Bittersweet Goodbye’s and Good News

By Mascha Davis

The summer is coming to a close and many students are leaving for home. It is sad to say goodbye to new friends but we know we will stay in touch and some of us already have reunions planned. It is incredible how quickly bonds are formed when you go through an experience like a summer in a foreign country together. I feel like I have known some of the students here for much longer than just one summer, and am grateful to have had the opportunity to meet them. I am also very impressed with what many of my peers are doing and accomplishing – from HIV research in China to starting their own non-profits to improve maternal and child health in developing countries. I am inspired to follow in their footsteps.

As for me, I have decided to stay on in Geneva and have some good news to share: I was offered a short-term contract at the organization where I interned. I am working with the policy department on expanding some of our harm reduction work based in Eastern Europe / Central Asia, which is a great fit with my interest in the region, policy work, and my Russian language skills. I really admire my boss and am already learning a huge amount as well as making some new connections. Every day is new and interesting; I’m reading UNODC reports about drug policy, looking up research papers and am in the process of setting up briefings with experts at WHO to provide us with some technical information for our project.

I'm including a few photos from our program reception. An enormous thank you to the Duke Program and all of the participants for a fantastic summer and ‘bonne chance’ to all!

The XVIII International AIDS Conference

By Mascha Davis

I am writing this from the XVIII International AIDS Conference in Vienna, Austria. It’s only Wednesday of conference week but it already seems that two weeks have gone by in the past few days. The conference draws about 25,000 delegates from around the globe, among them world leaders, policy makers, top researchers, advocates, journalists, as well as many of the big donors. The diversity is incredible – people gathering together from 190 different nations, galvanized by a common cause.

For most delegates attending, the most challenging decisions of the week include: which of these 10 sessions going on at once do I see, how little sleep can I function on, and is it ok to have 4 cups of coffee before noon? The sheer number of plenaries, special sessions, panels, and satellite presentations is astounding and absolutely impossible to see without cloning yourself. However, there were a few sessions that could not be missed, such as Bill Clinton’s plenary speech, Julio Montaner’s (President of IAS) opening presentation, the results of a much anticipated microbicide trial in Africa, and The Lancet special issue session on ‘HIV in People Who Use Drugs’ where many authors who wrote articles presented their work and answered questions.

Clinton’s speech was fantastic. He is such a talented speaker, but seeing him in person took it to another level. He discussed his foundation’s efforts to combat HIV/AIDS and his hopes for the future of HIV/AIDS work. He also talked about the relevance of this year’s conference theme, “Rights Here, Right Now”, especially in relation to decriminalization of drug users and the urgent need for improvement in treatment and harm reduction programs.

This all fit in nicely with the Vienna Declaration, a statement that was released just before the conference, which seeks to ‘improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies’ – it has already been signed by international leaders and many experts, as well as thousands of people who support drug policy reform. As of today, there are over 11,000 signatures – please add yours to the list here!

Probably one of the most exciting events of this whole week was the unveiling of the results of the CAPRISA study. It was released yesterday and the outcomes are front-page news right now on most of the major publications. Researchers conducted a study on microbicide gel and it’s potential to reduce HIV transmission in women in South Africa. The staggering outcomes indicate that when used correctly, HIV transmission is decreased by about 39-50%. This is huge news and the study itself was pretty well publicized leading up to the session yesterday, so an unprecedented number of people showed up to hear the results presented. So many in fact, that the initial conference room was moved to one double in size and then another large hall was opened for overflow – in addition to that there was a crowd outside the conference hall listening to the results. It was amazing. At the end of their presentation, the researchers got a standing ovation from the crowd. It was a truly powerful moment, and made one feel that there is so much hope for the future, and here we are, on the front lines of it all.

Mascha Davis completed her Master of Public Health degree at UCLA. She is participating in the Humanitarian Track of the Duke Program in Global Policy and Governance and is working as a policy and communications intern at the International AIDS Society.

Humanitarian Assistance and Human Rights

By Mascha Davis

My course week on Humanitarian Assistance and Human Rights was the week before last and it was captivating, enlightening and incredible. There were about 17 of us in the course, from varying backgrounds like med school, law school, public health and public policy. All are well traveled, passionate, and motivated individuals, which made the class intellectually stimulating and the discussions thought provoking.

