Council 206-SecGen Report-Apr2017

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THE WORLD MEDICAL ASSOCIATION, INC.
Document: Council 206/SecGen Report/Apr2017 Original:
English
Title: Secretary General’s Report to the
206th
WMA Council Session
(October 2016 – March 2017)
Destination: 206th
Council Session
Avani Victoria Falls Resort
Livingstone, Zambia
20-22 April 2017
Action(s)
required:
To be
received
Chapter I Ethics, Advocacy & Representations
1. Ethics
1.1 Declaration of Helsinki
1.2 Declaration of Taipei
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
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
3.5 Counterfeit medical products
3.6 Food security and nutrition
3.7 Health and the environment
4. Health Systems
4.1 Comparing healthcare systems using PROMS & PREMS
4.2 Patient safety
4.3 One Health
4.4 Antimicrobial resistance
4.5 Health workforce
4.6 Violence in the health sector
4.7 Caring Physicians of the World Initiative Leadership Course
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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
4. World Health Professions Alliance (WHPA)
5. WMA Cooperating Centers
6. Other partnerships or collaborations
Chapter III Communication & Outreach
1. WMA newsletter
2. WMA social media (Twitter and Facebook)
3. The World Medical Journal
4. WMA African Initiative
Chapter IV Operational Excellence
1. Advocacy
2. Business Development Group
3. Paperless meetings
4. Governance
Chapter V Acknowledgement
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CHAPTER I ETHICS, ADVOCACY & REPRESENTATIONS
1. ETHICS
1.1 Declaration of Helsinki
The Declaration of Helsinki is one of the most important international ethical regulations
of biomedical research, and also one of the core documents of the WMA. It has been
revised several times since its adoption in Helsinki in 1964. As a “living document”, it is
continuously adapted to new developments and challenges in biomedical research. The 7th
revision was adopted by the WMA General Assembly in Fortaleza in October 2013.
In line with our efforts to promote the Declaration of Helsinki, a ceremony marking the 50th
anniversary of the first adoption of the Declaration was held on 11 November 2014 in
Helsinki, Finland. The event was co-hosted by the Finnish Medical Association and
attended by the President of Finland. The WMA has also produced a celebratory
publication, “The World Medical Association Declaration of Helsinki: 1964-2014 – 50
years of evolution of medical research ethics”, which can be ordered online from the WMA
Secretariat.
1.2 Declaration of Taipei
The Declaration of Taipei on Ethical Considerations Regarding Health Databases and
Biobanks provides guidance for the protection of persons who allow their health data
and/or specimens to be used for future research or other uses. In some aspects, this is a
logical continuation of the safeguards provided by the Declaration of Helsinki; extending
them into virtual environments and scenarios such as administrative or commercial uses.
An important focus of the Declaration of Taipei is maintaining the protection provided by
informed consent. Since information about potential future uses of data or specimens is
naturally incomplete, the Declaration offers a multi-step mechanism to replace part of
informed consent. This is achieved through a predetermined governance structure and an
assessment by an ethics committee.
The WMA was invited to host a session on the new Declaration at the 12th
UNESCO
Chairs in Bioethics conference in Limassol, Cyprus in March 2017.
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.
2.2 Protecting patients and doctors
2.2.1 Actions of support
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Country Case
TURKEY
November 2016-
March 2017
Sources:
TMA,
Human Rights
Foundation of Turkey,
Media
In November 2016, the Standing Committee of European
Doctors (CPME) and the WMA sent a letter to the Turkish
authorities in support of the Turkish Medical Association and
their members facing increasing pressure from the authorities
in the context of the attempted coup d’état of July 2016. In
the letter, CPME and the WMA reaffirmed the unconditional
need to safeguard the civil and human rights of all, including
the right to health, and to ensure access to high quality
healthcare supported by a functioning healthcare system and
safe conditions for the health workforce.
In early March, a joint letter (from organisations including
Physicians for Human Rights, WMA, IRCT, BMA, GMA,
CPME) was sent to Prime Minister Erdoğan to demand the
immediate dismissal of all charges against Dr Serdar Küni,
the Human Rights Foundation of Turkey’s representative in
Cizre and former president of the Şırnak Medical Chamber.
Dr Küni was arrested and detained on 19 October 2016 on
charges that he provided medical treatment to alleged
members of Kurdish armed groups while they occupied parts
of the city in January and February 2016.
Mr Bjorn Oscar Hoftvedt from the Norwegian Medical
Association represented the WMA at the first hearing of Dr
Küni’s case on 13 March 2017 at the Şırnak 2nd
Penal
Court. He made a public statement in support of Dr Küni and
our TMA colleagues.
IRAN
January – March 2017
Source:
Amnesty International
In January, the WMA, together with the International
Federation for Health and Human Rights Organisations
(IFHHRO), the Standing Committee of European Doctors
(CPME) and the International Rehabilitation Council for
Torture Victims (IRCT), sent a letter to the Iranian authorities
condemning the denial of medical care in Iran’s prisons
revealed in a report by Amnesty International. The
Secretariat shared the letter with national medical
associations, encouraging them to take similar action.
Following this, the German and Norwegian medical
associations also sent letters.
