ISTANBUL, SEPTEMBER 11 AND 12TH, 2005
The meeting was called to order by President Adenike Grange on Sunday, September 11th, 2005 at 8 o’clock in the morning.
Attendance
Present were: President Adenike Grange (Nigeria), President-elect Chok-wan Chan (Hong Kong), Treasurer Sergio Cabral (Brazil), Coordinator Sverre O. Lie (Norway – representing the International Society of Pediatric Oncology), Executive Director Jane Schaller (U.S.A.), Ellis Avner (U.S.A – representing the International Pediatric Nephrology Association), Swati Bhave (India), Jose Boix Ochoa (Spain – representing the World Federation of Associations of Pediatric Surgeons), Alan Craft (U.K), Yoshikato Eto (Japan), Kevin Forsyth (Australia -- representing the International Pediatric Chairs Association), Ashok Gupta (India – representing the International Society of Tropical Pediatrics), Judy Hall (Canada – representing the American Academy of Pediatrics and the Canadian Pediatric Association), Manuel Katz (Israel – representing the Union of European Pediatric Societies), Najwa Khuri Bulos (Jordan), John Lewy (U.S.A), Manuel Moya (Spain – representing the Union of Mediterranean Pediatric Societies), M. Cherif Rahimy (Benin), Georgio Tamburlini (Italy),
Pongsakdi Visudhiphan (Thailand – representing the Asia Pacific Pediatric Assocation), Kadriye Yurdakok (Turkey – representing the Union of Pediatric Societies of Turkic Republics), Ahmed Younes (Egypt).
Absent were: Ashfaq Ahmed Khan (Pakistan), Alberto Bissot (Panama – representing ALAPE), Zulfiqar Bhutta (Pakistan – who was attending the launching of the New Partnership on Maternal, Newborn and Child Survival for IPA in New York on September 12th), Andreas Constantopoulos (Greece – President of the 25th International Congress of Pediatrics 2007), Philippe Evrard (France – representing the International Pediatric Neurology Society), James Tumwine (Uganda – representing the Union of African Pediatric Societies and Associations), and Honorary President Ihsan Dogramaci (who hosted a dinner for us at the conclusion of the meeting).
The structure of the IPA is meant to be representative of our Member Societies and of global pediatrics and child health concerns of all regions of the world. In the next elections for the Standing Committee at the time of the 25th International Congress in Athens in August 2007, a new election process will be in effect as mandated by the amended IPA constitution which was ratified at the ICP in Cancun in August 2004. This new election procedure will further refine the structure of IPA governing committees to permit even better representation of our Member Societies. The IPA exists to represent pediatricians everywhere in issues pertinent to global child health, and we seek the input of all of our Member Societies in fulfilling this mission.
Remembrances
The Standing Committee meeting began with a moment of remembrance for Professor Eberhart Schmidt of Germany who served IPA as a member of the Executive Committee and as the Treasurer in the past. A further moment of silence was observed for all of those who have died or suffered in disasters, whether manmade or natural. The IPA would like to be responsive to pediatric colleagues around the world with appropriate expressions of sympathy and offers of help for those caught up in disasters which have affected child health, the status of children, or pediatricians or child health personnel from the global child health world. We welcome being informed of such events by our membership.
Reports
Adenike Grange presented her President’s report, discussing the current state of global child health and the importance of mobilizing national pediatric societies to address these problems. She emphasized advocacy, quality education, public education, relationships between pediatricians and societies, and participation in partnerships as being important to global child health endeavors. She presented a fascinating account of a recent journey to China to witness a Silk Road running event sponsored by the Aprica Company to emphasize the importance of happiness in babies and children. She also reported on a meeting of the International Federation of Social Sciences and Health in Istanbul, and a conference on rotovirus in Barcelona.
