Address-Dr-Ketan-Desai—Nanjing-20170114

Address given by the President of the World Medical Association, Dr. Ketan Desai, on
occasion of the Annual Scientific Meeting of the Chinese Medical Association on Jan.14,
2017 in Nanjing, China

Ladies and Gentlemen,
I feel greatly honoured to address this erudite, learned gathering of people who have the
interests of the profession uppermost in their minds and are committed to dispense the
objectives thereto with commitment and credibility alike. The scope and relevance of the
medical profession has been paramount for men and mankind for wide and varied reasons
and will continue to be so until eternity. It is for this very reason that the concerns and
challenges that confront it need to be addressed in the nick of time so that its relevance
in terms of catering to mankind remains unbridled and uncompromised.
It is in this very context that I flagged up substantial issues of importance and
consequence in my presidential address made at the assembly of the World Medical
Association on resuming the charge of its presidency on 22nd
October 2016. One of the
important concerns which I put across therein pertained to the threat that looms large over
the medical professionals in a brazen manner. It is a matter of common realization that
physicians are under constant threat all over the world, in as much as that in some parts
of the world hospitals are bombarded, ambulances hijacked, nurses and doctors
kidnapped or killed and physicians are pressured, threatened and tortured in a most
inhuman manner. Likewise, especially in Asian countries, doctors are assaulted and
medical establishments attacked and damaged. To state it realistically, the Geneva
Convention is practiced more in its contraventions than in its faithful and diligent
observance, which invariably ends up in flagrant violation of otherwise inviolate human
rights. This scene needs to be changed and altered by desired initiatives emerging out of
committed will for the same.
It gives me immense joy to place on record that the World Medical Association
wholeheartedly participated in the global campaign under the title ‘Health Care in Danger’,
which is sponsored by the International Committee of the ‘Red Cross’. This has resulted
in not only invocation of a substantial degree of awareness, but has also contributed to
immense opinion making on the said count. Yet, there is a lot more which is required to
be dispensed in this arena in order to achieve the objectives set out in a timely manner to
cater to the larger interest of the profession and professionals alike.
It is imperative for all of us to bear in mind that borne out of the various international
charters and in terms of the constitutional mandate the “Right to Health” is not just a
human priority but also a legitimate right of the global population, which is not open to any
concession, compromise, or condonation of any type. This mandate in the interest of
humanity puts on our shoulders the huge responsibility of its effective and meaningful
dispensation in a focused and committed manner.
In spite of this being the core preposition, the reality is that professional honesty and
integrity are at stake in more ways than one. It is mandatory that the profession has to be
practised transparently. In view of this, kickbacks and cut practices do not have any place
as the same is obviously inconsistent with the desired value system of the medical
profession.
Dr. Ketan Desai, Jan.14, 2017 in Nanjing, China

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It is no secret that the image of the medical profession has suffered, and continues to
suffer a serious dent to its image and a severe beating to its credibility. This is basically
due to the unchecked rampant practice of kickbacks, cuts and commissions amongst the
fraternity of medical professionals. No amount of excuses would put us in a position to
defy the reality that these black spots do exist on the face of the profession and it is in the
full knowledge of the people and society at large. As a result of this, the credibility of the
profession has been eroded very badly. The respect that the profession and professionals
used to command amongst society at large turns out to belong to the remote past.
It is a matter of handy clarity that the credibility of the profession and the respect that it
deserves cannot be achieved until and unless its purity is restored back to the public gaze.
This, to my understanding, cannot just be achieved by enacting laws and even enforcing
them deftly. As a matter of reality laws were there, are there and will always be there, but
then laws alone have not and will never be in a position to establish nobility and purity of
the profession. The real positive modality on the said count is “self-regulation”. To my
mind self-regulation means a greater commitment to the clarity of purpose and purity of
the modality of its operation. It is not just the “Ends” that matter; it is also the “Means”
which count in order to establish the purity of the final results. This would need strong
opinion-making in the realm of desired introspection by the medical fraternity across the
globe.
Yet another dimension which has made the scenario murky is our own creation of poor
and reckless use of tools of radical cure. The world as a result is on the brink of losing
miracle cures in the form of antibiotics, which were designated as wonder drugs. I am
referring to the problem of anti-microbial resistance. WHO’s first global report on anti-
microbial resistance in 2014 reveals that it is not a country specific issue, but a global
concern that is jeopardizing global health security. The reckless use of antibiotics has
resulted in a huge problem in terms of the resistance of microorganisms to the very drug
which was originally effective for treatment of infections caused by them. This has raised
a huge challenge for the entire world and needs prompt and timely tackling.
In this context it is imperative to note that the misuse and abuse of antibiotics is far huger
in animal husbandry, farming and food production. This is one area which, if not addressed
with seriousness, the entire concern pertaining to the invocation of stringent policy on anti-
microbial resistance would not mean anything substantial. In view of the stark reality, this
domain needs to be seriously looked into under the rubric of ‘One medicine’ in all its
manifestations.
As such, there is a need to have in place meaningful, comprehensive national anti-
microbial resistance plans for each country in tune with global anti-microbial resistance
action plans. This is inevitable in the context of the material fact that a very significant part
of out of pocket expenditure on health care is on medicines, but longer treatments with
ineffective drugs and/ or second-line expensive antibiotics is pushing treatment costs
higher. This mandates appropriate prescription, auditing and rational usage of drug
therapy. Desired policy on this count is the need of the hour and effective surveillance is
the only answer. Any delay on this count is bound to prove costly in more than several
ways.
There are many other collateral issues which also merit timely attention and intervention.
It is necessary that policy making within countries is appropriately shaped by the required
Dr. Ketan Desai, Jan.14, 2017 in Nanjing, China

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expert inputs from professional associations, through diligent understanding of the issues,
and through required scientific evidence generated out of experimental and research
based indulgences. A huge and substantial onus lies on the shoulders of medical
professionals to dispense their larger responsibility in its elegance and bring the desired
succour to health care delivery systems so that it meaningfully extends health services to
all the needy, including the under privileged. This requires professionals undertaking
these challenges with a sense of decisive determination and focused commitment
upholding the larger purpose which would give them credit and credibility including
societal recognition and public respect which has been marginalized substantially as of
now. Let us therefore take inspiration from the words of Swami Vivekanand, the greatest
monk philosopher from India, to the effect that “We arise, awake and stop not till the goal
is achieved”
Thank you!