WMA Statement on Epidemics and Pandemics
Adopted by the 68th General Assembly, Chicago, October 2017
and revised by the 75th WMA General Assembly, Helsinki, Finland, October 2024
PREAMBLE
History demonstrates that new diseases will emerge, and old diseases re-emerge unpredictably and pose significant threats to global health.
Epidemics and pandemics highlight deep-rooted inequalities, hitting less-resourced regions hardest due to their constrained resources, fragile health systems, and significant disease burdens. The common but differentiated responsibilities (CBDR) principle can be applied to pandemic prevention, preparedness and response (PPPR) in order to bring equity and justice in cooperation between states.
The accelerating pace of epidemic-prone diseases, compounded by the repercussions of geopolitical conflicts, environmental degradation, climate change, increased human encroachment into natural ecosystems, antimicrobial resistance, widening socio-economic disparities, global travel, and the intrinsic link between the health of humans, animals, and our shared environment, underscores the vulnerability of global health security.
Integrating the One Health approach acknowledges the critical interdependence of all living organisms and their habitats, essential for understanding the emergence and spread of diseases and highlighting the need for a multisectoral, interdisciplinary and evidence-based approach to global health threats.
Robust and effective global surveillance is pivotal for improving the prevention and response to infectious diseases, enabling earlier detection and identification of emergent threats. The rapid spread of epidemics and pandemics in regions with underfunded and underdeveloped public health infrastructures highlights the urgent need for a global cooperative framework. Such a framework must prioritise the development of resilient health systems capable of withstanding the challenges posed by infectious diseases, thereby safeguarding the health and well-being of populations worldwide.
An investment in strengthening public health, primary care and other aspects of health systems is crucial for enhancing the capacity to prevent, detect, contain, and manage disease outbreaks, laying a solid foundation for core public health functions essential.
Particular attention should be paid to individuals in fragile, conflict-affected, and vulnerable settings; additionally other individual vulnerabilities factors should also be addressed including but not limited to disability, age, gender, indigeneity, ethnicity, etc..
RECOMMENDATIONS
The WMA calls on the following stakeholders to:
WHO and United Nations
- Global Pandemic Infrastructure: Strengthen global infrastructure for preventing, monitoring, and responding to pandemics under the leadership of the World Health Organization (WHO). Ensure that this bolsters WHO’s pivotal role in leading international health efforts, while fostering a comprehensive commitment across all levels of government and society.
- Political Commitment: Ensure engagement at the highest level in each country for political commitment to pandemic prevention and preparedness between emergencies and to respond during emergencies.
- Global Health Equity: Promote global equity by addressing social determinants of health and tackling inequalities that may drive epidemics and pandemics. Put in place mechanisms to ensure timely and equitable access to countermeasures for all, while prioritizing resource allocation to public health needs. Strengthen health systems and continue broader societal efforts to enhance equity and the effectiveness of the global response.
- Communication and Misinformation: Ensure consistent public messaging and monitor public discourse including on social media and combat misinformation and disinformation.
- Legal Frameworks: Strengthen means of implementation and enforcement of international legal instruments for pandemic response, ensuring the effectiveness of the International Health Regulations and developing a comprehensive international pandemic legal instrument.
- Data Collection, Sharing, and Universal Reviews: Strengthen data collection on infectious diseases and ensure its sharing across stakeholders, including health personnel, non-state actors (NSAs), and governments. Implement Universal Health and Preparedness Reviews with strengthened independent monitoring. Define benchmarks for equitable resource distribution, healthcare access, and outcomes across populations. Monitor disparities to guide equitable interventions.
- Stakeholder Collaboration: Broaden partnerships with governments and NSAs for an effective multi-sectoral response, focusing on pathogen and benefits sharing, and addressing intellectual property regulations for equitable resource distribution.
- Other Sources of Pandemic Risk: Enhance global health security by integrating climate change, environmental degradation, and conflict risk into pandemic preparedness giving particular attention to vulnerable populations through health system strengthening in climate and conflict-affected regions to improve resilience and response capabilities.
