Closing the Gap in OUR Generation

Reducing health inequities through action on the global and local determinants of health
A Pre-General Assembly Workshop

IFMSA General Assembly March Meeting 2013 March, 5-9, 2013 Baltimore, Maryland, USA

Background
In 2011, the International Federation of Medical Students Associations (IFMSA) placed health equity through action on the social determinants of health (SDH) as a key policy and advocacy focus. Since then, IFMSAs SDH advocates have organized activities geared towards raising awareness, building capacity, and inspiring action among medical students worldwide. All these efforts culminated with the creation of the IFMSA Global Health Equity Initiative (GHEI) in 2012. Today, GHEI serves as the nerve center for all activities within IFMSA that champion the SDH approach as the key intervention to achieve health for all. Unfortunately, health inequities inequalities in health outcomes and health care access that are deemed unacceptable, unfair, and avoidable remain until today, within and between countries. These inequities are produced and shaped by the social determinants of health the conditions in which people are born, grow, work, live, and age. The SDH act at all levels, from the most proximal local environment to the most upstream global sphere. Now more than ever, the 21st century physician has to contend with the SDH and act as the defender of health and advocate for health equity.

The Pre-GA Workshop on Social Determinants of Health

This intensive workshop on Social Determinants of Health is a perfect venue for medical student leaders to deepen their understanding of the global and local determinants that drive health inequities, gain tools and frameworks for applying the SDH approach in both future clinical practice and health care leadership, and contribute to the strengthening of the global movement for Health for All that has been continuously spreading worldwide, even within IFMSA. The workshop also matches the theme of the General Assembly itself Advocacy and the Physician-in-Training as this advanced workshop on SDH seeks to produce not just informed medical students but transformed physician-advocates for global health justice in the 21st century. Baltimore and the larger Washington, DC area, being centers of debate and activism in the United States, provide an enabling environment for global advocacy and local action to flourish. During this workshop, around 30 participants, along with experienced student facilitators and guest experts, will gather to learn about the global struggle for health equity, the political economy of health and how it influences the local drivers of health inequities, and current updates about global governance for health, sustainable development, and universal health care debates. Furthermore, the students will acquire skills and tools to apply the social determinants of health approach such as health impact assessments and Health in All Policies models. Finally, the workshop will culminate with activities that prepare participants for global advocacy as well as motivate them to concoct projects that will help advance their local struggles towards health for all.

Objectives
By the end of the workshop, participants should be able to: Understand the current global health situation, with particular attention to global health inequities and their multiple determinants at both local and global levels. Adopt the social determinants of health approach and learn its tools in order to contribute to the reduction of health inequities. Recognize the role of medical students and future health professionals in advocating for and influencing policies geared towards health equity.

Methodology
The three-day workshop will utilize a wide array of methods, including interactive lectures, small and large group discussions, film showing, field trips, and individual and group presentations. In fulfilment of our commitment to organize an action-oriented pre-GA workshop, an ideas caf will also be held to enable participants to come up with project ideas that address the SDH that they can implement at home. Furthermore, a dynamic simulation of global governance for health will allow participants to experience thinking along various global health frames, drawing from their inherent knowledge and skills as well as those that they acquired during the earlier parts of the workshop. Even before the pre-GA, the workshop trainers will begin interacting with the participants by giving them background reading materials, allowing them to introduce themselves to others, and throwing in initial ideas and insights about the subject matter. We will also advise them to prepare for the ideas caf in order to accelerate the exchange of ideas during the session.

Participants
We aim to gather 20-30 participants from around the world, ensuring regional representation and bringing in both newcomers and old timers in IFMSA. Applicants will be assessed according to expressed motivation for global health leadership in IFMSA and in the future, as well as recorded experience of positive engagement in global health advocacy and service. We envision this cohort to continue playing an active role in the IFMSA Global Health Equity Initiative at both international and national levels. All participants will be requested to prepare for the preGA workshop and continue their passion and action for action on SDH even beyond the workshop.

