SecGen Report-Oct2018

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THE WORLD MEDICAL ASSOCIATION, INC.
Secretary General’s Report
to the
WMA General Assembly, Reykjavik 2018
(April – September 2018)
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REPORT OF ACTIVITIES
TABLE OF CONTENTS
Chapter I Ethics, Advocacy & Representations
1. Ethics
1.1 Declaration of Taipei
1.2 Declaration of Geneva
1.3 Regional discussions on End-of-Life issues
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
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
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 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
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. 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
5. Meeting with Arab Medical Union leaders
6. Secondments / internships
Chapter IV Operational Excellence
1. Advocacy
2. Paperless meetings
3. Governance
Chapter V Acknowledgement
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CHAPTER I ETHICS, ADVOCACY & REPRESENTATION
1. Ethics
1.1 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.
As regulations on health and medical databases are currently under discussion, the
dissemination of the Declaration is being actively pursued with urgency. We are grateful
to our members and partner organisations which already use the Declaration or advocate
for it.
1.2 Declaration of Geneva
Both before and since its adoption at the General Assembly in Chicago, the Declaration
of Geneva has encountered a remarkable and overwhelmingly positive reception. The
WMA will use upcoming ethics conferences and other events to promote this revised
physicians’ pledge. We offer to explain the revision process and provide an in depth
analysis of the wording that has been used. Again, we are grateful to the early adopters of
the Declaration of Geneva and thank our members and partners for using and
disseminating it.
1.3 Regional Discussions on End of Life issues
At the 200th
Council Session in Oslo in April 2015 the WMA policies on physician-
assisted suicide (PAS) and euthanasia were reaffirmed. However, a controversial
discussion about the wording and effect of the current policies led to the submission of a
policy document by the Royal Dutch and the Canadian medical associations to the 201st
Council Session in Moscow in October 2015. The authors of the document ultimately
requested its withdrawal at the 203rd
Council Session in Buenos Aires in April 2016.
Instead, the Council mandated the Executive Committee to come back with a plan for
discussing end-of-life issues, including palliative care, living wills, physician-assisted
suicide (PAS) and euthanasia. At the 204th
Council Session in Taipei in October the
Executive Committee invited its members, especially those from Latin America, Africa
and Asia to hold regional meetings to discuss these issues. This took into account the
observation that the previous discussion was dominated mainly by voices from Europe
and North America.
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Since then, four regional discussions have been held in Latin America, (Rio de Janeiro,
March 2017 in cooperation with CONFEMEL), Asia and the Pacific (Tokyo, September
2017, in cooperation with CMAAO), Europe (Vatican City, November 2017 in
cooperation with the Pontifical Academy for Life) and in Africa (Abuja, January-
February 2018).
Reports from these meetings are available in the meeting document section of the 209th
Council Session in Riga, April 2018, under MEC folder. The discussions will be
continued at the global level during the joint WMA-Iceland Medical Association Ethics
Conference in Reykjavik this October.
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. Dr Puras will attend the General Assembly in Reykjavik and present a
keynote speech on “Opportunities and challenges on the way to realization of the right to
physical and mental health”.
2.2 Protecting patients and doctors
2.2.1 Actions of support
Country Case
TURKEY
July-August 2018
Sources:
TMA,
Human Rights
Foundation of
Turkey,
Amnesty
International
The WMA Secretariat remains mobilized on the situation in Turkey.
In July, the WMA along with CPME acted in support of Prof. Onur
Hamzaoglu, an internationally renowned researcher and practitioner, who
was arrested on 9 February by the Turkish police. Prof. Hamzaoglu is also
the editor of Society and Physicians journal, a scientific journal on health
policies published by the TMA. He is being prosecuted for complicity in
terrorism. Prof. Hamzaoglu was released on 19 July, although he is still
being prosecuted.
In early August, a press release was issued calling for the leaders of
the Turkish Medical Association (TMA) to be reinstalled following their
dismissal by the Turkish Government. This follows the removal of the
TMA Secretary General Dr Bülent Nazim Yilmaz from his duty as a
public servant and the termination of family medicine contracts of TMA
Council members. The dismissal is based on the claim that, through their
press statement “War is a Public Health Problem” (issued last January),
Council members are engaged in activities beyond the aims of their
organization, insulted the Republic of Turkey and caused disturbance to
peace and harmony within the Turkish Medical Association.
