Chok-wan Chan
IPA: 1,000,000 advocates in one voice
We think globally, we act locally
During its almost one-century-long history, the IPA has grown from a fraternity of pediatric organizations, to an institution where goals include the promotion of child health and improvement of child health services, to today’s structured organization that advocates for holistic care and the right of all children to health and to develop to their fullest potential. It is my deep honor to be able to serve as IPA President, to lead this great organization in delivering it worthy mission.
That worthy mission today, is for pediatricians from countries throughout the world, working with partners, to be leaders in promoting highest attainable standards of physical, mental and social health for all children. 1,000,000 pediatricians are represented today by the IPA’s 147 National & District Member Societies, 7 Regional Societies, 14 Specialty Societies and 1 Committee for Pediatric Chairs. The IPA works as partners of United Nations agencies, WHO, UNICEF, The World Bank, governments, as well as national and regional subspecialty pediatric societies. The IPA is indeed strategically placed for leadership in global child health.
However, in order to attain its goals and work effectively through complex networks, we need to steer IPA with intelligence and determination through a number of challenges that it faces today. These include 1) program area prioritizing, through convergence and political commitment of members, 2) promotion of evidence based practice and quality care, 3) effective communication between members and partners, 4) ethical practice and governance, and 5) resource generation to meet program needs. I will elaborate below my thoughts on each of these areas below.
First on program areas prioritizing, we are hard pressed as passionate child advocates to choose between the many desperate plights of today’s children. But we must focus on areas with the most impact and greatest need. Indeed, the IPA has an ambitious list of program areas. It recognizes the tragedy of preventable child death and ill health, and strives together with its partners to address urgent issues of global child health and to monitor progress towards achievement of the Millennium Development Goals (MDG) by the year 2015. IPA was instrumental in drafting of The Nairobi Declaration on Child Watch Africa and the New York Call to Action in 2002 for Pediatricians, and made its own IPA Millennium Declaration in 2005 on the urgency of attaining MDGs. IPA also renewed its commitment to child survival, health and development, and to maternal and family health, in Athens in 2007. Here IPA reaffirms that “child” refers to newborns to adolescents (0 to 18 years) and “child health” covers the medical, social and educational aspects. Currently, IPA programmes include child health in humanitarian emergencies, IPA MDG projects, immunization, TB, HIV/AIDS and malaria, childhood nutrition, environmental health, better medicine for children, adolescent health, promotion of quality care and evidence based practice and quality care, education, and others on the pipeline.
In addition, IPA highlights two further aspects in its programs: (1) meeting emerging challenges of this century, and (2) facing the serious problems of children of industrialized nations. In order to meet the ever changing challenges to children in the 21st century, we need to consider issues such as children’s rights, adolescent medicine, obesity and injury prevention. The IPA embraces problems of both industrialized and developing countries. Whilst conditions encountered in developing countries are primarily of a medical nature, many arising in the industrialized world are more of a social nature. These conditions include mental health and behavioral problems, specific learning disabilities, dyslexia, childhood autism, attention deficit disorders, parenting issues, and others. It is essential to promote pediatricians’ interest and knowledge in these areas for their effective management.
With so many needs to consider at once, there must be clear consensus and integrated strategies among members, realistic setting of plans and specific targets. Programme areas will be brought to regional and country levels through IPA Member Societies, and through collaboration with professional partners at all levels, including the Partnership for Maternal and Newborn and Child Health (PMNCH). Global Alliance for Vaccine and Immunization (GAVI), Global Action Plans for Pneumonia (GAPP), Integrated Management for Childhood Illness (IMCI), with attention to tracking the situation through the Countdown to 2015.
In the coming years, I plan to focus my mission on the reduction of mortality from childhood pneumonia through universal immunization and timely treatment, improvement of nutrition through promotion of breast feeding and use of zinc supplements, early identification and intervention through launching of developmental screening and assessment systems, and improvement of children’s environment through reduction of indoor pollution from second-hand smoke and household heating. Professional and public education to implement these will also be organized through our website and on-line courses. All these will be consolidated at our upcoming October 2008 strategic planning meeting on programme areas, whereby international technical advisors are invited to discuss streamlining of priorities, updating of programmes, and implementation strategies.