The Workshop Organizing Team

Renzo R. Guinto, MD (Philippines) is presently IFMSAs Liaison Officer to the World Health Organization. He was also the previous Regional Coordinator for the Asia-Pacific and founding coordinator of the IFMSA Global Health Equity Initiative. He headed the IFMSA delegation to the World Conference on Social Determinants of Health last October 19-21, 2011 in Rio de Janeiro, Brazil, and at present is a member of the Youth Commission on Global Governance for Health convened by The Lancet, University of Oslo, and Harvard Global Health Institute. Altagracia Mares de Leon, MD (Mexico) is a founding member of the IFMSA Global Health Equity Initiative and its forerunner Small Working Group on Health Inequities. A proud SCOPHian, she was also part of the IFMSA delegation to the World Conference on Social Determinants of Health last October 19-21, 2011 in Rio de Janeiro, Brazil. Currently, she is the Development Assistant for NMOs of the Americas region (PAMSA) of IFMSA. Waruguru Wanjau (Kenya) is IFMSAs current Regional Coordinator for Africa and is also a founding member of the IFMSA Global Health Equity Initiative. She was also part of the IFMSA delegation to the World Conference on Social Determinants of Health last October 19-21, 2011 in Rio de Janeiro, Brazil, and is a member of the Youth Commission on Global Governance for Health convened by The Lancet, University of Oslo, and Harvard Global Health Institute. Catherine Ji (Canada) is the Vice President for Internal Affairs of IFMSA-Quebec. She is also an alumnus of the pre-GA workshop on Universal Health Care organized by the IFMSA Global Health Equity Initiative last August 2012 in Mumbai, India.

Potential Partners
At present, the Workshop Organizing Team is negotiating with two potential partners for this workshop the Lancet-University of Oslo Commission on Global Governance for Health (in collaboration with the Harvard Global Health Institute) and the Johns Hopkins Bloomberg School of Public Health. These two organizations have been requested to provide some of the needed speakers for the sessions. Furthermore, the Workshop Organizing Team is committed to seek for more partners based in Washington, DC, such as the Pan-American Health Organization, World Bank, Council on Foreign Affairs, and Georgetown University.

Objectives-Topics Nexus
Objective Understand the current global health situation, with particular attention to global health inequities and their multiple determinants at both local and global levels Topics Covered Global Health Equity and the Social Determinants of Health Health Inequities in the United States: Field Trip in Baltimore communities Improving Global Governance for Health (GG4H) Sustainable Development, Climate Change, and the Post2015 Agenda Health for All Will it now become a reality in the United States? A Closer Look at the Patient Protection and Affordable Care Act Mapping the Causes of the Causes: The Social Determinants of Public Health Issues Health in All Policies and Health Impact Assessments Frames in Global Health: A GG4H Simulation Universal Health Care: The Health System as a Determinant of Health Advocacy for Health for All: Campaigning, Lobbying, and Social Change Ideas Caf: SDH in Action Rethinking the Physician of the 21st Century - Is it Time to Live Virchow's Vision?

Adopt the social determinants of health approach and learn its tools in order to contribute to the reduction of health inequities

Recognize the role of medical students and future health professionals in advocating for and influencing policies geared towards health equity

Tentative Program
Time 9:00-11:00 Day One March 6, 2013 Global Health Equity and the Social Determinants of Health Day Two March 7, 2013 Improving Global Governance for Health (GG4H) Day Three March 8, 2013 Health for All Will it now become a reality in the United States? A Closer Look at the Patient Protection and Affordable Care Act Advocacy for Health for All: Campaigning, Lobbying, and Social Change Lunch Ideas Caf: SDH in Action

11:00-13:00

Mapping the Causes of the Causes: The Social Determinants of Public Health Issues Lunch Health in All Policies and Health Impact Assessments Health Inequities in the United States: Field Trip in Baltimore communities

Sustainable Development, Climate Change, and the Post2015 Agenda Lunch Universal Health Care: The Health System as a Determinant of Health Frames in Global Health: A GG4H Simulation

13:00-14:00 14:00-16:00

16:00-18:00

Rethinking the Physician of the 21st Century - Is it Time to Live Virchow's Vision?