ETHIOPIA
September 2017 –
May 2018
Since September 2017, the WMA has taken several actions in
coordination with the Swedish Medical Association in support of the
Ethiopian-born Swedish cardiologist, Dr Fikru Maru, who has been in
detention for 4 years in Ethiopia.
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Source:
Swedish Medical
Association
Amnesty
International
In May, Dr Fiku Maru was released from prison and all charges against
him were dropped.
IRAN
February – July
2018
Source:
Amnesty
International
Physicians for
Human Rights
Dr Ahmadreza Djalali, an Iranian-born Swedish resident and academic,
has been sentenced to death for “corruption on earth” after a grossly
unfair trial. His conviction was based on torture-tainted “confessions” that
he was forced to make while in solitary confinement without access to his
lawyer or family. Amnesty International and Physicians for Human
Rights consider him a prisoner of conscience. The Secretariat wrote an
initial letter last November and issued a press release
(https://www.wma.net/news-post/wma-urges-immediate-release-of-jailed-
physician/). Dr Djalali’s last appeal was rejected by the Supreme Court in
February. A second press release was issued on 13 February calling for
his immediate release.
In July, the WMA issued another press release condemning complicity of
doctors in facilitating the execution of young prisoners in Iran. This
follows the execution last month of a 19-year-old adolescent who was
sentenced to death in 2014. His sentence was issued based on an official
medical opinion by the Legal Medicine Organization in Iran, stating that
he was mentally “mature” at the age of 14 when the crime of which he
was convicted took place.
NICARAGUA
June-August 2018
Source:
Media
Brazilian and
German Medical
Associations
Noting the rapidly deteriorating situation in Nicaragua, with pressure on
health professionals not to provide care to injured protesters and
increasing violence in the country, the WMA issued a press release last
June supporting the Inter-American Commission on Human Rights in
calling on the Nicaraguan Government to immediately end this state of
affairs. The WMA condemned the collapse of the public health care
system and the breakdown of medical ethics and human rights in the
country.
In July, another press statement went out to condemn the killing of a
medical student shot while driving home from her hospital shift in
Managua, Nicaragua’s capital city.
UNITED STATES
June 2018
Source:
American Medical
Association
Physicians for
Human Rights
In June, the WMA circulated through social media PHR’s call mobilizing
medical professionals across the US to speak out against the separation of
immigrant families at the US-Mexico border and calling attention to its
lasting negative health effects on children.
VENEZUELA
June 2018
Source:
Psychiatry Society
of Venezuela
In late June, the Psychiatry Society of Venezuela alerted us to the case of
Dr Jose Alberto Marulanda Bedoya, a surgeon from Venezuela in
detention since 20 May, who has been exposed to ill-treatment and denied
access to a fair-trial. The Secretariat is investigating the case further.
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UGANDA
August-Sept. 2018
Sources:
Uganda Medical
Association
In late August, the Uganda Medical Association (UMA) contacted us
regarding ongoing practices of torture in Ugandan places of detention and
denial of access to health care. In agreement with UMA, letters were sent
to the Ugandan authorities and a press release was issued.
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 2016, 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 long-standing 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.
The ICRC and the WMA organised a side-event during the 2018 World Health
Assembly last May, together with Médecins sans Frontières (MSF), the World
Health Organization (WHO) and the International Committee on Military
Medicine (ICMM). The event, entitled “Strengthening National Frameworks
for the Protection of Health Care”, provided examples of successful country-
based implementation approaches to protect health care.
The WMA also presented a public statement on WHO’s work on health
preparedness and response to the World Health Assembly on behalf of the World
Health Professions Alliance (WHPA).
Dr O. Kloiber, M. Mihaila and C. Delorme represented the WMA at the Health
Care in Danger annual meeting organized by the ICRC on 16-18 May in Geneva.
This brought together representatives of the HCiD Movement and the Community
of Concern, with the main objectives being to report on actions taken, share good
practices and challenges on specific thematic aspects, and explore new operational
opportunities collectively.
