By: Madhukar Pai
How do you think the world is tackling crises like pandemics and climate change? Poorly, irresponsibly, recklessly, inequitably, and lacking in urgency and global solidarity, were the responses I got from 24 young people in global health from around the world.
In fact, their responses were stunningly consistent and crystal clear. These young people are outraged with the short-sightedness and self-centeredness of leaders and governments. They are tired of waiting for grown-ups to grow up and do something. Instead, they see hope in other young people and take courage from people’s movements. Most importantly, they ain’t giving up. On the contrary, they are all chomping at the bit for a chance to lead, so they can help repair the broken world and systems they are inheriting.
A scathing report card on how is the world is tackling crises
If young people could assign a letter grade to how world leaders have tackled the Covid-19 pandemic or the climate crisis, I think they would unhesitatingly give an F grade. In fact, when I asked my 14-year old daughter, she said she might pick a grade lower than F.
In their responses to my question, young people offered a scathing, incisive and clear-headed analysis of how the world is failing to address the most consequential crises of our lifetime.
“We’re being short-sighted, bone-chillingly inequitable, and nationalistic in our approach to what are transnational challenges that transcend country boundaries,” said Prativa Baral, a doctoral candidate at the Johns Hopkins School of Public Health.
“It seems that during any crisis, be it health or climate related, the individualistic, me-first approach prevails,” said Kedest Mathewos is an Ethiopian global health advocate at the University of Global Health Equity in Rwanda. “I’m outraged that my home continent, Africa, was left last in line for COVID-19 vaccines,” she added.
“There is a serious lack of global solidarity in addressing structural and systemic inequalities which underpin the health crises we are experiencing today,” said Brian Li Han Wong, Youth Officer, The Lancet & Financial Times Commission on Governing Health Futures 2030: Growing up in a digital world.
“Governments and corporations give lip service to reducing emissions and pandemic preparedness, but those in power are not interested in the deep systemic change it would take to achieve a healthy, just world within ecological limits,” said Rhiannon Osborne, a medical student in UK, working with the People’s Health Movement. “At best they put plasters over a broken system, and at worst it’s greenwashing and lies,” she added.
“The world has politicized, polarized, and trivialized these fundamental threats to our global health and safety,” said Hloni Bookholane, a recent medical graduate from South Africa and author of Becoming a Doctor.
“Leaders have used a reactive approach instead of a preventative approach,” said Joy Muhia, a Kenyan global mental Health graduate at the London School of Hygiene and Tropical Medicine.
“The pandemic and climate change are being handled by the world using the same framework: individualist rather than collectivist solutions, unequal impacts between formerly colonized and colonizing nations, and the protection of capital rather than people,” said Daniel Krugman, a public health student at the Johns Hopkins School of Public Health.
“We cannot overcome these crises in silos – we need the collective. And this is where we fail – we don’t have the global leadership (or investment and prioritization) to inspire collective action to tackle these crises,” said Malvikha Manoj, an emerging public health systems and policy practitioner, and Chair at the International Working Group for Health Systems Strengthening.
“Countries are becoming more and more inward-looking and reluctant to devote resources to solve problems that do not respect borders,” said Zaw Myo Tun, a physician from Myanmar, now a postdoctoral fellow at the National University of Singapore’s Saw Swee Hock School of Public Health.
“The world is tackling the pandemic and climate change through a white-centered approach,” said Mohammad Yasir Essar, a global health advocate from Afghanistan.
“Global health security continues to be a preserve of rich countries,” said Nelson Evaborhene, African Leadership In Vaccinology Expertise Scholar at the University of Witwatersrand, South Africa. “We cannot continue to leverage the health of those in low- and middle-income countries to the security needs of high income countries,” he explained.
“The pandemic has exposed the extent to which the global system is tiered by power and privilege,” said Afifah Rahman-Shepherd, Research Fellow at the London School of Hygiene and Tropical Medicine.
