WMJ_2023_02x

Official Journal of The World Medical Association, Inc. Nr. 2, June 2023
vol. 69
Contents
Editorial   3
WMA Council Report Nairobi, Kenya, 20-22 April 2023   4
WMA Council Resolution for an Immediate and Effective Ceasefire in Sudan
and the Protection of Health Care   16
WMA Council Resolution on Proposed Legislation in UK on the Treatment of
Migrants Disregarding the Injunction Interim Measures Rue 39 of ECHR   16
WMA Council Resolution on Anti-LGBTQ Legislation in Uganda   17
‘One Medicine−One Health’: An Historic Perspective 18
WMA Members Share Perspectives about World No Tobacco Day 2023 28
American Medical Association   44
Australian Medical Association   45
Austrian Medical Chamber 46
Bangladesh Medical Association   47
Belgian Association of Medical Unions   48
Croatian Medical Association   49
Czech Medical Chamber   49
Estonian Medical Association   50
Finnish Medical Association   51
French Medical Council   52
Georgian Medical Association   53
British Medical Association   54
Italian National Federation of the Orders of Doctors and Dentists   55
Latvian Medical Association   56
Malaysian Medical Association   57
Myanmar Medical Association   58
Norwegian Medical Association   59
Polish Chamber of Physicians and Dentists   60
Royal Dutch Medical Association   61
Serbian Medical Chamber   61
Slovenian Medical Association   63
South African Medical Association   64
Swedish Medical Association   65
Swiss Medical Association   66
Thailand Medical Association   66
Tunisian National Medical Association 67
Teach Your Patients the Dangers of Gas Stoves: Free Education Webinar   69
WORLD MEDICAL ASSOCIATION OFFICERS,
CHAIRPERSONS AND OFFICIALS
Dr. Osahon ENABULELE
President
Nigerian Medical Association
8 Benghazi Street,
off Addis Ababa Crescent
Wuse Zone 4, P.O. Box 8829
Wuse, Abuja
Nigeria
Dr. Otmar KLOIBER
Secretary General
World Medical Association
13 chemin du Levant
01212 Ferney-Voltaire
France
Dr. Jack RESNECK
Chairperson,
Finance and Planning Committee
American Medical Association
AMA Plaza, 330 N. Wabash,
Suite 39300
60611-5885 Chicago, Illinois
United States
Dr. Lujain ALQODMANI
President-Elect
Kuwait Medical Association
123 Fifth Avenue,
1202
Kuwait
Dr. Tohru KAKUTA
Vice-Chairperson of Council
Japan Medical Association
113-8621 Bunkyo-ku, Tokyo
Japan
Dr. Zion HAGAY
Chairperson,
Socio Medical Affairs Committee
Israeli Medical Association
2 Twin Towers, 35 Jabotinsky St.,
P.O. Box 3566
52136 Ramat-Gan
Israel
Dr. Heidi STENSMYREN
Immediate Past President
Swedish Medical Association
(Villagatan 5) P.O. Box 5610
SE-114 86 Stockholm
Sweden
Mr. Rudolf HENKE
Treasurer
German Medical Association
(Bundesärztekammer)
Herbert-Lewin-Platz 1
(Wegelystrasse)
10623 Berlin
Germany
Dr. Jacques de HALLER
Chairperson,
Associate Members
Swiss Medical Association
(Fédération des Médecins Suisses)
Elfenstrasse 18, C.P. 300
3000 Berne 15
Switzerland
Dr. Jung Yul PARK
Chairperson of Council
Korean Medical Association
Samgu B/D 7F 8F 40
Cheongpa-ro,
Yongsan-gu
04373 Seoul
Republic of Korea
Dr. Steinunn
THÓRDARDÓTTIR
Chairperson,
Medical Ethics Committee
Icelandic Medical Association
Hlidasmari 8
201 Kópavogur
Iceland
www.wma.net
OFFICIAL JOURNAL OF THE WORLD
MEDICAL ASSOCIATION
Editor in Chief
Dr. Helena Chapman
Milken Institute School of Public Health, George Washington University, United States
editor-in-chief@wma.net
Assistant Editor
Mg. Health. sc. Maira Sudraba
Latvian Medical Association
lma@arstubiedriba.lv, editor-in-chief@wma.net
Journal design by
Erika Lekavica
dizains.el@gmail.com
Publisher
Latvian Medical Association
Skolas Street 3, Riga, Latvia
ISSN 0049-8122
Opinions expressed in this journal – especially those in authored contributions –
do not necessarily reflect WMA policy or positions
3
Editorial
Editorial
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The world has transitioned to a post-pandemic world,
as the World Health Organization (WHO) Director-
General confirmed the end of the coronavirus disease
2019 (COVID-19) as a global emergency, with over 765
million cases and 6.9 million deaths,on 5 May 2023.As our
medical community reflects upon the emerging health risks
that affect physical and mental health and well-being, our
collective expertise can contribute to advancing the global
health dialogue that drives the development of relevant
policy and guidance documents to promote population
health. Our strengths lie in using innovative approaches
to widely disseminate accurate health messaging for
our patients and communities, including easy-to-read
infographics, smartphone apps, and social media tools, and
identifyexistingdisparitiesinaccessandavailabilityofhealth
services. As a call to action, World Medical Association
(WMA) members can lead efforts that reinforce national
and global political commitment to support relevant
mitigation and adaptation plans and strengthen health
system resiliency.
The WHO held the 76th World Health Assembly from
21-30 May 2023. Using the theme, “WHO at 75: Saving
lives, driving health for all”, health leaders discussed an
array of topics, including the burden of communicable
and non-communicable diseases, emergency preparedness,
indigenous health, and refugee and migrant health, and
they shared the draft roadmap of the Global Health and
Peace Initiative. This initiative, which underscores the
interconnectedness between health and peace, aims to
address the social and structural determinants, among
other driving factors, that affect health in conflict and
other vulnerable settings. Recent global initiatives, such as
the UN Early Warnings for All initiative and the WHO
Global Digital Health Certification Network, can help
propel future collaborations that incorporate technology
into risk assessment or exposure tools (including disease
forecasting) and other nature-based solutions. Also, we
continue to recognize WMA members and collaborating
regional and national medical associations (NMAs) who
have supported the Ukraine Medical Help Fund and the
earthquake response efforts in Turkey and Syria.
After an energising 223rd World Medical Association
(WMA) General Assembly (https://www.wma.net/news-
post/world-medical-association-council-meeting-17/) in
April 2023, we are excited to support the 224th WMA
General Assembly that will be held in Kigali,Rwanda,from
4-7 October 2023. This meeting will offer opportunities
for WMA members to engage in dialogue that will
propel revisions to WMA statements and resolutions and
information sharing about NMA priorities and activities.
In this issue, Mr. Nigel Duncan prepared a comprehensive
summary of the event proceedings and incorporated three
resolutions related to events occurring in Sudan, Uganda,
and the United Kingdom, which were presented at the
224th WMA Council session. The One Health Initiative
autonomous pro bono team prepared a historical review of
the One Health Initiative and the “One Medicine – One
Health” movement. Dr. Todd Sack shared the WMA’s
My Green Doctor resource and the educational webinar
on the harmful effects of gas stoves. Notably, 26 NMAs
shared highlights on their leadership, history, mission and
objectives,national and international collaborations,current
challenges, and future vision. Finally, WMA members
representing 16 countries described their tobacco control
policies and community activities that support World No
Tobacco Day 2023.
As a global organisation, we hope that WMA members
can continue to reflect on our key clinical contributions to
improve the health and well-being of our local and national
communities. Together, our valuable leadership can truly
advance scientific knowledge and develop and refine relevant
health policies and guidelines that can mitigate risk of
emerging One Health risks.We look forward to connecting
and discussing important NMA topics in Kigali!
Helena Chapman,MD, MPH,PhD
Editor in Chief of the World Medical Journal
editor-in-chief@wma.net
4
Thursday, 20 April
Council
The 223rd Council session, attended
by around 200 delegates from almost
40 national medical associations
(NMAs), was called to order by the
Secretary General,Dr.Otmar Kloiber.
He welcomed new Council members
and read out apologies for absence.
Elections
Professor Jung Yul Park, Vice
President of the Korean Medical
Association, was elected unopposed
as Chair of Council, to succeed Dr.
Frank Ulrich Montgomery, who
stood down after four years.
Dr. Tohru Kakuta (Japan) was
re-elected Vice Chair of Council.
Mr. Rudolf Henke (Germany), was
elected Treasurer in a contest against
Dr. Phiippe Cathala (France). He
succeeds Dr. Ravindra Sitaram
Wankhedkar (India).
Chair of Council’s Report
Dr. Park said that physicians
around the world were only just
emerging from the long tunnel of
the COVID-19 pandemic and that
they were still facing many other
local and global health challenges.
They would only succeed in tackling
these challenges by working together,
and he believed that the WMA had
a crucial role by representing almost
15 million physicians worldwide.
He was convinced that the WMA
would become a more important
international organisation in the
future.
President’s Interim Report
The WMA President, Dr. Osahon
Enabulele, said that six months had
gone by since his inauguration as the
73rd President.He reported on deeper
relations with the World Health
Organization (WHO), the landmark
Memorandum of Understanding
between the WHO and the World
Health Professions Alliance, and that
the top priority was strengthening of
the health workforce in the pandemic
treaty, particularly as it concerned
their well-being, rights, working
conditions, safety, and protection.
He referred to the WMA support
for their Ukrainian colleagues in the
Russian invasion of Ukraine, and the
public campaign to halt oppression
and violence against physicians and
other health professionals in Turkey
and Iran. He also spoke about two
new initiatives – the Meet the WMA
President Roundtable and Leadership
Series – to improve physicians’
awareness of the WMA, and a WMA
Global Healthcare Excellence Award
Scheme.
Secretary General’s Report
Dr. Kloiber reported on the successful
dissolution of the WMA as an
incorporated association in the state
of New York. The Association was
now registered in France only.
He spoke about the Ukraine Medical
Help Fund, which had been set up
with the Standing Committee of
European Doctors and the European
Forum of Medical Associations.They
had just received another grant from
the Japan Medical Association of
€1.4 million. The money was being
used mainly on goods shipped to
Ukrainian physicians and the Ukraine
health system, and the Fund had now
spent a total of €2.5 million. Since
they believe that the conflict would
continue, with subsequent recovery
efforts, they hoped to receive more
donations.
He also thanked the Taiwan Medical
Association for making a donation
to the WMA’s travel stipend fund to
help junior doctors when they were
commissioned to attend meetings.
Immediate Past Chair of Council’s
Report
Dr.FrankUlrichMontgomerysaidthis
was his last report as Chair of Council
after four years. He said that the
WMA had grown from a handful of
medical associations at its foundation
to a world-spanning membership of
nearly 120 professional organisations
of physicians.The WMA had become
a ‘United Nations of Physicians’ – an
organisation of debate and discussion
– and recognised that they did not
always have same opinion on issues.
However, he said that they talked
to each other, tried to understand
one another, and where they did not
understand or follow the position
of their colleagues and friends, they
formulated clear standpoints and
firm positions of medical ethics and
deontology.
He referred to the Russian invasion
of Ukraine, sharing that physicians
on both sides were fighting for their
patients, and that physicians, nurses,
and other health personnel had been
killed in pursuit of their profession.He
wrote: ‘As a European citizen, I had
Nigel Duncan
WMA Council Report
Nairobi, Kenya, 20-22 April 2023
WMA Council Report
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WMA Council Report
believed that this type of imperialistic
and inhumane warfare was no longer
possible on a civilised continent – but
the Russian Government has proven
me wrong. We mourn over the lives
lost.’
He said that he had started work with
the WMA in the early 1980s. During
that time, the WMA had grown and
become ever more important. He
stated that: ‘If I had a wish for the
future, I hope it will be possible to
maintain the concept of a “United
Nations of Physicians”, maintaining
and expanding a platform for debate
and discussion. We must not fall back
into templates of “right or left” or
“democratic versus autocratic” – we
must not go into the trenches of a
global political discussion. We must
maintain our potential to talk to each
other, argue, convince each other –
and where that doesn’t seem possible,
we have to make clear statements
of opposing opinions – on a factual
matter, not on personal injuries and
insults.’
Matters of Urgency
Sudan
Dr. Kloiber submitted an emergency
resolution from the Executive
Committee on the conflict in Sudan.
They had all seen reports of attacks
that had not spared the health care
system, with attacks on hospitals
and other health care facilities.
Since three or four ceasefires were
not held, the resolution called for
an effective ceasefire. During a brief
debate,it was suggested by the British
Medical Association (BMA) that the
resolution should specifically mention
the need for a safe passage for health
care workers and patients, while the
South African Medical Association
proposed that reference be made to
facilitating humanitarian aid.
The amendments were accepted and
the Council unanimously supported
the resolution (see box).
Anti-LGBTQ Legislation in Uganda
The American Medical Association
submitted an emergency Resolution
calling on the Ugandan President
to veto the proposed Bill that would
criminalize certain homosexual acts,
making them punishable by death or
life imprisonment.The WMA shared
a policy condemning stigmatisation
and discrimination, as well as a policy
which stated that homosexuality was
a natural variation within the range of
human sexuality.
The Secretary General said this was
a matter of urgency as they still had
time to intervene.
The Council agreed to the Resolution
(see box).
Finance and Planning Committee
The Chair of Council welcomed the
Committee members.
The Committee approved the report
of the previous meeting held in Berlin
from 5-8 October 2022.
Election of Chair of the Committee
Dr. Jack Resneck, President of the
American Medical Association, was
elected unopposed as Chair of the
Committee to succeed Dr. Jungyul
Park.
Membership Dues Payments
Mr. Adolph Hällmayr, the financial
adviser, reported on the state of
membership dues, comparing
the membership dues paid to the
number of declared members
paid. The Committee considered
the membership dues arrears. Mr
Hällmayr said that those members in
dues arrears were regularly contacted
by the secretariat and encouraged to
return to good standing.
The Secretary General informed the
Committee that the New Zealand
Medical Association had now been
removed from the membership since
it was dissolved in 2022, and no
longer existed. There were currently
no organisations that met the criteria
for membership.
Financial Statement
The Committee considered the pre-
Audited Financial Statement for
2022, and the Treasurer, Mr. Rudolf
Henke, and Mr. Hällmayr, reported
that the WMA’s finances in 2022
were once again very solid.
The Committee recommended that
the Statement be approved by the
Council.
Finance Group
An oral report on the Finance Group
was given by Dr. Montgomery,
Immediate Past Chair of the Group.
He referred to an increase in the cap
amount of membership dues and a
proposed increase in membership
dues.
The Committee approved the
increases for forwarding to the
Council.
Statutory Meetings
The Committee considered plans for
future meetings and recommended
that the 229th Council Session be
held from 15-17 April 2027, that the
77th General Assembly be held from
20-23 October 2027, and that the
invitation from the Serbian Medical
Chamber for Belgrade,Serbia,to host
the 226th Council Session in 2024,be
accepted.
6
It also recommended that the theme
of the Scientific Session of the
General Assembly in Helsinki 2024
be “Inequalities in health and health
care – how to tackle them?”
Special Meetings
A report was given on future WMA
special meetings, including:
• Regional meetings on the
Declaration of Helsinki revision
planned in the European, Pacific,
and African regions
• Ethics conference in Ottawa in
October 2023
Associate Membership
An oral report given by the Chair of
the Associate Members, Dr. Jacques
de Haller. He said that the number of
associate members was nearly 1,900,
composed of medical students, junior
doctors, past Presidents, past Chairs
of Council and independent physician
members. The main activities of the
Associate Members had included the
formation of a steering Committee,
active involvement in numerous
workgroups and task forces, the
coordination of a plenary meeting
twice a year, and the organisation of
webinars.
Junior Doctors Network
The JDN Chair, Dr. Uchechukwu
Arum, reported that the Network
continued its activities with external
organisations, like the WHO, the
International Federation of Medical
Students’ Associations, the Student
Network of the International
Physicians for the Prevention of
Nuclear War, the European Junior
Doctors Association, and the WHO
Global Health Workforce Network
Youth hub.The Network would create
a toolkit to support existing and new
national junior doctors’ networks.
The JDN was increasing and
welcoming new members from
different parts of the world. It had
continued quarterly newcomer
sessions and also held regular
monthly meetings. It had been active
in contributing to WMA policy
discussions and had represented the
WMA at the 152nd WHO Executive
Board Meeting. The Network had
eight active working groups, and it
was working on producing special
editions of its JDN Newsletter.
Finally, the Network had been active
in regularly posting on social media
platforms.
Past Presidents and Chairs of Council
Network
A report of the Past Presidents and
Chairs of Council Network (PPCN)
was given by Past President,Dr.Kgosi
Letlape.He reported that a new Chair
had been elected, Dr. Kati Myllymäki
from Finland, WMA President from
2002-2003, and as deputy chair, Dr.
Wonchat Subhachaturas, WMA
President from 2010-2011. Dr. Jón
Snædal, WMA President from 2007-
2008,had been re-elected as Secretary.
He reported on the various activities
of the Network and he welcomed
Prof. Montgomery as a new member.
He said the PPCN planned to have
regular meetings.
Environment Caucus
Dr. Ankush Bansal, co-Chair of the
Caucus, said that the first meeting of
the group was in 2012, after it had
been set up as an informal forum to
discuss issues relating to environment
and health. Since then, the group
had met twice a year. Now, the
environment had become a key topic
globally,and he was proposing that the
Caucus be set up as a workgroup with
a defined mandate and membership.
The Secretary General explained
how the work of the Caucus could be
streamlined if it was converted to a
workgroup.
The Committee recommended that a
Caucus workgroup be set up and that
the Legal Advisor consider whether
the terms of service of the group
should be amended, and if so and if
approved by the Chair of Council,that
this recommendation be forwarded to
the Council.
World Medical Journal
An oral report was given by the World
Medical Journal’s Assistant Editor,
Ms. Maira Sudraba. She said that
author guidelines had been updated.
All NMAs had been invited to write
an article for the World Medical
Journal about their national activities.
She thanked those NMAs who had
replied and urged others to contact
the editorial team.
Public Relations
The Committee received a report
from the Press Officer, Mr. Nigel
Duncan. He encouraged members to
cite WMA press releases and policies
in their own press.He announced that
this would be his last meeting, after
28 years of engagement. The Chair
expressed gratitude for his many years
of dedication to the WMA.
WMA Global Healthcare Excellence
Award
A proposal for a WMA Global
Healthcare Excellence Award was
put forward by the President, Dr.
Enabulele. He said that the aim was
to create a platform for strengthening
health systems and the WMA brand,
through promotion of healthcare
excellence among physicians and
other critical stakeholders. The
objectives were to improve the
awareness and perception of the
WMA as a global brand, to motivate
physicians towards the strengthening
of health systems, and to improve
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the participation of physicians and
NMAs in the affairs of the WMA.
He suggested three categories of
awards – Global Physician of the
Year, Global Young Physician of
the Year, and Global Healthcare
Excellence Award of the Year – to
the country with the best efforts at
attaining Universal Health Coverage.
The overarching theme would be
centred around ‘Human Resource
for Health and Quality Patient Care.’
After a brief debate, the Committee
recommended that the Secretariat
should study the proposal and report
back at the next meeting with further
information and analysis of benefits,
risks, financial impacts, and possible
implementation strategies for further
discussion.
Medical Ethics Committee
The Chair of Council called the
meeting to order.
The Committee approved the report
of the previous meeting held in Berlin
on 5-8 October 2022.
Election of the Chair of the Committee
Dr. Steinunn Þórðardóttir, President
of the Icelandic Medical Association,
was elected unopposed as Chair of
the Committee.
Declaration of Helsinki
Dr. Resneck, Chair of the workgroup,
presented an update on the
workgroup’s progress and a timeline
of the revision process for the coming
months. They were six months into
what they expected to be a two-year
process. Since the last Committee
meeting, regional meetings had been
held in Israel on data collection,
and in Brazil, focusing on the use of
placebo. The next regional meetings
were scheduled for September
(Copenhagen, Denmark), November
(Tokyo,Japan),and early 2024 (South
Africa).
The Committee recommended that
the workgroup continues its work and
proceeds with the several regional
meetings.
Organ Procurement from Prisoners
The Committee considered a
proposed revision of the WMA
Declaration on Organ Donation
for Transplantation from Executed
Prisoners, submitted by a workgroup
chaired by the Spanish Medical
Association. This reiterated the
Association’s absolute opposition to
human trafficking in organs and the
use of organs from executed prisoners
for transplantation purposes. It
called on NMAs to work to ensure
that physicians in their countries
were not involved in any way in
trafficking in organs or in the removal
or transplantation of organs from
executed prisoners. The proposer
spoke of the strong determination
that the Chinese Medical Association
(CMA) had shown in trying to
combat these deplorable practices.
A letter, just received from the CMA,
was read out to the meeting.This said
thattheCMA fullysupportedChina’s
complete prohibition on the use of
organs from death penalty prisoners
for transplantation,implemented on 1
January 2015. The CMA encouraged
all her members to participate in
China’s efforts to establish a self-
sufficient organ donation system in
line with WHO guiding principles,
and condemned the practice of using
organs from executed prisoners for
transplantation.
The Secretary General, Dr. Kloiber
reminded the Committee of the
extensive discussions between the
WMA and the CMA over the past
18 years, during which the CMA said
it would support the WMA’s policy
opposing the transplantation of
organs from death penalty prisoners.
The WMA had asked the CMA to
make a clear statement to this effect
before it agreed to rescind its 2006
policy statement. He said that the
letter now received from the CMA,
fulfilled the WMA’s request, allowing
the 2006 WMA Declaration to
be rescinded and rendering the
revised Declaration proposed by the
workgroup unnecessary.
A lengthy debate followed, during
which the CMA explained what they
had done in combating the transplant
of organs from executed prisoners,but
indicated that the practice was still
going on elsewhere. Many speakers
congratulated the CMA, although
there were different views about
whether the revised Declaration was
necessary, as strong WMA policy
already existed.
The Committee voted to rescind
and archive the WMA Council
Resolution on Organ Donation in
China from 2006.