On 20 June, a side-event on “The right to health and the criminalisation of
impartial healthcare”was co-organized at the 38th
Session of the Human Rights
Council by Switzerland and Colombia, the Human Rights Centre at the University
of Essex, and the Safeguarding Health in Conflict Coalition,. The panellists
included Dr Dainius Pūras, UN Special Rapporteur on the right to health, Marine
Buissionniere, Independent Expert and Dr Otmar Kloiber, Secretary General of
the World Medical Association
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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 by the end of
the year.
Last February, 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 the 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 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 on 23-24 May in Geneva.
2.3.2 Psychiatric treatment – Mental health
In June 2017, the WMA Secretariat prepared written comments on the recent
report on mental health by the United Nations Special Rapporteur on Health, Dr
Dainius Purras (Report A/HRC/35/21). These comments were prepared with a key
contribution by Dr Miguel Jorge (Brazilian Medical Association), psychiatrist and
Chair of the WMA Socio-Medical Affairs Committee, with the aim of providing
the physicians’ perspective in the global discussion on the challenges and
opportunities related to the promotion of mental health as a global priority and a
fundamental human right. The written comments were then shared with the World
Psychiatric Association. Dr Puras replied by welcoming our report and a meeting
took place in September to discuss the matter further. The WMA Secretariat was
represented at this meeting by Dr O. Kloiber and C. Delorme.
Last August, the co-chair of the Standing Committee on Ethics of the World
Psychiatric Association (WPA) contacted the WMA Secretariat to share its
concerns about the positions taken by the UN Committee on the Rights of Persons
with Disabilities, the body charged with overseeing the implementation of the
Convention on the Rights of Persons with Disabilities (CRPD). In particular, the
Committee’s General Comment #1 interpreted the CRPD as ruling out any non-
consensual interventions affecting persons with disabilities. The WMA Secretariat
replied positively to the offer to collaborate on this issue, with the support of Dr
Miguel Jorge, Chair of WMA Socio-Medical Affairs Committee.
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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. 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 session of the WHO
Executive Board (January 2017) on the public health dimension of the issue, underlining
the need for a committed public health approach encompassing the availability and access
to medicines for effective treatment and related healthcare services.
On 1 March, 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
On 7 July 2017, country representatives meeting at a United Nations conference in New
York adopted the Treaty on the Prohibition of Nuclear Weapons, the first multilateral
legally-binding instrument for nuclear disarmament to have been negotiated in 20 years.
On the occasion of the opening for signature of the Treaty on the Prohibition of Nuclear
Weapons in New York on 20 September 2017, the International Physicians for the
Prevention of Nuclear War (IPPN) together with the WMA, the International Council of
Nurses and the World Federation of Public Health Associations, adopted a joint
Statement urging Member States to sign the Treaty and to ratify it as soon as possible
thereafter so that it can enter into force.
The WMA and IPPN are collaborating on the need to promote the global health
imperative to eliminate nuclear weapons. In this respect, the IPPN offered its assistance
on the revision of the WMA Statement on Nuclear Weapons in order to include reference
to the recently adopted Treaty. One of its representative attended the WMA Council in
Riga, where a Resolution on the prohibition of nuclear weapons was adopted.
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 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 regularly
attended WHO GCM/NCD meetings.
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During the WHO Executive Board meeting, the WMA made an intervention for
the preparation of the next high-level meeting on NCDs during the 2018 UN
General Assembly in New York and emphasized the strong commitment of the
WMA in the fight against NCDs. 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 and on the
mobilization of civil society. The Theme of the Third High Level Meeting is
‘Scaling up multi-stakeholder and multisectoral responses for the prevention and
control of NCDs in the context of the 2030 Agenda for Sustainable Development’.
Dr Yokokura was invited to be a panel speaker at the High Level meeting in New
York on 27 September 2018 during the plenary session on Strengthening health
systems and financing for the prevention and control of NCDs, on each country’s
path towards achieving universal health coverage, including sharing evidence-
based best practices, scientific knowledge and lessons learned.
The WMA was closely involved in the preparation process of the High Level
Meeting and commented on the conference outcome document.
