web Activity Report Oct 2019

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THE WORLD MEDICAL ASSOCIATION, INC.
Activity Report to the
WMA General Assembly, Tbilissi 2019
(April – September 2019)
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REPORT OF ACTIVITIES
TABLE OF CONTENTS
Chapter I Ethics, Advocacy & Representations
1. Ethics
1.1 International Code of Medical Ethics
1.2 Genetics in Medicine
2. Human Rights
2.1 Right to health
2.2 Protecting patients and doctors
2.3 Prevention of torture and ill-treatment
2.4 Pain treatment
2.5 Health through peace
2.6 Sexual orientation and gender identity
3. Public Health
3.1 Non-communicable diseases
3.2 Communicable diseases
3.3 Health and populations exposed to discrimination
3.4 Social determinants of health and universal health coverage (UHC)
3.5 Counterfeit medical products
3.6 Food security and nutrition
3.7 Health and the environment
4. Health Systems
4.1 Primary health care
4.2 Patient safety
4.3 Antimicrobial resistance
4.4 Health workforce
4.5 Violence in the health sector
4.6 Caring Physicians of the World Initiative Leadership Course
5. Health Policy & Education
5.1 Medical and health policy development and education
5.2 Support for national constituent members
Chapter II Partnership & Collaboration
1. World Health Organization (WHO)
2. UNESCO Conference on Bioethics, Medical Ethics and Health Law
3. Other UN agencies
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4. World Health Professions Alliance (WHPA)
5. WMA Cooperating Centers
6. World Continuing Education Alliance (WCEA)
7. Other partnerships or collaborations with Health and Human Rights Organizations
Chapter III Communication & Outreach
1. WMA newsletter
2. WMA social media (Twitter and Facebook)
3. The World Medical Journal
4. WMA Annual Report
5. Meeting with Arab Medical Union leaders
6. Secondments / internships
Chapter IV Operational Excellence
1. Advocacy
2. Paperless meetings
Chapter V Acknowledgement
Annex 1 Request to delete of wrong information about Hong Kong SAR China
in Council report to General Assembly
Action Items (see document GA 2019/Council Report Provisional Action
Items/Oct2019, to be replaced by the Final Action Items 1)
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CHAPTER I ETHICS, ADVOCACY & REPRESENTATION
1. Ethics
1.1 International Code of Medical Ethics (ICoME)
The Council decided to establish a workgroup to revise the International Code of Medical
Ethics at its meeting in Riga in April 2018. The workgroup began by developing a list of
priority issues to be included in the policy. During this General Assembly in Tbilisi, a
first draft version of the revised ICoME policy will be shared with delegates. The plan is
to discuss this draft policy version further in regional meetings over the coming year.
1.2 Genetics in Medicine
At the Council Session in Riga in April 2018 it was decided to establish a workgroup for
the revision of the WMA Statement on Genetics in Medicine. At the General Assembly
in Reykjavik in October 2018 the Council decided to call this WMA Statement the
Declaration of Reykjavik. The workgroup will propose a revised version of the policy to
the Medical Ethics Committee during this General Assembly in Tbilisi and aims for
adoption of the policy.
2. Human Rights
2.1 Right to health
The WMA Secretariat follows the activities of the UN Special Rapporteur on the right of
everyone to the enjoyment of the highest attainable standard of physical and mental
health, Dr Dainius Puras, as well as health related matters addressed by the UN Human
Rights Council.
In late April, Dr Puras called for submissions on the role of medical education in
strengthening the health workforce, including doctors and other health workers, in view
of his thematic report to the 74th UN General Assembly dedicated to this topic. The
Secretariat sent its contribution, together with one from the Junior Doctors’ Network,
highlighting the necessity for a high standard of medical education as well as financial
resources for the education, training, development, recruitment and retention of
physicians to meet the medical needs of the entire population in the country. Addressing
Social Determinants of Health is also referred to in the paper as a way to remove barriers
in accessing health care. The contribution included a list of relevant WMA policies.
2.2 Protecting patients and doctors
2.2.1 Actions of support
Country Case
TURKEY
April 2019 – September 2019
The WMA Secretariat remains mobilized on the situation in Turkey.
On 3 May, the WMA and the Standing Committee of European Doctors
(CPME) issued a joint statement condemning the outcome of the trial
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Sources:
TMA,
Human Rights Foundation of
Turkey,
Amnesty International
against the members of the Council (2016-2018) of the Turkish
Medical Association (TMA), who face prison sentences for defending
medical ethics, human rights and peace. An open letter was sent to the
leaders of the European Union and Council of Europe. On 21 May the
WMA called on all governments to condemn the prison sentences imposed
on leaders of the TMA and demanded that the Turkish Government annul
the convictions and prison sentences (Read the press release).
On 9 May, the WMA sent a letter to the President of Turkey protesting
against the conditions of detention of thousands of detainees in Turkish
prisons on hunger strike due to the widespread practice of solitary
confinement used as a disciplinary measure. A press release was issued.
On behalf of the WMA, Secretary General Dr Kloiber delivered an open
message of support to all Turkish doctors, and in particular to those
sentenced to prison for declaring in a press release that ‘war is a public
health problem’, on the occasion of the TMA Annual General Council
meeting in June (see also the video).
In August, the WMA and the Standing Committee of European Doctors
(CPME) condemned the arrest of four Turkish health professionals for
providing medical care to a wounded child in 2015 at a time when there
was a curfew and access to health services was almost impossible. A joint
letter was sent to Turkish leaders and a press release was issued.
HONDURAS
June 2019
Source:
Media
Confemel
In June, in support of Confemel (Confederacion Médica latinoamericana y
del Caribe), the WMA sent a letter to the President of Honduras calling for
an immediate end to the use of violence against protesters striking in
protest at the government’s health and education reforms. A press release
was issued.
IRAN
August 2019
Source:
Amnesty
Media
In August, the WMA made another urgent appeal to the Iranian authorities
to release an Iranian-born Swedish doctor facing the death penalty in Iran.
Dr Ahmadreza Djalali, a specialist in emergency medicine, has been in
detention since his arrest in April 2016 on charges of espionage and for the
last few weeks has been on hunger strike. He has not been allowed to see
his wife, his lawyer or to receive proper medical care.
INDIA
Sept. 2019
Source:
Indian Medical Ass.
Media
In early September, a letter was sent to the Indian Prime Minister
denouncing the violence against health professionals following the case of
a 73-year-old doctor was killed in Assam a week earlier. In the letter,
WMA President Dr. Eidelman asked for a robust response from the Indian
government to address the root causes of such violence. A press release
was issued.
The WMA has supported calls from the Indian Medical Association for an
emergency meeting to discuss the issue of violence against health
professionals.
SYRIA
Sept. 2019
Source:
Indian Medical Ass.
Media (BBC report 12.09.19)
In a press release on 16 September, the World Health Professions Alliance
(WHPA) condemned the continuing targeted attacks on hospitals in Idlib
province in Syria’s north-west. WHPA leaders called for urgent action to
stop the air strikes on hospitals, which are deliberate and systematic and
have left millions of people without proper healthcare.
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HONG KONG* (see annex)
June 2019
Sources:
Media
Individual complains
The Secretariat was informed through different and concordant sources
that a patient was denied medical attention and service at the Adventist
Hospital (Tsuen Wan) after injuries sustained during a mass protest in
Hong Kong on 12 June 2019. When asked for help, hospital staff asked the
injured patient to leave and allegedly called the Police afterwards, leading
to the patient’s arrest at Yan Chai Hospital. The hospital made a statement
that the hospital would “not treat a patient that got injured due to illegal
activities”.
On 25 June, WMA Secretary General Dr Kloiber, sent a mail to the
President of the Hong Kong Medical Association denouncing such
healthcare denial as constituting a severe violation of medical ethics, and
asking that all the necessary action be taken to conduct an independent
investigation and, if confirmed, to denounce publicly such grave
infringements of medical ethics. The Secretariat did not receive a response.
