Valedictory Speech Miguel Jorge

Valedictory Speech by the WMA President, Dr. Miguel Jorge, to the GA
Dear Colleagues and Friends, Ladies and Gentlemen,
Our tradition requests that the World Medical Association (WMA) outgoing
President, deliver a so-called Valedictory Speech at this Ceremonial Session
of our General Assembly. Accordingly to different dictionaries, valedictory
is related to “say goodbye” or “a statement of farewell”. As a psychiatrist, I
am very much prone to always try to be in contact with feelings and
emotions, mine and from those people to whom I am in relationship.
Therefore, I hope to not just shortly report what I have done during my
Presidential year but also how I felt others and myself during the period
ending today. I can guarantee to you all, that it was quite different from any
other Presidential term.
I started my Presidential term just after our General Assembly in Tbilisi,
Georgia, going from there directly to Tokyo, Japan, for the Commemorative
Ceremony of the 72nd
Anniversary of the Japan Medical Association (JMA)
on the 1st
of November 2019. JMA has carried out during its existence not
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just many important activities on behalf of the Japanese people but was and
continue to be an outstanding member of the WMA.
In the beginning of December 2019, Taiwan Medical Association, one
another important member of the WMA, has organized an International
Symposium on Primary Health Care, in Taipei, where I had the opportunity
to speak about the theme I choose to highlight during my Presidential term –
the importance of the doctor-patient relationship – which is even more
important in the context of primary health care.
From Taipei, I went directly to Muscat, in the Emirate of Oman, for the
World Health Organization (WHO) Global Meeting on Non Communicable
Diseases (NCDs) and Mental Health. I have spoken in two different panels,
emphasizing the contributions WMA and some of its National Medical
Associations (NMAs) have been developing, sometimes in collaboration
with other health professional organizations, to better prepare those
responsible for assisting patients with NCDs and their mental health.
Not exactly from my role as WMA President but as a member of the WMA
Workgroup which is revising the International Code of Medical Ethics
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(ICoME), I have organized in early March of the current year, in São Paulo,
a regional conference to discuss different medical ethics issues of interest to
Latin America countries and also to Portugal and Spain, our “country
brothers” from Europe. There were 50 people from nine different countries
discussing different themes of interest to the revision of the ICoME.
Well … then … the coronavirus pandemic impacted us. All meetings that
WMA and its NMAs were planning and/or were invited to participate, were
cancelled, postponed or changed to occur through Internet ways of
communication. Many countries, all over the world, started to face
lockdowns in different regions and cities, and a vast majority of international
flights was cancelled. As we say … the world was placed upside down!
Moreover, we have to experience months of quarantine at home.
With such a change in the way we live and work, we were pushed to be
more resilient and creative. I was confined in my apartment and did not see
even my daughter and grandsons for weeks in a row. Initially, I was thinking
that it would be a time to do all those things we never have time to do before
but … I have never worked so tireless. My duties as President of the World
Medical Association, Chair of the Research Ethics Committee of my
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University, and Director of the Brazilian Medical Association, left me not
much time to relax.
You can have an idea of my doings just reading my Presidential report to the
WMA Council, encompassing at least 24 activities during the pandemic:
live, recorded or written interviews, and presentations. I spoke about many
topics related to the pandemic such as the role of the WMA and other
medical organizations, physicians and patients’ safety, ethics, climate
change, solidarity, and different issues on mental health – of common people
and of physicians and other health personnel at the frontline care.
I am sure it was difficult times to all, much more to some than to others. At
the beginning, we had very little knowledge about the virus characteristics
and particularly about the COVID19 disease: no vaccine and no specific
treatment available; high transmission and a considerable lethality; great
concern of a collapse of health services. Therefore, most people were
experiencing anxiety and fears, including physicians who – at many and
different places – where also experiencing a work overload and a lack of
enough and adequate personal protective equipment. And, in times of many
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discrediting science and spreading fake news, with a major contribution even
from people in position of command – like the President of my country and
of the country of our next WMA President – I believe that much more
people were inadequately exposed to the virus, were infected and many died.
At the time when I am writing this speech – the middle of October – WHO
is counting more than 38 million of cases and more than one million of
deaths. Those numbers are considered very much under what happened in
reality and the pandemic is still going on everywhere.
During the pandemic, I have listened that we all were at the same ship. It
could be true but lets remember that many ships have passengers in the first,
second and third classes. Our world is an unequal world and for many
people the recommendation to stay at home and keep physical distance one
from another sounds as a joke. I am not just referring to people who lives in
slums or as homeless in my country, Brazil, but also to – accordingly to the
World Bank data – almost half of the world’s population who still struggles
to meet basic needs or to almost 10% of the world’s population who lives in
extreme poverty.
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COVID19 has directly affected physical and mental health of millions, and
indirectly affected socially and economically billions of people. Poverty and
inequality are growing and people will continue, for many years, to suffer
from fears, grief, anxiety, depression, loneliness, uncertainties, economic
loss, and social disruption. Now, more than ever, universal health coverage –
including mental health care – would be the best way to provide health for
all.
It is time to start thinking about the future, at short, medium and long-term.
It was clear that the WHO and governments were not well prepared to deal
with emergencies such as those related to pandemics caused by infectious
diseases or natural disasters. Health does not have enough priority for many
of those who lead our countries and usually is insufficiently funded. In many
countries, corruption also contributes to divert part of the budget allocated to
health. It was possible to see politicians trying to save their mandates and
not human lives, and even the WHO was accused to not act as required in
the beginning of the pandemic because of political influences. It was also
possible to observe in some regions, a lack of health services, hospital
infrastructure and health personnel. The supply chain of medical equipment
relies very much in few or sometimes just one source. All these factors will
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need to be realistic faced and fixed, and they will not be unless the health
stakeholders take initiatives to raise awareness and mobilize our
communities to push their governments in the desired and needed way.
The diagnosis exists. It needs to be completed and then to adopt a treatment
plan to what were harmed and preventive measures to not have further
damages.
I am deeply grateful for your continuous support and hope to see you all
soon again. Thank you!