National Governments
- Preparedness, Response, and Governance: Develop a robust national preparedness architecture by learning from previous pandemics, including local and regional manufacturing of health products, local stockpiling, and enhance national governance with anti-corruption measures. Medical associations and physicians from all specialties must be involved in epidemic planning, preparedness, and response at all levels to enhance health system effectiveness during crises.
- Financing: Provide sufficient and sustainable funding for global PPPR including for the WHO, for research and development, and for national health systems strengthening.
- Equitable Resource Allocation: Use a common but differentiated approach in establishing obligations for financing. Ensure resources are directed to those most in need while maintaining critical health services in order to mitigate the severity and duration of pandemics.
- Health Workforce Strengthening: Support the health workforce with appropriate education on PPPR and support for response, including mental health, safe working environments including access to protection measures, and sufficient human and material resources to deliver the services required.
- Health System Strengthening: Ensure health system continuity so that regular healthcare services continue to be provided and that the viability of services is not compromised by public health measures.
- Mental Health Service: Expand mental health services to ensure comprehensive support for all affected populations during and after pandemics including integrating mental health care into primary health services, establishing dedicated mental health teams, and facilitating access to psychological support for patients, health personnel, and communities.
- Digital Technology: Continue to develop digital health infrastructure to enhance PPPR capabilities while ensuring equitable and secure access to digital health services for all populations, with particular attention to remote and underserved communities.
- Social Protection: Implement socio-economic support measures during pandemics to protect populations from the adverse effects of health crises.
- Manufacturing infrastructure: Develop infrastructure for pandemic-related research and production of critical equipment, diagnostics, therapeutics, vaccines and personal protective equipment (PPE).
- Science-Guided Response: Guide response measures by scientific and expert recommendations, adapting to local contexts as necessary. Develop National Pandemic Preparedness Plans.
- Communication Management: Invest in public health education to improve health literacy. Implement laws, regulations, and administrative rules targeting the spread of disinformation. Provide prompt, accurate and transparent crisis communication guided by science.
Medical associations and scientific societies
- Education and Training: Promote the integration of pandemic preparedness and response into higher education curricula and continuous professional development education for health personnel, including courses to integrate knowledge and skills related to emerging infectious diseases.
- One Health: Collaborate with organizations in the animal environmental health fields to implement a One Health approach to epidemic risk management in order to establish new methods for surveillance and control of epidemics and pandemics.
- Research and Innovation Dissemination: Advocate for information sharing platforms that foster collaborative research and the exchange of data across the global scientific community.
- Partnerships in innovation: Promote partnerships between public institutions and private entities as appropriate to drive innovation, ensuring that the management of intellectual property rights promotes universal access to crucial medical technologies and treatments. Advocate for equitable and affordable access to innovations including medicines and patient-oriented technology.
- Community Involvement: Promote strong relationships between the public and healthcare providers for inclusive pandemic management.
- Resource Forecasting: Assist governments in resource forecasting and advocate for safe work environments and the access to quality assured PPE, and countermeasures with a specific focus on the protection in all clinical workplaces.
- Misinformation Counteraction: Support the fight against misinformation and disinformation including by partnering with social media and online platforms to effectively identify incorrect information and disseminate accurate, evidence-based information. Treat the spread of disinformation by healthcare professionals as an unethical behavior with relevant sanctions.
- Health Literacy: Organize campaigns to increase health literacy and awareness about medical misinformation and disinformation.
- Research Acceleration: Encourage investment in research and fast-track ethical and peer review processes for pandemic-related research, while ensuring full respect for the principles in the WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Participants.
Physicians
- People-Centred Communication Skills: Physicians should cultivate clear, empathetic communication skills to effectively convey accurate and evidence-based medical information, address misconceptions, and educate patients on identifying credible information in accordance with the WMA Declaration of Cordoba on Patient-Physician Relationship.
- Advocacy: Report critical resource shortages, health system failures, misinformation and disinformation, and inequities in access to health and public health.
- Contribution to public health: Stay informed about epidemics and collaborate with public health authorities on PPPR while meeting obligations of declaring pathogens of concern and facilitating appropriate interventions in the communities served.