In February, the WMA sent another letter to the Iranian
authorities concerning the critical case of Dr Ahmadreza
Djalali, an Iranian national and resident of Sweden, who has
been detained in Tehran’s Evin prison since his arrest on 25
April 2016. He has been threatened with the death
penalty and has been on hunger strike since 26 December
2016 in protest at his detention. A press release was issued in
early March.
EGYPT In January, the attention of the Secretariat was drawn to the
critical situation of Mr Mohammed Mahdi Akef, aged 89,
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January 2017
Source:
Amnesty International
who suffers from pancreatic, liver and gallbladder cancer. He
has been detained since 2013 and until recently was denied
medical care. A letter sent to President Abdel Fattah al-Sisi
urged him to ensure that Mr Mahdi Akef receives the
required medical care and that his family is regularly
informed of his condition and can visit him. Given his age
and state of health, it was also requested that he be granted a
pardon on medical grounds.
2.2.2 Protection of health professionals in areas of armed conflict and other
situations of violence
ICRC “Health Care in Danger” (HCiD) initiative
The WMA Secretariat has a close working relationship with the International
Committee of the Red Cross (ICRC) headquarters within the context of the HCiD
initiative, which has been prolonged by the ICRC for a second phase.
In early November, a Memorandum of Understanding (MoU) between the WMA
and the ICRC was formally signed by Yves Daccord, Director-General of the
ICRC, and Dr Otmar Kloiber, WMA Secretary General. This MoU develops and
consolidates the cooperation between the WMA and the ICRC and fosters
understanding on topics of common interest, including on the protection of health
professionals and patients in situations of violence, on the role of physicians in
addressing sexual violence, as well as torture and ill-treatment in detention, and
more generally in addressing Social Determinants of Health in the context of
insecurity.
In December, on the occasion of International Human Rights Day (9 December),
the ICRC, the WMA, Médecins Sans Frontières (MSF) and other international
health organisations released a joint statement in support of the Health Care in
Danger initiative, in particular to renew their call for wounded and sick people’s
right to healthcare during armed conflict to be respected and protected, and for
attacks on health personnel and facilities to stop.
The ICRC and the WMA decided to repeat the successful experience of last year
and are planning a joint side-event at the next World Health Assembly in May
2017. The permanent missions of Switzerland and Canada to the United Nations
will join the initiative.
Other related activities
The WMA made a public statement on the WHO response during severe,
large-scale emergencies at the WHO Executive Board session in January.
On 11-12 May 2017 Clarisse Delorme will participate in an expert meeting on
Health Care in Danger: a Central and Eastern European Perspective in
Olomouc, Czech Republic, co-organized by Palacký University, the Czech Red
Cross and the ICRC.
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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 Cooperation with the International Rehabilitation Council for Torture
Victims (IRCT)
In conformity with IRCT Statutes, the mandate of Clarisse Delorme as an
independent elected expert to the IRCT Council and the Executive Committee
ended in December 2016 at the General Assembly in Mexico. The WMA will
nevertheless continue working in close collaboration with the IRCT where relevant.
2.3.2 Role of physicians in preventing torture and ill-treatment
In March, the Secretariat shared with its members a survey on the use of the
Istanbul Protocol (IP) on the investigation and documentation of torture and ill
treatment. The IP has been used as UN standards for the effective investigation and
documentation of torture and ill treatment since 1999. During the past several years,
there has been some discussion on the need to update and enhance the IP. A few
NGOs active in this area (Physicians for Human Rights, the International
Rehabilitation Council for Torture Victims, the Human Rights Foundation of
Turkey, and REDRESS) initiated this survey in order to evaluate the use of the
instrument. The Secretariat encouraged members to share their experiences as
health professionals by completing the survey.
See also 2.2.1.
2.3.3 Psychiatric treatment – Mental Health
In June 2016, the WMA Secretariat made contact with the UN Special Rapporteur
on the Rights of Persons with Disabilities, Ms Catalina Devandas Aguilar,
presenting to her the revised WMA policy on patients with mental illness.
Further to the adoption of the UN Resolution on Mental Health and Human Rights by the
UN Human Rights Council during its 32nd
session in July, the Secretariat sent a
letter to Mr Zeid Ra’ad Al Hussein, UN High Commissioner for Human Rights,
asking to be included in the consultation to be set up on the implementation of the
Resolution. The High Commissioner replied positively and asked the WMA to send
its written contribution in view of the preparation of his report on mental health and
human rights. The Secretariat drafted a contribution based on WMA policies and
with the support of psychiatrist Dr Miguel Roberto Jorge (Brazilian Medical
Association). This was sent to the High Commissioner in October.
2.4 Pain treatment
The WMA continues to be active in the area of palliative care in cooperation with the
WHO and civil society organisations working in this area. Within the context of the current
global discussion and the Special Session of the UN General Assembly on the world drug
problem, the WMA made a public statement at the 140th
session of the WHO Executive
Board (January 2017) on the public health dimension of the issue, underlining the need for
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a committed public health approach encompassing the availability and access to medicines
for effective treatment and related healthcare services.
