World Medical Association General Assembly

Delegates from almost 50 national medical associations attended the annual General Assembly of the WMA in Montevideo, Uruguay from 12 to 15 October. The Assembly formally noted that membership had now risen to a record high of 100 national medical associations. Among the issues discussed were:

INDEPENDENCE OF MEDICAL ASSOCIATION

The Assembly denounced attempts by some governments to silence medical associations. It said some governments had placed their own representatives in positions of authority to subvert the message of medical associations. Delegates demanded that no government interfere with the independent functioning of national medical associations. They encouraged governments to work with physicians to improve the health of their populations.

TOBACCO AND CHILDREN

Around 700 million children, around half the world’s total, breathed air polluted by tobacco smoke, particularly in the home, according to a statement adopted by the meeting. This called for more concerted action to protect children from the effects of smoking, such as the provision of tobacco-free environments for children and the targeting of parents who smoked. It reiterated WMA policy for a ban on the sale, distribution, and accessibility of cigarettes, and other tobacco products to children and adolescents, as well as a ban on the production, distribution and sale of candy products that depicted or resembled tobacco products.

A ban on the manufacture and sale of e-cigarettes was also called for. The Assembly said they should be banned until they had been fully researched, tested and regulated as either a new form of a tobacco product or as a drug delivery device. Delegates warned about marketing to children, especially when flavors like strawberry or chocolate were added to the cartridges.

DECLARATION OF MONTEVIDEO ON DISASTER PREPAREDNESS

The Assembly agreed that the WMA should become a key channel of communication for national medical associations in times of natural and manmade disasters. Delegates adopted a new statement on disaster preparedness and medical response which it named the Declaration of Montevideo. Dr. Jose Gomes do Amaral, President of the WMA, said:

‘We would like to see greater consistency among disaster training programs for physicians across all specialties, as well as more sharing of information among medical associations.’

The Declaration urged physicians to work with national and local governments on more effective planning and on regional health databases to assist medical response efforts. In addition, systems for communicating directly with physicians and other front line health care providers should be strengthened.

PHYSICIANS WITH DUAL LOYALTIES

Delegates approved the development of a new reporting system to allow auditing of cases involving physicians and torture. They decided to increase WMA help for physicians with dual loyalties, such as those in the armed forces or working in prison, who were pressured to violate their professional ethics.

Dr. Mukesh Haikerwal, Chair of the WMA, said: ‘We will review evidence of physicians being forced to violate human rights and where necessary refer these cases to the relevant authorities. We will then support those associations and their members to resist such violations.’

LEPROSY

Physicians were urged to lead the way in combating prejudice and discrimination against people with leprosy and members of their families.

The Assembly supported a global appeal to set the record straight about the many myths and misconceptions about leprosy, which is a mildly infectious disease and is not spread by casual contact. The appeal statement noted that there were no medical grounds for isolating a person with the disease. Greater public awareness could end this stigma and without the stigma more people would come forward for treatment. New cases would then be detected sooner and the global burden of leprosy would be reduced.

REVISION OF HELSINKI DECLARATION

There was further discussion about the problem of placebo control in clinical research and it was agreed there should be a complete revision of the Declaration of Helsinki on medical research. A work group will report back.

TUBERCULOSIS IN PRISONS

A warning was given about the increase in TB in prisons and other places of detention, including the development of drug resistant forms of TB. This reinforced the need for considering public health as an important element when reforming existing penal and prison systems.

Dr. Haikerwal said: ‘Prisons can be breeding grounds for infection because of overcrowding, poorly lit and badly ventilated spaces. Where this is combined with poor hygiene and nutrition and limited access to adequate health care, prisons represent a major public health challenge. Prisoners have the same health care rights as all other people and this means we must ensure that conditions in prison do not contribute to the development of disease.’

PRESIDENT ELECT

Dr. Cecil B. Wilson from the USA was elected President for 2012/13. He will take up office in a year’s time.

MEMBERSHIP

Applications for membership were accepted from national medical associations in Trinidad and Tobago, Tanzania and Uzbekistan.

Press releases were also issued on Bahrain, armed conflicts and pain relief.

WORLD JUNIORS DOCTORS NETWORK INAUGURAL MEETING

The inaugural meeting of the WMA’s Junior Doctor Network was held, with junior doctors attending from Chile, South Korea, Brazil, Canada, Germany, Uruguay, Australia and New Zealand. Elections for the 2011-2012 term were conducted. Xaviour Walker (New Zealand) was voted Chair, Lawrence Loh (Canada) Deputy Chair and Thorsten Hornung (Germany) Secretary.