Second, on evidence based practice and quality care, it is critical that the IPA achieves its impact through application of scientific methods and peer-recognized epidemiological tools. These will safeguard results both for the individual child, and for countries when choosing programs that are most effective for them. Furthermore, evidence provides the IPA with the professional authority to promote programs at global and local policy levels. It is our objective in the coming years to improve and monitor practice standards of child care in different member nations. Our Committee for Paediatric Chairs will be launching an initiative - Quality Care Program - to work with heads of training programmes for paediatricians and child care workers, for implementing this objective.
The third challenge relates to effective communication, which is the cornerstone of IPA’s machinery. The hierarchy of the IPA management is clearly structured but complex because of its size and scope. The highest ranking body is the Council of Delegates (CD), represented by all member societies, which instructs policies, sets and amends constitutions, admits new members, approves budget and finance reports and gives directions to the running and activities for the IPA, while the Standing Committee (SC) represents the Council in between its meetings. The Executive Committee (EC) is charged with duty to implement decisions and resolutions of the Standing Committee (SC). With this multilayer infrastructure and the vast numbers of individual pediatricians to be reached, effective transfer of views and dissemination of information are daunting tasks. To do this, we will not only work through the personal influence of member advocates, but through enriched website and newsletters, the establishment of an IPA Journal of Global Child Health, and organization of themed meetings involving program owners and related stakeholders. Through these we endeavor to enlist the active participation of all society and individual members.
Effective communication does not stop within IPA’s structures and its members. International bodies, countries, associations and individuals alike are partners of IPA. We utilize our members’ professional expertise and provide views and support to international agencies on many fronts. In working with governments, we are deeply aware that programs must be delivered within countries in ways that are relevant to their needs and suitable for their infrastructure, capacities and cultures. Through the IPA network and cascade, we preach “thinking globally and acting locally”, rallying the whole world’s paediatricians to meet the global health needs of our children.
Fourthly, on ethical codes and governance, IPA will be reviewing its policy in relation to the kinds of financing we are open to, for developing our activities and practicing our goals. Any company that wishes to support us financially needs to submit a declaration on its activities. Companies working in the tobacco, fire arms or alcohol industries are, understandably, banned from being supporters. Companies that produce breast milk substitutes for infants are strictly banned, since their activities conflict with our goals on exclusive breastfeeding for babies. Other “black-listed” companies include those who have, as example, exploited children in labor, and so on. In summary, our dedication to children does not allow IPA to accept financial support from companies whose area of practice conflicts with the promotion of child health. Furthermore, overall fiscal accountability in IPA matters must be ascertained through transparent processes and verifiable auditing systems. In order to propagate and effect these messages, our Committee on Ethics in the coming years will be issuing further guidelines for members’ reference. Conferences on this subject for paediatricians will be incorporated into future IPA Congresses, covering ethical issues relating to commercial sponsorship, human research and end of life determinations. On governance, we will continue to roll out measures laid down in our revised 2004 Constitution. Eight areas for focused action by dedicated committees include membership, finance and fundraising, archives and alumni, governance and constitution, advocacy, ethics, education and communication. Updating of equitable regional representation and payment of membership dues will be addressed.
Last but not least, as with almost all non-government organizations, IPA faces the challenge of inadequate resources for meeting expenses of its program areas. We aim to meet this challenge through raising funds from its activitiesin the coming future, including through bi-annual conferences, continued professional development courses, and through program areas themselves. I will do my utmost to work with our members, not only to deliver our missions, but to influence people’s hearts and minds. Through this, we will be able to move people into action, and inspire the contribution of donors and the political will of governments.
In concluding, the world is in need of one unified powerful voice for global child health, expressed through solid collective work. Furthermore, we must also take on board the strong voices of parents. Only then can we hope to realize the fruit of a global consensus on child health. Through the support of IPA members in close collaboration with partners in the international child health arena, we can be confident in reaching new horizons of quality care for our children. With that, the IPA will be able to attain its mission: “Healthy Children for Healthy World.
Dr. Chok Wan CHAN
President of the International Pediatric Association (IPA)
2008