2.2.2 Protection of health professionals in areas of armed conflict and other situations
of violence
The WMA Secretariat has a close working relationship with the International
Committee of the Red Cross (ICRC) headquarters within the context of the
“Health Care in Danger” (HCiD) initiative. In early November 2016, a
Memorandum of Understanding (MoU) between the WMA and the ICRC was
signed. This MoU develops and consolidates the long-standing cooperation
between the WMA and the ICRC and fosters understanding on topics of common
interest, and more generally in addressing Social Determinants of Health in the
context of insecurity.
During the reporting period, the ICRC organized regional meetings bringing
together participants from the HCiD Community of Concern, National Societies,
ICRC delegations and other stakeholders to discuss opportunities for the
implementation of practical measures for the protection of healthcare within
countries (in Manila for the Asia-Pacific region, and in Beirut for the Middle
East). The Secretariat shared the information with the medical associations
concerned.
In June, a meeting took place at ICRC headquarters on a research project related
to military practice and medical ethics. This was an opportunity to promote the
WMA “Toolkit for doctors working in situations of violence” prepared by Prof.
Vivienne Nathanson, former Director of Ethics at the British Medical Association,
within the framework of HCiD.
The WMA made a public statement at the 72nd World Health Assembly last May
on public health emergencies, regretting that situations of armed conflicts are not
recognised in WHO reports as a major risk factor for public health, in particular
given the increasing attacks on healthcare professionals and facilities during
armed conflicts, in violation of international humanitarian and human rights law.
In addition, the WMA recalled that the implementation and maintenance of
Universal Health Coverage and robust primary health care systems should be the
foundation for sustainable emergency preparedness, together with adequate
funding at global, regional and national levels.
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2.3 Prevention of torture and ill-treatment
The WMA Secretariat follows relevant international activities in this area, in particular
those of the Human Rights Council.
2.3.1 Role of physicians in preventing torture and ill-treatment
Since May 2017, the WMA Secretariat has been cooperating with the Health Care
in Detention Unit of the International Committee of the Red Cross (ICRC) and the
Norwegian Medical Association on updating the online course for physicians
working in prisons. The ICRC is currently working on the update with the
support of external experts. The updated courses should be online in autumn
2019.
In February 2018, the WMA was invited to participate in a one-year project on the
development of a supplement to the Manual on Effective Investigation and
Documentation of Torture and Other Cruel, Inhuman or Degrading
Treatment or Punishment, commonly called the Istanbul Protocol (IP). The
initiative is headed jointly by Physicians for Human Rights (PHR), the
International Rehabilitation Council for Torture Victims (IRCT), the Human
Rights Foundation of Turkey, REDRESS, the UN Committee against Torture, the
UN Subcommittee for the Prevention of Torture, the UN Special Rapporteur on
Torture and the UN Voluntary Fund for Victims of Torture. The purpose of the
Project is to strengthen the IP with updates and clarifications based on practical
experience from users. C. Delorme (advocacy advisor, WMA Secretariat) is one
of the drafters and a member of the working group on ethical codes. She attended
the first editorial Committee and Primary Drafters meeting in May 2018 in
Geneva and has been contributing to the revision process.
The 2020 edition of the IP is planned to be submitted to the OHCHR1 Publications
Committee in October and the IP should be released around July-August 2020.
2.3.2 Psychiatric treatment – Mental health
Since 2017, the WMA Secretariat, with the support of Dr Miguel Jorge,
psychiatrist and WMA President-Elect, has been monitoring international
activities related to the promotion of mental health as a global priority and a
fundamental human right, with the aim of providing the physicians’ perspective in
the discussion.
In May, the Secretariat was invited by the Council of Europe’s Committee on
Bioethics (DH-BIO) to participate in a consultation on a new additional Protocol
to the European Convention on Human Rights and Biomedicine concerning the
protection of human rights and dignity of persons with mental disorder with
regard to involuntary placement and involuntary treatment. The Secretariat
1Office of the United Nations High Commissioner for Human Rights
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submitted a written contribution prepared in collaboration with Dr Miguel Jorge
and based on WMA relevant policies.
Following on from this, the Secretariat received an invitation from the Council of
Europe Committee on Bioethics to a roundtable on 26 November in Brussels with
a view to participating in a study on good practices in mental healthcare and the
promotion of voluntary measures. Dr Kloiber, Secretary General, and C. Delorme,
Advocacy Advisor, will attend the event.
2.4 Pain treatment
The WMA continues to be active in the field of palliative care in cooperation with the
WHO and civil society organisations working in this area.
In March 2018, the advisory group on palliative care of the Pontifical Academy for Life
issued a White Paper on Global Palliative Care Advocacy, including a set of “Selected
recommendations” calling on various stakeholders in the health care sector to step up
advocacy for health. As a representative of professional associations, they called upon the
WMA to especially foster the human rights aspect of access to palliative care.
2.5 Health through peace
Further to the adoption of the Treaty on the Prohibition of Nuclear Weapons, the
International Physicians for the Prevention of Nuclear War (IPPN), the WMA, the
International Council of Nurses (ICN) and the World Federation of Public Health
Associations (WFPHA) have been collaborating on the need to promote the global health
imperative to eliminate nuclear weapons and to advocate for the ratification of the Treaty
on the Prohibition of Nuclear Weapons. A joint Statement was issued on the occasion of
the opening for signature of the Treaty in 2017.
On the occasion of the World Health Assembly, the WMA, IPPNW, ICN and WFPHA
organised a joint side-event on 27 May: “Nuclear Weapons Today: An Update of the
Humanitarian Consequences of Nuclear War and the Role of Health Professionals in
Preventing it” in the Palais des Nations, Geneva, with the participation of the ICRC.
In July-August 2019, IPPNW and the WMA Secretariat collaborated actively to mobilise
WMA constituent members based in countries having expressed support or interest on the
issue, asking them to encourage their governments to ratify the Treaty.
2.6 Sexual orientation and gender identity
In January/February 2019, the WMA participated in a consultation organised by Mr
Victor Madrigal-Borloz, the UN Special rapporteur on sexual orientation and gender
identity in collaboration with the UNDP (UN Development Programme) aiming to
identify a human rights-based approach to data collection in the context of violence and
discrimination based on sexual orientation and gender identity. It was an opportunity to
emphasise ethical norms and standards to data collection, referring to the WMA
Declaration of Taipei.
Last May, the Secretariat was approached by Human Rights Watch (HRW) regarding the
current legislation in Japan on legal gender recognition requiring those seeking a legal
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gender change to be single and without children under 20 and to undergo a psychiatric
evaluation to receive a diagnosis of “Gender Identity Disorder”, and be sterilized. Japan’s
Supreme Court upheld the law last January, while expressing significant doubts about it.
These practices being in clear contradiction of medical ethics, including WMA policy
and human rights standards, HRW offered to collaborate to advocate for a change in the
legislation given the favorable context further to the Supreme Court decision and the
2020 Olympic Games in Japan. The Secretariat contacted the Japan Medical Association.
3. Public Health
3.1 Non-communicable diseases (NCDs)
3.1.1 General
In response to the first UN Political Declaration on Prevention and Control of
Non-communicable Diseases from 2011, the WHO also established the Global
Monitoring Framework as a Global Coordination Mechanism (GCM) on the
Prevention and Control of Non-communicable Diseases. The scope and purpose
of the coordination mechanism is to facilitate and enhance the coordination of
activities, multi-stakeholder engagement and action across sectors at local,
national, regional and global levels. The WMA is an official member of this
coordination mechanism, which was launched in March 2015.