After further debate, the Spanish
Medical Association said that in
view of the new CMA letter, it would
withdraw its revised Declaration.
On a vote, the Committee agreed to
the retraction.
Medical Ethics during Public Health
Emergencies
A proposed revision of the WMA
Statement on Medical Ethics in the
Event of Disasters was submitted by
the Thailand Medical Association,
Chair of the workgroup. The revised
policy focused on the medical
ethical aspects of public health
emergencies. It was proposed that
the title be changed to Statement on
Medical Ethics during Public Health
Emergencies, and if that was adopted,
to rescind and archive the Statement
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on Medical Ethics in the Event of
Disasters.
During a brief debate, several friendly
amendments were proposed and
agreed.
The Committee recommended that
the proposed Statement be approved
and forwarded to the Council for
adoption by the General Assembly,
and that the Statement on Medical
Ethics in the Event of Disasters be
rescinded and archived.
Medical Technology
The Committee considered a
proposed revision of the Declaration
on Medical Ethics and Advanced
Medical Technology submitted
by the workgroup chaired by the
Israeli Medical Association. This
updates ethical guidelines for
physicians in their use of medical
technology. While welcoming the
growth of medical technology and
the enormous benefits it brings for
the medical profession, patients, and
society, the revised document warns
that the rapidly developing use of big
data could challenge confidentiality
and privacy.
The Committee was told that the
reasoning behind the revision was to
produce a concise document with the
principles from a number of WMA
policies on this issue.
During the debate that followed,
several editorial amendments were
accepted, and the Committee agreed
to recommend that the revised
Declaration, as amended, be sent
to the Council for approval and
forwarded to the General Assembly
for adoption.
Friday, 21 April
Resumed Medical Ethics
Committee
Biological Weapons
A proposed major revision of the
Declaration of Washington on
Biological Weapons was submitted
by the Swedish Medical Association.
This declared that scientists working
in biomedical research have a moral
and ethical obligation to consider the
implications of possible malicious use
of their findings.
After a brief debate, during which
several small amendments were
accepted, the Committee agreed
to recommend that the revision be
sent to the Council for approval and
forwarded to the General Assembly
for adoption.
Armed Conflict and Other Situations of
Violence
The Associate Members submitted
a proposed major revision of the
WMA Regulations in Times of
Armed Conflict and Other Situations
of Violence. The revised policy
condemns the military targeting of
health care facilities and personnel,
as well as using the denial of medical
services as a weapon of war, by any
party, wherever and whenever it
occurs. The Committee was told
that this was a very relevant policy.
One paragraph related precisely that
when Turkish doctors pressed their
government not to use chemical
weapons, they were jailed. Several
friendly amendments were suggested
and approved.
The Swedish Medical Association
proposed amending the sentence
that physicians ‘must not take part in
any act of hostility and to the extent
possible,refuse any illegal or unethical
order’. They proposed deleting the
words ‘to the extent possible’, arguing
that this weakened the sentence.
The BMA supported this proposal,
arguing that there should be no
exemption. On a vote, it was agreed
to delete the words.
The Committee recommended that
the revised policy, as amended, should
be forwarded to the Council for
adoption by the Assembly.
International Medical Meetings
A proposed Statement on
International Medical Meetings was
submitted by the Associate Members.
The Statement called on the medical
community worldwide to refrain
from holding international scientific
medical events or conferences in
countries where physicians are
persecuted for speaking out for human
rights or for their ethical principles,
unless by holding the event, the
medical community was able to show
support for these physicians. It was
argued that having a WMA meeting
somewhere gave a strong signal of
support to the local physicians and to
the local health system. But if it was
understood as support for authorities
which oppressed physicians, then the
WMA should refrain from having
meetings in these locations.
During a lengthy debate, speakers
supported the intention behind the
Statement,but questioned how such a
policy would be implemented. Would
an NMA be contacted in advance
of arranging a meeting? Would it
cover only physicians’ human rights
or would it include the population?
Should a list of negative countries be
drawn up?
The French Medical Association
proposed an amendment that read
‘The WMA calls on the medical
community worldwide to carefully
evaluate the suitability of holding
international medical events in
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countries where physicians are
persecuted and where appropriate
to take a decision on whether to
refrain from such events or to provide
clear and explicit support for these
physicians at such events’.
The Committee approved the
amendment and agreed that the
proposed Statement, as amended, be
sent to the Council for approval and
for adoption by the General Assembly.
Classification of Policies
TheCommitteeagreedtorecommend
that the:
• WMA Statement on the
United Nations Resolution for
a Moratorium on the Use of the
Death Penalty be reaffirmed with
a minor revision
• WMA Statement on Advance
Directives (Living Wills) be
reaffirmed with a minor revision
• WMA Resolution on Prohibition
of Physician Participation in
Capital Punishment be reaffirmed
with a minor revision
Human Rights
The Committee received the activity
report of the Council with reference
to work in the field of right to
health, actions protecting patients
and doctors and the Health Care in
Danger Initiative.
Socio-Medical Affairs Committee
The meeting was called to order
by the Chair of the Council. The
Committee approved the report of
the previous meeting held in Berlin
on 5 October 2022.
Election of the Chair Committee
In a vote for Chair of the Committee,
Dr. Zion Hagay (Israeli Medical
Association) was elected in a contest
with Dr. Alvaro Dendi (Uruguay
Medical Association).
Health and Environment
Dr. Maki Lwando, Co-Chair of
the Environment Caucus, reported
on a recent meeting of the Caucus
when delegates discussed the WMA
contribution to the 2022 UN Climate
Change Conference in Egypt, global
activities on climate and health, and
implementation and monitoring
of Green Guidelines for WMA
meetings to create more sustainable
events.
Medical Technology
The Israeli Medical Association
reported on the activities of the
workgroup since the last Council
meeting. One of its discussions was
whether to formalise networking
between NMAs. The reason for
this was that members believed that
different NMAs were in different
stages of engaging with the idea
of medical technology. Some were
heavily involved, while others were
less involved. One idea was to set
up a WMA platform to enable
and facilitate collaboration among
member associations in the area of
medical technology and to promote
exchange of best practices.
The Committee was told that the
workgroup would work on a more
detailed proposal for discussion at the
next Committee meeting.
Acknowledgement and Condemnation
of the Human Rights Violations against
the Uyghurs and other Minorities in
China
The Committee considered a
proposed Resolution from the BMA
calling on the CMA to acknowledge
the human rights violations against
the Uyghurs and other minorities in
China. The Resolution read ‘In light
of the mounting body of evidence,
including the report of 31 August
2022 from the OCHCR of medical
involvement in severe human rights
violations against the Uyghur people
and other minorities in China, the
WMA requested that the CMA
acknowledges and condemns these
violations’.
The BMA said that there was a
very high degree of agreement with
CMA, but they did not reach full
agreement. As doctors, committed
to alleviating suffering, they could
not stand by while those who
claimed to represent them acted in
a way that threatened the health and
dignity of their fellow human beings.
They were independent medical
associations, and it was their duty to
speak out when they became aware of
physicians falling below the standards
they should uphold. Silence was
complicity. The BMA had listened
to the CMA and had made major
changes to its Resolution, such as no
longer referring to genocide. They
requested that the CMA respond to
these very serious issues and speak
out against what was happening with
the Uyghurs. The BMA answered
those who asked why they were doing
this, by saying that one day, a future
historian would prepare the WMA
history, and they were afraid that
there would be documented evidence
when the WMA should have spoken
out but did not. It was the WMA’s
duty to speak out. The report from
the UN High Commissioner for
Human Rights was a detailed,
WMA Council Report
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10
well-documented analysis of the
situation. It had concluded that
serious human right violations had
been committed in the Xinjiang
Uyghur autonomous region.
Several delegates from the CMA
responded strongly, saying that there
was no evidence of genocide. They
described the accusations from the
BMA as vile and unfounded, and
based on press reports. They spoke
about China’s one child policy
introduced in 1980, which had led to
a lower birth rate, and which had now
changed. There was nothing special
about the population and births
in Xinjiang, as compared to other
parts of China. The CMA invited
other NMAs to visit China to see
for themselves what was happening.
They strongly opposed the BMA’s
resolution, and called for mutual
communication and discussion.
A lengthy debate followed, with
delegates speaking for and against the
BMA’s resolution. Several speakers
urged the BMA to withdraw its
resolution in order to create better
harmony. It was also suggested that
the WMA should visit the Xinjiang
region to find out for themselves what
was happening.
The Committee decided that a vote
on the Resolution should by secret
ballot. The Resolution was approved
for forwarding to the Council by 13
votes to 11.
Electronic Cigarettes and Other
Electronic Nicotine Delivery Systems
The Committee considered a
proposed revision of the Statement
on Electronic Cigarettes and Other
Electronic Nicotine Delivery
Systems. The major revision, under
the rule of revising all policies that
are 10 years old, calls on the WMA
and its members to support further
research on the ‘harmful effects of
e-cigarettes and electronic nicotine
delivery systems (ENDS)’, especially
in children, adolescents and young
adults.
Both the Danish and the German
Medical Associations argued that
the wording of the Statement should
be much stronger and suggested
various amendments. They suggested
including the sentence that ‘evidence
already exists that e-cigarettes and
ENDS are harmful and not safe’.
Additionally, they recommended the
addition of ‘the belief promoted by
manufacturers that these devices are
acceptable alternatives to scientifically
proven cessation techniques, when
neither their value as therapeutic
aids for smoking cessation nor their
safety as cigarette replacements is
established.’ The suggestions were
accepted as friendly amendments.
The Committee agreed that the
Statement, as amended, be approved
by the Council and forwarded to the
General Assembly for adoption.
Support of the Medical Associations in
Latin America and the Caribbean
The Committee considered a
proposed major revision of the
Resolution in Support of the Medical
Associations in Latin America and
the Caribbean. This condemns any
government actions that undermine
the policy requiring physicians
working, either permanently or
temporarily, in a country other than
their home country to be treated
fairly in relation to other physicians
in that country.
The Committee approved the revised
Resolution, as amended, for sending
to the Council to forward to the
General Assembly for adoption.
Forced Sterilisation
A proposed revision of the Statement
on Forced and Coerced Sterilisation
was introduced by the American
Medical Association. It was explained
that minor changes had been made
to the original document to make
it stronger and align it with United
Nations policy.
The Swedish Medical Association
proposed deleting the statement
advocating for appropriate
disciplinary action, including possible
licence revocation, against physicians
who participated in such practices.
They argued that the WMA did not
usually suggest disciplinary action
against physicians. This sentiment
was agreed upon.
The Committee recommended that
the proposed Statement, as amended,
be approved by the Council and
forwarded to the General Assembly
for adoption.
Human Health as a Primary Policy
Focus for Governments Worldwide
The BMA submitted a proposed
Statement on Human Health
as a Primary Policy Focus for
Governments Worldwide. This
proposal aimed to understand how
they measured health and the wealth
of nations. This resonated with the
growing focus on the well-being
economy and was an attempt to
restate what they were asking their
governments to do to promote that
progress. Much of what it stated was
in other WMA policy documents,
especially about the primacy of
the way in which Gross Domestic
Product (GDP) was used as a measure
of progress. As Robert Kennedy
said in 1963, the GDP measured
everything except that that makes life
worthwhile.The BMA proposed that
the document be recirculated within
the membership for comments.
The Committee recommended that
the document be recirculated.
WMA Council Report
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11
Primary Health Care
A proposed Statement on Primary
Health Care was introduced by
the Junior Doctors Network,
recommending ways in which primary
health care can be strengthened to
ensure adequate financial resources
and equipment provision and a
well-trained supply of primary care
physicians.
A lengthy debate followed about
the sentence which read, ‘PHC
should be provided in a manner that
is accessible, comprehensive and
coordinated by a physician to ensure
appropriate and high-quality care.’
A suggestion was made that the
sentence should be amended to read
‘ideally led by a physician’. Several
speakers questioned the word’ideally’,
as some governments favoured non
physicians as a cheaper alternative.
The Secretary General warned that
in the international sphere there
was a strong belief that primary care
physicians were unnecessary and that
such care could be provided by nurses
and others.
Arguments were made for using
the words ‘physician-led’, which did
not mean that a physician had to
be present, but that he or she was
responsible. The Committee was
warned against ‘poor medicine for
poor people’.
The Committee voted to amend the
document to read that primary health
care should be provided in a manner
that was accessible, comprehensive
‘and led by a physician’ to ensure
appropriate and high-quality care.
Anotherlengthydebatethenfollowed,
about the sentence calling for NMAs
to ‘promote that PHC services,
whenever possible and appropriate,
are provided by physician-led, multi-
professional teams with an adequate
skill-mix.’ After several suggested
amendments, it was decided to delete
the whole sentence.
The Committee voted that the
amended Statement, as whole, should
be sent to the Council for forwarding
to the General Assembly for adoption.
Medical Workforce
TheCommitteereceivedareportfrom
the workgroup, revising the WMA
Resolution on Medical Workforce
from 2009. The revised document
made a series of recommendations to
tackle the global shortage of medical
staff. The Committee was told that
the Review Committee had pointed
out that some of the sections of the
proposed revision overlapped with
existing WMA policies and needed
to be shortened to address the core
issues in a more concise way.
The Committee recommended that
the revised Resolution be circulated
within the membership for comments.
Epidemics and pandemics
The Junior Doctors Network
proposed setting up a workgroup to
to revise the WMA Statement on
Epidemics and Pandemics from 2017.
Although recognised as a strong
statement, it argued that it needed
to be strengthened in the light of the
lessons learned from the COVID-19
pandemic response.
TheCommitteeagreedtorecommend
this to Council.
Postgraduate Medical Education
The Committee considered the
(WFME) Global Standards for
Quality Improvement: Postgraduate
Medical Education 2023.
It recommended that the document
be endorsed by the Council, and that
the WMA Resolution on WFME
Global Standards for Quality
Improvement of Medical Education
be updated, accordingly.
Classification of Policies
TheCommitteeagreedtorecommend
that the:
• WMA Statement on Forensic
Investigation of the Missing
undergo a minor revision
• WMA Statement on Fungal
Disease Diagnosis and
Management undergo a minor
revision
• WMA Statement on Right of
Rehabilitation of Victims of
Torture undergo a minor revision
• WMA Resolution on Supporting
the Ottawa Convention on the
Prohibition of the use, stockpiling,
production and transfer of anti-
personnel mines and on their
destruction undergo a minor
revision
• WMA Resolution on
Collaboration Between Human
and Veterinary Medicine undergo
a minor revision
• WMA Statement on Natural
Variations of Human Sexuality
undergo a major revision and
that in the revision process, the
Statement be kept distinct from
the Statement on Transgender
People. And that a workgroup be
set up to undertake the revision of
the Statement
• WMA Statement on Human
Papillomavirus Vaccination
undergo a major revision
WMA Council Report
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12
Saturday, 22 April
Plenary Council
The Council resumed to consider
reports from the three Committees.
Medical Ethics Committee Report
The Council agreed that the
following documents be forwarded to
the General Assembly for adoption of
the:
• proposed revision of the WMA
Declaration on Medical Ethics and
Advanced Medical Technology
• proposed major revision of the
WMA Declaration of Washington
on Biological Weapons
• proposed major revision of the
WMA Regulations in Times
of Armed Conflict and Other
Situations of Violence
• proposed WMA Statement on
International Medical Meetings
• proposed WMA Statement on
Medical Ethics during Public
Health Emergencies and that the
Statement on Medical Ethics in
the Event of Disasters be rescinded
and archived
It was recommended that the
workgroup revising the Declaration
of Helsinki should continue its work.
Organ Procurement from Executed
Prisoners
The Council considered the
Committee’s recommendation that in
light of the official statement from the
CMA, the existing WMA Council
Resolution on Organ Donation in
China be rescinded and archived.
The Danish Medical Association said
that rescinding the WMA Resolution
of 2006,and withdrawing the WMA’s
criticism of the donation practice
in China was unfortunate. They
appreciated the steps taken by the
CMA, but believed that the WMA
should maintain its pressure on the
Chinese authorities to stop the use of
prisoners for organ donation and not
only against death penalty prisoners.
Theyproposedthatratherthanrescind
WMA Resolution of 2006, it should
be amended and adopted or circulated
for comment. They suggested that
the Resolution read as follows: ‘The
WMA reiterates its position that
organ donation be achieved through
the free and informed consent of the
potential donor.The WMA demands
that Chinese authorities immediately
cease any remaining practice of using
any prisoners or detainees as organ
donors’.
This was supported by the American
Medical Association who believed
that the WMA should take a strong
stand, as they continued to receive
reports of Chinese prisoners being
subjected to organ donation. They
proposed Denmark’s amended
Resolution.
The CMA opposed the Resolution.
They said there was a law in China
banning any use of organs from death
penalty prisoners or detainees. This
applied to all hospitals, including
military hospitals. There had been
no use of death penalty organs for
transplantation since 2015. The
CMA said that disinformation was
being spread, and they asked NMAs,
when they cited evidence, to confirm
basic due diligence.
The Israel Medical Association
said the simplest thing would be
for the CMA to say they were
completely against organ donation
from prisoners. The Chinese argued
that other countries allowed the
voluntary donation of organs from
detainees, and they repeated that they
were against any use of organs from
prisoners.
The Australian Medical Association
said that existing WMA policy
did leave the door slightly open for
prisoners to be able to donate, so a
complete prohibition would not be in
line with their policy.
Several speakers expressed concern
about the proposed Resolution.
Some believed that it referred to
all prisoners and not just to death
penalty prisoners, while others argued
that the issue had been resolved by
statements from the CMA.
One speaker argued that if they
were going to discuss taking organs
from any prisoners, from all of the
transplantation societies in the world,
then this was a no go. However, there
were discussions now in the United
States on prisoners donating organs
as a trade-off for a reduction of
sentence. To date, it had been refuted
from the transplantation societies.
The Germany Medical Association
said that they had to be careful not
to conflict the two documents and
contradict WMA policy. The issues
of general donations and donations
from death penalty prisoners should
be separated.
It was eventually suggested that
the proposed Resolution should be
withdrawn for further consideration.
It was argued that this was a very
complex topic, and it was suggested
that the discussion be postponed for a
short break to see if some agreement
could be found. On a vote, this was
agreed by the Council.
The Council was later told that
agreement had proved impossible and
it was agreed that the matter should
be postponed until the next meeting
in Kigali.
WMA Council Report
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13
Finance and Planning Committee
Report
The Council approved the following
items:
• pre-Audited Financial Statement
for 2022
• increase in the cap amount
for forwarding to the General
Assembly for adoption
• 229th Council Session being held
from 15-17 April 2027 and the
77th General Assembly being held
from 20-23 October 2027
• invitation from the Serbian
Medical Chamber for Belgrade,
Serbia, to host the 226th Council
Session in 2024, and the theme of
the Scientific Session of the WMA
General Assembly, Helsinki 2024
be “Inequalities in health and
health care – how to tackle them?”
• setting up of an Environment
Caucus workgroup
• WMA Secretariat study the
proposal for a WMA Global
Healthcare Excellence Award and
report back at the next meeting
with information and analysis of
benefits, risks, financial impacts,
and possible implementation
strategies for further discussion
Socio-Medical Affairs Committee
Report
The Council agreed that the
following documents be forwarded to
the General Assembly for adoption:
• the proposed revision of the WMA
Statement on Electronic Cigarettes
and other Electronic Nicotine
Delivery Systems
• the proposed revision of the WMA
Statement on Forced and Coerced
Sterilisation
Acknowledgement and Condemnation
of the Human Rights Violations against
the Uyghurs and other Minorities in
China
The Council considered the WMA
Resolution from the Committee
on Acknowledgement and
Condemnation of the Human Rights
Violations against the Uyghurs and
other Minorities in China. The
Resolution read as follows: ‘In light
of the mounting body of evidence,
including the report of 31 August
2022 from the OCHCR of medical
involvement in severe human rights
violations against the Uyghur people
and other minorities in China, the
WMA requests that the Chinese
Medical Association acknowledges
and condemns these violations’.
The BMA proposed an amendment
to the Resolution, requesting the
CMA ‘to acknowledge the concerns
set out in the report by the UN
High Commissioner for Human
Rights and comply with the 2020
WMA Resolution on Human Rights
Violations against Uyghur People in
China.’ The BMA said it would be
a problem for the WMA if it could
not request its members to uphold
established policies.
The CMA said that it was
inappropriate and unjust to rush to
a vote on this Resolution, targeting a
NMA. Full deliberation had not been
given to this issue in Committee due
to lack of time.They highlighted once
again their criticism of the BMA’s
argument, emphasising the decline of
China’s birth rate as a result of its birth
control policy. They acknowledged
the existence of the UN report, but
they did not agree or accept the
content, and they stated that there
were errors in both the BMA’s report
and the High Commissioner’s report.
A lengthy debate followed, during
which the BMA accepted an
amendment to use the word ’ask’
instead of request.
On a secret vote, the Council agreed
to the amended Resolution by 15
votes to 11:
‘In light of the mounting body of
evidence, including the report of 31
August 2022 from the OCHCR, of
medical involvement in severe human
rights violations against the Uyghur
people and other minorities in China,
the WMA asks the Chinese Medical
Association to acknowledge the concerns
set out in the report by the UN High
Commissioner for Human Rights and
comply with the 2020 WMA Resolution
on Human Rights Violations against
Uyghur People in China.’
Support of the Medical Associations in
Latin America and the Caribbean
The Council considered the proposed
revision of the Resolution in Support
of the Medical Associations in
Latin America and the Caribbean.
The Council was told by the
Spanish Medical Association that
the statement needed some textual
changesinrelationtotheaccreditation
of physicians’ training and how
that was assessed. In addition, new
evidence had been received that the
More Doctors Program, which was
located in deprived areas in Latin
America and the Caribbean to
provide doctors to support primary
health care, no longer existed.
As a result, the Council agreed to
recirculate the document.
Primary Health Care
The Committee considered the
proposed WMA Statement on
Primary Health Care. The Spanish
WMA Council Report
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14
Medical Association suggested a
friendly amendment to add to the
recommendations the sentence as
follows: ‘To promote, through PHC
a more accessible, close and humane
medicine, centred in the person, and
prioritising the needs and interest of
patients.’