“It is unfair how the solutions of global issues are concentrated in high income countries,” said Praju Adhikari, a dental surgeon from Nepal currently studying public health at Tampere University in Finland. What angers her the most is the fact that the “Global South is underrepresented and often disregarded in global health.”
“High income country leaders have only paid lip-service to equity and global solidarity – failing to tackle the pandemic or climate crisis adequately,” said Shashika Bandara, a Sri Lankan doctoral student in global health at McGill University. “The lack of sense of urgency and siloed approaches among leaders is so tiring to watch,” he added.
“We seem to have not learnt anything from past health crises,” said Alice Bayingana, a researcher and health justice advocate from Rwanda. “We keep doing the same things over and over which would be easy to dismiss as silly if it didn’t mean that we’re continually condemning the most exploited and vulnerable among us to death and disability while setting ourselves up for future failures,” she explained.
“It has been abysmal,” said Pawandeep Kaur, a doctoral candidate at the Boston University School of Public Health. “Politicians are giving into public pressure instead of listening to experts,” she said.
Daniel Romero-Alvarez, an Ecuadorian, currently doing PhD on the ecology of infectious diseases at the University of Kansas, pointed out the gap between science and policy. “The world has the impression that science and policy/decision-making is closely interlinked, but this is seldom the case. This gap was evident during the COVID-19 pandemic,” he explained.
“I think that these crises have ‘lifted the veil’ for a lot of us, and what we have found is that the current system values obscene profits over human life and well-being,” said Nehemiah Olson, a medical student at the University of Minnesota. Anshumi Joshi, a nursing student at Trent University, Canada, concurs. “Corporate greed has a trickle down effect resulting in poor policy choices that negatively affect vulnerable populations globally,” she said.
Is there hope?
For young people, their diagnosis is clear: the global system is broken and unfit to protect their futures. How do they hold on to hope? Who or what gives them hope? What are their aspirations?
Many young people responded that they find hope in each other. In other young people, and in communities and social justice movements they are a part of. Interestingly, none of them said they found hope in world leaders. They are seeing themselves as the leaders they have been waiting for, aligned with the advice of Ben Phillips, author of the book “How to Fight Inequality.”
“I know I’m not alone,” said Yara Changyit-Levin, a high school student in St. Louis, Missouri and volunteer advocate with RESULTS. “I was recently accepted to study global health in college, and I’ve been connecting with other admitted students who all care deeply about health and social issues. It makes me so excited to work alongside them,” she explained.
“Undoubtedly, I get almost all my hope from my peers working within, against, and in between this current global health in order to advocate for and create a new one, “ said Daniel Krugman.
“My peers give me a lot of hope. I really feel as though there is a wind of change blowing through us and that we might end up being a really powerful force for social justice in global health,” said Nehemiah Olson.
“The ability of communities to come together in crisis times despite our leaders’ ineptitude gives me hope,” said Joy Muhia.
“One thing that gives me hope is the passion and energy of young people in tackling some of these “big issues,” said Sara Dada, a PhD candidate in the School of Nursing, Midwifery, and Health Systems at University College Dublin. “More than ever, youth advocates are speaking out and increasing their platforms, younger and more diverse candidates are running for elected office, and communities of youth are learning from peers around the globe to identify how they can affect positive change,” she explained.
“What gives me hope is the commitment and determination of humanity,” said Ramya Kumar, a Zambian student doing doctoral training at the University of Washington School of Public Health. During the pandemic, she believes there is newfound respect and appreciation of the “power of community change.”
Roomi Aziz finds hope in the “reasonable voices out there calling out for more responsive and integrated governance.” She is a Pakistani doctor doing PhD studies at the University of Essex.
“I find hope in the countless lives saved by global health advocates who refuse to accept that some lives are worth less than others,” said Kedest Mathewos.
“I really like seeing more and more global health folks engaging with and learning from other justice movements,” said Alice Bayingana.
Calls to decolonize global health and self-sustenance of the global south give hope to Nelson Evaborhene. “The growing call by scholars and leaders in the global south in addressing the structural determinants that generates health inequities for the world’s most vulnerable gives me hope,” he said.
