Charles Ssemugabo, EV 2016, member of the EV alumni taskforce & currently EV resident
For many Emerging Voices for Global Health (EV4GH), especially those from low- and middle-income countries (LMICs), participation in the past two Global Health Systems Research (HSR) symposia in Vancouver and Liverpool was not easy, in spite of their selection. This was largely due to lengthy and costly visa procedures or even visa rejections in some cases. Some Emerging Voices (EVs) raised these issues in blogs in British Medical Journal (BMJ) Global Health and International Health Policies (IHP), among others, in recent years. This issue has not only affected young researchers, but also more seasoned researchers from LMICs. I remember at the Fourth Global Symposium on Health Systems Research in Vancouver (when I was an EV), a renowned health policy and systems researcher from a LMIC being awarded the Sam Adjei Distinguished Public Service Award in absentia, partly due to lengthy visa processes. Unfortunately, the situation has not improved; a recent Guardian headline on the current visa situation in the UK highlights how some academics are denied visas on arbitrary and “insulting” grounds. UK Members of Parliament have also regretted how the “embarrassing and insulting” visitor visa systems have damaged UK’s relations with Africa. I suspect the situation may not be much different in the US.
Against that backdrop, a Twitter discussion on this topic was started by Stefan Peterson (UNICEF) and George Gotsadze (HSG), amongst others, in early April 2019. They asked for views from the health policy and systems research (HPSR) community on where future conferences should be organized. Twitterati quickly offered some valid suggestions, such as Addis Ababa, Bangkok, and Kathmandu. Countries like Indonesia/Malaysia and Singapore were also enlisted because of easy access from countries with Islamic backgrounds and visa-free or electronic visa entry policies respectively. Ethiopia and Rwanda were also high on the list of easy access locations, especially for participants from Africa.
As a follow up to this Twitter discussion, the EV4GH Thematic Working Group (TWG) was invited to share their opinions, based on their experience and insights. The quick crowdsourcing exercise conducted was meant to help to choose future (i.e. post-2022) locations for global and regional HSR symposia. As highlighted in their 11th July blog on selecting the venue for the 2022 Global Symposium on Health Systems Research, HSG is keen on selecting venues that exhibit the following:
- LMIC venue
- Large enough physical space to accommodate the symposium demands
- Tax and banking regulations that allow free flow of funds
- A strong HPSR network
- A human rights context that supports access for all
- A relaxed visa regime and affordable access with good prices of transport from different regions.
Based on the dimensions set by HSG, it is important to note that many of the locations suggested by the EVs have obvious advantages but also drawbacks that they did not fully take into account. As such, they may qualify for regional symposia but struggle to meet the requirements for global events.
In their responses, the issue of visa access certainly hit home among EVs, unsurprisingly. Most EVs who responded to this call were from LMICs; the African (54%) and South-East Asia (27%) regions got most responses, but there were also a handful from the region of the Americas (15%) and Eastern Mediterranean (4%). Some locations that had earlier been suggested in the twitter discussion re-emerged for both regional and global symposia. For example, Addis Ababa and Bangkok were often mentioned due to easy access by many airlines, relaxed visa policies, experience in organizing international conferences and excellent accommodation and conference facilities.
Other locations for regional and global symposia suggested by EVs that organizers of the health systems research symposia and possibly other symposia should consider include: Nairobi, Addis Ababa, Kigali, Durban and Johannesburg for the African region; New Delhi and Bangkok for South-East Asia, and Lima and Quito for the Americas. Many of these EVs based their responses on limited or no visa restrictions, but capacity, infrastructure and proven experience in organizing international conferences, as well as connectedness with major cities in the world, were also considered important criteria as shown in the quote below.
Kigali, Addis Ababa, and Nairobi have easier visa access, good hotels with different facilities, and plenty of airlines go to and through these cities although there might be shortage of venues with a large plenary and enough rooms for parallel sessions (EV, African region)
Cape Town, which already hosted the Third Global Symposium on Health Systems Research (in 2014), and boasts a great HPSR network, was also suggested by several EVs due to accessibility, availability of world class infrastructure and experience in organizing such international events as shown in the quote below:
Cape Town has hosted several conferences or symposia that have been successfully organised (EV, African region)
In addition, due to high-level conference facilities, transport and fast internet access, EVs also suggested some high income locations. Among these: London, Toronto, Sidney, Madrid, Barcelona, Milan, Antwerp, Lisbon, Seattle, Geneva, Amsterdam and The Hague.
However, in line with similar suggestions on Twitter, some EVs were of the view that locations in the United States, United Kingdom, and to a lesser extent Europe and Canada, should be blacklisted due to restricted and high-cost visa access, and costly flights and accommodation. Insecure locations such as Sudan, South Sudan, Somalia, Colombo (after the recent terror attack), and North Korea were also suggested to be excluded, mostly for reasons related to political conflicts and terrorism.
Overall, based on their own responses, visa access and funding are the two factors that limit EVs most – especially those from LMICs – from attending global and regional symposia. As such, they prefer conference locations that will guarantee access (visa, flights and affordable accommodation), while also advocating for increased funding opportunities for LMIC researchers. EVs are also mindful, however, of having good conference facilities that will boost their experience.
There is hardly any place on this planet that would meet everybody’s expectation. With that in mind, I feel it is time for a LMIC venue for a HPSR symposium.