The amendment was supported,
and the Council recommended that
the Statement be forwarded to the
General Assembly for adoption.
Migrants
An emergency Resolution was
introducedbytheBMA.Itarguedthat
the WMA had committed to uphold
international law and specifically
human rights law on numerous
occasions. They knew that they had
to be constantly vigilant in the face
of continued threats to the rule of
law. Since the British Government
was a signatory to the European
Convention of Human Rights,British
officials played a leading role in
drafting the Convention.Unlike many
international agreements, individuals
could take cases before the European
Court of Human Rights. Recently,
the British Government had adopted
legislation that would allow it to send
asylum seekers to Rwanda. They
would then be able to continue their
asylum applications there, but not for
asylum in the United Kingdom which
they had reached, but for asylum in
Rwanda, and they would have no
right to return. The UK Government
recently attempted to fly a small group
of these asylum seekers to Rwanda,
but the plane was stopped on the
runway by a ruling under article 39
of the Convention, which can impose
interim measures to prevent a breach
of human rights. This event had
infuriated the British Government,
which had now proposed legislation
that would allow ministers to
disregard such orders in the future. In
other words, they could send asylum
seekers to another country, and those
asylum seekers would then have a
right to take a case, although no
longer in the United Kingdom. The
special rapporteur for the UN High
Commissioner for Human Rights,
an organisation for whom the BMA
had the highest respect, had set out a
series of concerns about the Rwanda
policy and its lack of safeguards for
human rights. The BMA had spoken
out strongly about this on several
grounds, but particularly because of
the trauma it imposed on physicians
caring for these desperate people,
suffering from moral injury and
burnout as a result of the COVID-19
pandemic, and looking after people
whose rights were being overridden.
The BMA was asking the WMA
to condemn a government that was
blatantly proposing disregarding an
instrument of international law that
it had freely signed up to.
The Council agreed that this was an
emergency item, and the Resolution
was approved.
Advocacy and Communications
An oral report was received from
the Advocacy and Communications
Workgroup. The aim of the group
was to propose actions that WMA
constituent members could take
to help broaden the knowledge of
the Association and strengthen the
transmission of WMA ideas in the
medical community, the public, and
politicians. Progress was being made
to take forward this activity.
Disciplinary Matters
Dr. Montgomery, past Chair of
Council, presented a report on
the WMA’s rules for dealing with
disciplinary matters, in relation to
two issues where proposals had been
made for excluding various medical
associations – China and the Uyghur
problem, and Russia and Belarus in
relation to the Russian invasion of
Ukraine. He tabled a detailed report
from the Executive Committee that
set out the processes involved. He
spoke about the historical background
of the WMA following the Second
World War and its development as a
global consensus platform for medical
ethics.
He was supported by the Secretary
General who spoke about the
importance of being able to discuss
difficult problems without splitting
up.
The Executive Committee’s report
was received.
World Health Assembly
The Secretary General reported
on the forthcoming World Health
Assembly (WHA), mentioning
two items of concern. The first
was the continuing discussion on a
pandemic treaty, and the second was
the review of the international health
regulations,as the agreement between
states on how to interact and report
when epidemics occur.
On the pandemic treaty, the WMA
had been trying to concentrate on the
role of health personnel, because they
observed that health professionals
had suffered tremendously from the
COVID-19 pandemic through unfair
treatment and workplace stressors.
Other issues on the WHA agenda
were the extent to which health
personnel would be involved in the
global peace initiative, universal
health coverage, and the need for
more investment and support for the
health workforce.
IPPNW Presentation
A brief presentation was given by Mr.
Charles K.Johnson,Program Director
of the International Physicians for the
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15
Prevention of Nuclear War. He spoke
about the Russian invasion of Ukraine
and the threat of nuclear weapons,
as well as the consequences of any
war between India and Pakistan. To
prevent a nuclear war, he suggested
the continued participation in joint
statements and getting more nations
to join the treaty on the prohibition
of nuclear weapons. He said that
the WMA and NMAs could help
by advocating for the revision and
refreshment of the WHO study on
the effects of nuclear war on health
and health services, which was
completed in 1987.
The Council meeting ended with a
round of thanks from the Secretary
General to all those who had made
the meeting such a success.
Nigel Duncan
Public Relation Consultant
World Medical Association
nduncan@ndcommunications.co.uk
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WMA Council Report
Photo 1. Group photo of the Council Meeting in Nairobi. Credit: World Medical Association
16
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WMA COUNCIL RESOLUTION FOR AN IMMEDIATE
AND EFFECTIVE CEASEFIRE IN SUDAN AND
THE PROTECTION OF HEALTH CARE
Adopted by the 223rd WMA Council,
Nairobi, Kenya, April 2023
PREAMBLE
Since Saturday, 15 April, violent fighting has
broken out in Khartoum and several cities
of Sudan between the Sudan Armed Forces
(SAF) and Rapid Support Forces (RSF), an
independent paramilitary force.
Since the outbreak of the conflict, water,
electricity, and medicine have been in short
supply in the capital, and the humanitarian
situation is deteriorating by the day. Hospitals
are closing due to a lack of equipment and
staff who are prevented from going to work.
Medicines, oxygen bottles, and blood bags
are running out. Five facilities have been
evacuated after being riddled with bullets and
partially destroyed by rockets. Media reports
increasing numbers of civilians killed in the
fighting.
On 20-23 April, the WMA Council met
in Nairobi and condemned in the strongest
terms the outbreak of fighting in the country,
which has a devastating impact on the
healthcare system, and warns that hospitals
and healthcare facilities must never become
targets in a conflict.
RECOMMENDATIONS
The WMA Council supports the call for an
‘immediate’ and effective ceasefire in Sudan
by UN Secretary-General António Guterres
on Monday, 17 April, urging “all those with
influence over the deteriorating situation to press
for peace, and support efforts to end the violence
[and] restore order,”and calls upon all parties to
the conflict to:
• Respect the ethical principles of healthcare,
including medical neutrality, to guarantee
the safety of patients and health personnel,
and take immediate steps to ensure that
they are not targeted or affected by the
fighting, including the provision of safe
passage of healthcare workers and patients,
where evacuation is required;
• Ensure that hospitals and healthcare
facilities have adequate supplies and
staffing to provide care to those in need
and facilitate humanitarian aid.
WMA COUNCIL RESOLUTIONS
WMA COUNCIL RESOLUTION ON PROPOSED
LEGISLATION IN UK ON THE TREATMENT OF
MIGRANTS DISREGARDING THE INJUNCTION
INTERIM MEASURES RULE 39 OF ECHR
Adopted by the 223rd WMA Council,
Nairobi, Kenya, April 2023
The WMA expresses its grave concern
about reports that the United Kingdom
(UK) government has proposed legislation
that would allow ministers to disregard the
injunction interim measures issued by the
European Court of Human Rights (ECHR)
under Rule 39 of the rules of the court in
relation to the treatment of migrants. The
WMA is committed to the principle of
respect for international law. If enacted,
this legislation would remove an important
protection for people seeking asylum, other
migrants, and those health workers caring for
them.
Rule 39 interim measures have prevented the
forced removal of asylum seekers from the UK
to Rwanda, under a controversial offshoring
scheme that the UK medical community
has condemned on medical, ethical, and
humanitarian grounds.
Human Rights are only meaningful and
effective if they are applied equally to everyone.
Given the key role of the UK in drafting the
European Convention on Human Rights,
this creates a dangerous precedent that other
nations might seek to follow.
17
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WMA COUNCIL RESOLUTION ON ANTI-
LGBTQ LEGISLATION IN UGANDA
Adopted by the 223rd WMA Council,
Nairobi, Kenya, April 2023
PREAMBLE
The WMA Council is gravely concerned
about the “Anti-Homosexuality Bill,” which
makes certain homosexual acts punishable
by death, that was passed in the Ugandan
Parliament on 21 March 2023. The WMA
originally condemned the bill in a press release
issued on 24 March 2023.
The Ugandan bill would criminalize certain
homosexual acts and make them punishable
by death or life imprisonment. As stated in
the WMA Statement on Natural Variations of
Human Sexuality, “The WMA condemns all
forms of stigmatisation, criminalisation and
discrimination of people based on their sexual
orientation.” Further, “Homosexuality is a
natural variation within the range of human
sexuality”and “Discrimination,stigmatisation,
peer rejection and bullying continue to have
a serious impact upon the psychological and
physical health of people with homosexual
orientations.”
The Ugandan bill would also criminalize an
individual who “holds out” as transgender or
queer. As confirmed in the WMA Statement
onTransgenderPeople,“TheWMAcondemns
all forms of discrimination, stigmatisation and
violence against transgender people and calls
for appropriate legal measures to protect their
equal civil rights.”
RECOMMENDATIONS
Therefore, the WMA Council, reaffirming its
statements on Natural Variations of Human
Sexuality and on Transgender People, calls on:
1. Ugandan President Yoweri Museveni to
veto the Anti-Homosexuality Bill and
prevent it from becoming law;
2. WMA Constituent members to condemn
the proposed Ugandan bill and any similar
legislation that is proposed or enacted.
WMA COUNCIL RESOLUTIONS
18
‘One Medicine−One Health’: An Historic Perspective
‘One Medicine−One Health’: An Historic Perspective
BACK TO CONTENTS
Bruce Kaplan
Laura H. Kahn
Thomas P. Monath
Lisa A. Conti
Thomas M. Yuill
Helena J. Chapman
Craig N. Carter
Becky Barrentine
Richard Seifman
Adapted with permission from the One
Health Initiative [1]
As we reflect upon the array of global
healthchallengesthataffectmorbidity
and mortality rates, we recognize
the need to better understand the
determinants of health that influence
health outcomes. The One Health
concept offers a holistic perspective
of the interconnectedness between
human, animal, and environmental
health [2] (Figure 1). In short,
One Health is defined by the One
Health High Level Expert Panel
(OHHLEP), supported by the World
Health Organization (WHO), Food
and Agriculture Organization (FAO),
World Organisation for Animal
Health (OIE), and the United
Nations Environment Programme
(UNEP) [2]:
Jack P. Woodall
19
BACK TO CONTENTS
“One Health is an integrated, unifying
approach that aims to sustainably
balance and optimize the health of
people, animals and ecosystems.
It recognizes the health of humans,
domestic and wild animals, plants,
and the wider environment (including
ecosystems) are closely linked and
inter-dependent.
The approach mobilizes multiple
sectors, disciplines and communities
at varying levels of society to work
together to foster well-being and
tackle threats to health and ecosystems,
while addressing the collective need for
clean water, energy and air, safe and
nutritious food, taking action on climate
change, and contributing to sustainable
development.”
The One Health implementation’s
raison d’etre is to significantly help
protect and save untold millions
of lives in our current and future
generations. The One Health Joint
Plan of Action (‎2022‒2026), which
was published by the Quadripartite
Organizations (WHO, FAO, OIE,
UNEP) in October 2022, offers
specific guidance on how to support
the One Health concept in practice
and strengthen resilience of local,
national, and global health systems
[3]. In this article, authors will offer
a historical review of One Health,
where they will describe the main
scientific leaders – from human,
animal, and environmental health
sciences – who propelled the One
Health movement since the 1880s to
present day.
Before the Modern “One Health”
Era
Two main scientists led efforts to
expand the connections between
human and animal medicine. First,
Dr. Rudolf Virchow is recognised as
the father of cellular pathology. He
noted that disease transmission was
possible from animals to humans
and subsequently coined the term
“zoonosis”. He stated that “Between
animal and human medicine there
are no dividing lines–nor should
there be. The object is different but the
experience obtained constitutes the
basis of all medicine” [4]. Second, Dr.
William Osler is known as the father
of modern medicine and founder of
veterinary pathology [5]. By 1884,
Dr.Osler had made significant strides
in medical and veterinary sciences,
academic teaching, and laboratory
sciences.
Origin of the Present Day’s “One
Health” Concept
Two leading 20th century national
and international veterinarian leaders
paved the way as influential synergistic
One Health champions. Dr. James
H. Steele, who is recognised as the
Father of Veterinary Public Health,
was founder of the U.S. Centers for
Disease Control and Prevention
(CDC)’s Veterinary division in 1947
[6]. This division advocated for One
Health principles, zoonotic disease
management, and other prioritised
global health endeavours. Dr. Calvin
W. Schwabe, who is recognised as the
Father of Veterinary Epidemiology,
had monumental intellectual
contributions, including coining the
“One Medicine” term [7].
On 24 July 2007, Dr. Steele
wrote a note to the author saying,
“Congratulations. You have moved OH
[One Health] to a higher level with your
[OHI team] campaign, One World, One
Medicine, One Health.” Deliberately,
Dr.Steele routinely included the term
One Medicine prior to One Health,in
oral communications with the author,
during the late 20th and early 21st
centuries. As a former OHI Advisory
Board member, Dr. Steele followed
Dr.Schwabe’s One Medicine concept,
and helped usher in the historically
modern-day One Health movement.
These steps subsequently eventually
led to the American Veterinary
Medical Association (AVMA) and
American Medical Association
(AMA), together adopting and
highlighting the 21st century’s most
significant One Health forefront.
In the One Health vanguard, many
luminous One Health leaders
emerged, including physicians, and
highlights the ‘lest we forget’ phrase
about other physician and veterinarian
historic One Medicine-One Health
Figure 1. Definition of the One Health concept [2].
‘One Medicine−One Health’: An Historic Perspective
20
pioneers [8,9]. Early appreciation
and acknowledgment of comparative
medicine and translational research
[10] – now recognised in the One
Health umbrella (Figure 2) – was
presciently discussed in Dr.Schwabe’s
book, Cattle, Priests, and Progress in
Medicine, which was published in
1978. This book was an expansion
of the 1977 fourth series of Spink
Lectures in Comparative Medicine,
especially the fourth volume of
the Wesley W. Spink Lectures
on Comparative Medicine that
highlighted Dr. Spink’s work as a
physician who “maintained a deep
interest in comparative medicine for
almost forty years…” [11], as stated:
“…The author [Dr. Schwabe] shows
that over the centuries many of the most
significant breakthroughs in improving
humanhealthhavebeencloselyassociated
with observations and experiments on
animals other than man. Because human
medical progress has been so dependent
on veterinary studies, he urges that
schools of veterinary medicine assume
a much greater role in the training of
persons for research in human medicine.
To illuminate the historical link between
animals and man in medical progress,
Professor Schwabe recounts highlights in
thehistoryofmedicinefromancienttimes
onward. He describes the early history
of man in terms of animal cultures,
focusing on the prehistoric Nile Valley,
and points to similarities in medical
knowledge between present-day “cattle”
societies in Northeastern Africa and the
ancient people of the Nile. He discusses
the comparative healers of ancient
Egypt, the comparative foundations of
Greek medicine, the Arabic contribution,
Sicily and the beginnings of modern
medicine, and subsequent developments
through the Renaissance. Bringing
the history down to modern times,
Professor Schwabe emphasizes the
role of veterinary medicine in medical
research. He outlines specific reforms
in the curricula of schools and colleges
of veterinary medicine which would
provide for the education of medical
investigators.”
The 21st century physician trailblazer,
instrumental in establishing the
modern One Health movement,
was the late Dr. Ronald M. Davis,
who was the former president of
the American Medical Association
(AMA) and former director of the
Henry Ford Health System’s Center
for Health Promotion and Disease
Prevention [12].A visionary physician
One Health leader, Dr. Davis adroitly
guided the passage of the landmark
AMA One Health resolution that
has propelled further into the 21st
century “One Health” movement
lexicon.
On 3 July 2007, Dr. Davis and the
AMA shared a message with the
OHI team: “I’m delighted that the
AMA House of Delegates has approved
a resolution calling for increased
collaboration between the human and
veterinary medical communities and
I look forward to seeing a stronger
partnership between physicians and
veterinarians. Emerging infectious
diseases, with the threats of cross-species
transmission and pandemics, represent
one of many reasons why the human
and veterinary medical professions
must work more closely together.” Dr.
Davis’ prophetic coalition with Dr.
Roger Mahr, the former president
of the American Veterinary Medical
Association, signaled the re-
emergence of the human medical
profession’s participation in the
rekindling of a One Health surge
for the betterment of humankind,
animals, and the environment.
In 2006, Dr. Laura Kahn, a physician
and policy researcher at Princeton
University, published Confronting
Zoonoses, Linking Human and
Veterinary Medicine in the Emerging
Infectious Diseases journal [13].
Dr. Bruce Kaplan, a veterinarian,
contacted her to discuss the
implications of the article. Their
conversations led them to co-found
the One Health Initiative, a pro bono
Figure 2. One Health umbrella (Credit: https://onehealthinitiative.com/the-one-health-umbrella/)
‘One Medicine−One Health’: An Historic Perspective
BACK TO CONTENTS
21
group of individuals dedicated to
promoting the One Health concept.
Dr. Kahn has served as a columnist
with the Bulletin of the Atomic
Scientists (https://thebulletin.org/
biography/laura-h-kahn/) and has
authored several books, including
Who’s in Charge? Leadership During
Epidemics, Bioterror Attacks, and
Other Public Health Crises and One
Health and the Politics of Antimicrobial
Resistance [14,15]. She has also
created a free, online Coursera course
entitled, Bats, Ducks, and Pandemics:
An Introduction to One Health
Policy (https://www.coursera.org/
learn/onehealth). Currently, she is
working on her next book using the
One Health concept as a framework
to examine coronaviruses.
Important “One Health” 21st
Century Events
The AMA One Health resolution
was originally drafted by Dr. Kahn,
with guidance by Dr. Davis, and
contributions by Dr. Kaplan and
Dr. Thomas P. Monath. Dr. Davis,
Dr. Mahr, and Dr. Kahn testified at
the AMA convention in Chicago,
urging the organisation to support
the resolution. After the AMA
unanimously passed the resolution,
Dr. Davis and Dr. Mahr led the
historic One Health liaison between
the AVMA and the AMA. In
response, the AVMA passed a One
Health resolution concomitant with
the AMA House of Delegates annual
meeting on 24 June 2007.
One highly influential on the world
scene was the 2012 World Medical
Association (WMA) and World
Veterinary Association (WVA) One
Health statement published in 2012
[16]. Dr. Cecil B. Wilson (https://
www.wma.net/blog-author/cecil-
b-wilson/), who was the WMA
president at the time and AMA past
president, led this Memorandum of
Understanding, together with the
current and past WVA presidents, in
October 2012.
In November 2012, the American
Association of Public Health
Physicians (AAPHP) (https://www.
aaphp.org/OneHealth/) became
a supporter of OHI and the One
Health concept/approach. Dr.
Virginia “Ginny” Dato, who served
as AAPHP president and Dr. Dave
Cundiff who was the AAPHP’s AMA
representative, strongly endorsed One
Health.Thislentconsiderableimpetus
to the validity of implementing and
institutionalising the One Health
approach for efficaciously expediting
national and global public health
and clinical research endeavours. Dr.
Wilson and Dr. Dato are members of
the OHI Advisory Board (Hon.).
The World Bank recognised the One
Health concept, noting that, “Public
health systems have critical and clear
relevance to the World Bank’s twin goals
of poverty eradication and boosting
shared prosperity. …” [17]. Detailed
documentation and evaluation
guidelines helped established an
essential financial underpinning and
support for the One Health concept
[18-19].
In August 2022, Dr. Kahn, co-
founding physician member of the
OHI team, collaborated with the
OHI team’s prolific new member
associate and eloquent wordsmith.
Together with Mr. Richard Seifman,
former World Bank Senior Health
Advisor (https://onehealthinitiative.
com/former-senior-health-adviser-
at-the-world-bank-joins-one-health-
initiative-team/), they published a far
reaching proposal with, expressing
the vision that “A new World Bank/
WHO Fund could treat prevention as a
priority and for which the One Health
interdisciplinary approach is critical”
[20].
An important One Health
concept is the development of
disease countermeasures through
coordinated efforts of veterinary and
human medicine, that benefit both
animals and humans. Examples of
specific products that address diseases
common to both include vaccines for
prevention of rabies in racoons, foxes,
dogs,cats and humans,and ivermectin
for prevention of heartworm and
other parasites of animals and of
onchocerciasis (river blindness) in
humans. Other examples are vaccines
in development against West Nile
virus disease in horses and humans;
against coccidioidomycosis in dogs
and people; and against Lyme disease
in dogs, wild rodent reservoir hosts
and humans. Vaccination of animals
plays a potentially expanding role in
the prevention of zoonotic diseases
affecting humans [21-24].
In 2018, Dr. Fauci notified the
OHI team that he recognised and
endorsed the One Health concept
(https://onehealthinitiative.com/
again-follow-dr-faucis-lead/).
Important “One Health” 21st
Century Leaders
Three visionaries – Dr. Schwabe, Dr.
Steele, and Dr. Davis – were arguably
the historic titans of the expanded and
dynamic One Health era in today’s
21st century. Other health scientists
have helped propel the One Health
movement over the next years.
Dr. Roger Mahr [25] and Dr.
Lonnie King (https://vet.osu.edu/
deanking), select members of the
2008 AVMA One Health Task Force,
and European and Asian leaders
contributed immensely during the
21st century.These countries included
Australia, Canada (https://onehealth.
uoguelph.ca/), China, Greece, India,
Japan, Portugal (https://onehealth.
icbas.up.pt/en/), South America,
Sweden, Switzerland, and the United
Kingdom [26-35]. A promising
‘One Medicine−One Health’: An Historic Perspective
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22
newcomer to the world’s One Health
scene is Africa [36].
Since 2010, the One Health
Commission (OHC) (https://
www.onehealthcommission.org/en/
leadership__board_of_directors/)
and One Health Platform (OHP)
leaders have staunchly helped
elevate and propel the One Health
movement in the United States and
worldwide. Since 2013, Dr. Cheryl
M. Stroud has served as OHC
executive director and developed a
comprehensive educational website
(https://www.onehealthcommission.
org/), and together with the OHI
and OHP, initiated the popular
One Health Day concept (https://
onehealthday.com/). During the last
two decades, EcoHealth Alliance
(https://www.ecohealthalliance.org/
senior-leadership) leaders of a major
environmental and wildlife silo have
given One Health impetus.