Jane Schaller presented the Executive Director’s report on current business of the IPA. Alan Craft, President of the Royal College of Pediatrics, U.K., was welcomed as a new member of the Standing Committee, replacing Richard Cooke. Isabelle Bourzeix, our IPA Administrative Coordinator in Geneva, was welcomed back from maternity leave and introduced to new members of the Standing Committee. The Minutes and Action Points from the last Standing Committee meeting in Geneva in February of 2005 were reviewed and brought up to date with the actual actions that had occurred. The current status of the New Partnership for Maternal, Newborn and Child Health and the upcoming “Rolling Conference” on Child Survival which will occur in London in December were noted. The cost effectiveness of IPA offices was discussed, with note that the total workload of the organization must be taken into account regardless of the number of sites on which the work is being done, often by computer and e-mail. The IPA essentially has one virtual office. The relative roles of the Executive and Standing Committees were discussed, with emphasis that the Standing Committee constitutes the prime governing body of the IPA, representing the Council of Delegates which includes the designated representative from each of the150 IPA Member Societies, and that the Executive Committee represents the Standing Committee in implementation of its decisions. The Executive Director suggested that the next meeting of the Standing Committee six months hence might be in Nigeria to honor our President, Adenike Grange; this suggestion was met with general approval if funds can be raised to support such a meeting. The importance of holding IPA Executive and Standing Committee meetings in conjunction with Regional Society meetings whenever possible was emphasized; the present meeting is being held in conjunction with the Union of Mediterranean Pediatric Societies.
Sergio Cabral presented the Treasurer’s report. indicating that the IPA was in sound financial position for the present triennium (2004-2007), although funds must be raised for ongoing program activities. There was considerable discussion about new and clearer ways of financial reporting, and with the help of the Finance Committee, a new reporting structure was adopted. Year end financial reports will be hereafter presented to the Membership. The IPA also seeks to spend as little as possible on administration, and as much as possible on action for the children and the pediatricians of the world. We wish to function as an entirely transparent organization, and we welcome input in this regard from any of our member societies at any time.
The Partnership for Maternal, Newborn, and Child Health
At the same time we were meeting in Istanbul, the launching of a new Partnership on Maternal, Newborn and Child Health was being conducted in New York. This new Partnership is a brave attempt to address the neglected issues of child survival and health, newborn survival and health, and maternal survival and health. It represents the amalgamation of three distinct Partnerships which were formed within the last several years: the Partnership for Safe Motherhood and Newborn Health based at WHO Geneva, the Healthy Newborn Partnership based at Save the Children U.S., and the Child Survival Partnership based at UNICEF, New York. These are now combined into a single partnership covering maternal and child health, with attention to child survival and health in the most difficult parts of the world. The IPA has been a member of all of the three pre-existing partnerships, and now has a seat on the Steering Committee of the new combined Partnership which will be occupied by Professor Zulfiqar Bhutta of Aga Khan University in Pakistan. An additional pediatrician, Vinod Paul from India, has a seat representing academic newborn health on the Steering Committee as well. It will be of great interest to see whether this Partnership can actually serve to increase attention to needs of global maternal and child health, mobilize resources to meet the needs, and facilitate effective country level action. IPA will advocate that National Pediatric Societies have key leadership roles in this process; without effective country action, nothing will change. Other Partnership members include the International Associations of OB-GYN (FIGO), Midwives, and Nurses; (and this is the first time that professional organizations will have a seat at the table in endeavors like this) a number of government Ministries; funders (the Gates Foundation and bilateral donor organizations); and of course WHO and UNICEF. The new Partnership will be housed at WHO Geneva, and is currently seeking an Executive Director and staff. Stay tuned to this endeavor. We will keep you up-to-date, and will look to your guidance, particularly concerning country level action.
The Millennium Development Goals and IPA Declaration
Also going on concurrently in New York was the 2005 World Millennium Summit. Most of you are probably aware of the Millennium Development Goals (MDGs) which were adopted by 150 countries of the world stating eight specific goals for action between 1990 and 2015. Sadly, as you may also have heard, unless there is a rapid acceleration of change, the MDGs will not be met by 2015. The Goals that seem most pertinent to children are Goal Four referable to child health, and Goal Five referable to maternal health. However, it is apparent that all eight of the Goals contain a number of indicators pertinent to child health. With this in mind, the IPA has drafted an IPA Millennium Call to Action for pediatricians. This Call to Action presents a menu of activities referable to the Millennium Development Goals which can be adopted at country level by Pediatric Societies. A copy of the draft Declaration is attached, and we welcome your input. You will notice that you are probably already doing many of the activities described, and that none is out of the scope of what pediatricians consider part of their daily work. The IPA will now develop a more extensive document to describe in more detail how pediatric societies might become engaged in addressing the MDGs, including ways in which success or failure in child health at country level can be watched and monitored on a regular basis. The pediatric community worldwide should have a powerful voice in advancing the causes of child survival, child health and child development, and IPA feels that gearing pediatric activity to the Millennium Development Goals is both programmatically and politically a good move for our profession.