The GCM held a general meeting in November 2018, which brought together the
members of the partnership to discuss the means and resources required to
implement national NCD responses with a view to achieving SDG target 3.4 (“to
reduce, by 2030, premature mortality from NCDs by one third and promote
mental health”). Furthermore, members reflected on how this partnership can
continue to provide added value and implement its mandate. The WMA
participated in the meeting as a member of the partnership.
In December 2019, WHO will organise the next WHO Global Meeting to
Accelerate Progress on SDG Target 3.4 on Noncommunicable Diseases and
Mental Health, including a one day High-level Segment for Member States and
United Nations Organizations, as well as non-State actors, and a one day
Multistakeholder Partners’ Forum of the GCM. On the third day, regional
meetings with side events and site visits are planned. WMA is invited to speak on
several topics during the 3 day conference.
Following the long engagement of WMA with the WHO GCM Secretariat, WHO
appointed Dr Yokokura, WMA President, to be a member of the WHO Civil
Society Workgroup to advise the Director General on the planning and advocacy
of the High-Level meeting on NCDs in 2018 and on the mobilization of civil
society. The WHO Director-General has recognized the relevance of continuing
with this Working Group from April 2019 to April 2021 with three primary
objectives:
1. to mobilise civil society in the implementation of the outcomes document of
the 2018 UN High-Level Meeting on NCDs,
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2. to maximize the opportunity of the UN High- level Meeting on Universal
Health Coverage (UHC) (New York, September 2019) for NCD prevention
and control
3. to maximize the opportunities to forge synergies with civil society from
NCDs with other areas of global health (e.g. TB, HIV/AIDS, RMNCAH etc.)
to advocate in relation to prevention and control of co-morbidities and
integration of services across the continuum of care from prevention,
screening and diagnosis, treatment, care, and palliation as part of a
comprehensive approach to UHC.
3.1.2 Tobacco
The WMA is involved in the implementation process of the WHO Framework
Convention on Tobacco Control (FCTC). The FCTC is an international treaty
that condemns tobacco as an addictive substance, imposes bans on advertising and
promotion of tobacco, and reaffirms the right of all people to the highest standard
of health. The WMA attended the latest Conference of the Parties to the FCTC
meeting from 1-6 October 2018 in Geneva. At the conference, the 2018 Global
Progress Report was published showing progress in the implementation of most
articles of the convention, especially the time bound measures concerning smoke-
free environments, packaging and labelling and tobacco advertising, promotion
and a sponsorship ban.
Established by the eighth session of the Conference of the Parties, the WHO
FCTC secretariat started a new working group on Article 13 (Tobacco advertising,
promotion and sponsorship: depiction of tobacco in entertainment media) and
appointed the WMA as a member of the working group, where it is represented by
Dr Andreas Rudkjøbing.
3.1.3 Alcohol
The Secretariat maintains regular contact with the WHO staff in charge of this
topic, as well as with the Global Alcohol Policy Alliance (GAPA).
In the context of the collaboration plan between WHO and WMA for the period
2019-2021, WMA collaborates with WHO and other relevant partners on the
development and promotion of the WHO SAFER initiative (a safer world free
from alcohol related harms), in particular by fostering the role of health
professionals in reducing health risks linked to the consumption of alcohol.
The WMA participated in the 2019 WHO Forum on alcohol, drugs and addictive
behaviours “Achieving SDG 2030 health targets through enhanced partnerships
and collaboration”, which took place on 27-28 June in Geneva. C. Delorme,
WMA Advocacy Advisor, made a statement highlighting the crucial need to
prevent and reduce the harmful use of alcohol and related health, social and
economic consequences, in particular through a holistic approach with the
collaborative engagement of multiple sectors such as finance, trade, taxes or
education, and with adequate resources for health care provision, research and
education of health professionals.
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3.2 Communicable diseases
3.2.1 Multidrug-Resistant Tuberculosis Project
In 2010, the WMA participated in the development of the WHO guidance
document entitled ‘Guidance on Ethics of Tuberculosis Prevention, Care and
Control’. Building on this, the WHO is now in the processes of revising the
existing document with the aim of speaking more directly to the challenges faced
by healthcare workers (HCW) and decision-makers across the globe in helping
fulfil the third principle of the End TB Strategy, namely the protection of human
rights, ethics and equity. A first workgroup meeting has already taken place, with
the WMA delivering a presentation on health workers’ rights and obligations.
3.2.2 Immunisation
Since 2013 the WMA has been running an influenza immunisation campaign as
an implementation strategy of the WMA Statement on Avian and Pandemic
Influenza. Each year the communication campaign has a different focus. The 2019
campaign is again emphasising the role of physicians and highlighting their
ethical and public health responsibility to get immunised to avoid spreading the
virus. Physician should act as role models while reassuring their patients about
receiving the immunisation. The first part of the social media campaign will be
run in October and November, the start of the immunisation season in the
northern hemisphere; the second part will run in April/May 2020.
The two social media campaigns in 2018 together achieved 1.2 million
impressions on twitter and Facebook for the WMA, with 2,400 engagements on
twitter and 4,400 on Facebook. The spring campaign achieved the highest social
media engagement in India and the Philippines, whereas the autumn campaign
garnered most interest in Central and Eastern European countries.
The Chairman of Council and the Secretary General attended the WHO and
European Union “Global Vaccination Summit” in Brussels on 12 September
2019. The summit as described by the EU-Commission as aiming “to boost global
political commitment to vaccination, engage political leaders and opinion makers
to discuss and identify solutions towards eliminating vaccine preventable
diseases.”
The WMA, together with the German Medical Association and the Pontifical
Academy for Life, will organise a one-day conference to highlight the importance
of vaccination in the Vatican in May 2020.
WHO is revising its immunisation strategy Developing together the vision and
strategy for immunization – 2021-2030, Immunization Agenda 2030- A Global
Strategy To Leave No One Behind. The WMA is actively involved in the revision
process.
3.3 Health and populations exposed to discrimination
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3.3.1 Women and health
The WMA made a public statement at the 72nd World Health Assembly in May on
the WHO report on the Global Strategy for Women’s, Children’s and
Adolescents’ Health (2016–2030), recalling its firm opposition to the
medicalization of FGM and considering the participation of physicians in this
practice a grave breach of medical ethics and human rights standards. The
Statement also emphasises the need for adequate funding and programmes for the
education of physicians about HPV and associated diseases, HPV vaccination and
routine cervical cancer screening, and refers to the maternal and child health
handbook (MCH) as an important tool to improve continuity of care and benefit
health promotion for mothers, neonates and children.
3.3.2 Refugees, migrants & access to health
Since July 2017, the WMA has developed a fruitful working relationship with the
Migration Health Division of the International Organisation for Migration
(IOM). Dr Poonam Dhavan attended the last Council session in Riga (April 2018)
and delivered a presentation at the General Assembly in Reykjavik (October
2019) on potential areas of collaboration with interested WMA members.
The WMA made a public statement at the 72nd World Health Assembly in May on
the draft WHO Global Action Plan to Promote the Health of Refugees and
Migrants developed in collaboration with the IOM and UNHCR, among others. In
the Statement, the WMA calls for an explicit reference to the human right to
health of refugees and migrants, regardless of their legal, civil or political status,
in line with SDG 3 “Ensure healthy lives and promote well-being for all at all
ages” and recommends addressing the ethical challenge physicians might face – in
particular concerning practices involving their participation to non-medically
justified examination, diagnosis or treatment – as well as the ethical aspects of
health data collection on migrants.
3.4 Social determinants of health (SDH) and universal health coverage (UHC)
One of the most important global health topics this year is how countries can offer
universal health coverage to all, especially in marginalised societies, and protect citizens
from financial hardship. The UN General Assembly held the first ever High-Level
Meeting on Universal Health Coverage in New York in September 2019.
