Why passion has a place at a health systems symposium: reflections on Cape Town 2014

Passion. It is not a word that is used often in the health systems discourse, and it may be the last word that people outside of health systems circles would associate with our work.

Why passion has a place at a health systems symposium: reflections on Cape Town 2014

By Dina Balabanova, Board Member, Health Systems Global, and Jeffrey V. Lazarus, Secretariat Director and Co-founder, Health Systems Global

Passion. It is not a word that is used often in the health systems discourse, and it may be the last word that people outside of health systems circles would associate with our work. But passion is what indeed emerged throughout the recent Third Global Symposium on Health Systems Research in Cape Town, South Africa. Across two jam-packed days of satellite events and another three days of conference sessions, the 1,700 participants from 92 countries collectively made the symposium into a unique teaching, learning and networking opportunity.

But to characterise it with dry terms such as “unique” and a “networking opportunity” completely fails to convey how the symposium was experienced by those in attendance, as well as by those engaging virtually. Health systems as a field of inquiry is not new. But for complex reasons, the convening of the symposium and the related formation in 2012 of Health Systems Global as a cross-disciplinary health systems society appear to mark the coalescence of the first global health systems community.

It is a community that has been eagerly awaited by many people. We know this not only from the tenor of the formal sessions, with their provocative presentations followed by equally challenging comments from audience members, but also from what was happening when the sessions ended. Everywhere we turned, people were eager to introduce themselves to each other, to reconnect with long-time acquaintances and to rediscover synergies in their health systems experiences.

We were not surprised to hear first-time symposium attendees in Cape Town echo the sentiment expressed so often at the First Global Symposium on Health Systems Research four years ago – the sentiment that gave rise to the founding of Health Systems Global. I feel like I’ve found my home. Or – I really connect with these people, like family.

“Home” and “family,” we believe, are not euphemisms being thrown around casually. They are indicative of the incredibly vital role of our peer communities in our work. Whether people approach health systems from the realms of academia, policy-making, civil society or elsewhere, they are excited about the potential for the levers of various forms of health systems to be triggered in ways that will make the world a healthier and more equitable place. Being able to share that excitement with other people is an invaluable and invigorating experience.

Furthermore, many of us are doing cross-disciplinary work or cutting-edge work that cannot be tidily indexed in PubMed or easily tucked into the thematic streams of other health conferences. We have laboured too much in isolation, and now we are delighted to come into communities of people who share our interests. This is why, whether we are engaged in a debate about universal health coverage or we are hitting the dance floor to celebrate another successful symposium, our passion is irrepressible.

One concern about the global health systems community loomed large at the Third Global Symposium: under-representation of key regions and constituencies. Both the programme and the participant roster were reflective of important gaps; for example there appeared to be a real dearth of information-sharing in relation to health systems concerns in Latin America, the Middle East, and Eastern Europe and the former Soviet Union. Further, patient and physician organisations and other civil society groups with an interest in health were largely absent.

This observation is not meant as a criticism of the symposium organisers, who showed great resourcefulness in trying to promote all forms of diversity. The vast majority of symposium participants were Health Systems Global members – and there is widespread awareness that our fledgling organisation has not yet succeeded in attracting large numbers of members from certain key regions. Indeed, Health Systems Global’s board and secretariat called attention to the issue at the general assembly for members on the last day of the symposium and will again in a forthcoming commentary.

In early 2015, the leadership of Health Systems Global is likely to develop concrete strategies and initiatives to foster a more diverse membership base and encourage representation of more regions and countries in the global health systems discourse. Such efforts can only be successful if this cause is taken up by the health systems community at large. People doing various types of health systems work must remain cognizant of the potentially enormous benefits of sharing insights from different geographical contexts. There is also an ethical imperative to ensure that people – including patients – in all parts of the world are given opportunities to benefit from advances in knowledge and awareness of key health systems issues.

Much work remains to be done in these regards, but we are optimistic about what can be accomplished. If our passion has carried us this far, then surely it will carry us onward to the point where we can collaborate, debate and dance with a truly representative global health systems community.

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