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Fiona Godlee: International Congress of Pediatrics, Athens

3 Sep, 07 | by Fiona Godlee

To Athens for the 25th International Congress of Pediatrics. Very hot indeed – over 40 degrees. Smoke from the fires raging on the hills of the Peloponnese was clearly visible from the plane as we landed. A pall of ash hung over the south east of the city. All television news channels were fixed on images of the flames encroaching on houses and people fleeing on foot. A woman and her four children had been burned alive in their car as they tried to escape.

This tragedy, unfolding against claims of government incompetence, gave local edge to the conference theme – global child health. With only eight years until 2015, speakers at the plenary sessions veered from the impossibility of reaching the millennium development goals to optimism at how much is being achieved. Robert Salama from UNICEF explained that deaths among under fives are at their lowest ever, at less than 10 million per year. But can we get them down to under 5 million a year by 2015? In Asia possibly, but not in Africa. Some of the world’s poorest countries are on track – Malawi, Bangladesh. But of the 20 countries with the highest death rates in children under 5, three quarters have been or are affected by conflict. Half of the 2 million refugees from Iraq are children.

More eloquent than words were UNICEF’s maps of the world, showing Africa bulging obscenely with its burden of neonatal and child deaths and shrinking to a thread when its area represented the number of medically trained personnel. With resources at such stretch, we heard that the greatest potential to benefit comes from cheap, readily available community based interventions. So the networks established for measles vaccination campaigns have provided an effective channel for distributing insecticide treated bed nets.

After the opening session, Zulfi Bhutta (one of the presiding geniuses of the meeting, professor of pediatrics in Pakistan and also a member of the BMJ’s international editorial advisory board) explained that this was the first time the congress had focussed on global child health, encouraged by the Lancet’s recent series on child health and the injection of hard cash for global health from the Gates Foundation. Several countries, including the UK, Canada and Norway, have put the MDGs right at the top of their political agendas, and almost every speaker mentioned business plans for reducing child death. This is a new thing.

As the conference got into its more accustomed clinical medical stride, with sessions on childhood allergy, cancer, joint disease, I bumped into Delane Shingadia from Great Ormond Street Hospital, on his way to present new treatment guidelines for Kawasaki Disease. Tomisaku Kawasaki himself was at the meeting, he said. The BMJ debate about whether we should stop using eponyms has peaked my interest in eponymous doctors. So when I saw an elderly Japanese man heading towards the hotel I rushed over to shake his hand. Luckily it was him. He clearly didn’t have a clue who I was but he was very gracious. His interpreter did her best: “A very important lady. Makes decisions for the British Medical Journal.” She might have been less polite if she knew we were debating stripping his name from the text books.

Two e mails on my Blackberry as I waited in the departure lounge raised an interesting dilemma. One was about the BMJ policy on accepting expenses to speak at conferences. We are revisiting the policy and are likely to reconfirm that we will accept funds from non-profit organisations. As an example, my travel and hotel bill for speaking in Athens have been paid for by the International Pediatric Association. The other message on my Blackberry warned that the conference had been heavily sponsored by baby food manufacturers. This should perhaps give us pause.

Competing interests: Accommodation was paid for by the congress organisers. Travel was paid for by BMJ with a contribution from the congress organisers.

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