To better understand how the unpaid status

To better understand how the unpaid status of internships at WHO headquarters might affect their international accessibility, together with past and present intern colleagues, we did an online survey during two summer intern cohorts (2011 and 2013). The survey, which was distributed via email to all summer cohort interns by the WHO headquarters intern board, asked the interns to anonymously select their country of origin and present country of study. 349 interns responded (192 in 2011 and 157 in 2013) and responses were compiled and analysed. We plotted interns\' reported country of origin against the UN Development Programme\'s human development index. Most interns came from a country with a very high human development index in both the 2011 (139 [72%]) and 2013 (125 [80%]) cohorts (). Furthermore, we noted that this QVDOPh distribution became more skewed towards very high human development index when we analysed the interns\' reported country of study (154 [98%] in 2013). In the 2013 cohort, almost half of interns (72 [46%]) described their monthly expenditures as more than 1500 CHF (about US$1700), most of which is spent on accommodation (data not shown). Similar trends have been recorded at other UN agencies. Boosting the accessibility of internships for candidates from low-income and middle-income countries could be one mechanism to promote the acquisition of international skills and experience by these candidates, and help with the transfer of knowledge and expertise to their peers in-country. To this end, the WHO Intern Alumni Association and WHO headquarters intern board have been collaborating to improve internship accessibility for such candidates. We have sought to address obvious barriers to intern welfare, namely the high financial costs of living in Geneva. Successful initiatives have included sharing household appliances, bicycles, and other supplies between interns, and the introduction, in November, 2013, of intern discounts at the WHO headquarters canteen. To address the financial barriers that restrict access by candidates from low-income and middle-income countries, a scholarship is being established. Our objective is to financially support accepted candidates from low-income and middle-income countries to intern at WHO headquarters, thereby advancing equitable intern representation. However, we recognise that many qualified candidates from low-income and middle-income countries might not apply for an internship at WHO headquarters, and therefore aim to build networks among universities and health institutions in these settings to encourage candidates to apply, and to signpost available funding options. Fundraising for this scholarship is in progress, having benefitted from the work of previous intern cohorts and a pledge from WHO. Members of the public will soon be able to make online. Promotion of equal access is not confined to candidates from low-income and middle-income countries, and we intend to extend our advocacy to include other under-represented groups, such as prospective intern candidates living with disability. For sustainable improvements in internship access and improved global health education, academic and professional institutions need to partner with the public sector and foundations, donors, and governments to channel resources to achieve this aim. This scheme and its results could be replicated at other UN agencies and international health organisations with internships. However, the scale of this task necessitates the involvement of multiple stakeholders. Who else will step up and contribute to a growing movement towards equitable access for training, educational, and networking opportunities in global health? And who should lead this transition and monitor its success?
Jeffrey Eaton and colleagues (January, p e23) used modelling to inform international guidelines for antiretroviral therapy for HIV. Specifically, Periodicity of DNA undertook a comparative cost–effectiveness analysis based on predictions from 12 independent transmission models: seven were used for South Africa, four for Zambia, four for India, and one for Vietnam. They concluded that all 12 models show similar results—that earlier eligibility for antiretroviral therapy is cost effective. They implied that their consensus finding increases confidence in the use of modelling results to guide HIV health policy.