Several important conferences took place to negotiate the outcome document of the High-
Level meeting, one of which was the G20 meeting in Japan. To set the tone for the health
discussions at the G20 meeting, the WMA, together with the Japan Medical Association
and with the support of the Japanese Government, organised a Health Professional
Meeting (H20): The road to Universal Health Coverage on 13 – 14 June 2019 in Tokyo,
Japan.
The conference was opened by her Imperial Highness the Crown Princess as well as a
message by Japan’s Prime Minister Shinzo Abe, followed by a keynote speech from Sir
Michael Marmot, WMA Past President and Dr Naoko Yamamoto, WHO Assistant
Director-General, UHC/ Healthier Populations. At this well-attended conference, 240
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participants discussed how to make sustainable universal health coverage a priority for
global politics. What can physicians and their medical associations do to support
affordable, quality health care for all?
The WMA prepared a communication toolkit for its members to contact their national
governments to advocate for the importance of UHC and urge them to attend the High-
Level Meeting. Furthermore, it highlighted the important aspects and weaknesses of the
draft version of the outcome document during the negotiation process between the
countries.
The WMA attended the High-Level Meeting on UHC in New York, where it was
represented by its immediate Past President Dr Yoshitake Yokokura.
On the evening of the High-Level Meeting, the Japanese government, the Nikkei
foundation, WMA and other partners organized a side event on how digitalization and
innovations can enhance the acceleration of UHC. Representatives from international
organizations, government officials, the private sector and civil society gathered to
highlight the concept of people-centeredness as one of the keys to accelerating global
efforts to combat communicable diseases and at the same time promote progress toward
UHC, focusing on the potential role of innovations.
The WMA joined the UHC2030 network in an official side event during the WHA 2019.
UHC2030 is a multi-stakeholder platform to promote collaborative working in countries
and globally on health systems strengthening. Members advocate for increased political
commitment to UHC and facilitate accountability and knowledge sharing.
3.5 Counterfeit medical products
Counterfeit medicines are manufactured below established standards of safety, quality
and efficacy. They are deliberately and fraudulently mislabelled with respect to identity
and/or source. Counterfeiting can apply to both brand name and generic products, and
counterfeit medicines may include products with the correct ingredients but fake
packaging, products with the wrong ingredients, products without active ingredients, or
products with insufficient active ingredients. Counterfeit medical products threaten
patient safety, endanger public health, e.g. by increasing the risk of antimicrobial
resistance, and undermine patients’ trust in health professionals and health systems. The
involvement of health professionals is crucial to combating counterfeit medical products.
The WMA is a partner of the Fight the Fakes campaign that aims to raise awareness
about the dangers of fake medicines. Coordination among all actors involved in the
manufacturing and distribution of medicines is vital to tackle this public health threat.
The website also serves as a resource for organisations and individuals who are looking
to support this effort by outlining opportunities for action and sharing what others are
doing to fight fake medicines. The annual conference in October this year aimed to revise
the strategy and the list of priorities.
3.6 Health and the environment
3.6.1 Climate change
In May, the WMA was formally invited on behalf of WHO and the Global
Climate and Health Alliance (GCHA) to be a member of the newly launched
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WHO-Civil Society Working Group to Advance Action on Climate Change
and Health. This Working Group was proposed by WHO Director General, Dr
Tedros, at a previous meeting of WHO with civil society groups, including WMA.
The Working Group aims to foster a strong and sustained health voice, informing
decision-making on climate change nationally and internationally, and driving
urgent action on climate change. The proposed strategic partnership is well in line
with the agreed collaboration plan between WHO and WMA for the period 2019-
20212. Dr Lujain Al-Qodmani (Koweit Medical Association), co-chair of the
Environment Caucus, agreed to represent WMA in this new Working Group.
The WHO-Civil Society Working Group held its first meeting on the occasion of
the World Health Assembly in late May and has had two online meetings since, in
particular to prepare for the UN Climate Action Summit (New-York, 23 Sept) and
the Climate Change Summit (COP 25 in Santiago in December 2019).
Given its ECOSOC observer status, the WMA had the opportunity to nominate
one representative to attend the preparatory Coalition meetings on the key action
areas of the Summit (21-22 Sept.) and to attend the UN Climate Action Summit
(23 Sept) itself. Dr Yassen Tcholakov and Mike Eliasz, members of WMA Junior
Doctors Network and active participants in the WMA Environment Caucus, each
attended one of these events.
In view of the upcoming Climate Change Summit (COP25) on 2-13 December
2019 in Santiago, Chile, the Secretariat sent a call for nominations to WMA
members in July with the aim of forming a delegation to attend the event and
advocate for a stronger health component in the negotiations based on WMA
policies.
The WMA made a public statement during the 72nd World Health Assembly in
May on the draft WHO global strategy on health, environment and climate
change, recommending, in particular, a greater emphasis on the need for health
impact assessments of new trade agreements negotiated in multilateral settings in
order to protect, promote and prioritize public health over commercial interests
and secure services in the public interest, including those impacting on health and
the environment.
3.6.2 Air pollution
The WHO’s First Global Conference on Air Pollution and Health took place
from 30 October to 1 November 2018 in Geneva. It brought together global,
national and local partners to share knowledge and mobilize action for cleaner air
and better health. Dr Lujain Al-Qodmani, co-chair of the Environment Caucus,
was one of the keynote speakers at the session dedicated to the role of health
professionals in addressing air pollution. Dr Al-Qodmani also contributed to a
2 Other partners of the WG include: International Council of Nurses, International Federation of Medical Students’
Associations, International Federation of Red Cross and Red Crescent Societies, Health Care Without Harm, Health and
Environment Alliance.
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WHO discussion paper on air pollution and child health. A press release was
issued.
Dr Peter Orris, Co-chair of the WMA Environment Caucus, represented the
WMA at the WHO Expert Consultation on air pollution (12-14 February 2019
in Geneva,), which aimed to provide evidence‐based recommendations on the best
ways to communicate potential risks of the health effects of air pollution to the
public, to health care workers and to patients and to offer indications on how to
reduce air pollution exposure.
3.6.3 Chemical safety
The WMA is a member of the Strategic Approach to International Chemicals
Management (SAICM) of the Chemicals Branch of the United Nations
Environment Programme (UNEP) and follows the implementation of the World
Health Assembly Resolution on the Role of the Health Sector in the Strategic
Approach to International Chemicals Management towards the 2020 goal
and beyond (2016) and of the Chemicals Roadmap (2017), which identifies
actions in which the health sector has a supporting role to play.
Dr Peter Orris, Co-Chair of the WMA Environment Caucus, represented the
WMA at the second international meeting dedicated to the implementation of
the Minamata Mercury Convention (COP2) in November 2018 in Geneva. The
WMA sees the reduction of mercury environmental contamination as a critical
public health issue and the removal of mercury from health care as an unfinished
agenda.
3.6.4 WMA Green news
The WMA is partnered with the Florida Medical Association (FMA) on a joint
project “My Green Doctor”. This project is a medical office environmental
management service offered free of charge to members of the World Medical
Association (WMA) and the Florida Medical Association (FMA). The initial
version of My Green Doctor was launched by the FMA on World Earth Day
2010. In June 2014, the WMA and FMA agreed to work together on this project.
My Green Doctor provides a free practice management tool designed by doctors
to make medical offices more environmentally friendly. The My Green Doctor
website is now available in the “What we do – Education” section of the WMA
website. Calls to action are often published on the WMA social media pages.
4. Health Systems
4.1 Primary health care
On the occasion of the 40th Anniversary of the Declaration of Alma-Ata, the Second
International Conference on Primary Health Care was hosted by the President of
Kazakhstan, with the World Health Organization and the United Nations Children’s Fund
(UNICEF) in Astana, Kazakhstan from 25-26 October 2018. The Conference aimed to
strengthen primary health care as the foundation for UHC, building on lessons learnt over
the past four decades.