In September 2016, the WMA was approached by the International Association for the
Study of Pain (IASP) to support their request to include Gabapentin in the WHO essential
medicines list. Palliative care and pain specialists were consulted and their feedback was
positive, warning, however, that Gabapentin should not compete with morphine, both
being necessary for the treatment of pain. The request being in line with its policy, the
WMA agreed to support the IASP request.
3. PUBLIC HEALTH
3.1 Non-communicable diseases (NCDs)
3.1.1 General
Member States and the WHO have made progress in fulfilling their commitments
according to the 2011 UN Political Declaration on Prevention and Control of
NCDs. In the last two years, Member States have adopted a Global Monitoring
Framework with a set of global NCD targets, a Global NCD Action Plan
2013-2020, and a formalized UN Interagency Task Force on NCDs, which will
coordinate a UN system-wide response to NCDs.
In response to this UN Political Declaration, 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 the local,
national, regional and global levels. The WMA is an official member of this
coordination mechanism, which was launched in March 2015, and has attended
several WHO GCM/NCD meetings.
The third UN High-level Meeting on NCDs will take place during the 2018 UN
General Assembly. The WMA is in close contact with the WHO regarding
preparations, and made an intervention on this topic at the last WHO Executive
Board meeting in January 2017.
3.1.2 Tobacco
The WMA is involved in the implementation process of the WHO Framework
Convention on Tobacco Control (FCTC) http://www.who.int/tobacco/framework/en/.
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 attends every
Conference of the Parties meeting. The next Conference of the Parties to the FCTC
meeting will take place from 1-6 October 2018 in Geneva.
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). GAPA made a
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request to the WHO, accompanied by a list of supporting Member States, to
organise a side-event on the need for an international response to the harmful use of
alcohol during the upcoming 70th
session of the World Health Assembly (May
2017) and asked the WMA to sponsor it. This was agreed.
3.2 Communicable diseases
3.2.1 Immunization campaign
Background
Starting in March 2013, the World Medical Association (WMA), with the support
of the International Federation for Pharmaceutical Manufacturers and Associations
(IFPMA), has been implementing a successful global communication campaign to
promote physician immunization against seasonal influenza. In the first year
following its launch, the campaign targeted physicians through the WMA member
associations to promote influenza immunization and encourage physicians to act as
role models.
In 2014, the WMA proposed including people living with NCDs as secondary
targets given their heightened vulnerability to influenza complications. In addition
to the campaign activities, the WMA and IFPMA also co-authored and published a
paper on the link between influenza and NCDs in a peer-reviewed journal
(http://file.scirp.org/pdf/Health_2014112411134973.pdf).
In 2015, the campaign underscored the need to immunize children, since they have
a higher exposure potential to the influenza virus and less prior immunity, remain
contagious longer, and are particularly prone to complications if they suffer from
underlying conditions (e.g. asthma).
Due to budget limitations, campaign visibility in 2015, particularly online, was not
very high. Therefore, the WMA proposed continuing the campaign focus on
children in 2016 and investing more resources to increase the campaign’s visible
presence on the web and through social media outlets.
Campaign objectives 2016
Maintaining the same campaign message – Let kids be kids, the objectives in 2016
were as follows:
• Educate physicians to actively promote and practice immunization against
influenza to protect themselves, their children and young patients
• Help physicians and other healthcare workers become visible advocates and take
ownership of the campaign by actively engaging in social media and spreading
the message
• Create visibility with the “Let kids be kids” campaign with the Sophia character
as the main storyteller
Campaign Visibility Online and Social Media
After the campaign for more visibility created in spring 2016, the second activation
of social media outlets took place from 18 October – 21 November 2016.
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Autumn activation highlights:
▪ 13,682 likes on Facebook (vs 7,900 in the spring), 344 shares (vs 67 shares in
the spring) and 41 comments (vs 7 comments in the spring campaign)
▪ 6,333 tweet engagements (clicks, likes, retweets, comments), which was
almost double the number in comparison to the spring campaign activation on
social media
▪ Website visits increased, with 14,306 sessions during the autumn campaign,
which represents more than half the sessions for the whole year
The higher visibility of the campaign in the autumn can be explained by the (i)
longer campaign period (5 weeks, compared to 2 weeks in the spring); (ii) a higher
advertising budget; and (iii) the higher relevance of the campaign topic in the
autumn season compared with the spring.
Overall Campaign Social Media Activity in 2016:
• Visibility achieved: 4.2 million users reached via Facebook and Twitter
• Facebook post engagement: 21,582 likes, 411 shares, 48 comments
• Twitter engagement: 10,339 clicks on tweets (clicks, likes, retweets, comments)
• Follower growth: 2,316 new fans on Facebook and 337 new followers on
Twitter
• Website visits: The WMA website earned 21,539 sessions during the spring and
autumn campaigns out of the 23,953 visits in 2016
Next Steps
The WMA/IFPMA influenza campaign concluded at the end of December 2016.
The WMA has submitted a new proposal to the IFPMA on continuing the campaign
with a focus on immunizations as part of worksite wellness programmes. However,
due to the leadership change at the IFPMA, the proposal is temporarily on hold.