“Our voice and the initiatives we lead gives me hope.” said Yasir Essar. “The next generation would be more conscious and empathetic if we keep echoing our voice,” he added.
Ready and willing to lead
I asked them how they see young people contributing to making global health better?
“Whether it is vaccine equity, humanitarian assistance, or denouncing all war crimes, I believe young people can help bend the global health arc towards equity and justice,” said Hloni Bookholane.
“Young people are inheriting the health systems we have today, and they are going to be leading and shaping the health systems we have tomorrow. Therefore, we should be contributing at every level: critically analyzing, contributing to shift and shape, and demanding the space to show up,” said Malvikha Manoj.
“Young people have already started questioning the status quo. It starts there,” said Roomi Aziz. Joy Muhia concurs. “Young people can contribute by getting seats in the decision-making boardrooms (as key stakeholders), holding leaders accountable as well as leading the way in implementing creative solutions,” she said.
“We have been dealt a bad hand with climate change, pandemic, air pollution, and other crises,” said Pawandeep Kaur. But she believes the younger generations are smarter, better connected, bolder, and can hold leaders accountable for their failures.
“Young people can raise awareness of the struggles of an unequal society, and spread the word against injustice at any level,” said Daniel Romero-Alvarez. He gave Greta Thunberg as an example of a young person who inspired climate action.
“Giving youth from low and middle-income countries a seat at global platforms during decision making will serve to amplify the voices from the grassroots,” said Rohini Dutta, a Global Surgery Fellow from India, currently working at the WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle-Income Countries.
“I think the biggest contribution from young people is the change we can make in culture and thinking,” said Shashika Bandara. “Perhaps our greatest strength, is to build a culture that prioritizes caring about challenges and inequities that our communities face, locally and globally,” he argued.
“Many young people today are more global-minded, and less tolerant of social injustices. We are using our knowledge and ingenuity to contribute to a better global health through advocacy and practical action,” said Zaw Myo Tun.
“I believe young people should be one of the main groups driving the transformation of global health, for this is the fraught field we will inherent,” said Daniel Krugman. “Unafraid of institutional constraints, past precedents, or clear direction of what we are moving towards, we are beginning to organize ourselves, educate each other, and imagine new spaces in and ways to do “global health”” he explained.
“We know that business as usual isn’t going to cut it and have very different ideas of what it means to do meaningful work in global health,” said Rhiannon Osborne.
“We are moving away from the colonial origins of global public health and toward a more reciprocal, partnership-driven, empowering form of global health,” said Nehemiah Olson.
“Young people are saying enough is enough – it is our future, and it is our present that is being compromised, with some of the choices being made, more often than not without any youth representation,” said Prativa Baral.
“We are more willing to explore the 3 R’s: Retrofit existing systems, undertake major Reforms, or completely Reimagine public health systems all together,” said Ramya Kumar, citing Dr Monica McLemore’s “retrofit, reform, and reimagine” framework.
“By 2030, almost 40% (3·3 billion) of the world’s population will be younger than 25 years,” said Rohini Dutta. “Young people want to play an active role in restructuring the power imbalances within global health, as seen from the student-led ‘decolonize global health movement’,” she explained.
Brian Li Han Wong concurs. “There have been so many initiatives in global health in which children and youth are at the forefront, advocating for and championing change, and holding decision-/policy-makers to account for their commitments,” he said.
Indeed, it is worth pointing out that the decolonizing global health movement primarily started with young people challenging status quo within schools of global public health. Climate activism, gun control, Black Lives Matter, Women in Global Health and many other social movements today are mostly led by youth.
So, given how poorly grown-ups are doing with global health, the future of global health may well lie in letting young people take charge and for ‘adults’ to play the role of allies, ceding space, voice and power to youth.
Yara Changyit-Levin, the youngest person I interviewed, said it best: “I love to see young people taking matters into our own hands when the adults have failed.” Writing this post made me realize that when it comes to global health, young people have already taken matters into their hands. This fills me with hope during these dark days.
Source: Forbes