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Dr Otmar Kloiber, Secretary General, served as a member of the International Advisory
Committee for the preparation of the Primary Health Care Conference. The WMA
commented on the conference declaration and the technical background papers.
Recently, the WMA Secretariat and WMA members have noticed a tendency in
international discussions, personal exchanges and public events towards a push to
downgrade primary health care. Some international organisations think physicians in
primary health care could be replaced by mid or even low-level cadres equipped with
decision support tools for diagnosis. The reason for this push can be found in the fact that
the WHO, OECD and ILO have projected a shortfall of 18 million health workers
worldwide by 2030. In addition, national health expenditure is constantly rising, many
countries have difficulties implementing universal health coverage and many people have
doubts about how to achieve the Sustainable Development Goals. In this challenging
environment some might think downgrading could be an easy solution. The WMA
strongly advocates for a high quality, physician-led primary health care system, which is
closely linked with health promotion, prevention, secondary and tertiary care. The WMA,
together with the other members of the World Health Professions Alliance, gave a
statement during the WHO Executive Board meeting on community health workers in
UHC and supported WHO in its statement that CHWs should not be used as a cheaper
replacement for regulated health professionals.
The WMA has, with the help of our national medical associations, started a research
project on physician led primary health care. We are collecting arguments for and
national examples of physician-led multidisciplinary team approaches.
Furthermore, WHO has revised its guideline recommendations on digital interventions
for health system strengthening. WMA took part in this revision process.
4.2 Patient safety
In order to address the global problem of unsafe medication practices, the WHO has
launched a Global Patient Safety Challenge on Medication Safety with the overall goal to
“reduce the avoidable harm due to unsafe medication practices by 50% worldwide by
2020”. In order to develop this initiative, the WHO invited the WMA and other relevant
stakeholders to several consultations this year.
Some years ago, the WMA, along with the WHO and the other health professions, wrote
the ‘Patient Safety Curriculum Guide- Multi Professional Edition’, and also
participated in its update a few years later. Now the WHO would like to carry out a
second revision of this curriculum guide in several steps. As the first step, the chapter
‘Improving Medication Safety’ will be updated in such a way that it can also stand alone
as a single document. The WMA participated in several meetings to guide WHO in the
development process.
In line with the Patient Safety Curriculum Guide, WHO is developing Country Guidance
on how to implement the Patient Safety Guide at national, local or university level. The
WMA is also involved in this process.
This year on 17 September, the first World Patient Safety Day took place. WMA joined
the WHO social media campaign.
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4.3 Antimicrobial resistance
Antimicrobial Resistance (AMR) is a growing concern and an important challenge to
public health. It has various aspects and different actors contribute to the problem.
The WMA participated in a WHO expert consultation meeting on health workforce
education and AMR. The outcome of this meeting was the development of the first draft
of the Global Interprofessional AMR Competency Framework for Health Workers’
Education. This tool will assist health policy planners and decision makers in countries
to work towards achieving the first objective of the WHO Global Action plan on AMR,
which aims to improve awareness and understanding of AMR through effective
communication, education and training. It is also intended to serve as the basis for the
development of a global prototype AMR curriculum for health workers’ education and
scheduled training. The WMA commented on the first draft version together with the
World Federation for Medical Education. Our comments included the knowledge and
training aspects required to carry out a proper diagnosis and the importance of
differentiating between different origins and severity of infections, i.e. it is of utmost
importance to have a deep knowledge of diagnosis before prescribing an antibiotic in
order to reduce the burden of AMR. As a next step, WHO developed a draft Curriculum
for Health Workers’ Education and Training on AMR. The curriculum is designed to
serve all cadres of health workers, including prescribers, non-prescribers, policy makers
and managers, and set an international standard in AMR knowledge. The WMA
commented on this framework.
The September 2016 Political Declaration of the High-level Meeting on Antimicrobial
Resistance called for the establishment of an Interagency Coordination Group on
Antimicrobial Resistance (IACG), in consultation with the World Health Organization,
the Food and Agriculture Organization, and the World Organisation for Animal Health
(OIE). The IACG’s mandate is to provide practical guidance for approaches needed to
ensure sustained effective global action to address antimicrobial resistance, and to report
back to the UN Secretary-General in 2019. In 2018, the WMA, along with the
International Federation of Medical Students (IFMSA), participated in the open
consultation on the development of a discussion paper for the IACG.
The WMA participated in the 2nd informal consultation of Member States and relevant
partners on the global development and stewardship framework on AMR of the WHO in
October 2018.
The WMA was invited to contribute expertise to the
• Global AMR R&D Hub’s Expert Advisory Group (EAG)
And the
• WHO “Consultation on the Draft Framework for Regional Action and
Multistakeholder Accountability to Combat Antimicrobial Resistance in the
Western Pacific Region, 23-25 July 2019 Manila, Philippines.
Dr Caline Matar was nominated by the WMA for both and has been accepted as a
member.
4.4 Health workforce
In May 2016, the World Health Assembly adopted the Global Strategy on Human
Resources for Health. One new and important statement in the WHO strategy is the
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emphasis that investment in HRH has a growth-inducing effect and health care itself is a
large pillar of the economy. The argument that the health sector has a growth inducing
effect on the economy is now being adopted by more and more UN agencies. As a result,
the UN Secretary General appointed a High Level Commission on Health Employment
and Economic Growth, which launched its report ‘Working for Health and Growth –
Investing in the health workforce’ in September 2016. The report gives 10
recommendations on areas such as job creation, gender and women’s rights, education
technology and crisis and humanitarian settings. The Commission’s goal is to stimulate
and guide the creation of at least 40 million new jobs in the health and social sectors and
to reduce the projected shortfall of 18 million health workers, primarily in low and lower
middle-income countries, by 2030.
In the international discussions on how to achieve universal health coverage and establish
an integrated primary health care model as an entry point to the health system it is often
highlighted that this is only possible if countries invest in a well trained and equipped
health workforce. WHO asked the WMA and the other members of the World Health
Professions Alliance to organise an event during the World Health Assembly to highlight
the importance of the health workforce and ask for more investment.
With the support of the Israeli Medical Association, the WMA organized a conference on
the future of the medical profession in Tel Aviv from 13-15 May 2019. The conference,
chaired by WMA President Leonid Eidelman, was entitled Physician 2030: the future is
around the corner – be prepared. The conference looked into the demographic, economic,
regulatory and technological changes in the physician workplace and discussed scenarios
of the physicians’ workplace in the mid-term future.
4.5 Violence in the health sector
The Sixth International Conference on Violence in the Health Sector took place in
Toronto, Canada on 24 – 26 October 2018. The WMA was a member of the organisation
and scientific committee in charge of the preparations for the event and promoted the
event within its membership and through social media.
4.6 Caring Physicians of the World Initiative Leadership Course
The CPW Project began with the Caring Physicians of the World book, published in
English in October 2005 and in Spanish in March 2007. Some hard copies (English and
Spanish) are still available from the WMA Secretariat upon request.
Regional conferences were held in Latin America, the Asia-Pacific region, Europe and
Africa between 2005 and 2007. The CPW Project was extended to include a leadership
course organised by the INSEAD Business School in Fontainebleau, France in December
2007, in which 32 medical leaders from a wide range of countries participated. The
curriculum included training in decision-making, policy work, negotiating and coalition
building, intercultural relations and media relations. Please visit the WMA website for
more readings and videos which reflect some experiences of previous course alumni.
The eighth course was held at the Mayo Clinic in Jacksonville, Florida, USA from 3 – 8
December 2017. The courses were made possible by educational grants provided by
Bayer HealthCare and Pfizer, Inc. This work, including the preparation and evaluation of
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the course, was organised along with WMA Past President Dr Yank Coble, a member of
the Past Presidents and Chairs Network.