The One Health for One Planet
Education Initiative (1 HOPE)
has been indefatigably led by
Dr. George Lueddeke (https://
onehealthinitiative.com/wp-content/
uploads/2022/08/22.08.2022-pdf-
1-HOPE-Updated-Regional-
Consortia-1.pdf). Dr. Lueddeke’s
publications have included Survival:
One Health, One Planet, One Future
(Routledge Studies in Sustainability),
Planet Earth: Averting a Point of No
Return?, and a three-part Reflections
on the Transformation of Higher
Education in the 21st Century
[37-39].
Another remarkable trailblazer
physician One Health contributor
has been and is Dr. Gregory Gray.
Among many extraordinary One
Health accomplishments, including
the Duke One Health Newsletter
(https://onehealthinitiative.com/
duke-one-health-newsletter/),
Dr. Gray had established the first
doctoral degree with a concentration
in One Health (https://egh.phhp.
ufl.edu/education/degree-programs/
phd-in-one-health/), while directing
the University of Florida’s One
Health program (https://onehealth.
ifas.ufl.edu/). Dr. Gray recently left
Duke University and launched an
extraordinary One Health Program
at the University of Texas Medical
Branch (UTMB) at Galveston, Texas
(United States) (https://www.utmb.
edu/one-health).
The landmark textbook, Human-
Animal Medicine: Clinical Approaches
to Zoonoses, Toxicants, and Other
Shared Health Risks (2010), was
prepared by Dr. Peter Rabinowitz
(https://deohs.washington.edu/
faculty/peter-rabinowitz) and the
late Dr. Lisa A. Conti [40]. This
physician-veterinarian collaboration
set a high bar in the scheme of
One Health textbook publications.
Other important textbook
contributions followed (https://
www.onehealthcommission.org/en/
resources__services/one_health_
library/books/), including excellent
international educational endeavours
of 1 HOPE and One Health Lessons
(https://onehealthlessons.org/).
One major physician One Health
leader, Dr. Monath, an internationally
recognisedvirologistandvaccinologist
[41], co-founder of the OHI team,
and AVMA taskforce member,voiced
a suggestion to members of the new
OHI team alliance (2007) regarding
the value of instituting a unique
DVM (VMD)/MD (DO) degree
program. There are many examples
of where various individuals have
attained both degrees and went on to
become exceptionally prominent and
productive international health care
participants.
One such dual degree professional is
Dr. Steven W. Atwood, who practises
veterinary medicine at Animal Health
Care Associates in West Tisbury,
Massachusetts (United States). Dr.
Atwood,an avid One Health advocate
(https://onehealthinitiative.com/
portrait-of-a-dedicated-u-s-one-
health-leader/), co-authored a paper
discussing Dr. Monath’s suggestion
of combining medical and veterinary
medicine programs [42]. This article
was revised and reprinted in the One
Health & Implementation Research
journal.Also,one renowned physician
is Dr. Gary S. Roubin, who served as
an interventional cardiologist, with
the Cardiovascular Associates of the
Southeast Birmingham in Alabama,
endorsed the One Health concept
[43].
A strong longstanding One Health
advocate, Dr. Myron “Mike” G.
Schultz, a trained veterinarian
and physician, detected a cluster
of pneumonia cases in the early
1980s, which helped public health
officials identify the acquired
immunodeficiency syndrome (AIDS)
epidemic [44]. As an infectious
disease epidemiologist with the
U.S. CDC, Dr. Schultz created the
Parasitic Diseases Drug Service to
provide physicians with medicines
to treat rare illnesses, including
pentamidine. Prescribed for patients
with African sleeping sickness, it was
also made available to treat patients
with pneumocystis pneumonia in the
early years of the AIDS epidemic,
when few alternatives were available.
He published more than 110 papers
and book chapters, including
epidemiology and the history of
medicine, in the New England Journal
of Medicine, the Journal of the American
Medical Association, the American
Journal of Tropical Medicine &
Hygiene, and the Emerging Infectious
Diseases journal. He also served as
an epidemiology consultant to the
WHO, the Pan American Health
Organization, and the Ministries of
Health of the Egypt,Federal Republic
of Germany, Haiti, Indonesia, Israel,
Poland, People’s Republic of China,
‘One Medicine−One Health’: An Historic Perspective
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23
Republic of China (Taiwan),Republic
of South Vietnam, Saudi Arabia, and
Zimbabwe.
An excerpt of his career path was
shared in the Emerging Infectious
Diseases journal: “…With DVM and
MD degrees in hand, Mike interned
at the US Public Health Service
Hospital (Boston, MA, USA). This
internship led to his recruitment by
Alexander D. Langmuir (1910–1993)
and a transformative 2-year stint in
Langmuir’s Atlanta-based Epidemic
Intelligence Service (EIS) training
program at the (then-named) Center
for Disease Control (CDC). Mike’s
EIS experiences included a 1964
deployment to Vietnam to investigate
infectious disease threats in the war and
an important friendship with James
Harlan Steele, DVM (1913–2013), the
renowned veterinary epidemiologist/
epizootiologist whose leadership helped
to formulate their shared concept of
“One Health”—the idea that humans,
animals, and the environment are
all part of an intertwined ecosystem
with respect to disease occurrence and
microbial evolution—and to shape
the conceptualization of emerging
infectious diseases…” [44]. His
biography continues to inspire future
generations in veterinary medicine
and environmental health sciences
[44]. In July 2018, Dr. Schultz was
posthumously awarded the American
Veterinary Epidemiology Society’s
(AVES) (https://www.avesociety.
org/) coveted Gold Headed Cane
award.
The One Medicine-One Health
extensive 20th century dissertations
and public speaking engagements
– inspired by Dr. Schwabe’s and Dr.
Steele’s work – examined disease
transmission among humans,
domestic animals, and wildlife.
This was reaffirmed and expanded
upon in 2004, with the organisation
of the One World, One Health
conference in New York (http://www.
oneworldonehealth.org/sept2004/
owoh_sept04.html), which aimed to
explore how to best combat health
threats to humans and animals
from disease transmissions, using
a One Health approach. This was
widely documented well before the
21st century surge in awareness and
recognition, with various quests for
exclusive provincial nomenclature
credit and tribalism.
Indeed, the author personally
recalls telephone conversations
in the 1990s, wherein Dr. Steele
expressed the phrase, “One World-
One Medicine-One Health”, in the
context of discussing Dr. Schwabe’s
contribution to One Health origins
[45]: “…I met and spent part of a
morning and lunch with Dr. Schwabe
at the home of one of his close friend(s)
[a leading New Jersey Department of
Health]—public health authority in
Princeton, N.J. (USA), Oscar Sussman,
DVM, MPH, JD…in the early
1960s…” (https://onehealthinitiative.
com/20th-century-public-health-
leader-and-unheralded-early-
one-health-practitioner-dies).
Memorably, veterinarian Dr.
Sussman and his arbovirus research
physician collaborator, then New
Jersey’s laboratory director Dr.
Martin Goldfield, helped inspire this
author and contributor to further
appreciate the potent influence a One
Medicine-One Health approach (i.e.
transdisciplinary paradigm offered
to ‘grease the skids’ for advancing
society’s health care strategic
management).
A foundational public health
physician and One Health leader,
Dr. D. A. Henderson, professor of
medicine and public health at the
University of Pittsburgh, collaborated
extensively with Dr. Steele. He is the
late legendary leader of the worldwide
smallpox eradication program. On 22
April 2007, he commented to the
OHI team: “I thank you for your email
and congratulate you and your colleagues
in promoting the “One Medicine”
concept. It is an initiative that is long
overdue but, at the same time, I don’t
personally identify dramatic solutions
that are apt to change the landscape in
the short term. I would note that when
one has had the good fortune to have
enjoyed the tutelage of Jim Steele during
my tenure at CDC and periodically
ever since, as a friend, the one medicine
concept becomes well engrained. Indeed,
when I came to Hopkins as Dean in
1977, I cast about to determine how we
might link up with a veterinary school
for research and educational purposes.
Unfortunately, geography was simply
too great a hurdle to overcome. Bottom
line: I would be more than happy to
do whatever I could in support of your
efforts” (https://onehealthinitiative.
com/endorsements/).
There were abundant descriptive
publications and lectures from both
iconic leaders, Dr. Steele and Dr.
Schwabe, cogently and powerfully
voicing the One Medicine-One
Health concept during the latter
half of the 20th century. Dr. Steele
continued promoting One Health
activities for 13 years into the 21st
century, which were documented in
his biography [46-48].
The essence of how Dr. Steele and
Dr. Schwabe influenced the One
Health movement was captured by
Dr. King, Chair of the AVMA One
Health Initiative Task Force, in his
special report [49]. Dr. King was
recognised as a living “giant” in the
One Health movement, as the then
director of CDC National Center
for Zoonotic, Vectorborne, and
Enteric Diseases (https://www.cdc.
gov/ncezid/index.html) and member
of the AVES Board of Directors. In
2009,he proposed and established the
CDC One Health Office (https://
‘One Medicine−One Health’: An Historic Perspective
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24
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www.cdc.gov/onehealth/index.
html). Currently, Dr. Casey Barton
Behravesh is the director of the CDC
One Health Office.
The author suggests that readers
review the History of the One
Health Initiative CDC’s One Health
Resource Library, which offers
comprehensive websites including the
historic One Health chronicle [50-
51]. More than ample generational
evidence exists to literally scream out,
“Why was this One Health modality
not widely implemented much
earlier? While exponentially
expanded on the world stage today,
why is it still not ramrodded above and
beyond its current status?! Additional
resources can be found in the Impakter
Magazine collection of One Health
articles (https://impakter.com/
tag/one-health/), including a brief
analysis on innovative applications
of artificial intelligence for the future
[52].
Conclusion
As we join forces in the One Health
movement, we appreciate the
complementary poetic words by two
authors. Lewis Carroll wrote the
“Walrus and the Carpenter” poem,
where he highlighted the urgency
of the moment: ‘“The time has
come,” the Walrus said” [53]. Edwin
Milliken published the “Finest Hour
131, Summer 2006” poem, where
he reflected on a train wreck and
individual responsibility: “Who is in
charge of the clattering train?” [54].
Adapting these poetic references to
the One Health concept, we must act
promptly, take responsibility for our
actions,and promote transdisciplinary
collaborations to develop innovative
solutions to complex global health
challenges.
Hence, to the crewmen of the world’s
political and health establishments’
powers-that-be, WAKE UP!
Acknowledgments: The authors
would like to thank Ms. Claude
Forthomme (https://impakter.
com/team/claude-forthomme/),
who serves as Senior Editor and
Columnist of Impakter Magazine and
member of the One Health Advisory
Board (Hon.), who helped inspire
and nurture this One Health article
and those published in the Impakter
Magazine.
References
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CB, Bilivogui P, Bukachi
SA, et al. One Health: a new
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31. Pettan-Brewer C, Martins AF,
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BACK TO CONTENTS
51. US Centers for Disease Control
and Prevention. One Health
history [Internet]. 2022 [cited
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basics/history/index.html
52. Seifman R. How artificial
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[cited 2023 Mar 5]. Available
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53. Carroll L. The walrus and the
carpenter [Internet]. n.d. [cited
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56d222cbc80a9)
54. Milliken EJ. Finest Hour 131,
Summer 2006 [Internet]. 2015
[cited 2023 Mar 5]. Available
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org/publications/finest-hour/
f i n e s t – h o u r – 1 3 1 / p o e m s –
churchill-loved-the-clattering-
train/
Authors of the One Health
Initiative Autonomous
pro bono Team
Bruce Kaplan, DVM
Contents Manager/Editor, One
Health Initiative website
Co-Founder, One Health
Initiative team/website
Sarasota, Florida, United States
bruce@kaplandvm.com
Laura H. Kahn, MD,
MPH, MPP, FACP
Co-Founder, One Health
Initiative team
Former Research Scholar, Program on
Science and Global Security, Princeton
School of Public and International
Affairs, Princeton University
Bethesda, Maryland, United States
lkahn@alumni.princeton.edu
Thomas P. Monath, MD
Co-Founder, One Health
Initiative team/website
Managing Partner &
Chief Scientific Officer
Crozet BioPharma LLC
Lexington, Massachusetts,
United States
tom.monath@crozetbiopharma.com
Lisa A. Conti, DVM, MPH*
*Deceased 6 November 2020
Read about Dr. Lisa A. Conti https://
onehealthinitiative.com/prominent-
one-health-initiative-team-member-
and-public-health-leader-dies-at-57/
Thomas M. Yuill, PhD
Professor Emeritus, Pathobiological
Science, Forest and Wildlife Ecology
Director Emeritus, Nelson Institute
of Environmental Studies School
of Veterinary Medicine
University of Wisconsin-Madison
Madison, Wisconsin, United States
thomas.yuill@wisc.edu
Helena J. Chapman, MD, MPH, PhD
Milken Institute School
of Public Health,
George Washington University
Washington, DC, United States
hjchapman@gwu.edu
Craig N. Carter, DVM, PhD
Department of Veterinary
Science, College of Agriculture,
Food & the Environment
College of Public Health
University of Kentucky
Lexington, Kentucky, United States
craig.carter@uky.edu
Becky Barrentine, MBA
Partner, Head of Business
Operations & Communication,
Crozet BioPharma
Lexington, Massachusetts,
United States
becky.barrentine@crozetbiopharma.com
Richard Seifman, JD, MBA
World Bank Senior Health
Advisor (retired)
Washington, DC, United States
seifmanrichard@gmail.com
Jack P. Woodall, PhD*
*Deceased 2016
Read about Dr. Jack P. Woodall:
https://www.archive.
onehealthinitiative.com/news.ph
p?query=Extraordinary+Scientis
t%2C+Admired+One+Health+Su
pporter-Activist-Leader+Dies
‘One Medicine−One Health’: An Historic Perspective
28
WMA Members Share Perspectives about World No Tobacco Day 2023
According to the World Health
Organization (WHO), tobacco use
is attributed to more than 8 million
annual deaths, with 7 million due
to direct exposure and 1.2 million
due to indirect (or second-hand)
exposure [1]. With an estimated 1.3
billion tobacco users across the world,
more than 80% reside in low- and
middle-income countries [1]. Over
the past two decades, the global
prevalence trends of tobacco use
in adults (15 years and older) have
declined – 33.3% in 2000, 27.3%
in 2010, and 22.8% in 2020 – with
significant reductions in adult males
(50.0% 2000 to 37.5% in 2020) and
females (16.7% in 2000 to 8.0% in
2020) and across the Americas [2].
However, not all countries in a given
WHO region have reported similar
declines in prevalence trends. Hence,
although these global prevalence rates
are expected to decrease even more
by 2025, strict adherence to tobacco
control policies will be fundamental
to decrease prevalence rates of all
forms of tobacco use and ultimately
mitigate risk across all communities.
Each year, World No Tobacco Day
(WNTD) (https://www.who.int/
campaigns/world-no-tobacco-
day/2023) is commemorated on May
31, where the global community
aims to increase awareness about the
tobacco epidemic and its harmful
effects on health and well-being. The
WHO supports this international
health day, as an opportunity to
showcase historical, current, and
future efforts to combat the global
tobacco epidemic. First, the WHO
Framework Convention on Tobacco
Control (FCTC) (https://fctc.who.
int/who-fctc/overview) was adopted
in 2003, allowing WHO Member
States and participating countries to
promote tobacco control policies and
initiatives[1].Second,theMPOWER
– Monitor tobacco use and prevention
policies; Protect people from tobacco
use; Offer help to quit tobacco use;
Warn about the dangers of tobacco;
Enforce bans on tobacco advertising,
promotion, and sponsorship; Raise
taxes on tobacco – was established in
2007, which provided on-the-ground
opportunities to scale up activities
of the WHO FCTC [1]. Third, the
UN Sustainable Development Goal 3
(Ensure healthy lives and promote well-
beingforallatallages) highlights target
3.a (Strengthen the implementation
of the WHO Framework Convention
on Tobacco Control in all countries,
as appropriate) [2]. These efforts
support national health systems
and the health workforce, as they
organise educational initiatives that
highlight the risks of tobacco use
and emergence of new nicotine and
tobacco products as well as develop
relevant policies that regulate tobacco
production, commercialization, and
sales to protect population health.
Credit:
Attasit
saentep
/
shutterstock.com
WMA Members Share Perspectives
about World No Tobacco Day 2023
BACK TO CONTENTS
29
The WNTD 2023 theme entitled,
“Grow food, not tobacco”, offers
a unique perspective of the lives
of tobacco farmers, including
intense physical labor and risk of
pesticide exposure, stressors related
to the effects of climate change and
contracts with tobacco industries, and
economic sustainability. With over
124 tobacco-cultivating countries,
the WHO has presented examples
of tobacco farmers who have rotated
diverse crops (e.g. beans, cashews)
for increased economic benefit and
support for agricultural production
and food security [3,4]. In this
article, physicians from 16 countries –
Argentina, Australia, Brazil, Chinese
Medical Association, Dominican
Republic, India, Kenya, Nigeria,
Portugal, Spain, Taiwan, Thailand,
Trinidad and Tobago, Turkey,
United States, and Uruguay – shared
meaningful reflections about WNTD
activities and germane national
policies that support tobacco control
across their countries.
Argentina
In Argentina, the third-leading
tobacco growing country in the
Americas, tobacco use is a significant
health challenge in Argentina [4].
Since the 1970s, the tobacco industry
has greatly influenced policymaking
related to tobacco control, which has
effectively slowed national efforts to
reduce the prevalence of tobacco use
in the populace [5].Over the past two
decades, the prevalence rate of adult
smokers has decreased from 34%
(39.6% in males, 28.4% in females)
in 2000 to 24.5% (29.4% in males,
19.6% in females) in 2020 [6]. Health
leaders have reported that tobacco
smoking causes 123 deaths each day
across the nation – recognised as 14%
of the mortality burden – and that
the annual health care expenditure
associated with tobacco use across
Argentine hospitals is estimated at
nearly Arg $200,000 million pesos
(equivalent of US $846,000) [6].
With a national population of 45
million residents, the government
of Argentina and health leaders
recognize that the prevalence rate of
tobacco users remains high, and they
continue to strive toward improved
tobacco control. In 2004, the
Ministry of Health developed a toll-
free number (0800-999-3040), where
trained personnel helped tobacco
users reduce their smoking habits
with the overall goal to quit smoking
[7]. In 2011, the federal government
approved the Law for the Regulation
of the Publicity, Promotion, and Use of
Tobacco Products (Ley de Regulación de
la Publicidad, Promoción y Consumo
de Productos Elaborados con Tabaco,
N° 26687), which prohibited the sale
and distribution of tobacco products
to minors [8]. In 2016, the Executive
Branch of Argentina approved Decree
626, which raised domestic cigarette
taxes by 15% (60 to 75%), which
directly impacted tobacco costs [9].
Currently,Argentina adopted,but has
not ratified, the WHO FCTC [5].
As physicians of the Confederación
Médica de la República Argentina
(COMRA), we believe that health
professionals, representing diverse
medical specialties,have a fundamental
roleinthepromotionandpreventionof
risk factors associated with tobacco use.
We can refine our health counseling
with our patients and families, by
tailoring the public health message
about the harmful effects of direct
and secondhand smoke exposure and
encouraging them to select tobacco-
free lives. We can continue our
advocacy efforts to develop relevant
and timely tobacco control policies to
support the health system and guide
health professionals in their clinical
and public health duties. Finally, we
can support legislature that aims to
increase restrictions for individuals
working in tobacco production,
distribution, and sales, and hence
promote a tobacco-free nation and
world.
Australia
WNTD prompts Australian doctors
to reflect on how far we have come,
and how much further we need to go
in tobacco control. We have a lot to
celebrate – Australia’s smoking rate is
low compared to other Organisation
for Economic Cooperation (OECD)
countries. We have reduced the
proportion of daily smokers from
24.3% in 1991 to 11% in 2019 [10].
But tobacco remains the leading cause
of preventable death and disability in
Australia, killing an estimated 20,500
people in 2018 [10]. Populations
more likely to smoke in Australia are
those already experiencing social and
health inequities.
Smoking and vaping have recently
been prominent topics in Australia.
Earlier this month, Australia’s
Minister for Health and Aged Care,
the Hon Mark Butler MP, released
the National Tobacco Strategy 2023-
2030 [11]. The Strategy includes a
suite of measures to reach a target of
5% or less daily smoking prevalence
by 2030, and a target of 27% or
less by 2030 for the Aboriginal and
Torres Strait Islander population.
The government is increasing
the successful tobacco tax by 5%
for three years, while also aiming
to reduce the tobacco industry’s
ability to influence policy decisions
on smoking by either prohibiting
political donations or increasing
transparency of such donations. In
medicine, the government will aim to
improve methods to identify patients
who smoke and, at every health
system intervention, ensure that
they are provided with best practice
cessation support and treatment.
The Australian Medical Association
(AMA) is pleased to see tobacco
regulation reinvigorated under this
Strategy.
BACK TO CONTENTS
WMA Members Share Perspectives about World No Tobacco Day 2023
30
The Strategy also outlines important
vaping (or e-cigarette) reforms.
The AMA has been advocating
tirelessly for stricter, more tightly
enforced regulation and welcomes
the announcement that the
government will be banning the
retail sale of vapes and making them
prescription only, with restrictions
on nicotine concentration, flavours,
and packaging. Vaping is the new
smoking in Australia, and its previous
lack of regulation has resulted in a
new generation of younger people
becoming addicted to nicotine. The
prescription-only model ensures that
patients are provided with reliable,
effective medical advice if they wish
to stop smoking or vaping. It also
works to prevent never-smokers
from taking up vaping in the first
place. This emerging threat has the
potential to undo all our important
work in tobacco control.
We cannot make the same mistakes
we made with conventional cigarettes.
This WNTD, I implore doctors
around the world to work together
to prevent new and emerging threats
around nicotine addiction, while not
giving up the patients whose smoking
cessation journey has been more
difficult due to broader social and
health inequities.