The WMA supported the launch of the publication of a new speaking book for
children with cancer. Previously, along with other partners, the WMA has
supported the publication of speaking books on high blood pressure, tobacco use
cessation, kids in hospital and clinical trials.
On the occasion of the 20th
European Health Forum in Gastein, Austria in October
2017 WHO invited WMA to speak at the WHO workshop « investing in healthy
cities: « insuring” prevention ». The workshop focused on investing in healthy
cities as a means to improve population health and well-being.
At the Global Dialogue on Partnerships for Sustainable Financing of NCD
Prevention and Control in Copenhagen, Denmark from 9-11 April 2018 the
WMA organised a session on ‘A vital investment: Scaling up health workforce for
NCDs’. The aim of this session was to highlight the importance of the health
workforce in the fight against NCDs and the investment needs and roles of
various stakeholders in strengthening countries’ capacities to develop HRH
policies and plans in line with national health strategies to achieve UHC and
SDG3.4.
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 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
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The Secretariat maintains regular contact with the WHO staff in charge of this
topic, as well as with the Global Alcohol Policy Alliance (GAPA). During the 70th
session of the World Health Assembly in May 2017, the WMA took part in a
Civil Society consultation meeting organised by GAPA and the NCD Alliance in
order to discuss strategies to put alcohol back on the agenda of the WHO
governing bodies. The WMA was also invited by GAPA to an informal meeting
on the same topic with interested Member States.
In June 2017, the WMA made a statement at the WHO Forum on Alcohol, Drugs
and Addictive Behaviours, which took place at WHO headquarters in Geneva,
recommending the development of all-inclusive policies addressing the root
causes of alcohol use patterns, as well as strengthening health systems to improve
countries’ capacity to develop policy and lead actions that target alcohol problems.
Last February, the WMA decided to support a joint letter to the Global Fund
denouncing their partnership with Heineken and emphasizing the dangers inherent
in collaborating with the producers and marketers of hazardous products such as
alcohol.
In the context of the new planned collaboration between WHO and WMA for the
period 2019-2021, it is intended that the WMA will collaborate with WHO and
other relevant partners on the development and promotion of 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.
3.1.4 Physical Activity
The WHO is in the process of developing a draft global action plan to promote
physical activity. The WMA was invited to be member of the strategic advisory
network to support and guide the WHO Secretariat in the development of this
Global Action Plan on Physical Activity, and attended the first technical advisory
meeting in June 2017. Recognising the importance of physical activity to
wellbeing and the attainment of the sustainable development goals, the action plan
offers the global community a unique opportunity to elevate the profile and set a
new ambitious agenda for united action in creating physical activity opportunities
for all. The WHO Secretariat hosted an open web-based consultation on a first
draft of the report from August to mid-September.
The WMA submitted a statement to the 2018 World Health Assembly on physical
activity for health.
3.2 Communicable diseases
3.2.1 Multidrug-Resistant Tuberculosis Project
The WMA participated in the development of the WHO guidance document
entitled ‘Guidance on Ethics of Tuberculosis Prevention, Care and Control’ in
2010. 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
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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.
The High-Level Meeting on Tuberculosis will take place prior to the UN General
Assembly this October. The WMA will be represented at this event by Dr
Yokokura, WMA President. The WMA submitted an intervention at the WHO
Executive Board meeting in January 2018 on the preparation of the High Level
Meeting.
3.2.2 Influenza
The WMA was invited by Ms Françoise Grossetête, Member of the European
Parliament, and Prof. Thomas Szucs to be a member of the steering group to
develop an EU Manifesto on Influenza Vaccination, which aims to help shift the
agenda at European and national level in support of influenza vaccination. The
Manifesto confirms the need for stronger policy-driven actions to reduce the
burden of influenza and emphasises the importance of the health workforce in this
topic. The digital launch was on 6 March 2018, followed by the physical launch
later that month.
In May, the WMA restarted its communication campaign to increase influenza
immunisation uptake. The emphasis of this year’s campaign is on asthmatic
patients. People with asthma are at high risk of severe complications from
influenza – even if their asthma is mild. With their influenza more likely to
develop into bronchitis or even pneumonia, asthma patients are more likely than
others to end up in hospital with influenza. Additionally, influenza is also a trigger
for asthma and vice-versa, when people with asthma get influenza, the virus can
worsen asthma’s chronic irritation of the bronchial mucosa. The second part of the
social media campaign starts this autumn when the immunisation season for the
northern hemisphere starts.