5. Health Policy & Education
5.1 Medical and health policy development and education
In recent years, the Center for the Study of International Medical Policies and Practices at
George Mason University, which is one of the WMA’s Cooperating Centers, has studied
the need for educational support in the field of policy creation. Surveys performed in
cooperation with the WMA found a demand for education and exchange. The Center
invited the WMA to participate in the creation of a scientific platform for international
exchange on medical and health policy development. In autumn 2009, the first issue of a
scientific journal, World Medical & Health Policy, was published by Berkeley Electronic
Press as an online journal. It has now been moved to the Wiley Press. The World Medical
& Health Policy Journal can be accessed at:
http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1948-4682
5.2 Support for national constituent members
See item 2.2.1
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CHAPTER II PARTNERSHIP & COLLABORATION
During the reporting period, the WMA Secretariat held bilateral meetings with the WHO and staff
of other UN agencies on the following areas: Prevention of alcohol abuse, mental health, violence
against women, the environment, the migration of health professionals and the prevention of
torture. In addition, the Secretariat voiced the WMA’s opinion and concerns in various public
settings as follows3:
1. World Health Organization (WHO)
Memorandum of Understanding between WHO and WMA
In April 2018 a Memorandum of Understanding was signed by the World Health Organisation and
the World Medical Association to reaffirm and consolidate co-operation between the two
organisations.
WHO-Civil Society Working Group to Advance Action on Climate Change and Health
The WMA is a member of this new working group set up in May 2019 (see item 3.6.1 above for
more information).
World Health Assembly, 20-28 May 2019, Geneva, Switzerland
The WMA made public statements on a series of issues. For more information (agenda, working
documents and resolutions) – See also the official website for statements by non-State actors in
official relations with WHO.
Second WHO Forum on alcohol, drugs and addictive behaviours, 27-28 June 2019, Geneva,
Switzerland
A public statement was presented (see item 3.1.3 above for more information).
General Meeting of the WHO Global Coordination Mechanism on Noncommunicable
Diseases in November 2018, Geneva, Switzerland
WHO Global Consultation for Setting Priorities for Global Patient Safety in collaboration with the
Centre for Clinical Risk Management and Patient Safety, Department of Health
WHO organised a working dinner during the WHA on human resources for health: Addressing the
Shortfall of 18 million Health Workers
The side event “Nuclear Weapons Today: An Update of the Humanitarian Consequences of
Nuclear War and the Medical Role in Preventing it” was organized by WMA together with the
International Physicians for the Prevention of Nuclear War and the World Federation of Public
Health Associations during the WHA.
The Taiwan Medical Association, together with WMA, organised a side event during the WHA on
primary health care.
3 More information on the activities mentioned is set out under the relevant section of the report.
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WHO invited the WMA to take part in a “Stakeholder Workshop on Ethical Aspects of Radiation
Protection in Health Care” on 2-4 September 2019 together with the International Council on
Radiation Protection. The WMA was represented by its Secretary General.
WHO is discussing how NGOs can and will be involved in the Executive Board meetings and
WHA in the future. The amount of interventions submitted by NGOs has increased a lot over the
years and these prolong the meetings. As a first consequence, WHO has reduced the time given to
NGOs for their interventions, which on the other hand decreases the impact of these interventions.
Now, a further debate on how to involve NGOs in the governmental meetings has begun. The
WMA would wish to have a possibility to intervene with WHO and member states during the
process of the development of meeting documents so member countries can take the advice of
NGOs into account in their decisions. One proposal from WHO is to exclude NGOs from the
governmental meetings and to set up a separate meeting with NGOs. The WMA is against this
because this wouldn’t allow civil society to give expert advice directly to members. If such a
meeting takes place as an additional meeting to the Executive Board and WHA it would not exclude
civil society from participation at the governmental meetings, however it would make it very
difficult for smaller NGOs to participate.
2. UNESCO Conference on Bioethics, Medical Ethics and Health Law
In recent years, the WMA has supported the “UNESCO Chair in Bioethics World Conference
on Bioethics, Medical Ethics and Health Law” organised by the UNESCO Bioethics Chair,
Prof. Dr Amnon Carmi.
The WMA again participated in the 13th World Conference on Bioethics, Medical Ethics and
Health Law from 27-29 November 2018 in Jerusalem, Israel. The conference serves as a
platform to discuss WMA’s current policy with physicians, ethicists and other scientists.
The 14th World Conference on Bioethics, Medical Ethics and Health Law will be held from 11-
14 May 2020 in Porto, Portugal.
3. Other UN agencies
AGENCY ACTIVITIES
Human Rights Council of the United
Nations, in particular:
UN Special Rapporteur (SR) on the right of
everyone to the enjoyment of the highest
attainable standard of physical and mental
health (Dr D. Puras)
• Monitoring the SR’s activities
• Ongoing exchange of information
• Participation in the SR’s call for
submissions for his thematic report on
medical education and health workforce
strengthening (May 2019)
Special Rapporteur on torture and other cruel,
inhuman or degrading treatment or
punishment (Dr Nils Melzer)
• Monitoring the SR’s activities
• Contact to be made with new SR
Special rapporteur on sexual orientation and
gender identity (Victor Madrigal-Borloz)
 WMA part of a consultation on data
collection on sexual orientation and gender
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identity (January 2019 onwards)
High Commissioner for Human Rights (Mr
Zeid Ra’ad Al Hussein)
The WMA took part in the consultation
process within the framework of the UN
Resolution on mental health and human rights
adopted in September 2016 and continually
monitors the HCHR’s activities.
UNAIDS Regular exchange of information
OECD Regular exchange of information
International Organisation for Migration
(IOM)
 Regular exchange of information.
 The development of a Memorandum of
Understanding is being considered.
4. World Health Professions Alliance (WHPA)
WHO together with WHPA organized a technical briefing during the WHA on Addressing the
Shortfall of 18 million Health Workers: Investing in Jobs, which shared evidence of what
strategies work and built a new consensus on how to strengthen the future partnership role of
health worker organizations with Member States on investing in jobs and Health for All.
WHPA decided to continue the series of World Health Professions Conference on Regulation
WHPCR in May 2020 in Geneva. For further information on previous conference please see
here.
5. WMA Cooperating Centers
The WMA is proud to enjoy the support of five academic cooperating centres. The WMA
Cooperating Centers bring specific scientific expertise to our projects and/or policy work,
improving our professional profile and outreach.
WMA Cooperating Center Areas of cooperation
Center for the Study of International
Medical Policies and Practices, George-
Mason-University, Fairfax, Virginia, USA
Policy development, microbial resistance,
public health issues (tobacco), publishing the
World Medical and Health Policy Journal.
Institute of Ethics and History of Medicine,
University of Tübingen, Germany
Revising the Declaration of Geneva, medical
ethics
Institut de droit de la santé, Université de
Neuchâtel, Switzerland
International health law, developing and
promoting the Declaration of Taipei, medical
ethics, deontology, sports medicine
Steve Biko Center for Bioethics, University
of Witwatersrand, Johannesburg, South
Africa
Revising the Declaration of Helsinki, medical
ethics, bioethics
Institute for Environmental Research,
Yonsei University College of Medicine,
South Korea
Environmental health, climate change and
health issues
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6. World Continuing Education Alliance (WCEA)
The World Medical Association signed an agreement with the WCEA to provide an online
education portal that will not only enable the WMA to host its online education, but also offers
an opportunity for member associations to develop their own portals and online content. This
offer is directed specifically at medical associations and societies that wish to engage in
providing online education. Interested groups, medical schools or academies are invited to
contact the WMA Secretary General (secretariat@wma.net) for more information. The
educational platform was launched in June 2018.
