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Fourth Global Symposium on Health Systems Research: Reflections and Summary

Reflections and summary by Sumedha Sharma

From 14‐18 November 2016, over 2,050 delegates from 101 countries assembled in Vancouver, Canada, for the Fourth Global Symposium on Health Systems Research on the theme of ‘Resilient and responsive health systems for a changing world’. The five-day symposium consisted of 53 organised sessions, 248 oral presentations, 74 satellite and skills building sessions, 362 posters, and 155 e‐posters. In this large conference, where intersectoral collaboration emerged as a key norm to generate resilience, I was joined by many members of the PRE-EMPT consortium including Zulfiqar Bhutta, Laura Reichenbach, Charlotte Warren, Dustin Dunsmuir and Vivian Ukah.

The lack of definition of the word ‘resilience’, at least at the national and regional levels, and its dichotomy with health system strengthening, caused myself and many to examine whether it was just another ‘buzzword’ that has crept into the global health discourse due to our collective failure in arriving at tangible strides towards universal health coverage.  However, to its credit, the symposium succeeded in defining what constitutes ‘resilience’ stating that, “(h)ealth systems resilience needs to be qualified by an explicit focus on equity and social justice, and support the empowerment of the most vulnerable.”

Given the events that have transpired in the global community that threaten women’s sexual and reproductive health, include the reinstatement of the Mexico City policy by the US administration, the massive internal displacement in the wake of refugee crises, and the threats due to Zika and Ebola, it is evident that global maternal health is not immune to external threats. It is also evident that building resilience to improve the state of women’s health worldwide cannot be achieved without the protection of human rights. Although it is the role of the state to direct all public and private actors to achieve health system strengthening, it was recognised that health security needs to be an inclusive concern of entire global community and go beyond the ‘global public goods’ argument.

With a focus on communities as the reservoirs for absorbing health system shocks, the symposium reaffirmed WHO’s Alma Alta declaration whereby primary health care needs to form the crux of health system strengthening. This recognition highlights the instrumental role we expect community health workers to play to shape health systems.  In the CLIP Trial we aim to study whether empowering community health workers with diagnostic and referral abilities may prevent deaths and illness in mothers and babies.

A lesson on community strengthening that resonated in the conference was that high-income countries have much to learn from their own indigenous or marginalized populations, as well as from low-income countries. The symposium provided a much-needed and long-awaited global platform to highlight struggles of indigenous peoples against historic privileges, particularly in Canada. By discussing values of ‘cultural safety and humility’ recognised by the First Nations Health Authority ( ), the opening ceremony went beyond the mere acknowledgment the symposium was being held on the unceded traditional territory of the Musqueam, Squamish and Tsleil-Waututh First Nations.

On 'Emerging Voices for Global Health'

Photo: The Emerging Voices for Global Health (EV4GH) training cohort. Sumedha Sharma is pictured in the second bottom row, fifth from the left.

I was privileged to attend the symposium as an ‘emerging voice for global health (EV4GH)’, which is a an innovative multi-partner blended training programme that brought together 44 young researchers, decision-makers and professionals from over 30 countries. The aim of this training programme was to facilitate, support and transform young researchers into global health advocates and local change-agents and facilitate/contribute to positive change at global, regional, national and local levels. This demanding and extremely rewarding programme consisted of an online distance coaching (August - October 2016), a twelve-day face-to-face training programme, and a pre-conference event in November. The most meaningful part of this experience has been the opportunity to connect with inspiring young leaders in global health research and advocacy. With the mentorship fostered by the programme, I learned tools and gained agency to participate in forums as a young researcher. Through this programme, I attended the Canadian Global Health Students and Young Professionals Summit on 13 November 2016. Mark Ansermino was invited to provide valuable insight on how young researchers can build a career in global health. During this event and the conference, Dustin Dunsmuir presented the wide array of mobile health platforms including the PIERS On the Move and pulse oximeter to the global health audience.

For more information on Emerging Voices for Global Health, please visit