3.2.2 Multidrug-Resistant Tuberculosis Project
The New Jersey Medical School Global TB Institute, together with the University
Research Company in the USA and the WMA, has finalised the update of the TB
refresher course for physicians in pdf format and online. A revision of the course
was necessary given changes to the WHO Guidelines and the upcoming release of
the 3rd
edition of the International Standards of Tuberculosis Care. The next step
will be to update the MDR-TB course.
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 document, 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 taken place with the
WMA delivering a presentation on health workers rights and obligations.
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3.3 Health and populations exposed to discrimination
3.3.1 Women and health
The WMA continues to follow global activities on women and health and aims to
monitor the implementation phase of the “Global plan of action on strengthening
the role of the health system in addressing interpersonal violence, in particular
against women and girls, and against children”, which was adopted by the World
Health Assembly in May 2016.
3.3.2 Ageing
The WMA participated in the WHO consultation on the Global Strategy and Action
Plan on Ageing and Health, which was adopted by Members States at the last
World Health Assembly in May. The WMA will monitor the implementation phase
of the Global Strategy.
For more activities in the area of aging please see Chapter III, section 4.
3.3.3 Zero HIV-related stigma & discrimination in health care settings day
In March 2017, the Secretariat shared with WMA members the UNAIDS reference
document on eliminating discrimination in health care. This report aims to serve as
a reference for policy-makers and other key stakeholders engaged in shaping
policies and programmes to regulate healthcare and eliminate discrimination and
other structural barriers to achieving healthy lives for all. The WMA has been
involved in this initiative since it was started in November 2015.
3.3.4 Refugees, migrants & access to health
In response to the WHO initiative on migrants’ health, the WMA made a public
statement on behalf of the World Health Professions Alliance (WHPA) at the 140th
session of the WHO Executive Board (January 2017) welcoming WHO’s efforts in
promoting migrant health and highlighting that late or denied treatment is
discriminatory and contravenes a fundamental human right: “Refusing to provide
healthcare is not only ethically wrong, it poses a serious public health risk”.
3.4 Social determinants of health (SDH)
The WMA is actively engaged with the WHO Department of Health Workforce and sits on
a Steering Committee to develop an eBook on the Social Determinants of Health Approach
to health workforce education and training. The project is part of the WHO’s work to
implement the guidelines on “Transforming and scaling up health professionals’ education
and training”, launched in Recife in 2013. The project also supports World Health
Assembly Resolution WHA66.23 “Transforming health workforce education in support of
universal health coverage”. The collaboration involves participation in meetings organized
by WHO and providing technical assistance and guidance for the eBook.
3.5 Counterfeit medical products
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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 and the members of the World Health Professions Alliance (WHPA) have
stepped up their activities on counterfeit medical issues and developed an anti-counterfeit
campaign with an educational grant from Pfizer Inc. and Eli Lilly. The basis of the
campaign is the ‘Be Aware’ toolkit for health professionals and patients, which is
intended to increase awareness of this topic and provide practical advice for actions to take
in case of a suspected counterfeit medical product.
As part of the WHPA campaign, the WMA has developed three videos to explain the issue
of counterfeit medicines and what can be done about them. Each video targets a specific
group: policy-makers, healthcare professionals and patients.
The WMA has joined 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 organizations and individuals who are looking to support this effort
by outlining opportunities for action and sharing what others are doing to fight fake
medicines.
3.6 Food security and nutrition
The Food and Agriculture Organization of the United Nations (FAO) and the World Health
Organization (WHO) have received a mandate to develop a Declaration on Nutrition and
an accompanying Framework for Action (FFA) to guide its implementation. They will
organise several preparatory meetings and conferences during the development process.
The WMA is observing this process. One main criticism is the short timeline and the low
involvement of civil society in the process. NGOs also complain that problems concerning
the use of antibiotics in foodstuffs are not well addressed in the current discussion.
The focus so far is on: Social protection to protect and promote nutrition, nutrition-enhancing
agriculture and food systems and the contribution of the private sector and civil society to
improve nutrition.
3.7 Health and the environment
3.7.1 Climate change
The WMA continues to be involved in the UN climate change negotiations,
particularly the implementation of the Paris agreement adopted at COP21 in
December 2015. For this purpose, a WMA delegation attended the last round of
discussions in Marrakesh (COP22) on 7-18 November 2016 and will also be
monitoring the Bonn Climate Change Conference in May 2017. In collaboration
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with WHO and key NGOs partners, the delegation will follow the negotiations and
advocate for a health perspective in the conclusions.
3.7.2 Chemicals
In December 2009, the WMA joined the Strategic Approach to International Chemicals
Management (SAICM) of the Chemicals Branch of the United Nations Environment
Programme (UNEP), which aims to develop a strategy for strengthening the
engagement of the health sector in the implementation of the Strategic
Approach.
In May 2016, the 69th
World Health Assembly adopted Resolution 69.4 on the Role
of the Health Sector in the Strategic Approach to International Chemicals
Management towards the 2020 goal and beyond, which requires the WHO
Secretariat to present to the 70th
World Health Assembly (May 2017) a roadmap
outlining concrete actions to enhance health sector engagement towards
contributing to relevant targets of the 2030 Agenda for Sustainable Development.