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.
In August 2017, in line with the WMA’s related policy, the WMA Executive
Committee decided to support the United to End FGM knowledge platform. This
Platform is a new, free, online training tool to train professionals dealing with
those affected by female genital mutilation. It is currently available in nine
languages, with two modules specifically for health professionals. The Secretariat
shared this information through social media.
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During the reporting period, the WMA promoted the recommendations from the
German Medical Association on the management of patients with a history of
female genital mutilation (FGM).
3.3.2 Refugees, migrants & access to health
In September 2017, the WMA joined the working group led by the IOM and
WHO to ensure that the health needs of refugees and migrants are adequately
addressed in the “Global Compact for Migration” (GCM), the global UN process
currently taking place, which will culminate in a final outcome agreement by the
UN General Assembly further to intergovernmental negotiations at the end of
2018. The working group – composed of representatives from WHO and IOM in
close cooperation with ILO, OHCHR, UNFPA, UNAIDS1
, the World Bank and
other stakeholders including the International Federation of the Red Cross (IFRC),
the Platform for International Cooperation on Undocumented Migrants (PICUM)
and WMA – agreed on a Proposed Health Component, which should feed the
discussion around the zero draft GCM. The Proposed Health Component for the
GCM is available to Member States and partners on the GCM website.
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 70th
World Health Assembly (May 2017) welcoming WHO’s efforts in promoting
migrant health and highlighting that late or denied treatment is discriminatory and
contravenes a fundamental human right.
Last July, the WMA Secretariat attended the WHO briefing on the draft global
action plan on the health of refugees and migrants aiming to provide an update on
WHO’s work on health and migration and to outline the process for developing
the draft global action plan to be considered by the 72nd
World Health Assembly.
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 and will make a
presentation at the General Assembly in Reykjavik on potential areas of
collaboration with interested WMA members. A survey of the WMA membership
was launched late August in order to assess the work done by constituent
members in the area of migration and health.
3.4 Social determinants of health (SDH) and universal health coverage (UHC)
The WMA is actively engaged with the WHO Department of Health Workforce and is
participating in 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
1
ILO: International Labour Organisation – OHCHR: Office of the High Commissioner for Human Rights –
UNFPA: United Nations Population Funds – UNAIDS: United Nations Programme on HIV/AIDS
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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.
Dr Yokokura, WMA President, spoke at the opening session of the Universal Health
Coverage Forum in Tokyo in December 2017. The goal of the Forum was to mobilize
broad political support for accelerating progress towards UHC and the SDGs, including
health security and pandemic preparedness. This forum brought together over 300
participants, including heads of government, ministers of finance and health, and senior
representatives from bi- and multi-lateral institutions, civil society organizations, think
tanks, and academia. At the forum, WHO Director General Dr Tedros Adhanom
Ghebreyesus and WMA President Dr Yoshitake Yokokura agreed to strengthen the
collaboration of both organizations on universal health coverage and emergency
preparedness. Accordingly, a Memorandum of Understanding was signed on 5 April
2018 in Geneva.
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 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 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.
3.6 Health and the environment
3.6.1 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. The Secretariat sent out a call for nominations to WMA
members in early September with a view to forming a delegation to attend the two
weeks of negotiations during the COP24, which will take place on 3-14 December
in Katowice, Poland. The Secretariat is liaising with WHO and the Global
Climate and Health Alliance (GCHA) to ensure coordinated actions during these
negotiations.
October 2018 SecGen Report/Oct2018
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The WMA made a public statement during the 71st
World health Assembly last
May on health, environment and climate change.
During the reporting period, discussions were started with WHO and the GCHA
on setting up a regular mechanism of cooperation in the area of climate change.
The WHO’s First Global Conference on Air Pollution and Health is scheduled
from 30 October to 1 November in Geneva. It will bring 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, will be
one of the keynote speakers of the event. Dr Al-Qodmani also contributed to a
WHO discussion paper on air pollution and child health.