The IPA is also working to finalize a Vision and Mission Statement for the next three years, and the Standing and Executive Committees have suggested that a combined statement might include the Vision Statement and the Millennium Development Goals statement. This is a work in progress.
IPA Program and Action Areas
We discussed in detail the history and current status of IPA program areas.
Child Health in Humanitarian Emergency:
Karen Olness of Case Western Reserve University, co-chair of the IPA Committee on Child Health in Humanitarian Emergency, presented a report on the current status of the Committee and of this program area. The IPA and Case and other partners have been conducting a series of workshops in countries around the world to train pediatricians in basic responses to disasters, whether manmade or natural. In this regard, the Pediatric Societies of Thailand and Sri Lanka were particularly active in tsunami response in December 2004, working with their own governments and WHO and UNICEF. The IPA conducted two training courses in Thailand shortly after the tsunami in conjunction with UNICEF and other partners, directed by Professor Srivieng Pairojkul, co-chair of our IPA Committee. The IPA was represented at the WHO Tsunami Conference in Thailand in May 2004 by Professor Pairojkul, Professor Manouri Senanayaki (President of the Sri Lankan Pediatric Society), and Executive Director Jane Schaller. The IPA is now discussing with WHO, UNICEF, and the International Red Cross the training of pediatricians for emergency preparedness in countries all over the world. We are happy to assist with sponsoring such a training course in any of the countries of our Member Societies on request. The Standing Committee voted to formalize a relationship between Dr. Olness’ fine academic program in Children and Disaster at Case Western Reserve University.
Other current areas of IPA program include:
- Child Health in sub-Saharan Africa (the Child Watch Africa Program) This program area seeks to establish country level programs in sub-Saharan African countries to focus on country level child health problems and to increase the visibility and roles of pediatricians in national child health endeavors. This is considered an extremely important area by the IPA, and will be highlighted at the Union of African Pediatric Societies and Associations meeting in Cotonou, Benin, the first week of December 2005. The IPA has so far raised approximately $200,000 for these endeavors. Cherif Rahimy of Benin, the current President of UNAPSA, has been the Chairman of the Program Committee, aptly assisted by President Grange from Nigeria and representatives from Kenya, Uganda, and Ivory Coast.
- Children’s Environmental Health. This IPA program committee has been extremely busy, co-chaired by Ruth Etzel of the United States and Georgio Tamburlini of Italy. This program has been formed with strong partnerships with WHO and more recently with United Nations Environmental Program. The committee has produced a series of leaflets for pediatricians concerning major children’s environmental health issues, has received a number of small grants, and has just received a larger grant from the Environmental Protection Agency of the United States. In Nairobi in October of 2005, the first of three regional workshops on Children’s Environmental Health will be held in conjunction with WHO and the United Nations Environmental Program; subsequent workshops will be held in Asia (India) and Latin America (Haiti). The goal of this program is to train pediatricians at country level in basic matters of children’s environmental health, and to designate country level point people for children’s environmental health who can act as spokespersons for the pediatric communities in this important and too often neglected aspect of child health. Trained pediatricians will be entered into a so-called “Virtual Institute for Children’s Environmental Health”, with accreditation, continuing education, and country level activity. We welcome queries from any and all interested members.
- Childhood Tuberculosis. This IPA program area has resulted in change, although we have not yet established a formal working committee (for reasons of funding). Childhood tuberculosis has been generally left off the global screen of tuberculosis programs and control, but now thanks in good part to IPA advocacy in conjunction with the International Union of TB and Lung Disease and the WHO Stop TB program, there is an official working group on childhood tuberculosis within the structure of WHO Stop TB –Geneva- which is currently drafting guidelines for childhood tuberculosis. The IPA role in the future will be in bringing these guidelines to country level pediatricians, and facilitating bridging the gap between the pediatric community and the national TB control programs, which too often have been miles apart. Let us know if your Society is interested.
- Universal Immunization. The IPA has gained seats on the Board of the Global Alliance for Vaccine and Immunization, represented by our President, Adenike Grange, and on the Strategic Advisory Group of Experts of the World Health Organization, with IPA being represented by Executive Director Jane Schaller. Drs. Grange and Schaller are working together in these endeavors, and will make universal immunization a major thrust for pediatricians at country level throughout the world. Again, please indicate the interest of your Society.