The Resolution requests that the roadmap be developed in consultation with
Member States, bodies of the United Nations system, and other relevant
stakeholders, including NGOs. The WMA was invited to participate in an
electronic consultation on the draft roadmap and sent its contribution in September
2016.
The WMA made a public statement at the 140th
session of the WHO Executive
Board welcoming the draft roadmap prepared by the WHO Secretariat, while also
insisting on the need to focus on hazard reduction and to aim at continuously
improving the safety of chemicals and not only managing hazardous chemicals
safely. The role of health professionals was also highlighted.
3.7.3 WMA Green Page
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.
The My Green Doctor website is now available in the “Courses & resources”
section of the WMA website.
4. HEALTH SYSTEMS
4.1 Comparing healthcare systems using Patient Reported Outcomes (PROMS) and
Patient Reported Experiences (PREMS)
The Organization for Economic Cooperation and Development (OECD) presented its
plans to use Patient Reported Outcomes (PROMS) and Patient Reported Experiences
(PREMS) to measure and compare the healthcare systems of member countries at its
Health Forum in Paris on 16 January 2017. The new strategy was endorsed by the
ministerial conference the following day.
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In contrast to previous methods of data collection and comparison, the organisation hopes
the new measurement approach will lead to more patient and outcome relevant
information.
The WMA had the opportunity to participate in the health forum. In a subsequent exchange
of letters, the WMA Secretary General welcomed the attempt to achieve more meaningful
statistics. He also pointed to the perception characteristics of this methodology and its
limitations in non-local comparisons. Among other points, the Secretary General stressed
the fact that physicians already have a tremendous workload of data collection tasks, which
rarely have any effect on patient treatment or work efficiency. The WMA will monitor and
accompany the implementation of the new strategy.
4.2 Patient safety
To address the global problems 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.
The aims of this initiative are to:
1. Establish the global baseline of medication errors and create a global monitoring
system to facilitate the tracking of medication errors.
2. Develop a multi-modal strategy to engage governments, organizations and front-line
healthcare providers to improve medication safety by decreasing the incidence of
medication errors by means of improving prescribing, transcription, preparation,
dispensing and administration practices.
3. Develop guidelines, tools, materials, and technologies to promote and support
medication safety and reduce the incidence of medication errors.
4. Engage key stakeholders, partners and industry to actively pursue efforts to improve
medication safety.
The WMA was invited by the WHO to participate in a Global Consultation for Setting
Priorities for Global Patient Safety in collaboration with the Centre for Clinical Risk
Management and Patient Safety, Department of Health. This high-level global event will
bring together key international experts and senior policy makers from ministries of health
from both developed and developing countries. The objective of this consultation was to
identify main challenges and barriers in improving patient safety for patients, health-care
providers and the environment of care and define priorities for future action by the WHO
and countries.
4.3 One Health
In May 2015, the World Veterinary Association (WVA) and the World Medical
Association (WMA) in collaboration with the Spanish medical (SMA) and veterinary
(SVA) associations organized the Global Conference on ‘One Health’ Concept with the
theme: “Drivers towards One Health – Strengthening collaboration between Physicians and
Veterinarians”. The Global Conference brought together 330 delegates from 40 countries
around the world. Veterinarians, physicians, students, public health officials and NGO
representatives listened to presentations by high-level speakers and had the opportunity to
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learn, discuss and address critical aspects of the One Health concept. The main objectives
of the conference were to strengthen links and communications between the professions
and to achieve closer collaboration between physicians, veterinarians and all relevant
stakeholders to improve different aspects of the health and welfare of humans, animals and
the environment.
The 2nd
conference was hosted by the Japan Medical Association and the Japan Veterinary
Association together with the World Veterinary and the World Medical Association in
Kitakyushu City, Fukuoka Prefecture, Japan on 10-11 November 2016. The conference
was attended by more than 600 participants from 44 countries around the world with
approximately 30 lectures covering different One Health issues. A summary of the
conference is available on the WMA website.
4.4 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.
In May 2015, the World Health Assembly adopted the Global Action Plan on
Antimicrobial Resistance, which articulated five main objectives with the healthcare
workforce being a key player in their attainment. Most notably, Objective 1 strives to
“improve awareness and understanding of antimicrobial resistance through effective
communication, education and training.’’ The WHO established an AMR secretariat
whose purpose is to link the various stakeholders, get them involved and coordinate the
activities of the Action Plan. One emphasis will be on the education of medical students
and physicians. The WMA has discussed how the WHO and WMA can collaborate on this
topic in several meetings. The WMA is currently in discussions with the WHO regarding
becoming an expert member of the Strategic and Technical Advisory Group to the
secretariat.
The WMA attended a WHO consultation to establish if a global development and
stewardship framework to support the development, control, distribution and appropriate
use of new and existing antimicrobial medicines, diagnostic tools, vaccines and other
interventions should be set up.
The World Medical Association and World Health Organization are planning to develop a
multi-country health professional awareness survey on antibiotic resistance. The aim
would be to gain further insight into the levels of awareness of antibiotic resistance among
health professionals and their perspectives on the prescription of antibiotics within their
profession. A pilot questionnaire was conducted in preparation for the survey.
