draft 4+ GAP- comments WMA-Nov2018

THE WORLD MEDICAL ASSOCIATION, INC.
L’ASSOCIATION MEDICALE MONDIALE, INC
ASOCIACION MEDICA MUNDIAL, INC
Centre International de Bureaux FEIN : 13-2566243
Immeuble A « Keynes » Website : www.wma.net Postal Address :
13, chemin du Levant Telephone : (33) 4 50 40 75 75 Boîte Postale 63
01210 FERNEY-VOLTAIRE Fax : (33) 4 50 40 59 37 01210 FERNEY-VOLTAIRE Cedex
France E-mail address : wma@wma.net France
13 November 2018
Draft WHO Global Action Plan
to Promote the Health of Refugees and Migrants (Draft 4)
WMA COMMENTS
The World Medical Association is an international organization representing millions of physicians
worldwide. Acting on behalf of patients and physicians, the WMA endeavors to achieve the highest
possible standards of medical care, ethics, education and health-related human rights for all people.
As such, the WMA plays a key role in promoting good practice, medical ethics and medical
accountability internationally.
General comments
The World Medical Association (WMA) considers that health is a basic need, a human right and
one of the essential drivers of economic and social development. All people are entitled without
discrimination to appropriate medical care according to the international codes of human rights and
medical ethics, including the WMA Declaration of Lisbon on the Rights of the Patient.
The WMA expresses concern over the systemic difficulties which health professionals face when
upholding guiding ethical principles in environments hostile to the provision of healthcare to
migrants. Health professionals have a duty to provide appropriate healthcare, regardless of the civil
or political status of the individual. The right to receive medical care should be based on need and
health professionals must be allowed adequate time and sufficient resources to assess the physical
and psychological condition of refugees and migrants. Late or denied health care is not only
ethically wrong and contravenes a fundamental human right, it poses a serious public health threat
as well.
We would like to recall WMA recent policy on migration and call for:
• Strong continued engagement of physicians in the defense of human rights and dignity of all
people worldwide, as well as combatting suffering, pain and illness;
• The prioritization of the care of human beings above any other consideration or interest;
• Providing the necessary healthcare, through international cooperation, directed to countries that
welcome and receive large number of migrants.
• Governments to reach political agreements to obtain the necessary health resources to deliver
care in an adequate and coordinated manner to the migrant population.
WMA page 2
Specific comments on the draft WHO Global Action Plan to Promote the Health of Refugees
and Migrants1
We welcome the draft WHO Global Action Plan to Promote the Health of Refugees and Migrants
developed in collaboration with IOM and UNHCR amongst other international organisations. This
inclusive partnership, which comprises the consultation of other relevant partners as well,
constitutes a positive advancement to address the complexity of the issue, with health as an essential
component of good migration governance. We also welcome the various references in the GAP to
the required need to develop educational courses/tools for health professionals in relation with the
health of migrants and refugees.
In line with WMA policies, we suggest the following additions to the current proposed draft:
1. The draft GAP should include, in the preamble of the strategic guidelines, an explicit reference
to the right to health to refugees and migrants, regardless of the legal, civil or political
status of the individual.
2. The draft GAP should unequivocally condemn and prohibit the participation of health
professionals in any punitive or judicial action involving refugees and migrants (regardless
of the civil or political status) or to administer any non-medically justified diagnostic measure or
treatment (such as sedatives to facilitate easy deportation from the country or relocation).
3. Regarding the priority 4 “Strengthen health monitoring and health information systems”, we are
worried that the current draft does not refer to the ethical aspects of health data collection and
the related role of physicians. The WMA Declaration of Taipei on ethical considerations
regarding health databases and biobanks lays down essential ethical principles in collecting and
using health data, including the principles of confidentiality and the required informed consent
of the individuals concerned. Paragraph 9 states: “Respecting the dignity, autonomy, privacy
and confidentiality of individuals, physicians have specific obligations, both ethical and legal, as
stewards protecting information provided by their patients. The rights to autonomy, privacy and
confidentiality also entitle individuals to exercise control over the use of their personal data and
biological material.” The draft GAP should include clear references to these ethical principles as
safeguards to any possible misuses in health data collection.
Given the length of the document, we suggest including an executive summary indicating the main
actions under each priority.
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Draft 4