7. Other partnerships or collaborations with Health and Human Rights Organizations
Organisation Activity
Amnesty International Ongoing contacts (exchange of information and support)
during the reporting period, in particular on the situations in
Turkey, Syria, Honduras and Iran.
Human Rights Watch Regular contact on issues of common interest, in particular on
sexual orientation and gender identity during the reporting
period.
Global Alliance on Alcohol
Policy (GAPA) and its
members
Regular exchange of information and ad hoc joint actions.
International Committee of
the Red Cross (ICRC)
Partners on the Health Care in Danger (HCiD) project since
September 2011.
Permanent cooperation with the Health in Detention and
HCiD Departments.
Memorandum of Understanding between the ICRC and the
WMA signed in November 2016.
International Council of
Military Medicine (ICMM)
A Memorandum of Understanding between the ICMM and the
WMA was signed at the WMA General Assembly in October
2017 (Chicago).
Council for International
Organizations of Medical
Sciences (CIOMS)
Development of guidance for the scientific community in
medicine and health care in general. The WMA is a member
and currently represented on the Executive Board and
participates in various work groups on matters of research in
resource poor settings, patient information and healthy
research subjects (planned).
International Federation of
Medical Students
Associations (IFMSA)
Internship program since 2013 (3 students in 2013 and 2
students in 2014).
Regular collaboration, mostly in relation to WHO statutory
meetings.
Participation of WMA officers and officials in the pre-World
Health Assembly IFMSA conference in Geneva.
International Federation of
Associations of
Pharmaceutical Physicians
(IFAPP)
Cooperation on issues of human experimentation and
pharmaceutical development, the role of physicians in that
process. A memorandum of understanding was signed at the
WMA General Assembly, October 2017 (Chicago).
Together with the WMA, IFAPP is exploring the possibility of
a course on medicines development for physicians in clinical
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research, ethics committees or regulation.
University of Pennsylvania
International Internship
Program
Annual internship program on health policy, public health,
human rights, project management. Usually 2-3 students come
as interns to our office for the summer. The programme has
been running since 2014.
International Rehabilitation
Council for Torture Victims
(IRCT)
Regular exchange of information and joint actions on specific
cases or situations.
Global Climate & Health
Alliance (GCHA)
Regular exchange of information and ad hoc collaboration
within the context of the UN climate change negotiations.
New Jersey Medical School
Global TB Institute
The WMA is working with the New Jersey Medical School
Global TB Institute and the University Research Company
(URC) to update its online TB refresher course for physicians
with the support of the US Agency for International
Development (USAID).
World Veterinary
Association
Co-organisation of the Global Conference on One Health, 21-
22 May 2015 in Madrid, Spain in collaboration with the
Spanish medical and veterinary associations. 2nd Global
Conference on One Health, Kitakyushu City, Fukuoka
Prefecture, Japan, 10-11 November 2016. Common advocacy
on matters like AMR, zoonotic diseases and food safety.
US Defense Health Board –
Ethics Subcommittee
WMA Past President, Dr Cecil Wilson, represented the WMA
at two sessions of the Defense Health Board – Ethics
Subcommittee in 2014 and 2015 advocating for always
allowing physicians in military service to respect medical
ethics, even in conflict. The report of the Board is available on
our website.
Physicians for Human
Rights (PHR)
Regular exchange of information and joint actions on specific
cases or situations in support of physicians in distress.
International Physicians for
the Prevention of Nuclear
War (IPPNW)
Exchange of information and joint actions, in particular in the
context of the UN Treaty on the Prohibition of Nuclear
Weapons.
Association for the
Prevention of Torture
Exchange of information on the implementation of the
Convention against Torture with regard to the role of
physicians in preventing torture and ill treatment.
Safeguarding Health in
Conflict Coalition
Observer status in the coalition.
Regular exchange of information.
World Coalition Against
The Death Penalty
Regular exchange of information, in particular regarding
individual cases requiring international support.
Medical Human Rights
Network (IFHHRO)
Regular exchange of information on human rights and health
matters.
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CHAPTER II COMMUNICATION & OUTREACH
In July 2017 a new member of staff joined the WMA Secretariat. Ms Magda Mihaila is a journalist
and communications specialist who is now helping our team improve the way we get out messages
to our members and into our social media stream.
1. WMA Newsletter
In April 2012, the WMA Secretariat started a bi-monthly e-newsletter for its members. The
Secretariat appreciates any comments and suggestions for developing this service and making it
as useful for members as possible.
2. WMA social media (Twitter and Facebook)
In 2013, the WMA launched its official Facebook and Twitter accounts (@medwma). The
Secretariat encourages members to spread the word within their associations that they can
follow the WMA’s activities on Twitter and via Facebook. Besides communicating WMA
activities and policies, the accounts have proved a powerful tool for supporting WMA
Constituent Members in difficult political and social contexts.
3. The World Medical Journal
The World Medical Journal (WMJ) is issued every 3 months and includes articles on WMA
activities and feature articles by members and partners. The 60th anniversary edition was
published as a final printed copy in 2014. It transferred to an electronic format in 2015, which
is available on the WMA website. The Journal is edited by Dr Peteris Apinis and Prof. Elmar
Doppelfeld and managed by Ms Maira Sudraba of the Latvian Medical Association.
4. WMA Annual Report
The WMA has started issuing an Annual Report. So far reports have been issued for the years
2017 and 2018. The report highlights the main activities of the WMA, focusing on the report of
the President, the events organised around topics such as Health, Environment, NCDs,
Influenza, Human Rights, but also on the categories of WMA Membership and the Financial
Report. It is available both on the WMA website and a very limited number of copies are
distributed at the WMA Council and General Assembly.
5. Secondments / internships
We have been running an internship programme with the IFMSA since 2013 (one intern in
May-July from Canada and one in July-September from Pakistan), with the University of
Pennsylvania since 2014 (two interns for the summer of 2019) and in 2016 we started an
internship programme with the Palack University Olomouc in the Czech Republic.
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CHAPTER III OPERATIONAL EXCELLENCE
1. Advocacy
In April 2017, the Council decided to discontinue the Advocacy Workgroup and to replace it
with a new Advocacy and Communications Advisory Panel with the mission to provide input
and guidance to:
 Enhance the promotion of WMA policies and positions among the NMAs and to
relevant external organisations, associations, and institutions; and
 Recommend advocacy and communications strategies to increase the visibility and
positive impact of WMA policies and activities.
The 3-year term of the mandate of the 1st panel, chaired by Dr Ashok Zachariah Philip
(Malaysian Medical Association), ended in April 2019.
A new panel has been appointed by the Chair of the Council as follow:
• Dr Angelique Coetzee (Chair), South African Medical Association (SAMA)
• Dr Jacqueline Kitulu, Kenya Medical Association
• Dr Shantanu Sen, Indian Medical Association
• Dr Mworozi Edison, Uganda Medical Association
• Dr Ashok Philip, Malaysian Medical Association
• Bente Hyldahl Fogh, Danish Medical Association
• Dr Jon Snaedal, Icelandic Medical Association, Past Presidents & Chairs of Council
network (PPCN)
2. Paperless meetings
At its 188th meeting, the WMA Council expressed its desire to reduce its environmental impact
by going paperless. Since the 189th Council meeting, documents posted on the website before
the meeting have no longer been provided at the venue in print. Council members and officials
are responsible for downloading documents from the members’ area of the WMA website and
bringing them to the meeting via electronic media or on paper, if desired. Documents
developed on site during the meeting are available online via a WiFi connection or in print. The
Secretariat introduced box.com at the 197th Council meeting as a parallel sharing and
synchronizing tool for official WMA documents. In October 2016, the WMA General
Assembly in Taipei decided to introduce entirely paperless meetings provided a suitable WiFi
connection is available.