4.5 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
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
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recommendations on areas such as job creation, gender and women’s rights, education
technology and crisis and humanitarian settings. The report emphasises the need to create
40 million new jobs in the health sector and to reduce the projected shortfall of 18 million
health workers.
At the High Level Ministerial Meeting on Health and Economic growth in December 2016,
the WMA made an intervention on the report and spoke at the round table ‘Acceleration
investments in scaling up education and skills’. At the meeting, the draft 5 year action plan
was discussed.
During the WHO Executive Board session, the WMA made an intervention on human
resources for health and implementation of the outcomes of the United Nations’
High-Level Commission on Health Employment and Economic Growth.
The WMA, together with the WHO and the other health professional associations,
organised a side event at the Prince Mahidol Award Conference on Health Workforce
Demography. The session brought together stakeholders and experts in the health
workforce, labour markets and demography to present a framework for health workforce
demography, including examples related to ageing, gender, and international migration.
The session highlighted the importance of understanding the population of health workers,
including relevant demographic tools, in order to achieve Universal Health Coverage and
the Sustainable Development Goals.
Following the conclusion of its 10-year mandate, the Global Health Workforce Alliance
has transitioned into the Global Health Workforce Network. The Global Health Workforce
Network aims to facilitate evidence generation and exchange, foster intersectoral and
multilateral policy dialogue, including providing a forum for multi-sector and
multi-stakeholder agenda setting, sharing of best practices, and harmonization and
alignment of international support for human resources for health. The overall goal is to
enable the implementation of Universal Health Coverage and the Sustainable Development
Goals. The WMA attended the first network meeting at the end of 2016.
4.6 Violence in the health sector
The fifth International Conference on violence in the health sector “Broadening our views;
responding together”, took place in Dublin, Ireland from 26 – 28 October 2016. The WMA
was represented in the organisation and scientific committees in charge of the preparations
for the event. The Secretariat shared the information on the event with its members and
liaised with the organisers of the Conference and the Irish Medical Organisation regarding
the activities for the event. The next Conference will take place in October 2018.
4.7 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, which is now available in html and
pdf. Some hard copies (English and Spanish) are still available from the WMA Secretariat
upon request. Please visit the WMA website to access the electronic versions and to order
any hard copies. 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.
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The seventh course was held at the Mayo Clinic in Jacksonville, Florida, USA from 2 – 6
May 2016. The courses were made possible by educational grants provided by Bayer
HealthCare and Pfizer, Inc. This work, including the preparation and evaluation of the
course, is supported by the WMA Cooperating Center, the Center for Global Health and
Medical Diplomacy at the University of North Florida.
An eighth course at the Mayo Clinic is planned for 2017.
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 originally 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 concerns in various public settings as follows1
:
1. WORLD HEALTH ORGANIZATION (WHO)
WHO Governance
Executive Board Meeting of the World Health Organisation 2017:
The 140th session of the Executive Board of the World Health Organisation took place on 23 January
– 1 February 2017 in Geneva, Switzerland. The WMA made public statements on a series of issues.
For more information (agenda, working documents and resolutions) see:

Interventions

WHO Public Health Events
Meeting of the International Partnership for UHC 2030 – working together to strengthen
health systems in December 2016 in Geneva.
First Global Health Workforce Network meeting in December in Geneva. The network, hosted by
the WHO, transitioned from the Global Health Workforce Alliance, whose mandate ended after 10
years.
High Level Ministerial Meeting on Health and Economic growth in December 2016 to discuss the
draft 5 year action plan and presentation at one of the round tables.
The WMA attended the WHO expert consultation meeting on health workforce education and
antimicrobial resistance control in March 2017.
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. In October 2015, the conference convened in Naples, Italy. The WMA
participated again by structuring sessions on WMA policy-related issues. In October 2015, the
WMA-led session focussed on end-of-life issues and the draft of a new policy on Ethical
Guidelines for Health Databases and Biobanks. WMA Past-Presidents, Dr Yoram Blachar and
Dr Jon Snædal, WMA Ethics Advisor Prof. Vivienne Nathanson, WMA Legal Counsel, Ms
Annabel Seebohm and the Secretary General served in preparing these sessions. Immediate Past
President, Dr Xavier Deau, held a keynote speech at the opening of the conference.
The WMA was again invited to arrange two scientific sessions at the 12th
UNESCO Chair of
Bioethics Conference held in Limassol, Cyprus from 21-23 March 2017. The first discussed the
ongoing revision process of the Declaration of Geneva, the physicians’ oath. This session was
moderated by Dr Ramin Parsa-Parsi, Chair of the WMA work group, and Prof. Urban Wiesing,
Director at our cooperating institute the University of Tübingen. The second session was
moderated by WMA Past President Dr Jon Snædal and Dr Otmar Kloiber, with contributions by
Dr Emmanuell Rial-Sibag, from our cooperating Center at the University of Neuchatel and Ms
Annabel Seebohm, Secretary General of the Standing Committee of European Doctors (CPME).
1
More information on the activities mentioned is set out under the relevant section of the report.
