Blog: Leadership 2030 - Global Health Internships

From cities to societies, organisations to nations; young people are the future. They face a world that is marked by increasing complexity and near constant change, but they also stand to benefit from this flux. Hierarchies are shifting, and present new opportunities to challenge traditional structures and practices out of step with tomorrow’s expectations.

I recognise - as do many of my peers - that the international structures and systems built before or during our lifetime, such as the United Nations, the European Union, and in many cases the Nation State, are continually trying to adapt to the new contexts and challenges their constituents face; whether persistent poverty, unemployment, war, displacement, health threats or climate change, with varying degrees of success. Just as most of these current and emerging challenges are borderless, so too must be their solutions. It’s time to look ahead, rather than the default position of  behind, to what the pursuits of today’s young people could mean for tomorrow’s leadership. 

Rising international mobility is aiding greater exposure and understanding of the cultures, customs and challenges faced by a global community. As a young person from a well-developed high-income country, and a believer in international cooperation, I was privileged to work as an intern at the Geneva Headquarters of the World Health Organization (WHO-HQ) in 2012.

There, I found myself amongst a group of 300 international intern colleagues, aspirational about the future. But to our shared disappointment, the opportunity to intern was not accessible to much of the global community we hoped to work alongside. In 2011 and 2013, only a quarter of interns were from a low-income or middle-income country (LMIC). Given that 85% of the world’s disease burden is in LMICs, this struck me (and many others) as counter-productive. Shouldn’t the first aim of a development industry be to achieve an equitable distribution of health skills and capacity across all countries? If so, where are the interns from those member states with the greatest health needs?   

It got me thinking about the organisational structures my generation are climbing up and the shortcomings we’re encountering along the way. Do you pop your head up and point things out, or keep quiet and carry on? Take WHO-HQ as an example. It has established one of the most sought after internship programmes in global health. That is to be lauded. Yet, the unpaid status of internships and the structural bias which favours candidates who possess both academic connections and personal finance, has unintentionally led to imbalance in member state representation. Like several international organisations, its interns are now heavily skewed to wealthy country candidates such as the UK, United States and Canada; countries that already possess developed health systems and an abundance of trained personnel. 

It could be cynically argued that it’s not in the interest of high-income country interns to address internship imbalance, at the WHO or any other international organisation. After all, they’re currently benefiting from it and are under no duress to speak out. Moreover, why rock the boat of a potential future employer? Yet, intriguingly, they are challenging it. A network of former interns I helped establish, published an article on this very issue last year.

This year, we’re seeking to bring a human voice to the statistics, by creating a short video documentary on the issues surrounding global health internship access, narrated through the stories of two LMIC interns accepted at WHO-HQ in Geneva.

It’s supported by the RSA; you can read more and donate to the Kickstarter campaign here.

Beyond this campaign, what can be drawn more widely? In an altering world marred by escalating grievance, it will take the concerted will of a generation to advance progress at the rate our populations and environments demand. That will include challenging institutional practices or status quo, even when it’s easier not to. So the lesson I draw? If today’s young people are already willing to take on issues proactively, free of self-interest and rooted in shared responsibility, we should be hopeful for the future: However formidable the challenges that lie in wait.