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CHAPTER IV AKNOWLEDGEMENT
The Secretariat wishes to record its appreciation of member associations and individual members
for their interest in, and cooperation with, the World Medical Association and its Council during the
past year. We thank all those who have represented the WMA at various meetings and gratefully
acknowledge the collaboration and guidance received from the officers, as well as the Association’s
editors, its legal, public relations and financial advisors, staff of constituent members, council
advisors, associate members, friends of the association, cooperating centres, partner organizations
and officials.
We wish to mention the excellent working relationships we have with colleagues and experts in
international, regional and national organizations, be they (inter-)governmental or private. We
highly appreciate their willingness and efforts to enable our cooperation.

24.10.2019
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ANNEX 1
to the
Report of the Council to the WMA General Assembly, Tbilisi 2019
Document no: GA 2019/Council Report/Oct2019
In referring to item 2.2.1 (Hong Kong) of the Council Report 2019, we received the following
message by Dr Rao Keqin, Vice President and Secretary General of the Chinese Medical
Association sent us the following message dated 21st October 2019:
“Request to delete of wrong information about Hong Kong SAR China in Council report to
General Assembly
In Council report to GA, item 2.2.1 included the individual complain about Hong Hong SAR China,
regarding a patient who seek for treatment but got refusal by Adventist Hospital on 12 June, 2019.
As a matter of fact, Hong Kong Adventist Hospital has made clarification on 20 June, 2019. The
hospital provided basic medical service to the patient immediately after patient’s arrival, confirmed
patient’s normal basic physical signs and stable condition of injury, then suggested the patients to
seek medical assistance from other hospitals. The patient decided to leave the hospital by
him/herself. The information by media and individual complain are not true. The action to include
these information into council report to GA is not serious and appropriate, therefore, we suggest to
delete this part. The statement by Hong Kong Adventist Hospital is attached. “
_________________________________________________________________
September 2019 GA 2019/Council Report REV/Oct2019
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Annex 1.1 News Release from Hong Kong Adventist Hospital, 20 June 2019
香港港安醫院－荃灣 新聞稿
News Release from Hong Kong Adventist Hospital – Tsuen Wan
首先感謝市民大眾及傳媒朋友對本院的關注及查詢。
Firstly, we thank the citizens and media for your attentions on and inquiries about
our hospital.
香港港安醫院─荃灣將病人的福祉視作首要考慮，為所有有需要的病人提供
專業而嚴謹的醫療服務，不受任何年齡、疾病或殘障、教義、裔屬、性別、國籍、
政見、種族、性傾向、社會立場或任何其他因素干擾。
Hong Kong Adventist Hospital – Tsuen Wan takes the well-beings of patients into
primary consideration, and provides professional and rigorous medical care to all
patients free from any factors, including age, disease or disability, creed, ethnicity,
gender, nationality, political views, race, sexual orientation, and social position, etc.
根據本院 2018 年更新的入院指引，醫院不適宜處理以下嚴重創傷個案，例
如：懷疑斬人、懷疑車禍、懷疑槍傷、墮樓等，以及懷疑與法律訴訟有關個案。
除此之外，由於本院的醫療設備有限，亦未能處理以下個案：病人如有自殺或暴力
傾向；精神狀況不穩定或處於精神病狀態；病人如服用過量精神科藥物、酗酒或
濫用藥物；病人如已確診或懷疑患有 SARS 非典型肺炎或禽流感。本院會先為
病人提供急救及基本治療，確定病人情況穩定後，才會建議轉介至附近公立醫
院。
According to our updated admission guidelines in 2018, it is not appropriate for the
hospital to handle the cases with severe injuries caused due to suspected homicide,
suspected car accident, suspected gunshot, falling off a building and so on, and the
cases suspected to be involved in legal proceedings. In addition, due to limited
medical facilities, the hospital is also unable to handle such cases in which the
patients have suicidal or violent tendencies; are mentally unstable or in a psychotic
state; have taken excessive psychotropic drugs, drank excessively or abused drugs;
have been diagnosed with or are suspected of suffering SARS or avian influenza.
The hospital provides patients with first aid and basic treatment firstly, and only
after their conditions are stable will we suggest them to transfer to the public
hospitals nearby.
September 2019 GA 2019/Council Report REV/Oct2019
30
警察建議懷疑有刑事成份的個案，例如：懷疑虐兒個案、懷疑逾期逗留期間
在港分娩的人士等，均需要通報予警方。
The police officers advise us to notify them of the suspected criminal cases,
including suspected child abuse cases, and the cases in which the persons are
suspected of giving birth to children in Hong Kong during their overstaying, etc.
2019 年 6 月 12 日，約下午六時，有 4 位荃灣警署的軍裝警察前往本院，
要求本院通報懷疑涉及「金鐘衝突」而受槍傷人士的個案予警方。
At about 6:00 PM on 12 June 2019, four uniformed police officers from Tsuen Wan
Police Station came to the hospital and requested us to notify them of the persons
suspected to be wounded by the gunshot in the “Admiralty Conflict”.
同日，約晚上十時半，有病人到本院急診中心求診，本院急症科護士立即為
病人提供基本護理服務，包括清洗傷口、監察生命指數等。本院急症科護士確定
病人呼吸系統運作正常，而且神智清醒，及傷勢穩定，才建議為病人召救護車轉
到最近的公立醫院求助，惟病人最後選擇自行離開。
At about 10.30pm on the same day, a patient came to the emergency center of our
hospital for treatment. The nurses of the emergency department immediately
provided the patient with basic nursing services, including cleaning up the wound
and monitoring the vital index, etc. The patient was advised to be sent to the nearest
public hospital by ambulance only after the nurses of the emergency department
confirmed that the patient’s respiratory system was functioning normally, that he
was conscious, and that the condition of his wound was stable. But, the patient
chose to leave finally.
其後，本院當值經理應警方要求，通報懷疑槍傷個案。
After that, at the request of the police officers, the manager on-duty of the hospital
notified them of the suspected gunshot wound case.
針對平衡病人私隱與配合警方調查的疑慮，本院亦認為當中並無清晰指引。
由於本院並無駐院警察，需要靠前線醫護人員判斷是否通報警方，當中存在灰色
地帶，容易令前線醫護人員混淆。
We also think that there is no clear guidance on balancing patient privacy and
cooperation with the police investigation. As there was no resident policemen in our
hospital, so it was up to the front-line medical staffs to decide whether or not to
notify the police. There are grey zones which can easily confuse the front-line
medical staffs.
2019 年 6 月 20 日
June 20, 2019
September 2019 GA 2019/Council Report REV/Oct2019
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Annex 1.2 Press release of Hong Kong Adventist Hospital, 22 June 2019
September 2019 GA 2019/Council Report REV/Oct2019
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Press Release of Hong Kong Adventist Hospital – Tsuen Wan
Hong Kong Adventist Hospital – Tsuen Wan (HKAH – TW) places the well-being of
patients as its first priority.
Hong Kong Adventist Hospital – Tsuen Wan is committed to providing emergency
medical services and treatment to anyone seeking medical assistance at the hospital.
HKAH – TW is deeply aware of the public’s growing concern for the privacy of
patients and has always sought to protect the access rights of its patients by strictly
adhering to the requirements set out in the Personal Data (Privacy) Ordinance.
The Urgent Care Center at HKAH – TW offers emergency medical care to all patients.
In cases of major trauma that result from incidents such as suspected car accidents,
attempted homicides, firearm injuries, or falls from heights, the hospital will provide
immediate medical help and ensure the patient’s condition is stabilized. The hospital
is then required to recommend or arrange for the patient to be further treated at a
more suitable healthcare facility.
HKAH – TW would like to reiterate its unwavering commitment to providing
professional and quality medical services to the community while protecting the
privacy of its patients.
*In case of any discrepancy between the English version and the Chinese version, the
Chinese version shall prevail.