3.6.2 Chemical safety
The WMA is member of the Strategic Approach to International Chemicals
Management (SAICM) of the Chemicals Branch of the United Nations
Environment Programme (UNEP) and supported the adoption in 2016 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.
The 70th
World Health Assembly in May 2017 adopted the Chemicals Roadmap,
which identifies actions in which the health sector has a supporting role to play.
The roadmap was developed in consultation with Member States, United Nations
agencies, and other relevant stakeholders. The WMA participated in the
consultation phase through the electronic consultation and meetings.
During the 71st
World Health Assembly, the WMA was invited by WHO’s
chemical safety programme and SAICM to a civil society meeting to discuss
implementation of the WHO Chemicals roadmap and engagement in the
intersessional process beyond 2020. C. Delorme participated in the meeting and
presented the WMA position on chemicals and proposals for implementation.
3.6.3 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. It provides everything
needed to assist practice or clinic managers in establishing their own
environmental sustainability programme: office policies, presentations, a step-by-
step guide for your Green Teams, and even free advice by telephone. 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.
October 2018 SecGen Report/Oct2018
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In August 2018, the WMA Secretariat launched a WMA Green List through the
Slack platform. Its purpose is to facilitate and promote an exchange of
information within WMA membership on issues related specifically to health and
the environment. The list is open to all WMA associate members and interested
constituent members.
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 will be 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 aims to
strengthen primary health care as the foundation for UHC, building on lessons learnt over
the past four decades.
Dr Otmar Kloiber, Secretary General, is a member of the International Advisory
Committee for the preparation of the Primary Health Care Conference. The WMA has
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.
4.2 Patient safety
In order 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.
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. At a first meeting in December 2017 we discussed the topics, order
and priorities of this chapter. Based on this discussion, the WHO will develop a first
revised version to be commented on by the WMA and other health professionals.
October 2018 SecGen Report/Oct2018
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In April 2018, the Third Global Ministerial Summit on Patient Safety took place in
Tokyo. The conference reaffirmed the commitment to improving patient safety in order
to reduce all avoidable harm and the risk of harm to all patients and people during their
interaction with health care systems, whoever they are, wherever they live, by 2030. Dr
Yokokura, WMA President, chaired the keynote speaker session at this conference.
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 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. A summary of the conference is available on the
WMA website.
The second conference was hosted by the Japan Medical Association and the Japan
Veterinary Association, together with the World Veterinary Association and the WMA 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.
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
October 2018 SecGen Report/Oct2018
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and managers and set an international standard in AMR knowledge. The WMA
commented this framework.
The WMA participated in the ninth Meeting of the Strategic and Technical Advisory
Group on Antimicrobial Resistance (STAG – AMR) and the Meeting of the Technical
Coordination Group (TCG) in February 2018 in Geneva.
The September 2016 Political Declaration of the High-level Meeting on Antimicrobial
Resistance called for the establishment of the 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 summer this year, 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 will participate in the 2nd
informal consultation of Member States and relevant
partners on the global development and stewardship framework on AMR of the WHO
this October.
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
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.
Following the conclusion of its 10-year mandate, the Global Health Workforce Alliance
has transitioned into the Global Health Workforce Network (GHWN). 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 WHO, together with the GHWN and Ireland, organised the
Fourth Global Forum on Human Resources for Health in November 2017 and
adopted the outcome document Dublin Declaration on Human Resources for Health.
During this forum, the WMA and the International Federation of Pharmacists (FIP)
organised a side session on: How can regulation ensure quality health care,
professional autonomy and protect the public’s interest?
October 2018 SecGen Report/Oct2018
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Commercialised health care models may affect professional autonomy and the quality of
delivered care. The purpose of health care regulation is to protect the public’s interest and
ensure patient-centred quality care based on ethical principles, as opposed to profit-
oriented models of care. Professional autonomy through self-regulation defines standards
and ensures quality for health care models. Therefore, regulation has an important role in
the implementation of strategies such as the WHO Global Strategy on Human Resources
for Health to accelerate UHC and ensure a sustainable health workforce.
