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Silenced Voices: How Swiss Gatekeeping Stifles Global Health Collaboration at the World Health Assembly

The World Health Assembly (WHA) in Geneva is a beacon of hope, a yearly gathering where health professionals and leaders from across the globe convene to tackle critical health issues. As a global surgery advocate, I was looking forward to sharing the experience of millions of Ethiopians affected by the  War in the north. However, as my colleagues are boarding flights to Geneva, I sit in Addis Ababa trying to understand what I could have done better during my Swiss visa interview. As a young Ethiopian public health advocate with years of experience working with people affected by cleft lip and palate, I thought that my rich travel history and full travel sponsorship by my employers would be enough to grant me a visa. I thought the World Health Assembly was a forum for young global health practitioners working closely with communities. Turns out, I was naïve.

71st World Health Assembly | Geneva, 21 May 2018

After overcoming my disillusionment, I scoured the internet for explanations as the Swiss Embassy failed to provide any meaningful information. Instead of answers, I encountered further frustration. Africa has the highest Schengen visa rejection rate in the world, at 30%, despite having the lowest number of applications per capita. African rejection rates are consistently higher than the global average, three times higher than the highest rejection rate, and ten times higher than those of US applicants.

The most common reason for visa rejection is the concern that the applicant will not return to their home country after the event. While many people might assume this is due to a fear of economic migration, embassies have criteria in place to assess a visa applicant's financial situation. Many African global health professionals often travel to Geneva with full sponsorships. Interestingly, many Western global health professionals do the same—Geneva is not only an expensive city, but at certain times of the year, like during WHA, it's simply unaffordable. However, African health professionals are unfairly singled out and mistreated. As a result, my colleagues and I have lost money, time, and faith in the World Health Assembly.

These frustrations stem from meticulously prepared applications—accommodation, flights, and official invitations secured months in advance—only to be met with a cold, bureaucratic "reasonable doubt" from the Swiss Embassies in Africa.

Unfortunately, Swiss Embassies are not the only ones engaging in this practice. The Schengen Area, consisting of twenty-nine countries, tends to host most high-level global health events.

Decisions that significantly impact Africa are being made without considering the input of African voices. There is evidence to suggest that this is intentional. For instance, the European Union recently suspended visas for Ethiopians, citing "security concerns." Dr. Mehari argues that the security and economic reasons are just a cover for a deeper issue—inherent bias against African applicants. Racism and neocolonial ideologies are driving this system, and we need to challenge them at every opportunity, starting with our Ministries of Foreign Affairs/External Relations.

The systematic rejection of Schengen visas for African professionals goes against our national interests. Therefore, the leaders of our diplomatic corps must demand transparency in visa decisions and fair visa reciprocity practices. Some have suggested that host countries and global health organizations should provide support systems for participants from the global south, but we have yet to see this happen.

When I had my visa application denied, it was unclear who I could reach out to at the World Health Organization or at the Swiss Embassy. In simple terms, if the World Health Organization cannot champion this cause in Geneva, then it is hard to see how it can claim to teach young professionals like me to advocate for change in our home countries. If our Ministries of External Relations and the World Health Organization cannot implement these changes, then we must seriously reconsider hosting these events in countries that weaponize visa applications. I urge the World Health Organization and Ministries of Foreign Affairs/External Relations to take a stand and address this issue, as it directly affects the inclusivity and effectiveness of global health events. Lastly, sizeable global health coalitions must create task forces to advocate for change.

My story is not isolated. Unfortunately, visa denial has become a rite of passage in global health. The repercussions of such high denial rates are profound: a shortage of knowledge exchange, diminished collaboration, and the absence of critical African perspectives in shaping health discourse—a discourse that impacts Africa more than any other region. This is not just an African issue but a global one. Persistent advocacy is crucial to enhance visa accessibility for practitioners and leaders from the Global South. This responsibility falls on all stakeholders, including Ministries of Foreign Affairs , the World Health Organization, and Global Health Coalitions. For a global agenda to be truly inclusive, it must guarantee fair visa access and active participation of professionals and leaders from the Global South, ensuring that no voice vital to our collective health is left unheard.