- Essential Medicines for Children. The IPA is now organizing a project in conjunction with WHO to review the treatment guidelines, drug lists, and formularies of essential medicine at WHO and make recommendations for the inclusion of children. Tariq Bhutta of Pakistan, Jane Schaller, Stuart McLeod of Canada and Sverre O. Lie are among those concerned with this process, with help from a number of other consultants. We are drafting a grant proposal, and hope to proceed with this project within this year. Please indicate the interest of your Society.
The Standing Committee affirmed continuation of these six existing IPA program areas.
Four new program areas were also discussed. These include:
- Newborn Survival and Health. This is a major global child health problem. In May 2005 the IPA convened a meeting of 24 newborn survival pediatricians representing all areas of the world in Washington, D.C. to discuss forming an IPA Interest Group in Newborn Survival and Health within the IPA, and launching a Global Movement of Pediatricians for Newborn Survival and Health. This was affirmed as a new IPA program area , with new idea of forming an IPA Interest Group of Member Societies who are interested in newborn survival and health. A notice will be sent out soon to all of our Member Societies inviting Member Societies to join this Interest Group.
- Adolescent Health. The Standing Committee ratified adolescent health as a new area for formation of an IPA Interest Group, to be convened by Swatti Bhave of India and Kadriye Yurdakok of Turkey. The first event in forming this Interest Group will be a workshop jointly sponsored by WHO and IPA concerning issues of adolescent confidentiality and HIVAIDS; this workshop will be held in Delhi in the coming months. Again we invite all of our member societies to let us know whether their society would be interested in having a representative join the Adolescent Health Interest Group.
- A new program area on nutrition was proposed and accepted. IPA is already active in a number of issues involving nutrition, including public statements on the importance of breastfeeding and adherence to the Code on Marketing of Breast Milk Substitutes, membership in a new Global Alliance for the Prevention of Obesity and Chronic Disease, and future collaboration with WHO to bring new child growth standards to country level pediatricians. This program area will be spear headed by Ricardo Uauy of Chile, a member of our Standing Committee and the new President of the International Union of Nutrition Sciences.
- A proposal was received concerning quality of care and evidence based medicine, proposed by Georgio Tamburlini with help of Trevor Duke from Australia. This area will be further explored and discussed at the next meeting.
Concerning all program areas: IPA invites comments and expressions of interest in any or all program areas. Please address your comments to the Executive Director’s office, the President’s office, and the Administrative Office. Action of our Member Societies at country and regional levels is what is needed to affect any change in any of our program areas.
Member Relations
Considerable discussion emphasized the importance of member relations in the IPA. In this regard communications are important. We are planning the release of a regular IPA newsletter soon, along with restructuring of the IPA website to include more material, regular up-to-date features, and an easier web design. For all of these endeavors, we invite news from our Member Societies as often as you would like to send us items. We are interested in hearing what is going on in your regions and your countries, what issues you think are important, and anything else you would like to tell us. We plan to include regular news from IPA Member Societies on both the web site and in the newsletter.
Other events concerning member relations include the new election procedure for members of the Standing Committee; a notice of the new election procedures will be sent out soon to all member societies. We are forming an Alumni Committee for past officers and officials and helpers of the IPA, and also a Government Relations Committee to discuss issues of relationships between societies and their own governments, and how pediatricians might become more effective advocates for attention to child health at country, regional and global levels.
External Relations
IPA has a number of important external relationships. We have met the new Executive Director of UNICEF, Ms. Ann Veneman, and found her to be quite open to working relationships between UNICEF and pediatricians around the world. IPA has met on two occasions with directors of programs within the World Health Organization - Geneva of interest to IPA, and we are hoping to gain a seat on the Advisory Committee for Child and Adolescent Health this year. IPA already has seats on the Strategic Advisory Committee for Immunizations, Vaccines, and Biologicals, and also on the Advisory Committee for Essential Medicines. As noted previously - we have strong relationships with the Global Alliance on Vaccines and Immunizations and the Global Alliance for Prevention of Obesity and Chronic Disease.
Brief Committee Reports
Our meeting also highlighted the results of various IPA committees. Among these the Ethics Committee report is particularly important to all of us. The IPA has adopted a new Ethics Statement on Relationships with Industry (attached). This Statement outlines guidelines for ethical relationships between the IPA with special attention to the manufacturers of infant foods. This is a matter of great importance to the international pediatric community, and we welcome your comments on this new Statement.
The IPA has been active, and looks forward to continuing action for children everywhere and pediatricians everywhere. We want to hear from all of you, and we promise to do a much better job of communicating with our member societies in the future.
Submitted by:
Jane Schaller
Executive Director
9-30-05