Brazil
Although Brazil is the leading
tobacco exporter and the third-largest
producer, its three-decade leadership
in tobacco control is recognised
across the region. These efforts led
to historic achievements to reduce
the prevalence rate of adult smokers
from 35% in 1989 to 9% in 2021 [12].
This national success started with the
inaugural WNTD campaign that was
held on 31 May 1993, at the Heart
Institute (INCOR) of the University
of São Paulo, and was coordinated by
Dr. Claire Chollat Traquet (WHO)
and supported by Dr. Adib Jatene
(INCOR co-founder and director).
Brazilian leaders even implemented
the WHO FCTC in Brazil [13]. To
educate about dangers of tobacco
smoking, the WHO prepared health
visualizations and videos for WNTD
events (https://www.youtube.com/
watch?v=7189anrfIQE), and the
Brazilian Medical Association
(Associação Médica Brasileira,
AMB) used pop culture symbols and
humor in public health messaging
( h t t p s : / / w w w. y o u t u b e . c o m /
watch?v=t3ADnztN7eQ).
The main transformation started
when Dr. Adib Jatene became the
Minister of Health in 1996, and
developed the Federal Law 9294/96,
creating tobacco-free spaces and
restricting tobacco advertising. As Dr.
José Serra became the next Minister of
Health, he maintained these policies
and approved additional laws that
permitted graphic images of tobacco-
related diseases on cigarette packages,
prohibited cigarette advertisement
in the media, and banned tobacco
smoking in indoor settings. The
Brazilian health system implemented
diverse clinical and community health
campaigns to educate the public
about the harmful effects of direct
and indirect exposure to tobacco use
as well as created tobacco treatment
programs. National research
studies demonstrated the beneficial
effects of this smoking ban law,
including reduced carbon monoxide
concentrations in hospitality
venues and reduced hospitalization
and mortality rates of myocardial
infarction [14,15].
Recognizing these historical
achievements, the Brazilian Medical
Societiesstronglybelievethatsmoking
cessation is the best way to reduce risk
of non-communicable diseases and
premature deaths. In July 2022, the
Brazilian Health Regulatory Agency
(Agência Nacional de Vigilância
Sanitária, ANVISA) endorsed the
ban on e-cigarette sales in July 2022,
aiming to reduce e-cigarette use
among youth and young adults. With
a total of 216 million residents, of
which 20 million are tobacco smokers,
our efforts should support health
policies (like Federal Law 9294/96),
widely share public health messages
with youth, and offer effective
treatment options like cue restricted
smoking and smoking cessation drugs
(like varenicline) [16,17].
Chinese Medical Association
Astheworld’slargesttobaccoproducer
and consumer, Chinese leaders have
recognised that tobacco control is
a long-term endeavor to protect
population health. With a population
of 1.4 billion, the prevalence rate of
smokers aged 20-69 is an estimated
25.1% (47.6% in males, 1.9% in
females) [18]. The increasing trend
in tobacco use among the Chinese
population is largely attributed to
tobacco dependence [18].
Pledging to make progress toward
fulfilling national objectives in
tobacco control, China formally
joined the WHO FCTC in 2006.
Over the past two decades, national
educational efforts have continued
to encourage all citizens to avoid
smoking initiation and exposure to
secondhand smoke. In 2017, the
government adopted measures where
tobacco advertising was banned in
public settings and mass media, stores
were forbidden from selling tobacco
products to minors, and smoking
scenes were eliminated in popular
movies and television programs. In
fact, more than 20 cities have adopted
laws banning smoking in indoor
public settings, at workplaces, and on
public transport [19].
The Healthy China Action Plan
2019-2030, established in 2019,
incorporated a tobacco control action
plan that set a target of reducing
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WMA Members Share Perspectives about World No Tobacco Day 2023
31
national tobacco prevalence to below
20% by 2030 [20].The plan highlights
the valuable role that physicians serve
in guiding patients to meet their
smoking cessation goals, promoting
smoking cessation services, and
supporting the development of a
“12320” national smoking cessation
hotline. Innovative approaches, such
as message-based tobacco cessation
programs, may enhance health
educational initiatives for the public
as well as strengthen rapport between
physicians and patients, which can
lead to reduced tobacco use across
China and the world [21].
Dominican Republic
Of the tobacco growing countries,
the Dominican Republic (DR) is
recognised as the eighth-leading
in the Americas and 40th in the
world [4]. Significant measures are
needed to strengthen tobacco control
programs in the DR and across the
Americas region, as nine countries
(including the DR) have not yet
joined the WHO FCTC [22]. To
address the national tobacco burden,
the DR government and the Ministry
of Health leaders have taken diverse
measures to recognize and promote
WNTD.
First, the DR government approved
the General Health Law 48-00 in
July 2000, to implement measures
that control the publicity of
tobacco use, including prohibiting
tobacco advertisements on massive
communication media, eliminating
sponsorship by the tobacco industry
at sporting or cultural events, and
restricting the sale of tobacco products
to minors (under 18 years) [23]. It
also established national regulations
for the production, distribution,
and commercialization of tobacco
products and prohibited smoking
in closed public and private settings
(including modes of public and
passenger transportation) [23]. To
build upon the General Health Law
48-00, they authorized the General
Health Law 42-01 in March 2021, to
ensure that adequate health messages
(“Smoking is harmful for your health”
/ “Fumar es prejudicial para la salud”)
was placed on tobacco packages [24].
These laws were amended by the
Resolution 000018 in May 2015, and
subsequently revised by the Resolution
000066 in February 2022, to mandate
that all closed public and private
settings across the country, including
restaurants, bars, workplaces, and
public transportation, were smoke-
free establishments [25].
Second, the DR government has
augmented the tobacco tax, as a
strategy to disincentive consumption
and reduce the harmful exposure
of direct or indirect tobacco use on
population health [26]. Third, the
DR Ministry of Public Health has
collaborated with other institutions
and organisations to develop
educational campaigns about the risks
of tobacco use and the importance of
adopting a healthy lifestyle. These
events are widely shared through
social media as well as television
commercials, radio shows, primary
and secondary school activities,
and community-wide celebrations.
Finally,they have developed treatment
programs, including nicotine
replacement therapies, medications,
and personalized counseling, to help
smokers reduce and ultimately stop
tobacco use [27].
The DR government has supported
these laws and regulations, as part of
a national effort to increase awareness
of the health risks associated with
tobacco use, control the access of
tobacco, and reduce the harmful
effects of tobacco use in the DR
population. As a medical community,
it is our moral obligation to continue
advocating for research investment,
including social science approaches
to better understand the tobacco
culture, as well as supporting local
and national efforts to implement
effective policies and regulations that
ensure compliance,reduce tobacco use
(including e-cigarettes and hookah),
and protect population health [28].
India
According to the 2016-17 Global
Adult Tobacco Survey (GATS), India
represents one of the top three
countries associated with smoked
or smokeless tobacco use among
the populace, where 28.6% (or an
estimated 267 million) of Indian
adults use tobacco [29]. The burden
of this tobacco epidemic drives
the participation of healthcare
professionals to promote WNTD and
increase public awareness regarding
the detrimental effects of tobacco
use and encourage individuals to
quit smoking. This awareness is
raised through various social media
platforms (like YouTube), displays
with WNTD posters in hospitals,and
health educational events in hospitals
and local communities.
Through several legislature actions,
national leaders have implemented
several tobacco control policies
that support efforts to combat the
tobacco epidemic in India. First,
the Cigarettes and Other Tobacco
Products Act (COTPA) was passed
by the Indian government in 2003, in
efforts to regulate tobacco products,
prohibit the sale of tobacco products
to minors, and mandate pictorial
warnings on packaging [30]. This act
warranted that smoking was illegal
in public settings, including offices,
restaurants, educational institutions,
and public transportation, and a fine
(up to 200 Indian Rupees) could be
imposed for smoking in public places,
selling tobacco products to minors
or marketing tobacco products
within a radius of 100 meters from
any educational institution. Second,
India was one of the first countries to
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WMA Members Share Perspectives about World No Tobacco Day 2023
32
implement graphic health warnings
on tobacco product packaging, and
such warnings (covering 85% of
the package surface area) have been
mandated on tobacco products since
2016.
Third, India’s Ministry of Health
launched the National Tobacco
Control Program in 2007, to
implement tobacco control policies
and programs at the national and state
levels.This program focuses on raising
awareness about the harmful effects
of tobacco use, providing cessation
services,andenforcingtobaccocontrol
laws. In 2016, they established the
National Tobacco Quitline Services
(NTQLS) (http://ntqls.in/), as the
first national telephone counseling
service for tobacco cessation. This
program operates through a toll-
free number (1800-11-2356) and
offers behavioral counseling services,
health information, and relevant
community resources to callers.
Fourth, the government banned the
production, sale, and importation
of e-cigarettes in India in 2019.
Finally, the government has regularly
increased taxes on tobacco products,
to discourage their use and generate
revenue for tobacco control programs.
Although these policies have
contributed to a decline in tobacco
use in India, tobacco use remains a
significant public health problem.
Moving forward, doctors can lead
efforts to reduce tobacco use through
robust educational efforts, by
educating patients about the harmful
effects of smoking and recommending
counseling and supportive services.
They can also promote tobacco-
free workplaces, support employers
to offer comprehensive smoking
cessation resources, and serve as role
models by incorporating tobacco-free
lifestyles. They can work with local
and national health organisations to
promote policies that reduce tobacco
use, such as higher taxes on tobacco
products, smoke-free environments,
and advertising restrictions. We hope
that doctors can collaborate with other
healthcare professionals (e.g. nurses,
pharmacists) to organise campaigns
and events that raise public awareness
about the harmful effects of smoking
throughout the year.
Kenya
In Kenya, a country of 57 million
residents, an estimated 13.3% of
adults (older than 15 years) and
9.9% of adolescents (13-15 years)
use tobacco [31]. As physicians, we
understand that tobacco use is a risk
factor that can increase risk of non-
communicable diseases, which with
other risk factors, are collectively
attributed to 60% of hospital
admissions and over 55% of deaths
[31]. With the rise in the use of novel
tobacco products (e.g. electronic
cigarettes, nicotine pouches) that
primarily target youth,with the covert
goal of creating a new generation of
tobacco users, there is a grave need
to continue educating the public,
especially youth, on the harmful
nature of all tobacco products.
As one national survey reported that
over 80% of smokers in Kenya were
unaware of the availability of tobacco
cessation services, the Ministry
of Health (including the Tobacco
Control Board) and civil society
organizations within Kenya have
developed and continue to strengthen
various initiatives to enhance tobacco
control and support tobacco cessation
[32]. First, the National Authority
for the Campaign Against Drugs and
Alcohol (NACADA), as part of the
Ministry of Interior and Coordination
of Government, developed an
operational toll-free helpline 1192 in
2015, which offers counselling and
appropriate referrals to the public
[32]. Second, the Ministry of Health
developed the tobacco cessation
guidelines in 2017, which grants
clinicians access to contextualized
guidelines for tobacco dependence
treatment and cessation [33].
Third,the Ministry of Health updated
the Kenya Essential Medicine List in
2019, by including pharmacological
agents (e.g. bupropion, nicotine
gums, patches) that are proven to
improve the efficacy of cessation [34].
Fourth, as part of section 7(4b) of the
Tobacco Control Act 2007, the Tobacco
Control Fund was established and
operationalized to support cessation
and rehabilitation programs [35].
Fifth, the Ministry of Health ensured
that the National Health Insurance
Fund would cover the expenses of
citizens seeking drug deaddiction
services at rehabilitation centers,
among other tobacco cessation
services [36]. Finally, Kenyan leaders
– together with the UN Food and
Agriculture Organization,WHO,and
Farm to Market Alliance (FtMA) –
collaborated on the inaugural tobacco
free farms initiative, to help farmers
transition from growing tobacco to
alternative crops (like beans) [37].
Across Africa, our call to physicians
is that we must work together to
understand the tobacco epidemic
and educate communities about
the harmful impacts of tobacco use
on health, especially novel tobacco
products. With the support of
National Member Associations
(NMAs), such as the Kenya
Medical Association, we continue to
advocate for robust policy advocacy
to emphasize capacity building
of healthcare workers on tobacco
harms, offer cessation support and
psychological counselling,and initiate
appropriate referrals. Furthermore,
adopting tax exemptions on effective
pharmacological agents may support
comprehensive care as well as reduce
the prevalence of tobacco users in
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WMA Members Share Perspectives about World No Tobacco Day 2023
33
Kenya and across Africa.
Nigeria
In Nigeria,common tobacco practices
include cigarette smoking, chewing
raw tobacco, and sniffing ground
tobacco powder (snuff) [38]. Notably,
snuff – known as ‘suadiri’ in Ibani,
‘ifienya’ in Izon, ‘utaba’ in Igbo, and
‘yaba’ in Yoruba local languages – is
frequently used among the Nigerian
populace for recreational, spiritual,
medicinal (common cold, toothache),
and prevention (e.g. snake repellant)
purposes. These unproven scientific
medicinal beliefs,coupled with readily
available tobacco plants perceived as
snake repellants,can increase its usage
and lead to addiction.
With an estimated population of 210
million residents, Nigeria represents
a nation with accelerated economic
growth and cross-border migration
that can drive the tobacco market
[39]. According to the WHO, the
prevalence rate of tobacco use in
adults (15 years and older) in 2020
was 3.4% (6.2% in males, 0.5% in
females),declining from 8.5% in 2000
(15.2% in males, 1.7% in females)
[2]. Since 1970, national tobacco
control legislation and initiatives
have been proposed, including the
first Tobacco Smoking (Control) Decree
20 established in 1990, but the
influence of the tobacco industry has
hindered significant progress in such
implementation [40].
To address this burden, the federal
government of Nigeria and health
leaders have led efforts to enhance
tobacco control across the populace.
First,NigeriajoinedtheWHOFCTC
in 2006, leaders enacted the National
Tobacco Control Act (NTCA) in 2015,
which formed the National Tobacco
Control Committee [2]. Second,
the federal government banned the
advertisement and promotion of
cigarettes in mainstream and social
media, cigarette sales to minors, and
smoking in public places or within 10
metres from health facilities, public
transportation, and vehicles carrying
minors. Cigarette packaging was
mandated to include health advisories
(“The Federal Ministry of Health
warns that smokers are liable to die
young”), and the sale of cigarettes
were required in the form of a pack
(20 sticks) rather than single cigarette
sticks. Third, the federal government
established the National Tobacco
Regulation in 2019, with approval
by the House of Representatives and
the Senate [41]. Finally, professional
associations (e.g. Nigerian Medical
Association, Nigerian Association
of Resident Doctors, Medical
Women’s Association of Nigeria),
non-governmental organisations,
and community support groups have
regularly organised campaigns on
smoking cessation at open markets,
motor packs, and schools, as well as
television and radio shows and social
media.
Although significant policy and
community education efforts have
been conducted across Nigeria, no
current strategies or policies exit to
tackle non-smoking tobacco use [38].
At the national level, the government
should prioritize steps to achieve
universal health coverage, which will
offer sufficient resources for Nigerian
citizens to seek traditional treatment
options. Nigerian physicians should
also lead advocacy efforts that enforce
current laws and propose new laws
and initiatives to reduce the use of
all tobacco forms as well as continue
educational efforts that dispel
myths of using tobacco as a cure for
common colds, coughs, toothaches,
and headaches.
Portugal
Portugal, a country with 10 million
residents, has a reported prevalence
rate of tobacco smoking in adults
(15 years or older) of 17.0% (23.9%
in males, 10.9% in females) [42].
Compared with the National Health
Survey 2014, the prevalence of
tobacco use has dropped by 3% and
decreased across all age groups of
both sexes [42].To address this health
burden, the Portuguese Respiratory
Society has led an array of activities
that engage other Portuguese
medical societies, health professional
organisations, patient associations,
and civil society, in raising awareness
of the health, environmental, social,
and economic consequences of the
tobacco epidemic. Physicians have
also highlighted the health policies
of the WHO FCTC, describing
deceptive strategies of the tobacco
industry and publicising smoking
cessation programs of the Portuguese
Health System [43].
After Portugal joined the WHO
FCTC in 2005, national leaders have
led efforts to improve tobacco control.
In 2007, the Portuguese Government
adopted Law No. 37/2007, which
restricted tobacco use in closed public
settings [44]. In 2016, they adopted
Law 109/2015, which allowed the
inclusion of pictorial health warning
labels on tobacco product packaging,
limited harmful components in
cigarettes, further strengthened the
smoke-free policy, and expanded the
smoking ban to vaping [44].
In January 2023, an amendment of
the smoke-free law was implemented,
which further restricted smoking in
closed public places. Although the
Portuguese smoking ban was not
comprehensive, compliance with
the ban was optimal, and public
spaces for smoking were difficult to
find. To support these efforts, the
Portuguese Respiratory Society and
the Brazilian Respiratory Society
launched an ongoing social media
campaign to educate youth and
young adults about the harmful
health effects of using e-cigarettes
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WMA Members Share Perspectives about World No Tobacco Day 2023
34
and vaping and dispel myths (https://
www.instagram.com/p/CosuRt-
Orgd/?igshid=OWEyOTRmYTI=).
Also, the Portuguese government
approved a set of innovative tobacco
control measures that aimed
to contribute to a tobacco-free
generation by 2040. This initiative
included comprehensive restrictions
of tobacco sales (e.g. retailers, vending
machines) and extended smoke-
free policies to outdoor settings
(e.g. hospitals, schools, universities,
terraces,bus stations,sports stadiums).
This law, which transposes the
European Directive 2022/2100 that
baned flavours from heated tobacco
and removes member states’ right
to exempt heated tobacco products
from the required health warnings, is
currently being discussed within the
National Parliament [45].
Taking into account the WHO’s and
the European Respiratory Society’s
recommendations, we urge physicians
to act as role models and tobacco
control leaders for their patients and
their communities.They can advocate
for comprehensive tobacco control
and prevention of nicotine use among
adolescents and young adults and
effective regulations (and possibly
restricting sales) for e-cigarettes and
heated tobacco products. Physicians
can also offer evidence-based
treatment and pharmacotherapy
approaches that empower their
patients with smoking cessation and
adopting healthier lifestyles [46].
Spain
In Spain, a country of 46 million
residents, has experienced a steady
decline in tobacco use over the past
two decades. In 2020, the prevalence
of tobacco use among adults estimated
at 23.3% in males and 16.4% in
females, as compared to 43.5% in
males and 24.5% in females in 1998
[47]. This trend has significantly
declined in the 15–24-year
population group, which was reported
16,4% in males and 12,0% in females
in 2020, as compared to 39.0% in
males and 40.5% in females in 1998
[47]. Since adolescents and young
adults are smoking less than previous
generations, tobacco industries have
developed innovative campaigns to
widely promote their new products
(like e-cigarettes) among this
population group.
To support tobacco control efforts,
the Spanish Parliament approved
the 2005 Tobacco Control Law, which
prohibited smoking across public
settings, including universities,
restaurants, and bars [48]. In 2020,
more than 50 civil rights and health
organisations in Spain (https://
nofumadores.org/end-game-del-
tabaco-en-espana-2030/) joined
forces and submitted the Tobacco
Endgame by 2030 Declaration to the
Ministry of Health, which aimed to
reduce the prevalence of smoking rates
to less than 5% by 2030 [49]. In 2018,
with only 3% of beaches declared as
smoke-free, the Nofumadores.org
organisation (https://nofumadores.
org/) led efforts to ban cigarette
smoking on beaches, supported by
several regional health authorities
in the Canary Islands, Balearic
Islands, Galicia, and Catalonia [50].
Subsequently, Spain’s Congress and
Senate authorized an ecological law
that instilled authority upon local
councils to sanction individuals who
smoked tobacco on beaches.
To continue supporting tobacco
control initiatives in Spain, the
Spanish government recently
approved two resolutions that amend
original legislation. In December
2022, the Ministry of Health adopted
the resolution (to Article 48.8 of Law
40/2015) that highlighted a joint
collaboration between the Ministry of
Health and the National Commission
for the Prevention of Smoking
(Comité Nacional para la Prevención
del Tabaquismo, CNPT) (https://
cnpt.es/), to leverage prevention and
control efforts that aim to reduce the
prevalence of tobacco smoking across
the nation [51]. In March 2023, the
Ministry of Treasury and Public
Functions added the resolution
(to Article 4 of Law 13/1998) that
obligated the Presidency of the
Commissioner for Tobacco Markets
to publish the retail prices of tobacco
products in federal records [52].
Asamedicalcommunity,werecognize
that tobacco use and nicotine
dependence represent a serious health
risk factor. The Spanish General
Medical Council, as a member of
CNPT,supports strict tobacco control
measures, ranging from graphical
health warnings on product packages
and bans of flavored cigarettes, that
prioritize population health [53].
Physicians have important clinical,
educational, and advocacy roles
in providing the best care for our
patients and supporting community-
wide initiatives to encourage tobacco-
free lives.
Taiwan
Taiwan, with 23 million residents,
has an estimated 2.7 million smokers
and a prevalence rate of tobacco
smoking in adults of 13.1% (23.1%
in men, 2.9% in females) [54]. The
Taiwan Health and Promotion
Administration reported that the
use of novel tobacco products, such
as e-cigarettes and heated tobacco
products, has doubled over the past
few years in Taiwan. Tobacco use
has also impacted the adolescent
population, as the prevalence of
senior high school students using
e-cigarettes was 8.8% in 2021, up
from 3.4% in 2018 [55].
Since 2020, the Taiwan Medical
Association,Taiwan Medical Alliance
of Tobacco Control, Taiwan Tobacco
Control and Smoking Cessation
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WMA Members Share Perspectives about World No Tobacco Day 2023
35
Education Association, and 170
non-government organisations
have collaborated to combat the
influences of big tobacco companies
that interfered with tobacco control
efforts. The Taiwan Ministry of
Health and Welfare adopted the
Tobacco Hazards Prevention Act in
1997, with subsequent amendments
in 2009 and 2023. This recent
amendment raised the smoking age
from 18 years to 20 years, banned
flavored tobacco products (e.g.
chocolate, fruit, mint), and prohibited
smoking on all campuses including
colleges and universities [56].