Expected Outcomes
For Participants Better understanding of global health inequalities and how the social determinants of health influence them at both local and global levels Development of skills for advocacy, health care leadership, and policy engagement towards action on social determinants of health to reduce health inequities For the Federation A new breed of IFMSA members with enhanced knowledge and understanding of the social determinants of health approach with the potential to lead discussions and advocacy efforts within the IFMSA Global Health Equity Initiative New advocacy and project ideas pertaining to health equity and social determinants of health at both local and global levels A newly-designed workshop on global health equity and social determinants of health that can be replicated by NMOs and various groups within IFMSA

Follow-up Plan
Create a googlegroup and Facebook group that will continue discussions and interaction among participants even after the General Assembly Encourage pre-GA participants to initiate local projects and activities pertaining to social determinants of health in their own countries and track their progress Link participants up with international NGOs, advocacy groups, and research institutions working on addressing the social determinants of health at national and international levels Involve pre-GA participants in international initiatives of the IFMSA Global Health Equity Initiative

Resources Needed
Room for 20-30 people with high speed internet access Accommodation for 20-30 people (plus trainers) Chairs that can be easily rearranged, depending on activities Breakfast, lunch, and dinner, as well as morning and afternoon snacks, during the entire pre-GA period Flipcharts, markers, metacards, Post-It notes, bond paper LCD projector, speaker, microphones, extension cords for laptops For the field trip: tour guide (preferably an NGO) working on addressing health inequities in Baltimore; a local community in Baltimore with existing health inequities; transportation; snacks and water for participants

Note: In support of the IFMSA Green Charter, all hand-outs will be provided in electronic version.

Projected Budget
Item Pre-GA participant package* Materials/Stationery** Transportation for field trip**/+ Tokens for Resource Persons **/++ TOTAL Cost 11,850 USD 100 USD 200 USD 100 USD 12,250 USD

*Assumption: when the MM2013 Organizing Committee projected the pre-GA participation fee to be 395 USD per person, already included in this are accommodation, food, airport transfer, and venue for the pre-GA. This amount is computed for 30 participants EXCLUDING trainers and guest speakers. **Should the pre-GA fee be flexibly utilized, these three items are therefore requested to be shouldered from the same fund as well. +May use local transportation to save costs ++Can give IFMSA merchandise as token

As already mentioned, the Workshop Organizing Team is currently negotiating with some institutions to fund the travel and accommodation expenses of the resource persons whom they are sending to the workshop. Since we will not be printing our hand-outs, we will only seek for assistance for flipcharts, markers, metacards, Post-It notes, and bond paper which hopefully can be obtained from the pre-GA fee. It is assumed that other requirements such as LCD projector and speaker are already included in the venue reservations made by the MM2013 Organizing Committee. The only major expense aside from the aforementioned expected expenses is the local transport for the field trip to a disadvantaged community in Baltimore, as well as tokens for the tour guide and invited speakers.

Fundraising Plans
Should the pre-GA participation fees cannot cover the materials, transportation, and tokens for tour guides and speakers, we will be happy to coordinate with the IFMSA VPE and Treasurer in order to find potential financial sources for the 400 USD. Hopefully, we will be able to acquire the stationery for free due to having access to surplus stationary from other conferences or through automatic provision by the MM2013 Organizing Committee. In the event we fundraise more than is required, we will use the excess for providing travel assistance for participants facing financial constraints.

Contact Details
Renzo Guinto, MD Founding Coordinator, IFMSA Global Health Equity Initiative Liaison Officer to the World Health Organization globalhealthequity@ifmsa.org / lwho@ifmsa.org /renzo.guinto@gmail.com