We were all impressed with the amount and quality of speakers who came to discuss the ins and outs of working in this field and the ethical, moral and practical dilemmas that are faced. Some of our topics included the Geneva Conventions and their Additional Protocols, which form the core of IHL (International Humanitarian Law), as well as specific case studies like the genocide in Rwanda where the lines between following the humanitarian imperative and acting in a way that could be viewed as politicized and biased were seemingly blurred.

It was also exciting to see and sit inside the buildings where a lot of major humanitarian decisions and high level meetings take place, like OHCHR (Office of the High Commissioner for Human Rights), the ICRC (International Committee of the Red Cross) and the US Mission in Geneva. Some of the highlights included the speakers from MSF (Médecins Sans Frontières), UNHCR and visiting the ICRC museum, which is actually one of the best museums I've ever been to - for sure a 'must do' when in Geneva. We also learned about Sérgio Vieira de Mello, a Brazilian UN Diplomat who had a prolific career and made a tremendous impact on the field of humanitarian work - his story is both tragic and inspiring. So, after this insightful course, I feel that I have some new hero's and their incredible work to aspire to, as well as a much deeper understanding of humanitarian assistance and human rights.

After a week spent weighing heavy moral issues, engaging in discussion with top humanitarian experts and completing many readings, I had to decompress...so what better way than head to the French wine country for some vino and relaxing? Bordeaux was simply divine - beautiful, bucolic countryside and a vibrant city full of delicious food fresh from the nearby Atlantic coast. A weekend wasn't quite enough but it was definitely worth it - we went wine tasting (of course!), spent time at a lovely chateau, and met up with some friends for the most succulent mussels, oysters, escargots and other delicacies.



Mascha Davis completed her Master of Public Health degree at UCLA. She is participating in the Humanitarian Track of the Duke Program in Global Policy and Governance and is working as a policy and communications intern at the International AIDS Society.

Global Health Course Reflections

Hello from Geneva!

I mentioned in my last post that I would soon begin my Health Policy in a Globalizing World course with Anthony So and said I would be sure to blog about it. Surprise, surprise, the course week came and went and I didn't have a chance to post. I was way too busy.

In short, the course was great. It was a broad survey of global health topics as told by people that have devoted their careers to working in those areas. We heard from Dr. Jorge Bermudez about the success of UNITAID's innovative airline tax to fund malaria, Tb and HIV interventions (he's the Executive Director and pictured here). We heard Dr. Manuel Dayrit discuss the Human Resources for Health framework that the WHO is using to address this aspect of health system strengthening (he's the HRH Director and former Minister of Health for the Phillipines). And we heard from about 20 other experts in their fields with chances for questions and answers.

Every day was packed. Every morning was filled with lectures, every afternoon with site visits around Geneva and every evening with a social event aimed at interacting with each other and with our mentors and hosts at various organizations.

On Friday afternoon we finished the course up at MSF (Doctors without Borders) and Dr. So delivered a great closing address encouraging us to take what we had learned and make the world a better place.

Hopefully we will.

Aaron Stoertz is in the Master of Global Health program at Duke University. He is participating in the Global Health Track of the Duke Program in Global Policy and Governance and is working as a human resources for health intern at the World Health Organization.

Settling in and Moving on

Time does not stand still in Geneva! I've been here for almost one month but it still feels like that first day when I walked into my internship not quite sure what to expect. As I've been remiss in my blogging, let me recap. After settling in when I first arrived I started my internship with a lot of reading, researching, and writing! Interning with the WHO is an incredible opportunity because of all of the rich resources interns have at their disposal. I had the good fortune of attending a seminar on Health and Migration one week during lunch, and another lecture on Health and Human Rights during another week.

We have an extremely strong intern board as well, and last week they organized an "Intern Day," at which we were able to take a photograph with Dr. Margaret Chan, the Director-General of the WHO, and listen to her speak about some important issues facing the organization. Being here, you are constantly surrounded by incredible opportunities like that-as long as you remember to take advantage!

