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Guest Blog: Teaching, Advocating, Participating: IFMSA and the pharmaceutical companies
IFMSA. The word itself may sound a bit silly, but the structure behind doesn't. The International Federation of Medical Students' Associations is the largest medical students' organization in the world, and has more than 100 member associations working together to cooperate in everything that binds us with the society -that is, Public Health, social concerns, Human Rights- and the Medical Education itself -including the largest medical students' exchange program in the world.
A perfect target. That is, if you are a pharma company. An international organization, so they have to organize big events that probably need a lot of funding. And they are also students. If students start, from the very beginning, to see pharma funding as something normal and totally acceptable, they will probably fall for our marketing later on [1] [2].
But I'm a Medical Student, not a Big Pharma CEO, and the thing is that I care about my training, and about all the issues related to the pharmaceutical industry. And pharma funding was common in IFMSA some years ago. And thanks to the big effort of different people from many countries, and with the power of the advocacy, this practice was long abandoned. Or was it?
The last IFMSA General Assembly that received pharmaceutical funding took place three years ago, in Tunisia. It had been told beforehand that no funding would come from the industry, but when our delegates arrived there, a huge logo of Merck was waiting for them. A huge outcry was heard, and for many people the lesson was learned, thanks to the campaigning that developed, but the damage was already done. And it has happened again. Two months ago, with the European Regional Meeting in Prague.
The reasons given were simple: lack of funding, last-minute partnership cancellations, etc. I think, though, that being the Organizing Committee for such an event you need to start balancing your decisions very carefully when money shortages arise*. For many of us, cutting some expenses (as one Finnish guy said, “I'd meet in a camp site if needed, sharing ideas is the core: everything else can be cut off”), like Social Programs (which could be sponsored by the participants themselves), or unnecessary luxuries, would be the best option. In any case, it is expected that, as a medical students' organization, you have some ethical guidelines. If not, I'd recommend to consider it ASAP. It may also help medical students throughout the country.
This came as a surprise and a disappointment to many of us. Why all of a sudden? And why so late? Do other organizations fear that this will rise discussions and debates? It surely has, in any case. And it has made us ponder if we're on the right track.
And by us, of course, I mean all the National Member Organizations of the IFMSA who have declared themselves to be free from pharma funding and who, in many cases, also work to advocate for an ethical and transparent relationship between (future) doctors and the industry. We are quite a few: Medsin, IFMSA-Spain, NMSA (Norway), bvmd (Germany), IMCC (Denmark), AMSA (USA) and many others**.
And it's us who then think if all that we took for granted (that, for example, no event of IFMSA in the last two years had been sponsored by the pharmaceutical industry, or that the Universities Allied by Essential Medicines' workshop during our last March Meeting was a huge success) is nothing but a big fantasy of ours.
I don't believe that's the case. I think that huge progress has been made, and little by little, people start to change their point of view. It takes time and energy, and also people who know how to teach. Because teaching is the first step here. You can't defend what you can't understand, even more when addressing this issue [3].
This has been the focus of Farmacríticxs, a movement that started three years ago in IFMSA-Spain, and has since then been one of the most successful projects we have coordinated. With participation of both involved medical students, doctors, health management professionals and many others, we have managed to hold more than 10 conferences spawning many different topics: marketing and science, industry's involvement in health policy, access to essential medicines, copyright laws, and many, many others. We have also collaborated with other Spanish associations who share our goals, and results have been very positive to date, and we hope they will continue to be.
There is a long way to go. We have done a great job trying to promote a healthy relationship between us and the Big Pharmas, and the greatest challenge we face is to pass down that information, so that those who come behind us may be able to do as well.
*Funny thing is, the companies' offer is always regarding some money in exchange for a logo. No per se product placement, no specific merchandising, no drug shows. I guess they save that for the already-graduated.
**I can count at least 20. You always know when there's a pharm-free Organization around, because we do campaign for it. Those who receive pharmaceutical funding usually keep a low profile, even if there might be more of them. Have we turned the tide with the shame approach, as with smoking? Normalizing the rejection of funding may be the most important step we've achieved.
[1] Austad KE, Avorn J, Kesselheim AS (2011) Medical Students' Exposure to and Attitudes about the Pharmaceutical Industry: A Systematic Review. PLoS Med 8(5): e1001037.doi:10.1371/journal.pmed.1001037
[2]: IOM (Institute of Medicine). 2009. Conflict of Interest in Medical Research, Education, and Practice. Washington, DC: The National Academies Press.
[3] Bellin M, McCarthy S, Drevlow L, Pierach C., Medical students' exposure to pharmaceutical industry marketing: a survey at one U.S. medical school. Acad Med.2004 Nov;79(11):1041-5.
I'm Andrés, the current President of IFMSA-Spain, the Spanish member organization of the IFMSA. I've been working in IFMSA for more than three years, and in this time I've been able to hear, see -and also tell- a lot regarding internal policies of this huge organization. I couldn't attend the EuRegMe in Prague but by proxy -that is, through my Spanish colleagues-, and have been to enough pharm-free medical students' meeting to see this not only as a possible option, but as THE option. The pic was taken at the 60th anniversary of the IFMSA in Copenhagen, Denmark, and it should depict students from all over the world forming the letters "IFMSA". Good luck if you can see them.
1 comment
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PharmAware Campaign
Wednesday 20 June 2012, 08:18
Brilliant blog, Andrés!
Keep up the great work with Farmacritics :-) Although PharmAware and Farmacritics are yet to collaborate properly, it is really promising that student organisations are working in parallel across Europe to raise awareness about the consquences of Drug Promotion and unethical practices by the pharma industry.
I really loved the quote you included: “I'd meet in a camp site if needed, sharing ideas is the core.."
It is true that often we may have to sacrifice a yummy lunch put on by pharma for a crappy student sandwich or we have to book a free lecture theatre for an event as opposed to a conference hall, but these are sacrifices worth making, as if we were to accept free gifts and funding from pharma companies we may jeopardise our future prescribing and what is then potentially jeopardised is patient health.
Great blog. Thanks
Keep in touch,
Beth