April 2017 Council 206/SecGen Report/Apr2017
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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 SRs’ activities
• Ongoing exchange of information
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 appointed
in November 2016
Special Rapporteur on the Rights of Persons
with Disabilities (Ms Catalina Devandas
Aguilar)
• Monitoring the SR’s activities
• Contact made late 2016
High Commissioner for Human Rights (Mr
Zeid Ra’ad Al Hussein)
WMA is part of the consultation process within
the framework of the UN Resolution on mental
health and human rights adopted in September
2016 (see item 2.3.3)
UNAIDS Campaign on Zero HIV-related stigma &
discrimination in health care settings day
See item 3.3.3
United Nations
Commission on Narcotic Drugs
at its 58th
Session, Vienna, March 2015
The WMA joined a coalition led by former
WHO Department Head, Dr Willem Scholten,
to lobby against the scheduling of Ketamine as
a narcotic drug. The scheduling of Ketamine
would have put the drug under international
control, which according to the WHO and many
humanitarian organisations would have made it
practically unavailable for surgery in resource
poor countries and especially rural areas, as
well as for veterinary medicine worldwide. The
WMA lobbied the Commission members and
joined the World Veterinary Association in
issuing synchronized press statements. The
Chinese government, initiator of the move to
schedule Ketamine, finally amended its move to
have the decision postponed, which was
welcomed by nearly every delegation.
4. WORLD HEALTH PROFESSIONS ALLIANCE (WHPA)
World Health Professions Alliance Leadership Forum will take place on 21 May 2017 in Geneva
with the two main topics being (1) the new OECD concept to compare health systems by patient
reported outcome measurements (PROM) and (2) antimicrobial resistance.
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The WHPA participated in a WHO-led process to develop a 5 years strategy for the G7
countries on healthy and active ageing: key issues and priorities for action for 2016-2020. Six
thematic working groups were convened to identify priorities for concrete actions that might be
undertaken by the G7 group. The six working group areas were:
1. Creating age-friendly environments
2. Aligning health systems to the needs of older populations
3. Developing sustainable and equitable systems for long-term care
4. Achieving a sustainable and appropriately trained workforce
5. Attaining universal health coverage
6. Improving measurement, monitoring and research for healthy ageing
The WHPA was involved in workgroup 4: Achieving a sustainable and appropriately trained
workforce. The global workforce is largely unprepared to deal with the health- and social care
needs of older people, especially when it comes to health promotion, prevention and long term
geriatric care. Overall workforce shortages and siloed ways of working, especially across the
divide of health and social services, further complicate the situation. To provide integrated and
person-centred care for older people, health and social care workers must have the right
competencies, and they must be organized and deployed in ways that make the best use of their
potential contributions. Both health and social care workers need general competencies related to
integrated care, such as working as part of a multidisciplinary team and proactively supporting
older people to optimize their health and health care. The proposed areas for activities were:
• To assess the quantitative and qualitative gaps between services currently available and
those required in the next 5-15 years;
• Building or strengthening education and training capacity to scale up a health and social care
workforce that has the right competencies to provide care to older people;
• Building or strengthening governance capacity and mechanisms, including policies,
regulations, and financing, for ensuring a sustainable health and social care workforce in
years to come.
The overall strategy on healthy and active aging is still in development. The G7 group included 3
of the proposed activities in its overall strategy.
WHPA members have identified population ageing and the ageing workforce as one of the
major challenges for health workforce development over the next decade, and defined this topic
as the key priority for the next year. A project has just started to develop a high level
advocacy/communication strategy and implementation plan to raise awareness of the issue and
trigger change.
5. WMA COOPERATING CENTERS
The WMA is now 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.
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Center for Global Health and Medical
Diplomacy, University of North Florida,
USA
Leadership development, medical diplomacy
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
6. OTHER PARTNERSHIPS OR COLLABORATIONS
Organisation Activity
Amnesty International Ongoing contacts (exchange of information and support)
during the reporting period on the situations in Iran, Egypt and
Turkey.
Human Rights Watch Contacts on palliative care (WHO resolution) and other human
rights issues.
Global Alliance on Alcohol
Policy (GAPA) and its
members
Regular exchange of information, in particular in the context of
the next World Health Assembly (May 2017) and the Global
Conference on Alcohol scheduled for October 2017 (see 3.1.3).
International Committee of
the Red Cross (ICRC)
Partners in the Health Care in Danger project since September
2011.
Cooperation with the health and legal units.
Permanent cooperation with the Health in Detention
Department.
A second Memorandum of Understanding between the ICRC
and the WMA was endorsed in November 2017 (see 2.2.2).
International Council of
Military Medicine (ICMM)
A Memorandum of Understanding between the ICMM and the
WMA was finalised in late 2016.
International Federation of
Health and Human Rights
Organisations (IFHHRO)
Regular exchange of information on human rights and health
matters.
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.
University of Pennsylvania
International Internship
Program
Internship program on health policy, public health, human
rights, project management (2 students in 2014).
International Rehabilitation
Council for Torture Victims
(IRCT)
Regular exchange of information and joint actions on specific
cases or situations (see item 2.2.1).
Global Climate & Health
Alliance
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
April 2017 Council 206/SecGen Report/Apr2017
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with the support of the US Agency for International
Development (USAID).
