WHO: are unpaid internships undermining helping those most in need?

The Geneva-based World Health Organization (WHO) stands out as a center of international cooperation to build health systems and combat disease. It achieves this in part by supporting the next generation of leaders, hosting around 600 interns every year. Yet, it’s troubling that only 25% of interns come from low- and middle-income countries—those most heavily burdened by disease. How can we build the health policymakers and researchers of tomorrow in developing countries if they are so underrepresented today? Daniel Bornstein discusses how addressing this gap could lay the groundwork for new innovations central to advancing human health and well-being.

The problem is in large part due to the unpaid nature of the internships, presenting a financial barrier to students from lower-income regions. This issue is seen at many international organizations, including the United Nations. A group of former WHO interns, as part of the Network of WHO Intern Alumni, have launched an effort to increase developing world representation in the WHO internship program. They have just successfully completed their Kickstarter fundraising campaign to support WHO internships for two candidates from low- and middle-income countries. These interns will feature in a documentary on their journey which will shine a light on issues related to internship access. Their efforts, the alumni network hopes, will be a springboard for a serious discussion on the internship programme and the steps needed for balanced recruitment, including of those from nations of highest disease burden. The bigger goal, over time, is to promote such access across all global health agencies.

The network’s next step is to work with Child Family Health International and other partners to begin soliciting funding applications from interns who will be supported at WHO. They are also collaborating with filmmakers around the world to prepare for creating the documentary on the interns’ experiences.

©Ted Eytan/Creative Commons License

©Ted Eytan/Creative Commons License

Let’s think about why it’s a concern that interns are overwhelmingly from wealthy countries. The WHO has an almost unrivaled credibility in the health sphere, yet its impact may fail to fulfill its real potential if its training programs for young people aren’t sufficiently tailored toward those from the most vulnerable countries. Indeed, one of the oft-repeated critiques of global development programs is their failure to grasp the particularities of local context. Might recruiting more students from developing countries help to address this problem for the future of the international development sector?

To grasp the transformative potential of such reform, recall that investments in human capacity in recent decades have delivered major breakthroughs in global development, changing the lives of millions in the process.

For example, investment in promising Indian scientists was at the core of the 1960s “Green Revolution”, which averted dire malnutrition through the introduction of high-yielding crop varieties. The U.S. Agency for International Development established partnerships between six U.S. universities and nine Indian agricultural universities. The Indian professors were trained by their U.S. counterparts, who also helped to strengthen the research programs in India. Researchers at India’s agriculture schools developed and then disseminated new varieties of wheat that staved off mass hunger. This model has shown repeated value in an agricultural context. Why not apply this success with the same ambition to the health field?

More recently, through investment in human resources for health, the Clinton Global Initiative facilitated a partnership that enabled one of Rwanda’s most vulnerable areas to become a regional leader in cancer treatment. It built the Butaro Cancer Center of Excellence, which provides the rural poor with access to comprehensive cancer care and also works to develop treatment protocols to benefit patients nationwide.  Nurses are advised by their visiting counterparts from Dana-Farber Cancer Institute. Only by investing in the people providing healthcare has this initiative been successful.

©Gates Foundation/Creative Commons License

©Gates Foundation/Creative Commons License

While infectious diseases such as AIDS and malaria tend to grab headlines, the Butaro Cancer Center shows the need for investment in a wide-spectrum of healthcare resources, including people and their facilities. The WHO Internship Programme, viewed by many as an in-house training initiative for human resources for health, could multiply the gains of these investments, by providing trained future leaders to staff and support their local health systems.

Investing in human capacity is a key aim of the World Health Organization, as demonstrated by its Human Resources for Health programme. This has proven to be a critical strategy in successful international development initiatives in years past and present. But to what extent are these lessons being applied internally? WHO has a tremendous opportunity to invest in the next cadre of global leaders capable of tackling some of the world’s most daunting challenges.

We would do well to remember that the advances of the 20th century would not have been possible without such foresight.

You can donate to help this cause at: https://donatenow.networkforgood.org/WHOinternalumni


The views expressed in this article are those of the author and do not necessarily represent the views of Development in Action.

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