Dr Julia Tainijoki, WMA Medical Advisor, spoke at another side event during this forum
entitled: “Addressing discrimination in health care settings through a focus on the
rights, roles and responsibilities of health workers” and presented the physician’s
perspective and WMA policies on this issue.
4.6 Violence in the health sector
Building on the success of the previous conference in Dublin, preparatory work has
started for the sixth International Conference on violence in the health sector, which will
take place in Toronto, Canada on 24 – 26 October 2018. The WMA is a member of the
organisation and scientific committees in charge of the preparations for the event. Two
meetings of the organisation committee took place during the reporting period. C.
Delorme, as a member of the Committee, liaised with the ICRC so that a representative
of the Health Care in Danger initiative will be invited to the conference as a keynote
speaker.
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. 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
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
October 2018 SecGen Report/Oct2018
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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
The centre invited WMA Secretary General, Dr Otmar Kloiber to present the new
Declaration of Taipei and the revised Declaration of Geneva at a seminar at the Schar
School of Policy and Government, Arlington, Virgina last December.
5.2 Support for national constituent members
See item 2.2.1
October 2018 SecGen Report/Oct2018
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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
follows2
:
1. World Health Organization (WHO)
WHO Governance
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 Executive Board, January 2018, Geneva, Switzerland:
The WMA made public statements on a series of issues. For more information (agenda, working
documents and resolutions), see http://apps.who.int/gb/e/e_eb142.html
71st
World Health Assembly, May 2018, Geneva, Switzerland:
The WMA made a series of public statements. For more information on the WHA, visit the
dedicated website
WHO Public Health Events
WHO Briefing on the draft global action plan on the health of refugees and migrants, July 2018,
Geneva
Fourth Global Forum on Human Resources for Health in November 2017 organised by WHO,
GHWN and Ireland in November 2017
WHO Meeting of the Strategic and Technical Advisory Group on Antimicrobial Resistance (STAG
– AMR) and Meeting of the Technical Coordination Group (TCG) in February 2018 in Geneva
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 workshop « investing in healthy cities: « insuring prevention » at the 20th
European Health
Forum Gastein, Austria in October 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
again participated by structuring sessions on end-of-life issues and the (at that time) 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
2
More information on the activities mentioned is set out under the relevant section of the report.
October 2018 SecGen Report/Oct2018
22
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 of our cooperating institute at 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).
The WMA is invited to the 13th
World Conference on Bioethics, Medical Ethics and Health
Law, which will take place from 27-29 November 2018 in Jerusalem, Israel. Please visit the
conference page for more details.
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
Participation of the SR in the 2018 WMA
General Assembly in Reykjavik
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 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)
The WMA is part of the consultation process
within the framework of the UN Resolution on
mental health and human rights adopted in
September 2016
UNAIDS Campaign on Zero HIV-related stigma &
discrimination in health care settings day
See item 3.3.3
OECD Meeting with Mrs Francesca Colombo, Head
of the Health Section, and her team.
Discussion about the new work strategy on
health system reporting and the use of Patient
Reported Outcome Measurements (PROMS).
November 2016 (see also item 6.1 and 10)
International Organisation for Migration
(IOM)
The WMA is part of the IOM-WHO working
group on Migrants’ Health. (see point 3.3.4).
October 2018 SecGen Report/Oct2018
23
The development of a Memorandum of
Understanding is being considered.
WHO and World Bank Dr Yokokura gave one of the keynote speeches
at the Universal Health Coverage Forum,
December 2017 in Tokyo, Japan
4. World Health Professions Alliance (WHPA)
After over ten years, the WMA passed on the secretariat of the World Health Professions
Alliance leadership to the World Dental Federation (FDI) at the beginning of 2018.
World Health Professions Regulation Conference
Health professional regulation faces many challenges in a world characterised by political,
social, economic and technological change. Widespread reform of health professional
regulation reflects policy initiatives by many governments to ensure sustainable, efficient and
effective health service delivery. But what are the implications of these challenges, and how do
we ensure the public’s best interests are met?
Running over one-and-a-half days immediately before the World Health Assembly in May
2018, the 6th
World Health Professions Regulation Conference (WHPRC) provided participants
with insights, perspectives and discussion on current challenges in health professional
regulation. Three main themes were addressed during the conference:
1. A call to set the right standards in regulation
Topics included: setting the right standards, who is regulating the regulators, ethics and
professional autonomy, barriers to implementation, and reimbursement.
