies for engaging a wide coalition of partners, and their respective strengths and interests, in advocacy efforts. Ultimately mobilization was a key focus and the last session examined how advocacy could be ramped up, especially in the context of the UN high-level meeting on UHC and other global priority meetings.
Dialogue with U.S. government representatives
A lunchtime panel with members of the U.S. government Executive Branch was moderated by GHC’s own President and Executive Director, Loyce Pace. The session engaged administrators from the Bureau of Global Health at USAID, the Center for Global Health at the U.S. Centers for Disease Control and Prevention, and the Office of Global Affairs and the U.S. Department of Health and Human Services.
Soon after, California representative from Sacramento County, Rep. Ami Bera, MD (D-CA-07) took the stage to discuss government’s role in understanding global health and how to address these problems in the 21st century. Rep. Bera noted that the U.S. Congress has the opportunity to take a broader definition of “health” and consider poverty, displacement, hunger, and other underlying issues. He emphasized that many in Congress are new to health issues and so in conversations with them and their staff, it’s helpful to connect global health issues to issues that are important to constituents.
Transformation and amplification – propelling global health advocacy goals forward into 2019
The late-afternoon panel, “Transforming Global Health Advocacy,” featured Carolyn Reynolds, (PATH), Grace Virtue (ACTION), Lisa Cohen (Global to Local), and Luc Kuykens (Sanofi). All mentioned the importance of working in advocacy on national and sub-national levels in each country. The sub-national arenas are where sustainable moves are made. Grace emphasized the need for urgent action beyond talk, saying “as each decade goes by, we’re losing generations.” We can only strategize so long – if we are to make any difference at all we have to listen to those who are suffering and act.
Three health reporters participated in a concluding plenary on global health in media entitled, “Amplifying our Agenda.” Adva Saldinger (Devex) moderated a Q&A style forum with Washington Post reporter Lena Sun and Huffington Post reporter on public health policy Lauren Weber. Both reporters were explicit in differentiating between issues that are news-worthy, and issues that are important for global health advocate agendas. One of Lena’s recommendations was to think about what and how you talk about issues around the dinner table; that is what they want to be covering – with depth and sources that create a story. Not necessarily each and every annual World Health Day, which, though they serve as opportunities to showcase achievements and goals, do not represent gripping news per se.
GHLS18 was the ideal setting to get an overview of who is doing what in global health in Washington, DC and to examine the challenge of how global health and universal health coverage advocacy can be aligned for greater impact. The Symposium showed that advocacy goals and strategies are comparable across all topics and disease areas. In order to move forward towards international aims of universal health coverage and health equity, we must continue to share best practices and operate with these overarching goals in mind rather than in such an individual organizational manner. Speakers and attendees alike called on attendees to operate at every level considering people and patients as the center of all equations rather than at some distance down the road.
Looking back at those 9:00 AM comments, it’s interesting that most ended up being predictors of the main themes of the rest of the day. There is a lot of work to be done yet but the ideas that were brought to the table were solutions focused and dismantled organizational distractions in favor of real, experience-based approaches. Those who attended GHLS18 can leverage the knowledge, inspiration, and renewed focus on universal health coverage to continue to advocate in all spaces for the universal right to quality health for all on the upcoming “UHC Day” on December 12. But don’t be disappointed if reporters from mainstream outlets don’t pick up that particular story.
This blog post was written by Samya Stumo. Samya works as a (remote) research consultant for the Health Systems Research team at the Barcelona Institute for Global Health and is a recent MSc graduate from the University of Copenhagen School of Global Health. She is engaged in research and writing on topics of health systems, health equity, patient experience, and people-centered approaches to health. Twitter: @samyastumo