This recent amendment may permit
the legalization of heated tobacco
products, if tobacco companies pass
the “Health Risk Assessment” before
thesaleoftheseproducts.Throughthis
risk assessment, tobacco companies
are requested to provide evidence
that the new product does not cause
higher health risks than current
market products. Another remarkable
achievement is that the manufacture,
importation, sale, distribution,
presentation, advertisement, and use
of e-cigarettes are all prohibited across
Taiwan. Violators of this amendment
could be fined up to NT $50 million
(equivalent to US $1.6 million).
As the next steps, the medical
community should continue to engage
in education and advocacy efforts to
combat all forms of tobacco use across
the country.Although the proposition
to quit heated tobacco products is
emerging, tobacco companies are
promoting these products as safer
alternatives to traditional cigarettes.
Hence, we must collectively fight
against this tactic, as all tobacco
products are harmful to health and
well-being.
Thailand
Thailand, a country of 70 million
residents, has reported a high
prevalence of tobacco use (11
million adult smokers), where half
of adults aged 35-54 years smokers
[57]. Despite these statistics, the
nation has taken proactive strides to
develop relevant legislation, public
health messaging, and community
projects. In 2004, King Bhumiphol
of Thailand expressed his concern
about the harmful effects of tobacco
smoking among youth and elderly in
his public address, and the Medical
Association of Thailand was inspired
to take action.
Starting with the “The Role of
Health Professionals in Tobacco
Control” theme in 2005, the Medical
Association of Thailand has regularly
contributed to WNTD events [58].
They launched the project entitled,
“Thai Physicians Alliance and
Tobacco Control”, to educate the
publicaboutthehazardsoftobaccouse
and non-communicable disease risks
caused by tobacco consumption. Over
the next decade,this project expanded
across the country to include health
professionals and 23 health agencies
as the “National Alliances forTobacco
Free Thailand (THPAAT)”. Notably,
the World Health Professional
Assembly awarded this project team
an honorary award in 2015.
One landmark legislation was the
Thai Tobacco Products Control Act of
2017, which continued to enforce the
minimum age for tobacco purchases as
well as bans on tobacco advertisement,
packaging, and sponsorship [57].
According to a recent survey
conducted by the National Statistical
Institute of Thailand, smoking rates
in Thailand had declined from 23%
in 2005 to 17.4% in 2021 [59]. The
national collaboration to promote
smoking cessation and preserve public
health aims to reduce the prevalence
of adult smokers to 14% by 2027. To
support these efforts, the Medical
Association of Thailand has signed
a memorandum of understanding
with the Hospital Accreditation
Institute of the Thai Ministry of
Public Health, to ensure that hospital
patients will be screened for a medical
history of smoking and provided with
appropriate treatment and resources.
Today, one of our primary concerns
is the emergence of e-cigarettes,
which are strongly supported by the
tobacco manufacturers with high
marketing technologies, budget, and
tricky information. For this reason,
we would like to urge the world –
especially health professionals – to
collaborate on novel initiatives that
protect youth, reduce risk of non-
communicable diseases, and promote
community health and well-being.
Trinidad and Tobago
Tobacco use is a significant public
health concern, as it remains the
single most preventable cause of
death in the world today [1]. For
physicians in Trinidad and Tobago,
WNTD motivates us to increase
awareness of the harmful effects of
tobacco use and encourage smoking
cessation in our population. Our
medical community supports
this important day by conducting
health promotion activities such
as community outreach, public
speeches, social media posts, and
radio broadcasts. Notably, Trinidad
and Tobago leaders joined the WHO
FCTC in 2005, and adopted the
Tobacco Control Act in 2009, which
establish strict requirements for
advertising and selling cigarettes and
prohibits smoking in indoor public
settings [60].
Using the theme, “We need food, not
tobacco,” the Trinidad and Tobago
Ministry of Health’s Tobacco Control
Unit has developed the campaign,
taking a multisectoral approach to
engage smokers and non-smokers
in healthier lifestyle practices. They
have launched the campaign entitled,
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WMA Members Share Perspectives about World No Tobacco Day 2023
36
“Healthy Lifestyle Alternatives to
Smoking Campaign”, which includes
a community gardening initiative
and digital advocacy for healthy
lifestyle practices. As physicians, we
understand that tobacco use affects us
all,andwearecommittedtoimproving
the health and well-being of our
patients. Educating our population
including smokers, non-smokers
and adolescents on the dangers of
tobacco use including e-cigarettes
must be a priority. As we move closer
to achieving our goal of a tobacco-
free Caribbean, we urge persons who
wish to quit smoking tobacco to join
the Smoking Cessation Clinics at
our Regional Health Authorities for
additional support
Turkey
InTurkey,with a population of around
85 million people, the Ministry of
Health reported that the rate of
tobacco use in adults (older than 15
years) was 28.0% (41.3% in males,
14.9% in females) in 2019 [61]. From
2000 to 2012, the prevalence rates in
tobaccousehadshowedsteadydecline,
but then in 2012, the rates increased
[61,62].This trend is thought to have
resulted from weak compliance to
tobacco control legislation, including
an increase in tobacco promotional
advertisements and violations of such
policies across communities.
As part of the national tobacco
control efforts, the Turkish Medical
Association (TMA), the organisation
of national medical associations, leads
the National Coalition on Tobacco
OR Health (NCoTOH) (http://
www.ssuk.org.tr/). The NCoTOH is
composed of a variety of public and
private sector organisations,including
non-governmental organisations.The
executive committee of NCoTOH
represents the Association of Public
Health Specialists (HASUDER)
(Türkiye), the Health Institute Society,
the Turkish Medical Association, and
the Turkish Thoracic Society.
The first national anti-tobacco
legislation, Legislation on the
Prevention of Harms of Tobacco
Products No.4207 (Tütün Mamüllerinin
Zararlarının Önlenmesine Dair Kanun
No:4207), was adopted in 1996 [63].
Türkiye joined the WHO FCTC in
2004 [64], which propelled the anti-
tobacco activities across the country,
including the foundation of the
National Tobacco Control Program
and revision of current legislation
[62,65]. The revision of the first
legislation was approved in 2008 and
renamed, Legislation on the Prevention
and Control of Harms of Tobacco
Products No. 4207 (Tütün Ürünlerinin
Zararlarının Önlenmesi ve Kontrolü
Hakkında Kanun No:4207) [66].
With its broader perspective, the law
added sanctions for non-compliant
organisations, and stronger policies
and guidance for the tobacco industry,
which ultimately contributed to
a decrease in tobacco use in 2012
[67]. These national milestones were
strongly supported by the wider
community of health professionals,
non-governmental organisations, and
private businesses.Based on the recent
observations that the rate of tobacco
users is increasing, the Turkish health
system is recommended to plan to
target ongoing and future efforts
on tobacco control covering all the
population.
The TMA, as a strong supporter of
WNTD events and tobacco control
activities throughout the year, calls
on all the doctors in Turkey to unite
and advocate for a tobacco-free
world. This year (2023), the TMA
prepared a social media campaign
that disseminated public health
messages about the harmful effects
of tobacco use. TMA members plan
to continue their advocacy work
on encouraging adolescents and
young adults to avoid tobacco and
other addictive substances, as well as
developing appropriate policies that
improve restrictions on tobacco use in
closed settings and protect vulnerable
populations.
United States
The American Medical Association
(AMA) has a long history of
advocating for control of tobacco
use and supporting the U.S. Centers
for Disease Control and Prevention’s
and the U.S. Food and Drug
Administration’s (FDA) efforts to do
the same. An area of concentration
for AMA’s initiatives is tobacco and
health equity. The tobacco industry
has successfully and intentionally
marketed mentholated cigarettes to
African Americans [68]. The AMA
and 14 other organisations called on
the FDA to prioritize enforcement
against two manufacturers for
introducing new flavored tobacco
products in defiance of the FDA
review requirements. The AMA has
also been involved in multiple legal
cases against tobacco companies
through its Litigation Center [69].
Anotherareaofemphasisispreventing
youth use of e-cigarettes, vaping,
and use of other electronic nicotine
delivery systems. Manufacturers of
these devices have tried to evade
FDA rules by switching to synthetic
nicotine. As a result, the AMA and
other public health organizations
called upon the U.S. Congress to give
the FDA the authority to regulate
synthetic nicotine. Most recently,
WNTD in the United States has
focused on the enormous detrimental
environmental impacts of the tobacco
lifecycle, including growing, curing,
manufacturing, transporting and
disposal [70].
Uruguay
Over the past decades, Uruguay
has implemented comprehensive
tobacco control policies and has
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37
successfully achieved favourable
health outcomes. After becoming the
first indoor smoke-free country in the
Americas in 2006, a comprehensive
tobacco law was passed in 2008,
enacting the world’s largest pictorial
health warning labels and the single
presentation per brand requirement
for cigarette packs. In 2010, Philip
Morris International (PMI) claimed
that this law was unreasonable and
sued Uruguay at the the International
Centre for Settlement of Investment
Disputes (ICSID),which after six
years of arbitration, ruled in favour
of Uruguay and its sovereign right
to protect people [71]. In 2020, the
government approved the policy
for plain packaging of tobacco
products, which has proved to protect
consumers and future smokers from
misleading terms, increasing risk
perception, and avoiding fancy design
features that attract youth [72].
Overthepasttwoyears,severaldecrees
were adopted – allowing the import
and sales of heated tobacco products
and loosening restrictions of plain
packaging – which appear contrary to
the provisions of the WHO FCTC
[73]. Hence, physicians representing
civil society organisations, medical
unions, and academic sectors have
strongly and publicly opposed
these new regulations. In fact, the
Uruguayan Society of Tobaccology
(Sociedad Uruguaya de Tabacología),
as a group of health providers who are
actively involved in tobacco control
efforts, has successfully filed a legal
act against these decrees [74].
Nevertheless,severalWNTDactivities
are being planned by the government
and civil society, including health
seminars, conferences, short courses,
and community-based activities,
which highlight the importance of
tobacco control, tobacco cessation,
healthy behaviors. Specifically,
the “Dr. Manuel Quintela” Clinic
Hospital (Hospital de Clínicas “Dr.
Manuel Quintela”), which is the
largest hospital in the country and
located in Montevideo, visitors will
be able to obtain health information
about tobacco cessation as well as
interact with the tobacco cessation
health team for brief counselling and
carbon monoxide measurements.
As physicians, we should lead the
call to action to engage with other
health professionals and collectively
organize timely tobacco control
activities across our institutions,
regions, and countries. A strong and
organised civil society is a key factor
to defend public health policies
and people’s rights, recognizing the
potential influences from industries
and government administrations.
Conclusion
The tobacco epidemic is a significant
global challenge for health systems,
especially for tobacco-cultivating
countries and the emergence of new
tobacco products (e.g. e-cigarettes,
heated tobacco products) [4]. As the
global prevalence trends of tobacco
use in adults have decreased over the
past two years, global leaders remain
optimistic about their collective
progress – including contributions to
the WHO FCTC and MPOWER
– to combat the tobacco epidemic
[2]. They understand, however, that
each nation has not observed similar
trends, signifying that leaders should
identify limitations in their tobacco
control programs, adopt relevant
policies to support tobacco control,
and implement innovative solutions
to enhance public health messaging.
As WMA members represent diverse
clinical and surgical specialties, our
expertise is essential to increase
awareness about the harmful effects
of tobacco use (nicotine dependence)
and gain trust during our close
interactions with patients and the
general public. This collective article
offers other NMAs an opportunity
to learn about the robust national
policies and community activities
that support tobacco control and
prevention across 16 countries. These
collaborations highlight the value of
strong health systems and political
commitment across the African,
Americas, European, South-East
Asian, and Western Pacific regions,
which have highlighted the successful
adoption and implementation of
comprehensive tobacco control
policies. Hence, these national
and global efforts can guide future
legislation and educational initiatives
that can advance progress toward
achieving target 3.a of the Sustainable
Development Goal 3.
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Authors
AMA’s Office of
International Relations
Chicago, Illinois, United States
Samprith Ala, MD
JDN Member
Narasaraopet, India
María Rosa Arroyo, MD
Vice-Secretary, Spanish General
Medical Council (CGCOM)
Madrid, Spain
Dilek Aslan, MD, MSc
Hacettepe University,
Faculty of Medicine,
representing Association of Public
Health Specialists (HASUDER)
Ankara, Turkey
Sofia Belo Ravara, MD, MSc, PhD
Coordinator, Tobacco Working Group,
Portuguese Respiratory Society
University of Beira Interior Covilhã
Covilhã, Portugal
Public Health Research Centre,
National School of Public Health,
Nova University of Lisbon
Lisbon, Portugal
Dabota Yvonne Buowari, MBBS
Department of Accident
and Emergency,
University of Port Harcourt
Teaching Hospital
Port Harcourt, Nigeria
Carolina Cardozo
Press Officer, Confederación Médica de
la República Argentina (COMRA)
Buenos Aires, Argentina
Brian Bih-Jeng Chang, MD
Secretary General,
Taiwan Medical Association
Taipei, Taiwan
Helena Chapman, MD, MPH, PhD
Milken Institute School
of Public Health,
George Washington University
Washington DC, United States
Shiyi Chen, MD
President, Chinese Society of Sports
Medicine, Chinese Medical Association
Department of Sports Medicine,
Huashan Hospital, Fudan University
Shanghai, China
Ching-Ming Chou, MD
President, Taiwan Medical Association
Taipei, Taiwan
Jorge Coronel, MD
President, Confederación Médica de
la República Argentina (COMRA)
Buenos Aires, Argentina
Fei-Ran Guo, MD
Adjunct Assistant Professor,
National Taiwan University
Hospital and College of Medicine
Taipei, Taiwan
Laura Llambí, MD, PhD
Hospital de Clínicas,
Universidad de la República
Sindicato Médico del Uruguay
Montevideo, Uruguay
Rohit Nayyar, MD
Director, Surgical Oncology,
Max Institute of Cancer Care
Saket, New Delhi, India
Brenda Obondo, MBChB, MBA
Chief Executive Officer,
Kenya Medical Association
Nairobi, Kenya
Leon Ogoti, MBChB, Msc
Public Health Committee,
Kenya Medical Association
Nairobi, Kenya
Sara K. Ramjit, BSc, MBBS,
PG Dip, MSc, DM
Family Medicine Primary
Care Physician 2
South-West Regional Health Authority
Port of Spain, Trinidad and Tobago
Prof. Steve Robson, BMedSc,
MBBS, MPH, MMed, MD,
PhD, FRANZCOG, FRCOG,
FACOG, FAMA, CertGovPract
President,
Australian Medical Association
Canberra, Australia
Francisco Rodríguez Lozano, MD
Board member,
Cancer Patients Europe &
Former President,
European Network for Smoking
and Tobacco Prevention,
Brussels, Belgium &
Former President,
National Committee for Tobacco
Prevention, Madrid, Spain
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WMA Members Share Perspectives about World No Tobacco Day 2023
43
Jaqueline Scholz, MD, PhD
Director, Smoking Cessation
Program, Heart Institute
University of São Paulo Medical School
São Paulo, Brazil
Wonchat Subhachaturas, MD
Past President, Medical
Association of Thailand
Past President, WMA (2010)
Bangkok, Thailand
Bienvenido Veras-Estévez,
MD, MPH
Department of Epidemiology,
Hospital Regional Universitario
José María Cabral y Báez &
Faculty of Health Sciences,
Universidad Católica del Cibao
Santiago de los Caballeros & La Vega,
Dominican Republic
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WMA Members Share Perspectives about World No Tobacco Day 2023
44
Leadership
President: Jesse M. Ehrenfeld, MD, MPH (until June 2024)
President-Elect: Bruce A. Scott, MD
(assumes Presidency in June 2024)
Immediate Past President: Jack Resneck, Jr., MD
(until June 2024)
Chair, Board of Trustees: Willie Underwood III, MD, MSc,
MPH (until June 2024)
Executive Vice President and Chief Executive Officer:
James L. Madara, MD
History in brief
The American Medical Association (AMA) is the largest and
only national association that convenes more than 190 state
and specialty medical societies and other critical stakeholders.
For more than 170 years, the AMA has worked to create a
better future for patients and physicians, including being at the
forefront of advocating against racial and ethnic disparities in
health care.The AMA has always put patients first.
• 1847: founded.
• 1849: AMA established a board to analyse quack remedies
and nostrums and to enlighten the public in regard to the
nature and danger of such remedies. The Department of
Investigation (1913-1975) gathered and disseminated health
fraud and quackery information for the public for more than
60 years.
• 1873: AMA Judicial Council was founded to deal with
medical ethical and constitutional controversies (https://www.
ama-assn.org/delivering-care/ethics).
• 1883: Journal of the American Medical Association (https://
jamanetwork.com/journals/jama) is first published, and
Nathan Davis is first editor.
• 1910: Medical Education in the United States and Canada,
funded by the Carnegie Foundation and supported by the
AMA, is published and facilitates new standards for medical
schools.
AMERICAN MEDICAL
ASSOCIATION
Jesse M. Ehrenfeld
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NMA Highlights
• 1943: AMA opened an office in Washington, D.C.
• 1961: AMA recommended a nationwide vaccination using
the Sabin oral vaccine against polio.
• 1966: AMA published the first edition of the Current
Procedural Terminology (CPT®) (https://www.ama-assn.org/
practice-management/cpt), a system of standardised terms for
medical procedures used to facilitate documentation.
• 1972: AMA launched a war on smoking, urging the
government to reduce and control the use of tobacco products
and supporting legislation prohibiting the disbursement of
tobacco samples.
• 1986: Resolution passed opposing acts of discrimination
against AIDS patients and any legislation that would lead to
such categorical discrimination or that would affect patient-
physician confidentiality.
• 1990: AMA Fellowship Residency Electronic Interactive
Data Access System (FREIDA) (https://freida.ama-assn.
org/) describing residency programs in the United States was
available in electronic form.
• 1997:AMA launched the National Patient Safety Foundation
(http://www.npsf.org/) to help ensure that all patients in all
health care settings receive health care services safely.
• 2008: Ronald M. Davis, MD, then the AMA’s immediate
past president, apologised for more than a century of AMA
policies (https://www.ama-assn.org/about/ama-history/
history-african-americans-and-organized-medicine) that
excluded African-Americans from the AMA and that also
barred them from some state and local medical societies.
• 2022: AMA marked its 175th anniversary.
Mission
“To promote the art and science of medicine and the betterment
of public health.”
As the physicians’ powerful ally in patient care, the AMA
delivers on this mission by representing physicians with a unified
voice in courts and legislative bodies across the nation, removing
obstacles that interfere with patient care, leading the charge to
prevent chronic disease and confront public health crises,driving
the future of medicine to tackle the biggest challenges in health
care and training the leaders of tomorrow.
Current challenges
• Physician burnout
• Physician payment reform
• Supporting telehealth
• Scope of practice issues
• Cost of prescription drugs
• Ensuring adequate supply and equitable distribution of
physicians
• Overdose epidemic
• Liability and risk in digital health innovation
45
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Future vision
• Share opportunities, best practices, and learnings for how
digitally-enabled care can address workforce issues and
industry-wide burnout through AMA convened efforts,pilots,
and organised (virtual and in-person) learning collaboratives
• Commit to the principles of equity and innovation
• Help ensure that the physician-patient relationship continues
as the “heart and soul” of medicine and support physician-led
team-based care
• Collaborate on aligned advocacy efforts focused on addressing
industry fragmentation and payment reform as well as
advancing digitally-enabled care
Contact information
Address: 330 N. Wabash, Suite 39300, Chicago,
Illinois, United States 60611
Email: elizabeth.larocca@ama-assn.org,
hannah.longstaff@ama-assn.org
Website: http://www.ama-assn.org
AUSTRALIAN MEDICAL
ASSOCIATION
Stephen Robson
Leadership
President: Prof. Stephen Robson
History in brief
The Australian Medical Association (AMA) is a federation of
the AMA state and territory bodies and a federal secretariat,
which is based in Canberra, Australia.
• October 1961: it was founded after many decades of doctors
trying to form a body autonomous and independent from the
British Medical Association.
• May1962: the six former state branches of the British Medical
Association became branches of the AMA,and the first AGM
of the organisation was held at the University of Adelaide, in
Adelaide, the capital of South Australia,. Dr Cecil Colville
became the AMA’s first president. The AMA has published
the Medical Journal of Australia since 1914.
Mission
The AMA’s motto – pro genere human concordes – means
“united for humanity” or “all as one for mankind”. The AMA,
which represents and supports all Australian doctors and
medical students, works with governments to develop and
influence health policy to provide the best outcomes for doctors,
their patients, and the community.
Objectives
The AMA aims to preserve, maintain, promote, and advance the
intellectual, philosophical, social, political, economic, and legal
interests of its members and to promote the wellbeing of patients.
The AMA participates in promoting health care programs for
community benefit and addressing major social and community
health issues. The AMA also works with affiliate organisations
and publishes and circulates the Medical Journal of Australia.
National collaborations
The AMA has partnerships with the Doctors for the
Environment Australia.
International collaborations
The AMA is a member of the Council of the World Medical
Association (WMA) and the Confederation of Medical
Associations in Asia and Oceania (CMAAO).
Current challenges
The Australian health system is under significant pressure, due
to growing demand and efforts by governments to constrain the
funding available to deliver patient services as well as evidence
of medical workforce shortages across geographies and clinical
specialties. Some non-medical professionals are pursuing a role
substitution agenda, often outside of the team-based approach
supported by the AMA.
Future vision
The AMA’s vision supports a first-class health system in
Australia, supported by the government that works to meet
the demands of a changing society and environment, including
COVID-19,increasing incidence of chronic diseases,and effects
of climate change. The AMA is working on an urgent reform
agenda to improve Australia’s chronically underfunded public
hospital and primary care systems and defend the hybrid public-
private model in Australia over the past 50 years.
