Reflections on LonWHO 2024

It is not often that you realise you are experiencing something you will remember for years to come. Something transformative, that changes how you see the world. In hindsight, sure, we can all appreciate lessons learned. But feeling it happen in real time is rarer – and, thus, all the more enjoyable. That is exactly what I felt at LonWHO 2024. Let me rewind.

I grew up in Portugal and moved to London to study Neuroscience. I’m still fascinated by Science and how little ol’ us humans use the scientific process to learn more about the world around us and ourselves. However, throughout my PhD, I realised I was just as interested, if not more, in how Science can then be used to contribute to society, to positively impact on the lives of (hopefully) everyone. This interest in public policy led me to join PARSUK (Portuguese Association of Researchers and Students in the UK) as Science Diplomacy coordinator. It was through the amazing team at PARSUK that I heard about LonWHO.

LonWHO is one of several Model WHO conferences, simulations of the World Health Assembly, the World Health Organisation's supreme decision-making body. The main objective of a Model WHO simulation is to generate innovative and feasible solutions on the conference’s theme in the form of resolutions, which will be sent to the WHO. This year’s topic, 'Digital Health: Improving Health Through Digital Solutions', immediately caught my eye. I am fascinated by its complexity: the exciting opportunities opened up around disease prevention and management versus the complex ethical and regulatory issues it raises, such as the potential for privacy violations of health data and for increasing health gaps. Looking through our action-packed schedule, the decision to sign up was a no-brainer. Annual leave booked for the Friday, and Easter return flight rescheduled, and I was ready to go!

I decided to register as a member state, representing Mozambique. I was keen to learn more about a Portuguese-speaking country other than Portugal. This is something that has been increasingly a priority for me, partly through my work with Cartas com Ciência, an association that organises letter exchanges between scientists and students in Portuguese-speaking countries to promote access to what science is and who can be a scientist. Little did I know how much this decision would shape my experience of LonWHO.

After a Friday afternoon of insightful talks, a particular highlight of which being Dr Anders Nordstr?m’s account of his time as Acting Director-General at the World Health Organisation, Saturday morning arrived – it was finally time for us to present our position papers detailing our country’s priorities in Digital Health. I instinctively found myself paying more close attention to the presentations from countries I thought would share my interests, due to geographic and/or socioeconomic proximity. And, indeed, once our committee initiated the debate, I was more interested in the motions and ideas put forward by other African countries. When the first motions for unstructured debates passed, allowing us to walk freely around the room, you could almost immediately see the split by geography – I quickly approached Nigeria and South Africa, EU countries grouped together, and many were drawn to the (perceived?) promise of money, power, and security offered by the USA.

If you have made it this far, you are probably wondering at what point the “transformative” experience came. Surely, I cannot be surprised by the fact that countries with shared interests worked together in order to more effectively push for said interests? I am not.

The “surprise” came when, on Sunday, my teammate representing South Africa informed the rest of the group (Nigeria, Maldives, Kenya and myself, Mozambique) she had been approached by members of the USA-led group regarding their draft resolution – by which I mean, they had pulled South Africa to one side (ignoring the rest of us), and asked her to back their draft resolution, as they felt they needed support from “Africa” – unconditional support, I suppose, since they did not actually involve South Africa in the drafting of the proposal.

You will have noticed I used inverted commas around the word surprise, since I was not actually all that surprised – despite being white, I did not only then discover that racism exists and that with money comes power and the opportunity to have a seat at the table and have your say. But knowing all this rationally is very different from standing there, with your Mozambique placard, knowing that a group of maybe a dozen countries working on a proposal for a global framework had completely disregarded a whole continent, until, as an afterthought, they decided to exclusively “include” South Africa. It is very different knowing this happens in the real world and seeing a bunch of young people, largely in their 20s, immediately replicate those same patterns in a simulation. And above all, it is very different knowing I have my own work to do to become truly inclusive, to deconstruct the biases the world forces upon me – and being confronted with the sad realisation that, had I decided to represent Portugal instead, I, too, would have likely defaulted to that (perceived?) promise of money, power, and security offered by the USA and the EU and, most likely, neglected to include anyone else. In a sense, this second realisation was even more powerful than what happened at the conference. I hope to use the shame and guilt I felt to continue the journey we are all on of putting ourselves in other peoples shoes, and truly valuing diversity, inclusion and intersectionality in my professional and personal life.

Still, all’s well that ends well. Our teammate representing Kenya wittily suggested we expressed our disappointment and discontentment at how the situation was handled and used it as leverage to get the support of the USA-led group for our own proposal. This led to a series of apologies from them, together with invitations to provide input to their draft and a promise to support our proposal. While this reversal of the power dynamics between countries is, I daresay, what least accurately reflects the real world, I am hopeful that the experience has been one of learning and growth for us all.