Yesterday the Commonwealth Health Ministers had their meeting before the start of the World Health Assembly. The Commonwealth is a strange beast, a range of English-speaking countries, many of them former British colonies, that still hold together as a group.
Apparently the Queen believes that Britain made a big mistake in joining the EU rather than building a free-trade area with Commonwealth countries.
Interestingly, last year Rwanda joined the Commonwealth, a decision partly-raletd to its decision to switch from French to English as its official language.
It does not include all English-speaking countries; for example the United States has never been a member and neither currently is Zimbabwe as a result of concerns about the state of its democracy.
The Commonwealth has a large number of professional bodies, many in health, to share experiences and knowledge, but it lacks any mechanism to coordinate its different interests.
Some members are aid recipients, some are donors. They are such different countries that there are not obvious areas of common ground.
This was evident in a number of the discussions yesterday. Although the day was to discuss progress on the Millennium Development Goals, many middle income countries were keen on discuss “non-communicable diseases” such as those conditions caused by lifestyles as populations get richer, issues which are important but not the top priority when basic maternal and child health services are not available to many of the world’s poor.
Similarly, there was a discussion about healthcare staff who were trained in developing countries but now work in rich ones. Many of the developing countries wanted to talk about “compensation” for this training that they paid for.
Needless to say, rich countries preferred to talk about “cooperation” and insert safety valves like “where appropriate” into the text.
The draft statment also failed to talk about removing user fees from healthcare, until Dr Komba-Kono, Minister of State from Sierra Leone, proposed to include some wording.
This was accepted thankfully. This was probably a rehearsal for the debates that are to come at the main World Health Assembly.