Medical students as champions for social justice

Abstract

Last week we launched TheLancetStudent.com—a forum to encourage medical students to become more involved in global health—at one of the largest gatherings of international medical students to date. Over 900 medical students from 92 countries gathered in Canterbury, UK, for the 56th General Assembly of the International Federation of Medical Students Association (IFMSA). The theme of the conference, access to essential medicines, demonstrates the growing enthusiasm of medical students to learn more about global health issues—not just through the orthodox disease-focused model but also through debate and discussion on the wider political, economic, and social factors intricate to global health. In the UK for example, following the lead at University College London in offering an intercalating Batchelor of Science degree in International Health, Bristol and Leeds also have similar degrees and Birmingham is due to start one this October. And the Global Health Education Consortium is now active in over 70 health profession schools and training programmes in the USA, Canada, Central America, and the Caribbean. However, the general feeling at the IFMSA conference was that there is not enough teaching on global health in the medical curriculum to equip the doctors of the future to best help patients around the world. Many delegates agreed that in order to be more relevant, the rigidity of the current medical curriculum needs to be replaced by one better suited to help create committed, motivated, and engaged doctors who are best adapted to the future uncertainties of global medicine. Some also thought that teaching in global health should include more multi-disciplinary approaches where input from medical professionals, sociologists, economists, and anthropologists is given equal weight and attention. Such improvements in global-health teaching raise some controversial issues, for individual medical students, medical educators, teaching institutions, and medical organisations, such as the IFMSA. For example, how can medical students learn more about global-health issues, including the social, economic, and political determinants of health, without becoming active participants in society, being prepared to become more involved in challenging and addressing the huge inequalities and injustices at the core of global health? Many delegates at the conference agreed that it is the responsibility of the medical profession to not only speak out about such injustices, but also to tackle and address them. However, campaigning for social justice often requires political activism and it is therefore unsurprising that many individual doctors and medical students, and medical organisations and institutions, shy away from such activity. The IFMSA, for example, stresses that it is a non-political organisation. IFMSA delegates at last week's conference heard how many of the factors which prevent the world's poorest people from accessing medicines involve wider social, economic, and political issues. The challenge then for medical students as individuals, and for medical student organisations such as the IFMSA, is how far they are prepared to go to address such issues. Some medical students are already highly active in campaigning to bring about change. For example, within the context of access to essential medicines, the Universities Allied for Essential Medicines works with student groups across the USA, Europe, and Canada to determine how universities can help ensure that medicines, are made more accessible in poor countries. It also campaigns to increase the amount of research done on neglected diseases which predominantly affect people who are too poor to constitute a market attractive to private-sector investment. In addition, many doctors and medical students signed, and actively promoted, the petition of over 450 000 signatures organised by Medécins Sans Frontières Access to Essential Medicines campaign to call on the drug company Novartis to drop its case against the Indian patent office—which it lost last week—for not granting a patent for the drug imatinib mesilate. It is therefore a most welcome and positive step forward that, as a result of the conference, the IFMSA proposes to devise a Canterbury Declaration on access to essential medicines—a consensus statement from the IFMSA which will support and encourage action in three areas: intellectual property, human resources, and health-care systems. The willingness to devise such a declaration by the world's largest body of medical students hopefully signals the desire of the next generation of doctors to not only be the barometer of social justice, but also to be its champion.