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.
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.
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.
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.
Physicians for Human
Rights
Regular exchange of information and joint actions on specific
cases or situations (see item 2.2.1)
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CHAPTER III COMMUNICATION & OUTREACH
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.
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. It enjoys a wide circulation. The 60th
anniversary edition was published as a final printed copy in 2014. It transferred to an electronic
format in 2015.
4. WMA AFRICAN INITIATIVE
WMA President 2013-2014, Dr Margaret Mungherera, started an initiative to bring African
medical associations closer to the WMA. The idea was that stronger inclusion of organised
medicine in international cooperation should not only help to get the African voice better heard,
but would also leverage national visibility and standing.
Dr Mungherera brought together medical associations from various parts of Africa in small
regional meetings to discuss issues around their current work, what obstacles they face and where
they have had success. Invitations are open to all African medical associations, regardless of
whether they are already members of the WMA.
Dr Mungherera set up regional consultative meetings with African NMAs in Kenya, South
Africa, Tunisia and Nigeria. This initiative has been supported by the medical associations of
South Africa and Tunisia, WMA President 2014-2015, Dr Xavier Deau, Past Chair of Council,
Dr Mukesh Haikerwal, as well as the Chairman of the Past-Presidents and Chairs of Council
Network, Dr Dana Hanson.
Immediate Past-President Dr Mungherera delivered presentations at the 4th International
Conference on Violence in the Health Sector in Miami from 22-24 October 2014, the African
Health Conference in London from 27-28 February 2015, and at the 6th
World Congress on
Women’s Mental Health in Tokyo from 22-25 March 2015, amongst others.
Sadly, Dr Mungherera passed away on 4 February 2017 after a brave battle with cancer over
recent years.
As a psychiatrist by education, a public health activist by nature, and a determined advocate for
the people of Africa by conviction she was a marvellous physician leader on the global stage. For
many of us she was more than a colleague, she became a friend, teacher and companion.
April 2017 Council 206/SecGen Report/Apr2017
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Margaret was with us for every meeting she could arrange for. The WMA remains grateful for
her service to our community.
CHAPTER IV OPERATIONAL EXCELLENCE
1. ADVOCACY
The WMA set up a permanent Advisory Advocacy Committee in 2007 with the mission:
• To maintain effective liaison with relevant UN organisations, branches and institutions,
health care organisations, coalitions and NGOs;
• To ensure that WMA policies and positions are promoted among appropriate organisations,
associations and institutions;
• To simultaneously provide advocacy tools and content with the ultimate goal of being
visible and having a positive impact.
The interim Chair of the Advisory Group is Dr Steven Stack (American Medical Association).
The Advisory Group includes representatives of the medical associations of the following
countries: Germany, Israel, UK, Uruguay and the USA, along with WMA Public Relations
Consultant, Nigel Duncan. Participants from the WMA Secretariat include the Secretary
General, Dr O. Kloiber, and Advocacy Advisor, Ms C. Delorme.
Under the initiative of Dr Stack, the Advisory Group is currently reflecting on its mandate,
composition and operating procedures.
2. BUSINESS DEVELOPMENT GROUP (BDG)
After the BDG presented its new work plan to the Council in Taipei, the Chair of the work group,
together with legal counsel Adv. Leah Wapner, Advisor Prof. Vivienne Nathanson and the
Secretary General, evaluated the possibility of offering an educational online platform to its
member associations. After negotiations with the World Continuing Education Alliance
(WCEA), a British/Spanish company, the chair of the work group presented a contractual
agreement for approval to the WMA Executive Committee on 27 February 2017. Following the
assent of the Executive Committee, the Secretary General signed an agreement with the WCEA
on 15 March 2017.
3. 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 Wi-Fi 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 with a suitable Wi-Fi connection.
April 2017 Council 206/SecGen Report/Apr2017
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4. GOVERNANCE
At the Council meeting in Durban, it was decided that the Secretariat should start a process of
aligning various terms and definitions in WMA policies with the long-term objective of
developing a glossary. The WMA Secretariat has started with a list of terms for which the
definitions are unclear, and will investigate how these terms are used in our existing WMA
policies.
At the last Council meeting in Moscow, the Workgroup on Governance Review was set up and
started its work by collecting workgroup members’ observations on SWOT (Strengths,
Weaknesses, Opportunities and Threats) of/to the WMA. The workgroup held its first in-person
meeting in Buenos Aires and will deliver another interim report of its work to the 206th
Council.
Following the resignation of the WMA Legal Advisor Adv. Ms Annabel Seebohm at the 203rd
Council Session in Buenos Aires, the Council expressed its gratitude for the services of Ms
Seebohm from 2007 to 2016 and to the German Medical Association who seconded her, and
wished her well with her new position as Secretary General of the Standing Committee of
European Doctors (CPME). Upon the invitation of the WMA Secretary General to the
Constituent Members to consider seconding a legal advisor to the WMA, the French Medical
Association volunteered and seconded Mrs Marie Colgrave-Juge to the function. She was
appointed at the General Assembly in Taipei in October 2016.
CHAPTER V 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 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.

21.03.2017