Contact information
Address: 39 Brisbane Avenue, Barton, Canberra, Australia
Email: president@ama.com.au
Website: www.ama.com.au
NMA Highlights
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Leadership
President: Dr. Johannes Steinhart
Vice Presidents: Dr. Harald Schlögel, Dr. Harald Mayer
International Affairs: Dr. Edgar Wutscher, Dr. Christian Toth
Directors: Dr. Lukas Stärker, Dr. Johannes Zahrl
History in brief
• 1891: the first medical chambers were created in Austria
and lasted until 1938, when the provisions of the German
“Reichsärzteordnung” were enforced in Austria and the
Austrian medical chambers were dissolved.
• 1938: they were replaced by the “Reichsärzteführung” with its
headquarters in Munich. After the end of the Second World
War, professional associations of doctors were provisionally
formed in all provinces on the basis of the regulations of the
Austrian Medical Association Act of 1891.
• 30 March 1949: associations were later essentially legalised
by the Austrian Medical Act. This precursor of the modern
Austrian Medical Act was also first in establishing an umbrella
organisation in the form of the Austrian Medical Chamber
to represent the collective interests of the provincial medical
chambers.
• 1998: the Medical Act led to a complete restructuring of the
medical chambers, involving the creation of separate bodies
(“curiae”), in order to address specific concerns of different
groups within the medical profession. Three of them were
originally created: one for doctors employed by medical
institutions, another for self employed doctors running their
own practice, and a third group for dentists.
• 2005:the third curia was split off,to form the Austrian Dental
Chamber, leaving the two current curiae.
Mission
In accordance with the Austrian Medical Act, the Austrian
Medical Chamber (Österreichische Ärztekammer, ÖÄK)
represents the collective professional, social, and economic
interests of all physicians working in Austria.It works to preserve
and further the public standing and the rights of physicians,
AUSTRIAN MEDICAL CHAMBER
(ÖSTERREICHISCHE ÄRZTEKAMMER)
Johannes Steinhart
while ensuring their compliance with the duties of the medical
profession. It acts as an umbrella organisation under public law
for the nine provincial medical chambers, which are considered
its members.
The ÖÄK pays special regard to socially oriented, universal,
modern healthcare, provided by doctors in hospitals and private
practices. For this purpose, doctors in Austria are committed to
a high medical standard with special consideration to ongoing
quality management to increase patient safety. The medical
profession is headed by the President of the ÖÄK, who is
supported by three Vice-Presidents, one of whom heads the
curia of employed doctors; a second heads the curia of self
employed doctors.
Objectives
The Austrian health care system and its financing are socially
oriented and based on the principles of solidarity and
subsidiarity. The goals of a sustainable reform of the Austrian
healthcare system must be to ensure a continuing, universal
access to medical care of a high standard for all insured persons
and dependents, and to guarantee that the ethical principles, in
accordance to which doctors practise medicine,as well as protect
their professional independence. Patient services should not be
decided by medical and health-political expertise of doctors and
politicians, respectively, rather than based on economic interests.
National collaborations
The ÖÄK collaborates on a national level with other chambers,
professional societies, and organisations on diverse projects:
“Arznei und Vernunft” (Medicine and Reason) represents an
initiative for a reasonable and evidence-based use of medicines
at all levels of the healthcare system, in collaboration with
the Austrian Chamber of Pharmacists, the Association of
the Austrian Pharmaceutical Industry and the Umbrella
Organization of the Austrian Social Insurance Institutions;”Du
+ Ich= Österreich” (You + Me = Austria) serves as a campaign
that promote a respectful exchange of opinions, in collaboration
with the Austrian Broadcasting Services,the Austrian Red Cross,
and the Austrian Health Insurance Fund; “Doctors Against
Smoking” Initiative promotes the protection of non-smokers,
in collaboration with the Austrian Society of Pneumology and
the Institutes of Environmental Hygiene and Social Medicine
of the Medical University of Vienna.
International collaborations
Besides its WMA membership, the Austrian Medical Chamber
is also a member of European Association of Senior Hospital
Physicians (AEMH), the Standing Committee of European
Doctors (CPME), European Working Group of Practitioners
and Specialists in Private Practice (EANA), European
Junior Doctors Association (EJD), Federation of European
Microbiological Societies (FEMS), European Union of General
Practitioners (UEMO), European Union of Medical Specialists
(UEMS), and Symposium of the Central and Eastern
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European Chambers of Physicians (ZEVA). The ÖÄK actively
participates in the work of these organisations and regularly
attends meetings.
Current challenges
Over the next few years, the most pressing challenges will be to:
• improve the working conditions for hospital physicians
• increase the attractiveness of the social health insurance sector
• ensure low-threshold healthcare services close to where people
live
• significantly reduce the bureaucratic burden for the medical
profession
These steps will help address the acute shortage of doctors
in Austria, which is projected to increase in the social health
insurance sector amidst a steadily growing and ageing population.
Future vision
The ÖÄK aims to achieve a positive framework for medical
practice in Austria, including the improvement of doctors’
specific working conditions. The work of the ÖÄK constitutes
a major contribution to patients’ wellbeing within the Austrian
healthcare system.
Contact information
Address: Weihburggasse 10-12, 1010 Wien, Austria
Email: post@aerztekammer.at
Website: https://www.aerztekammer.at/
President photo: Picture credit: © ÄK Wien / Anna Rauchenberger
BANGLADESH MEDICAL
ASSOCIATION
Mustafa Jalal Mohiuddin
Leadership
President: Dr. Mustafa Jalal Mohiuddin
Secretary General: Dr. Md. Ehteshamul Huq Choudhury
History in brief
Founded in 1971, the Bangladesh Medical Association (BMA)
represents an active service oriented organisation in Bangladesh.
There are 67 branches of the Association around the country.
Mission
To promote dignity of its members, encourage members
to pursue continued medical education on the latest health
innovations, ensure workplace safety, and guide government
leaders to develop suitable health policies for the populace.
Objectives
The BMA participates in public health related activities, ethical
issues and laws relevant for health professionals, research and
publications, activities with other organisations, social welfare
activities, education and training, and foreign affairs.
National collaborations
The BMA collaborates with Directorate General of Health
Services at the Ministry of Health and Family Welfare,
Directorate General of Medical Education at the Ministry of
Health and Family Welfare, National Heart Foundation of
Bangladesh,Bangladesh Medical Research Council,Bangladesh
Medical and Dental Council, and Directorate General of Drug
Administration (DGDA).
International collaborations
The BMA collaborates with the Confederation of Medical
Associations in Asia and Oceania (CMAAO), the World
Medical Association (WMA), and the South Asian Association
for Regional Cooperation (SAARC) (medical association
conferences and assemblies). It also has continued medical
education programs with the Bangladesh Medical Association’s
North America Chapter.
Current challenges
Workplace safety for health professionals
Future vision
• To assist the Government in developing a legislature that will
ensure workplace safety for health professionals
• To establish modern health care facilities at the root level and
promote the best health care delivery system in Bangladesh
Contact information
Address: BMA Bhaban, 15/2 Topkhana Road,
Dhaka-1000, Bangladesh
Email: bma.org.bd@gmail.com
Website: bma.org.bd
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BELGIAN ASSOCIATION
OF MEDICAL UNIONS
(ASSOCIATION BELGE DES SYNDICATS
MÉDICAUX – BELGISCHE VERENIGING
VAN ARTSENSYNDICATEN)
Johan Blanckaert
Leadership
President: Dr. Johan Blanckaert
Vice Presidents: Dr. Bart Dehaes, Dr. Gilbert Bejjani,
Dr. Luc Herry, Dr. Marcel De Clercq
General Secretary: Dr. Yves Louis
General Secretary for International Affairs: Dr. Vincent Lamy
Treasurer: Dr. Alin Derom
History in brief
The history of Belgian unionism has been marked by major
doctor’s strikes, national institutional reforms, and the adopted
law on the status of hospital doctors.
• 17 May 1962: the first Chamber in Liège – Luxemburg was
established.
• 21 March 1963: the Chamber of the provinces of Hainaut,
Namur, and Walloon Brabant established.
• 31 May 1963: the Chamber of the doctors of Brussels
agglomeration established.
• 23 August 1963: the Dutch-speaking part followed this
movement by creating the Chamber of Doctors of the
provinces of Antwerp, Limburg, and Flemish Brabant, and
later the chamber of West and East Flanders. These five
chambers acted on the national level through the Federation
of Syndicate Chambers of Doctors. During the national
communitarisation, this federation was renamed the Belgian
Association of Medical Unions (ABSYM-BVAS), whose
operation is conducted on a joint basis of general practitioners
and specialists and the Flemish community as well as the
Walloon and German-speaking communities.
• 2022: the Union chambers of physicians of Hainaut,
Namur, and Walloon Brabant as well as those of Liège and
Luxembourg merged to form ABSYM Wallonia.
Mission
Building the medicine of tomorrow means continuing to defend
doctors and their patients.
Objectives
• Freedom: Defending freedom of doctor-patient engagements
in health decision-making
• Respect: Supporting doctors in their right to find a balance
between their profession and their private lives
• Protection: Defending doctors’rights to professional insurance
(accident and illness) as well as to civil liability insurance
• Quality: Promoting accessible medicine for patients with best
doctors’ practices
National collaborations
The ABSYM-BVAS representatives support more than 350
mandates in the various bodies of INAMI, Public Health,
and e-Health, including the National Medico-Mutualist
Commission (INAMI-RIZIV) for doctor-insurer engagements
and agreements, General Health Care Council for guideline
development on health care policies, Medical Technical Council
for proposal development,and Medical Assessment and Control
Service (SECM).
International collaborations
The ABSYM-BVAS collaborates with the European Union of
General Practitioners (UEMO),the World Medical Association
(WMA), Standing Committee of European Doctors (CPME),
European Working Group of Practitioners and Specialists in
Free Practice (EANA), and European Association of Senior
Hospital Physicians (AEMH).
Current challenges
Some challenges include:
• limited commitment by younger generations to medicine
• current focus on work-life balance of the medical profession
• support for the independent status of the medical profession
Future vision
At the legislative level, we continue to defend:
• liberal installation of doctors
• fees for service payment
• intramural and extramural equilibrium in respect and payment
• reviving the moral role of doctors
• defending free standing centres of specialised medicine
• administrative help so that doctors can focus on main duties
Contact information
Address: Terhulpsesteenweg 150 – 1170 Brussels, Belgium
Tel: 02/644.12.88
Email: international@cn.medecin.fr
Website: www.absym-bvas.be
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CROATIAN MEDICAL
ASSOCIATION
Željko Krznarić
Leadership
President: Prof. Željko Krznarić
Vice Presidents: Prof. Boris Brkljačić, Dr. Hrvoje Pezo
Secretary General: Prof. Adriana Vince
Treasurer: Dr. Neven Miculinić
Head office: Ivona Matišić, Mag.oec., univ.mag.admin.sanit.
History in brief
• 26 February 1874: the Croatian Medical Association
(Association of Physicians of the Kingdom of Croatia and
Slavonia) was founded to protect people’s health, support
professional and scientific work, and foster medical ethics.
• January, 1877: the first issue of the oldest Croatian medical
journal, Liečnički viestnik, was published.
• 1919: the Association changed its name to the Association
of Doctors of Croatia, Slavonia and Međimurje 1923: the
Association changed its name to the Croatian Medical
Association (CMA).
• 1945: the Association changed its name to the Association of
Doctors of Croatia.
• 1971: the Association changed its name to the Academy of
Association of Doctors of Croatia.
• 1991: the Association changed its name to the Croatian
Medical Association.
Mission
Active communication and cooperation with all doctors and
medical associations in order to preserve the dignity and quality
of profession at all levels.
National collaborations
The CMA collaborates with the Ministry of Health in Croatia,
Croatian Health Insurance Fund, Croatian Institute for Public
Health, Croatian Medical Chamber, Croatian Dental Chamber,
Croatian Medical Union, hospitals, and medical schools in
Croatia.
International collaborations
The CMA collaborates with the European Union of Medical
Specialists (UEMS), European Society for Clinical Nutrition
and Metabolism (ESPEN), the World Medical Association
(WMA), National Guideline Alliance, and Slovensko
Zdravniško Društvo.
Current challenges
Strengthening the European Standards of Postgraduate Medical
Specialist Training,including the actual use and implementation
of the European Training Requirements (ETR).
Future vision
The Croatian doctor is a representative of the progress of the
Republic of Croatia and the guarantor of preserving the health
of citizens of the Republic of Croatia. A Croatian doctor should
uphold high ethical principles within the medical profession,
ranging from primary care to specialised medicine of the 21st
century.
Contact information
Address: Zagreb, Croatia, Šubićeva 9
Tel: +38514693300
Email: tajnistvo@hlz.hr
Website: www.hlz.hr
CZECH MEDICAL CHAMBER
Milan Kubek
Leadership
President: Dr. Milan Kubek
Vice president: Dr. Zdeněk Mrozek
History in brief
• 1894: the Medical Chamber, as part of the Austro-Hungarian
Monarchy, was founded.
• 1929: after the declaration of the independent Czechoslovak
Republic on 28 October 1918, the new Act on Medical
Chambers (Bohemia, Moravian-Silesian, Slovakia including
Subcarpathian Rus) was adopted.
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• March 1939: the Chambers maintained their independence
until the Nazi occupation in March 1939,and then Communist
dictatorship resulted in February 1948.
• 1950: the Act on Medical Chamber was illegally abolished by
a simple decree of the officiating Minister of Health.
• 1989: democracy was established.
• 8 May 1991: the Czech Medical Chamber was restored by
law.
Mission
The Czech Medical Chamber (CMC) is a guarantor of the
quality of medical care and a guardian of medical ethics. We
defend the professional and economic interests of members so
that doctors can perform their profession to the highest possible
standard.The existence of a strong and independent professional
self-government is a basic condition for preserving the autonomy
of doctors, which is of vital importance for patient safety.
Objectives
• Administer the Registry of All Physicians Working in the
Czech Republic
• Guarantee proper qualification and certify fulfilment of the
conditions required for optimal professional performance
• Be a guarantor of a lifelong learning
• Conduct professional supervision and disciplinary power
toward all physicians
National collaborations
The CMC collaborates with the government, Parliament,
regional and municipal self-governments, medical schools,
professional medical associations, health care providers, trade
unions, and health insurance companies.
International collaborations
The CMC collaborates with the Standing Committee of
European Doctors (CPME), the World Medical Association
(WMA), and the CMC Division of Junior Doctors.
Current challenges
Although doctors, nurses and other healthcare professionals
have helped save more than tens of thousands of lives and keep
an active economy during the pandemic, they have experienced
reduced income and compensation. Furthermore, as the CMC
has provided support,medical care,and asylum for half a million
Ukrainian refugees in 2022, future efforts may be needed to
address the ongoing conflict.
Future vision
The strategic goals of the CMC include:
• quality, safe, and accessible medical care for all citizens
• fair cost of labour and acceptable working conditions for all
doctors
• quality and accessible training for doctors
• preservation of professional autonomy and dignity of the
medical profession
• advocacy of humanity, solidarity, and democracy
Contact information
Address: Česká lékařská komora, Drahobejlova 1019/27, 190 00
Praha 9, Czech Republic
Email: foreign@clkcr.cz
Website: https://www.lkcr.cz/
ESTONIAN MEDICAL
ASSOCIATION
Jaan Sütt
Leadership
President: Dr. Jaan Sütt
President-Elect: Prof. Neeme Tõnisson
Secretary General: Dr. Katrin Rehemaa
History in brief
• 28 February 1921: the Estonian Medical Association (EMA)
was founded inTallinn,Estonia.During the Soviet occupation
(1944-1987), the Association was prohibited in Estonia,
and the Estonian Physicians Society in Sweden (EASR)
conducted traditions of the doctors’ union.
• 11 June 1988: the EMA activities were restored.
Mission and objectives
EMA supports the development and reputation of the medical
profession, protects the interests of doctors, promotes medical
ethics and medical culture and represents the views of the
medical profession in shaping health care policy.
National collaborations
EMA works in close collaboration with the local organisations
representing patient interests, other healthcare specialists, and
relevant state institutions.
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International collaborations
EMA is a full member of leading international medical
organisations: the World Medical Association (WMA),
Standing Committee of European Doctors (CPME), European
Union of Medical Specialists (UEMS), and European Junior
Doctors Association (EJD).
Current challenges
EMA’s main areas of activity are related to promoting the quality
of medical care, improving the working and salary conditions of
doctors, promoting continuing medical education and medical
ethics.The main challenges in Estonian healthcare are:
• shortage of medical workforce
• overworking specialists
• burnout of doctors
Future vision
EMA aims for the healthcare system which is accessible,
affordable and provides high-quality care for our patients.
Contact information
Address: Pepleri Str 32, 51010 Tartu, Estonia
Email: arstideliit@arstideliit.ee
Website: https://arstideliit.ee/
FINNISH MEDICAL
ASSOCIATION
Niina Koivuviita
Leadership
President: Dr. Niina Koivuviita
Chief executive officer: Dr. Janne Aaltonen
History in brief
• 1910: the Finnish Medical Association (FMA) was
established and the first President expressed the hope that
it would become “the heart and conscience of the medical
profession”.This mission has been implemented by promoting
ethical principles and guidelines to members. The FMA
celebrated its 100-year anniversary in 2010, with international
guests, and published a comprehensive history of the
organisation.
• 1964: the FMA hosted the WMA General Assembly, when
the WMA Declaration of Helsinki was adopted. FMA also
hosted 2003 WMA General Assembly as well as 50-year
celebration of Declaration of Helsinki in 2014. We look
forward to hosting the WMA General Assembly in 2024 and
celebrating 60 years of the WMA Declaration of Helsinki.
Mission
Doctors together for the benefit of the patient.
Objectives
The FMA is a professional organization and a trade union.
Almost all doctors practising in Finland are members although
the membership is voluntary.
• Add Values promoted by the FMA include advancement
of medical expertise, humanity, ethics, and collegiality. The
FMA binds its members together to support these values, and
represents their common professional, social and economic
interests.
• The FMA also works in numerous ways to develop health care
and advance medical expertise on the basis of the professional
knowledge of its entire membership.The Association is active
in relation to ethical issues and safeguarding the interests of
doctors and patients in Finland and internationally.
National collaborations
The FMA collaborates with the government and parliament as
well as national, regional, and local authorities.
International collaborations
In addition of being a member of the World Medical Association
(WMA), the FMA is a member of four European Medical
Organizations: Standing Committee of European Doctors
(CPME), European Union of Medical Specialists (UEMS),
European Union of General Practitioners/family doctors
(UEMO), and European Junior Doctors (EJD). The FMA also
closely collaborates in different fields with Nordic countries.
Current challenges
WiththeFinnishsocialandhealthcarereformon1January2023,
the organising responsibility of social and health care services
shifted from around 200 municipalities to 21 counties. As the
employer of social and health care workers including physicians
changed, many questions were raised from our members. We
support physicians in this changing working environment,
including negotiations on salaries and other working conditions.
Future vision
The FMA is a strong influencer and a respected trendsetter, as
stated in the FMA 2022-2024 Strategy.
NMA Highlights
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François Arnault
Leadership
President: Dr. François Arnault
Secretary General: Dr. Pierre Maurice
Treasurer: Dr. Pierre Jouan
Vice Presidents: Dr. Marie-Pierre Glaviano-Ceccaldi,
Dr. Jean-Marcel Mourgues, Dr. Gilles Munier,
Dr. Jacqueline Rossant-Lumbroso
General delegate for EU and international Affairs
Dr. Philippe Cathala
History in brief
• 24 September 1945: the current French Medical Council
(Ordre National des Médecins, CNOM) was created, which
highlighted the role of medical ethics. The members of the
Council were elected by the doctors listed on the Register.
• 1947: the first code of ethics was published.
• 2002: the Council mission was expanded by the Law on
the Quality of the Health System, establishing regional
councils and entrusting the Council to ensure that doctors’
competences were guaranteed throughout their career.
Mission
The commitment of the French Medical Council is “At the
service of doctors in the interest of patients”.
Objectives
The CNOM fulfils its mission as a private organisation assigned
to a public service mission. It is the only body in France that
unites doctors of all specialties and practice types. It completes
its duties through Departmental Councils, Regional Councils,
and the National Medical Council. Through its moral,
administrative, consultative, mediation and jurisdictional roles,
the CNOM contributes to building trust in the doctor/patient
relationship. Its members also support:
• Guaranteeing professional ethics
Compliance with medical ethics and deontology is one of the
main areas of competence of the Council which is responsible
for drafting the code of medical ethics that is enshrined in
the public health code. The Council also prepares comments
on the code to make it easier for doctors to understand and
comply with the code in their daily work. It also acts as a
disciplinary body for doctors who fail to comply with the
principles of professional ethics.
• Ensuring the competence of physicians
The law has given the Council the role of ensuring that
the competence and probity of the medical profession
are maintained. It maintains an up-to-date list of doctors
authorised to practise. It manages the registration of doctors
on this list.
• Supporting and helping doctors
The Council supports doctors in their daily work. In an
increasingly complex legal and societal environment, it acts as
an advisor to help them set up in business, choose the status
best suited to their mode of practice and carry out their activity
as serenely as possible throughout their career. The Council
provides doctors with tools to facilitate their professional
practice: model contracts,practical guides,etc.It provides legal
advice, particularly when drawing up contracts and statutes,
in matters of insurance or in the event of a dispute between
the doctor and the patient or between colleagues. Finally,
the Council manages a mutual aid fund to help doctors in
difficulty and their families.
• Ensuring access to and quality of care
Alongside the representatives of other health professionals,the
Council monitors the quality of care, access to it and respect
for patients’rights.It ensures the professional independence of
all its members in their relations with the pharmaceutical and
biomedical industries.
• Dialogue with the public authorities
The Council is a key player in discussions on changes in the
healthcare system. It is present in many bodies and acts as
an expert for ministries, regional health agencies (ARS)
and French public health bodies (Haute Autorité de Santé,
Agence Nationale de Sécurité du Médicament, etc.). As an
interlocutor with the public authorities, it issues opinions on
draft laws and decrees relating to health.To reinforce its role as
an expert, the Council carries out various surveys on medical
demography, physician safety and the availability of care.
NMA Highlights
Contact information
Address: Mäkelänkatu 2, 00501 Helsinki, Finland
Email: international@laakariliitto.fi
Website: www.laakariliitto.fi
FRENCH MEDICAL
COUNCIL
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National collaborations
The Council is a valued partner at local and regional level in
every part of France.