2. Safety, quality and compliance: Benefiting patients, communities and populations
Topics included: best practice guidelines, the role of regulation in sustainable prevention,
facilitation of migration, the cost of maintaining licenses, use of big data and case studies of
outcome-oriented models.
3. Supporting the quality of lifelong learning
Topics included: continuing professional development (CPD) and a discussion on the need for
global standards, fostering innovation, improving patient treatment, the shift in CPD to
assessment vs independence, and regulation of specialization.
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
October 2018 SecGen Report/Oct2018
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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
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, Ethiopia, Uganda and Iran.
Human Rights Watch Regular contact on issues of common interest.
Global Alliance on Alcohol
Policy (GAPA) and its
members
Regular exchange of information.
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 in matters of research in
resource poor settings, patient information and healthy
research subjects (planned).
Medical Human Rights
Network (IFHHRO)
Regular exchange of information on human rights and health
matters.
International Federation of
Medical Students
Internship program since 2013 (3 students in 2013 and 2
students in 2014).
October 2018 SecGen Report/Oct2018
25
Associations (IFMSA) 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).
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).
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. 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.
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.
International Physicians for
the Prevention of Nuclear
War (IPPN)
Exchange of information and joint actions, in particular in the
context of the UN Treaty on the Prohibition of Nuclear
Weapons.
October 2018 SecGen Report/Oct2018
26
CHAPTER III 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 technically managed by Ms Maira Sudraba at the Latvian Medical Association.
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, among others.
October 2018 SecGen Report/Oct2018
27
Sadly, Dr Mungherera passed away on 4 February 2017 after a brave battle with cancer over
previous 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.
Margaret was with us for every meeting she could arrange for. The WMA remains grateful for
her service to our community.
5. Meeting with Arab Medical Union leaders
Upon the invitation of the President of the Kuwait Medical Association, who at the time also
chaired the Arab Medical Union, the WMA Chair of Council, Dr Ardis Hoven, and the
Secretary General had an opportunity to attend the Scientific Conference of the Kuwait
Medical Association and the coinciding meeting of Arab Medical Union leaders. The Chair
delivered a presentation on the WMA to the leaders of the Arab Medical Union, most of which
are not members of the WMA, and invited them to join. Later the Chair was given the
opportunity to participate in a panel discussion about End-of-Life issues, which mainly dealt
with the provision of palliative care, the withdrawal or withholding of futile treatment and the
respect for patient will (denial of treatment).
In another section, the Secretary General presented the WMA Declarations of Taipei and
Geneva.
6. Secondments / internships
The Georgian Medical Association seconded Dr. Tinatin Supatashvili to the WMA Secretariat
in Reykjavik. We have been running an internship programme with the IFMSA since 2013 (one
intern in 2018 from Croatia and one more expected in October-December), with the University
of Pennsylvania since 2014 (two Interns in 2018) and in 2016 we started an internship
programme with the Palack University Olomouc in the Czech Republic.
CHAPTER IV 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 Panel is chaired by Dr Ashok Zachariah Philip, Malaysian Medical Association and
composed of the following members: Israel Medical Association (IsMA), South African
October 2018 SecGen Report/Oct2018
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Medical Association (SAMA), Spanish Medical Association (CGCoM), American Medical
Association (AMA), Japanese Medical Association (JMA), French Medical Association
(CNOM), Junior Doctors Network (JDN).
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.
3. Governance
A Workgroup on Governance Review was set up at the Council Session in Moscow in 2015
under the chair of Dr Rutger Jan van der Gaag. The Workgroup delivered its final report to the
207th
Council in Chicago after extended discussions with Constituent Members. The
discussions and findings of the group will provide input for the strategic development of the
WMA. It has already triggered the installation of an information session for delegates before
the General Assembly, increased communication through social media and an initiative for our
members to consider rotations for council positions. In Reykjavik an additional WMA Region
will be proposed to guarantee members from the Eastern Mediterranean Region Council
representation.
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, 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.
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14.09.2018