Last week was also the week of my course entitled "Humanitarian Assistance and Human Rights." What an amazing week!!! We had some really great discussions about the principles of humanitarian assistance and what that means in practice for organizations that are based in Geneva. We were able to hear from practitioners and individuals that had significant field experience and were able to take a few field trips along the way.

Not bad for the first few weeks in Geneva!

Angel Desai is a medical student at the University of Illinois at Chicago. She is participating in the Humanitarian Assistance Track of the Duke Program in Global Policy and Governance and working as an intern at the World Health Organization.

health systems & illness systems

In a few days I will mark my one month anniversary as an intern at the World Health Organization in Geneva. I'm still very much on the steep part of the learning curve here in many ways-- from unfamiliarity with the local language (French) to the WHO process to even the content of my work. That's not a bad thing, I like being in places where there's a lot to learn.

The WHO (and Geneva in some respects) looks at problems from 30,000 feet and tries to produce recommendations and guidelines to solve them from that high. At 30,000 feet (where the air is a bit thin and the horizon a bit fuzzy) problems become harder to get your arms around and the interconnectedness of our world really becomes more evident. From up that high, boundaries are difficult to differentiate. And I haven't yet even started my policy course with Dr. Anthony So yet, a man famous for framing and attempting to solve some unbelievably complex global health problems. The course starts next week, and I'll be sure to post about it.

I found myself in consultative group meeting on Monday and Tuesday of this week with representative experts on medical education from around the world. The WHO had convened this group around the issue of health worker education and how disconnected it has become from the health systems in many parts of the world. In other words, we have made a 100 year push to make medical/health education more science-oriented and evidence-based. And in many respects we have succeeded. In the meantime, we may have lost sight of the fact that a lot more than science is needed to actually make people healthy.

One way to look at medical schools is to think of them as factories. They are factories that produce doctors as their product. Once out of the factory, the product then enters a health system where it either wildly succeeds in making people healthier or miserably fails or (more likely) somewhere in between. In this drastically over-simplified view of the health workforce, if the products are malaligned with either the health system or the population's burden of disease, they will not succeed in the big-picture (30,000 feet) goal: making people healthy.

At the crux of this issue, according to this panel of experts, is whether we are training doctors (and health workers in general) to be part of an illness system that is good at fixing illnesses or training them to be part of a health system that is good at keeping people healthy. Very different training is needed for each.

Personally, it seems like we need a balance between the two.

Aaron Stoertz is in the Master of Global Health program at Duke University. He is participating in the Global Health Track of the Duke Program in Global Policy and Governance and is working as a human resources for health intern at the World Health Organization.

Switzerland: Integration

By Mascha Davis

We have arrived and we are definitely not in the US anymore. The first week was a whirlwind of moving in, exploring the neighborhood, taking a spontaneous trip to Zurich, going on a trek in the Swiss Alps and...lots of grocery shopping. Why so much grocery shopping? Because our fridge is tiny, as in: small, compact, efficient and well thought out - like pretty much everything in this country.

Our foyer is right by Lake Geneva and a ten minute walk from the train station so our location is très parfait. Everyone speaks French and it is amazing how quickly one picks up the language when 'forced' to (the French classes before arriving didn't hurt, either). I have by now consumed enough pastries for probably the next month or so (and the delicious chocolaterie / boulangerie next door is not helping my case here), and am totally enamored with the adorable cafès everywhere.

After being here for such a short time, we have already managed to achieve the impossible: getting lost on a trail in the Alps. Our Lonely Planet guidebook claims that it is 'impossible' to get lost while trekking in this country. The authors, however, have apparently not attempted to summit a peak during a whiteout.

It was actually the weather's fault, not ours, because it's supposedly spring time, but somehow we ended up in multiple feet of snow and unable to see more than twenty feet in front of us, after climbing a mountain. At this point we decided it was best to turn around. At the bottom it was of course raining, and we were tired, wet, cold, and hungry. But, luckily, in Switzerland, you are never too far from a charming town and warm bowl of bubbling fondue, which we found an hour's walk away.

Mascha Davis completed her Master of Public Health degree at UCLA. She is participating in the Humanitarian Track of the Duke Program in Global Policy and Governance and is working as a policy and communications intern at the International AIDS Society.