International collaborations
The Council has established strong links with Medical Councils
and similar bodies from other European countries. It has a
permanent office in Brussels and is represented in several
organisations and networks of doctors in Europe, including
the European Council of Medical Orders (CEOM), Standing
Committee of European Doctors (CPME), European
Association of Senior Hospital Physicians (AEMH), European
Network of Medical Competent Authorities (ENMCA),
Conference of French-speaking Medical Councils (CFOM),
and World Medical Association (WMA).
Current challenges
• Guarantee for patients access to high-quality, safe care.
Implement a local health organisation under the coordination
ofthedoctorandinpartnershipwithotherhealthprofessionals.
• Ensure that the physician remains at the core of this
organisation, as a real pillar of the healthcare team around the
patient and his or her health care pathway.
• Adopt a position on the societal and ethical issues it faces
today, particularly the issue of the end of life, in line with
current national legislation (Claeys-Leonetti Act).
• Enhance the value of the medical profession and improve
its attractiveness, especially for the younger generations. The
latter must continue to consider practising this profession
with passion and pride.
• Continue its modernisation. It already ensures a strict parity
of elected representatives and enhances the role of practising
doctors. It also fully meets its mission to serve doctors
throughout their career.
Contact information
Address: 4 Rue Léon Jost – 75855 PARIS CEDEX 17, France
Email: international@ordre.medecin.fr
Website: https://www.conseil-national.medecin.fr
GEORGIAN MEDICAL
ASSOCIATION
Gia Lobzhanidze
Leadership
Chair, Board of Directors: Dr. Gia Lobzhanidze
Vice Chair, Board of Directors: Dr. Gia Tsilosani
Secretary General: Dr. Tinatin Supatashvili
History in brief
Founded on 5 May 1989, the Georgian Medical Association
(GMA) is an independent, professional union of doctors that
supports the professional and personal needs of doctors working
in Georgia.
Mission
The GMA aims to protect the civil, professional, legal, and
socioeconomic interests of the medical community, by serving as
the voice and uniting doctors of all medical disciplines within the
country. It encourages active member participation in strategic
development and health policy of the country.
Objectives
Some GMA tasks include supporting decentralisation of the
health system,protecting doctors’rights,fostering junior doctors’
professional development, prioritising biomedical ethics,
organising and managing educational, scientific, and practical
actions, and assisting with licensing and accreditation.
National collaborations
The GMA collaborates with federal departments, like the
Georgian Parliament, the Ministry of Refugees from the
Occupied Territories of Georgia, and the Ministry of Labor,
Health and Social Affairs of Georgia.They also are connected to
more than 90 professional associations in Georgia.
International collaborations
The GMA collaborates with the European Forum of Medical
Associations (EFMA), World Health Organization (WHO),
World Medical Association (WMA), South-East European
Medical Forum (SEEMF), and European Permanent
Committee (CPME).
NMA Highlights
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BRITISH MEDICAL
ASSOCIATION
Philip James Banf ield
Leadership
Chair of the Council: Professor Philip James Banfield
Chair of the Representative Body: Dr. Latifa Patel
History in brief
• July 1832: the Association was originally set up as the
Provincial Medical and Surgical Association, a collective
organisation for doctors. Established in the midst of a cholera
outbreak, the association was established for exchanging
scientific knowledge and ideas.
• 1855: the body became known as the British Medical
Association (BMA), following the weekly publication of the
British Medical Journal.
• 1971:the Association was officially recognised as a trade union,
representing and negotiating on behalf of all doctors and
medical students in the United Kingdom. As a professional
association, the BMA also campaigns on a range of global
health issues that impact doctors.
Mission
The BMA is defined by its mission: we look after doctors so they
can look after you.
Objectives
The BMA represents, supports and negotiates on behalf of all
UK doctors and medical students. We are member-run and led,
and fight for the best terms and conditions as well as lobbying
and campaigning on the issues impacting the medical profession.
The Association also provides individual advice pertaining to
employment, immigration, ethics, pension, and contract matters.
National collaborations
The BMA undertakes research and produces recommendations
for both national and local government on a variety of public
and population health issues, as well as health system and
delivery models. The Association works with Westminster, the
Northern Ireland Assembly, Scottish Parliament and the Welsh
Assembly to ensure doctors’ voices are heard and their views
are taken into account by policymakers. We issue briefings to
Members of Parliament and peers, influence consultations and
inquiries, and seek members’ views to influence legislation. As
the collective voice for doctors on population and global health
issues, we collaborate with civil society to develop analysis and
take part in campaigns for change.
International collaborations
The BMA works closely with international organisations
such as the World Medical Association (WMA) and the
Commonwealth Medical Association (CMA) as well as various
European Medical Organisations including the Standing
Committee of European Doctors (CPME), European Union
of General Practitioners (UEMO), European Union of Medical
Specialists (UEMS), and European Junior Doctors (EJD).
Current challenges
There are currently a number of key challenges facing the
National Health Service (NHS) including immediate health
system pressures and funding pressures – yet the single most
important challenge for UK doctors is the workforce crisis.
First, staff shortages have been growing in the NHS for years.
This has been driven by inadequate workforce planning and
lack of government accountability – including insufficient
funding and infrastructure to train enough new doctors. Second,
increasing workload and bureaucracy have made the NHS a
‘leaky bucket’. Additional issues – like years of demoralising
pay erosion and punitive pension taxation rules – have made it
even harder to retain the doctors we have. As a result, Junior
Doctors in England, Scotland and Wales are campaigning for
full pay restoration, with Junior Doctors in England voting
NMA Highlights
Current challenges
• Insignificant number of public hospitals (federal and municipal
hospitals) and university clinics
• Postgraduate medical professional development
• Workforce shortage, especially nursing staff
• Unsafe work conditions of medical personnel in private clinics
• Financial problems to solve everyday tasks, pay membership
fees for international organisations, and send delegates to
international events
• Working with the government to give the NMA more rights
and responsibilities in the medical field
Contact information
Address: 11 Budapeshti Str. 0160 Tbilisi, Georgia
Phone: (+995 32) 2 39 86 86; (+995 32) 2 18 00 19
Email: Georgianmedicalassociation@gmail.com;
info@gma.ge
Website: GMA.GE
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ITALIAN NATIONAL
FEDERATION OF THE ORDERS
OF DOCTORS AND DENTISTS
Filippo Anelli
Leadership
President: Dr. Filippo Anelli
History in brief
The National Federation of the Orders of Doctors and Dentists
(FNOMCeO) is a public body that unites 106 provincial Orders
of Doctors and Dentists in Italy.
• 1910: the Orders of Doctors were established by the Giolitti
Government by Constitutive Law No 455.
• 1946: after the fascist regime in 1935, the Orders were
reconstituted by the Legislative decree No 233.
• 1985: the Medical Orders changed their legal denomination
to “Provincial Orders of Doctors and Dentists”, following the
enactment of Law No 409, which established the profession
of dentistry, creating a Registry of Dentists within the Order
of Doctors.
• 2018: the legal status of the Order was modified by Law No
3, which stated that the auxiliary bodies are subsidiary bodies
of the State, with the aim of protecting public interests, when
connected to professional practice.
Mission and objectives
The FNOMCeO directs, coordinates, and administratively
supports the provincial Orders in conducting institutional tasks
that include maintaining the Registers of Doctors and Dentists
and establishing the Code of Medical Deontology.
National collaborations
The FNOMCeO collaborates with the Ministry of Health,
Ministry of University and Research, Ministry of Finance, and
State-Regions Commission of the National Observatory on
Training in General Medicine.
International collaborations
The FNOMCeO collaborates with the World Medical
Association (WMA), European Union of Medical Specialists
(UEMS), European Union of General Practitioners (UEMO),
European Association of Senior Hospital Physicians (AEMH),
European Council of Medical Orders (CEOM), Federation
of European Dental Competent Authorities and Regulators
(FEDCAR), Association for Dental Education in Europe
(ADEE).
Current challenges
• Environmental protection
• Violence against healthcare professionals
• Infodemics and misinformation in science and medicine
• Fundamental rights, such as self-determination, cultural
pluralism, freedom of research and science
• Communication,in the context of doctor-patient relationships
and relationships with other health professions and society
• New technologies, including artificial intelligence, robotics,
and telemedicine
• Responsibility, autonomy and clinical risk, which considers
conflicts of interest and relationships between the Code and
the Law
Contact information
Address: Via Ferdinando di Savoia, 1 – 00196 Rome, Italy
Email: estero@fnomceo.it; presidenza@fnomceo.it
Website: https://portale.fnomceo.it/
NMA Highlights
overwhelmingly for industrial action.
Future vision
Our guiding vision is to ensure ‘A profession of valued doctors
delivering the highest quality health services.’ We will achieve
this through:
• actively increasing our membership density by listening to our
members and improving services
• representing the profession by acting on their concerns to
achieve the best possible outcomes, both individually and
collectively
• external influencing on issues that matter the most to the
profession
• building a sustainable organisation with a supportive culture
Contact information
Address: BMA House, Tavistock Square, London, England
WC1H 9JP
Email: info.international@bma.org.uk
Website: https://www.bma.org.uk/
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Leadership
President: Dr. Ilze Aizsilniece
Vice Presidents: Dr. Maris Plavins, Prof. Angelika Krumina
History in brief
• 1988: the Latvian Medical Association (LMA) was founded.
• 1993: started certifying doctors.
• 1998: the Latvian Code of Ethics for Doctors was approved
The LMA aims to defend the legal, professional and economic
interests of Latvian doctors. Currently, they have organised 9
Latvian Doctors’ Congresses, and the total membership is 3336
physicians.
Mission
The purpose of the association’s activities is the continuous
improvement of the health care system and the qualifications
of doctors, the promotion of public health and health literacy,
the improvement of the health care organisation and medical
education system,and the promotion of the principles of medical
ethics.
National collaborations
The LMA collaborates with the Ministry of Health of Latvia,
National Health Service, State Agency of Medicines of the
Republic of Latvia, and Centre for Disease Prevention and
Control of Latvia.
International collaborations
The LMA collaborates with the World Medical Association
(WMA), Standing Committee of European Doctors (CPME),
and European Union of Medical Specialists (UEMS).
Current challenges
• Implement the developed new salary model in accordance with
the “Public Health Guidelines for 2021-2027”, and ensure
that the salary of those working in the health care sector is
increased by 10% every year until it reaches the EU average
ratio against the national average salary from 2021 to 2027
• Make the necessary changes in the regulatory framework so
that government spending on health care increases to at least
6.5% of GDP and Latvian government spending on health
care (% share of all spending) approaches the EU average of
15%
• Use the latest version of the International Code of Medical
Ethics in the development of existing legislation
• Create a code of ethics/principles for the actions of LMA
institutions, boards, vice presidents and president Raise
discussions and reach common understanding with the
Ombudsman and politicians on issues of medical ethics
• Cooperate with patient organisations on issues of medical
ethics
• Inform and educate the public about ethical issues
• Increase active involvement of colleagues working in the
regions in the Association’s work, ensuring the exchange of
opinions
• Involve Latvian specialists in international cooperation, thus
increasing the competences of specialists and strengthening
the country’s international visibility
• Restore health education in school programs as well as
improve health literacy in Latvian society, thus increasing
patient satisfaction and participation in the treatment process
• Ensure the availability of rehabilitation at all stages of
treatment,including rehabilitation as a mandatory component
also in currently prioritised sectors – psychiatry and oncology
• Plan the associate degree and postgraduate education of
doctors according to health care needs. Young doctors should
be provided with the opportunity to continue postgraduate
training in Latvia, thus reducing the outflow of young
colleagues to other countries.
• Implement qualitative and functional digital solutions in
healthcare. Health data and their analysis must become
the basis for decision-making, creation of new strategies
and implementation of health sector reforms, therefore it
is necessary to reduce data fragmentation. Special attention
should be paid to the use of secondary data and the security
of personal data, which should not be an obstacle to the
implementation of public interests in the field of health.
Future vision
• Promoting person-centred and result-oriented healthcare as
well as equal access to healthcare services and medicines for
all Latvian citizens
• Increasing state support for research work in both the
biomedical field and public health
• Increasing the number of LMA active members
• Collaborating with LMA institutions and corresponding
institutions within the European Union
• Supporting federal investment in health care services for
Latvian citizens, reducing individual health care expenses, like
in other Baltic countries (Estonia, Lithuania)
Contact information
NMA Highlights
LATVIAN MEDICAL
ASSOCIATION
Ilze Aizsilniece
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Leadership
President: Dr. Muruga Raj Rajathurai
Immediate Past President: Dr. Koh Kar Chai
President-Elect: Dr. Azizan Binti Abdul Aziz
Honorary General Secretary: Datuk Dr. Thirunavukarasu A/L
Rajoo
Honorary General Treasurer: Dr. Vasu Pillai A/L Letchumanan
History in brief
The Malaysian Medical Association (MMA) is the main
representative body for all registered medical practitioners in
Malaysia.With more than 15,000 members,the MMA (initially
known as Malayan Medical Association) now embraces the
largest number of doctors in the country.
• 9 November 1858: the idea to form the MMA came at
this meeting, attended by a group of doctors from Malaysia
(formerly known as Malaya) and Singapore, the two countries
that had just gained independence.The MMA was formed to
take over the functions of the Malayan Branch of the British
Medical Association following its dissolution in Malaya.
It also took over the professional functions of the Alumni
Association of the King Edward VII College of Medicine and
the Faculty of Medicine, University of Malaya.
• 21 December 1959: the MMA was officially registered in the
Federation of Malaya. Due to its consolidation of objectives,
the MMA became deeply involved in formulating the
country’s medical foundations and presenting a strong front
for doctors in Malaysia.
• 1971: the name Malayan Medical Association was changed to
Malaysian Medical Association, with the addition of various
branches across Malaysia.
• 6 April 1973: the MMA House was officially declared open
by the then Prime Minister Tun Abdul Razak.
Mission
• Promote and maintain the honour and interests of the medical
profession
• Sustain the professional standards of medical ethics
• Serve as the integrated voice of the profession
• Educate and direct public opinion on public health matters
• Participate in the conduct of medical education
• Promote social, cultural, and charitable activities in building a
united Malaysia
Objectives
• Promote and maintain the honour and interest of the
profession of medicine in all its branches and in every one of
its segments and help to sustain the professional standards of
medical ethics
• Serve as the vehicle of the integrated voice of the whole
profession and all or each of its segments both in relation
to its own special problems and in relation to educating and
directing public opinion on the problems of public health as
affecting the community at large
• Participate in the conduct of medical education, as may be
appropriate
• Promote social, cultural and charitable activities in building a
united Malaysian nation
• Participate in, or invest a portion of the Association’s funds
in any entity, corporation or association by way of joint
venture, business partnership, commercial arrangement,
transaction and/or any legal means permitted, which would
be in the interest of and beneficial to the Association, and be
advantageous, profitable or calculated directly or indirectly
to enhance any or all of the Association’s fixed, current,
liquid assets, properties, business, investments, commercial
arrangements, and rights, provided that they are never in
conflict with the Code of Medical Ethics.
National collaborations
The MMA collaborates with the Ministry of Health,
Malaysia (MOH), Ministry of Higher Education, Malaysia
(MOHE), Ministry of Finance, Malaysia (MOF), Ministry of
International Trade and Industry,Malaysia (MITI),FOMEMA
Sdn Bhd (an appointed company to operate a comprehensive
Foreign Workers’ Medical Examination Screening System
in Peninsular Malaysia on behalf of the Ministry of Health,
Malaysia), Malaysian Medical Relief Society (MERCY
Malaysia), Association of Private Hospitals, Malaysia (APHM),
Academy of Medicine of Malaysia,Federation of Private Medical
Practitioners’ Association, Malaysia (FPMPAM), Medical
Practitioners Coalition Association of Malaysia (MPCAM),
Malaysian Organisation of Pharmaceutical Industries (MOPI),
Pharmaceutical Association of Malaysia (PhAMA), Malaysian
NMA Highlights
MALAYSIAN MEDICAL
ASSOCIATION
Muruga Raj Rajathurai
Address: Skolas iela 3, Riga, Latvia, LV-1010
Email: lma@arstubiedriba.lv
Website: www.arstubiedriba.lv
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MYANMAR MEDICAL
ASSOCIATION
Aye Aung
Leadership
President: Professor Aye Aung
Vice President: Professor Saw Win
Secretary General: Dr. Kyaw Lynn
Joint- Secretary General: Professor Khay Mar Mya
Treasurer: Professor Yin Yin Sein
Joint-Treasurer: Professor Yee Yee Khin
History in brief
1949: The Myanmar Medical Association (MMA) was founded
in 1949, as a non-governmental, non-political, non-profit, and
independent organization in Myanmar.It stands for professional
integrity and serves the health of the people. Nearly 22,000
registered members are involved in academic and technical
activities with the Association. The MMA has a democratically
elected executive committee with 42 specialty societies, 6 special
interest groups, 5 social groups, and over 80 branches of the
Medical Association in States, Regions, and Townships in
Myanmar.
Mission
Continuing and updating medical education and maintaining
professionalism and ethical conduct among the members of the
MMA.
Objectives
• Promote the knowledge of medical doctors of the latest
developments in medicine
• Improve quality of health care of the nation
• Maintain and promote high ethical standards
• Encourage and implement research activities
• Build unity, friendship, and co-operation
• Nurture newer generations of medical profession
• Participate in public health activities
• Correlate and co-operate with regional and international
medical professional organisations
National collaborations
The MMA collaborates with the Ministry of Home Affairs,
Ministry of Health, Ministry of Social Welfare Relief and
Resettlement, and local non-governmental organisations
(Myanmar Health Assistant Association, Myanmar TB
Association, Pyi Gyi Khin, Myanmar Nurses Association).
International collaborations
The MMA collaborates with the World Medical Association
(WMA) (since 2012, as the 111th member nation),
Confederation of Medical Association in Asia and Oceania
(CMMAO) (since 2009), and Medical Association of South-
East Asian Nations (since 1996). They also work with the
United Nations for Population Fund (UNFPA), World Health
Organization (WHO), Global Fund (GF), Access to Health
Fund (AHF), United Nations Office for Program Services
(UNOPS), United Nations Development Program (UNDP),
United Nations Children Fund (UNICEF), Three Diseases
Fund (3D), German Fund, Bill Gate & Melinda Foundation
(BGMF), Nippon Foundation (Japan), and international
non-governmental organisations (World Vision International,
Population Service International, Médecins du Monde, Care
Myanmar).
NMA Highlights
Pharmacists Society, Malaysian Society for Quality in Health
(MSQH), Medico-Legal Society of Malaysia, Malaysian
Professional Centre,and Federation of Malaysian Manufacturer’s
Infant Formula Ethics Committee (FIFEC).
International collaborations
The MMA is a member of the Medical Associations of
Southeast Asian Nations (MASEAN), Commonwealth
Medical Association (CMA), and Confederation of Medical
Associations in Asia and Oceania (CMAAO). The MMA
is affiliated to the Australian Medical Association (AMA),
British Medical Association (BMA), Chinese Medical
Association (CMA), New Zealand Medical Association
(NZMA),Singapore Medical Association (SMA), Indian
Medical Association (IMA), Hong Kong Medical Association
(HKMA), Confederation of Medical Associations in Asia &
Oceania (CMAAO), Medical Association of Southeast Asian
Nations (MASEAN) and World Medical Association (WMA).
Contact information
Address: 4th Floor, MMA House 124, Jalan Pahang, 53000
Kuala Lumpur, Malaysia
Email: info@mma.org.my, secretary@mma.org.my
Website: https://mma.org.my/
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NORWEGIAN MEDICAL
ASSOCIATION
Anne Karin Rime
Leadership
President: Dr. Anne Karin Rime
Vice President: Dr. Nils Kristian Klev
History in brief
The Norwegian Medical Association (NMA) was founded in
1886. It includes more than 39,000 physicians and medical
students, which corresponds to 94% of physicians practising in
Norway. The NMA has three main constituencies, including
local branches, occupation branches, and medical societies.
Mission
• Promote the highest medical and ethical professional
standards among members
• Safeguard members’ social, collegial, and economic interests
NMA Highlights
Current challenges
Due to the national situation and the COVID-19 pandemic,
MMA members experience difficulties attending in-person
continuingmedicaleducationcourses,meetings,andconferences.
Future vision
As a professional organisation to continue supporting goals and
maintaining high ethical standards for our medical professional
members.
Contact information
Address: 249, Thienbyu Road, Mingalartaungnyunt Township,
Yangon, Myanmar
Tel/Fax: 01-8378863, 8380899,8388097, 8394141, 09 8601677
Email: mmacorg@gmail.com, mmacoffice249@gmail.com
Website: www.mmacentral.org
• Safeguard members’ mental and physical health
• Promote medical education and medical scientific work
• Promote appropriate measures for the improvement of public
health and address political issues related to health
Objectives
• Promote a public health service with universal access to
equivalent health services
• Promote medical education, quality, patient safety, mental
health, and global health collaborations
• Safeguard physicians’ professional autonomy and improve
physicians’ working day and work environment
• Improve financing and resource efficiency and level of
emergency preparedness within the health service
• Strengthen collaborations between health service departments
• Ensure a high quality specialist training and professional
development and promote research and clinical application of
new knowledge
National collaborations
The NMA is one of the largest professional trade unions in
the country. Organising 94% of physicians in Norway, the
Association is a key negotiating and discussion partner with
national health authorities, regional health corporations, and
municipalities.
International collaborations
The NMA is a founding member of the World Medical
Association (WMA) and member of the Standing Committee
of European Doctors (CPME) and European Union of
Medical Specialists (UEMS). In addition, our medical societies
and occupational branches participate in their corresponding
European and global collaborations.
Current challenges
The Norwegian health care system is available to all residents
across the country. To address emerging health priorities,
the health care system will require regular monitoring and
evaluation and make relevant modifications to maintain high-
quality service delivery.The main challenges include:
• hospitals are constructed with an inadequate infrastructure for
effective operations
• significant recruitment challenges exist in the primary health
care system
• medical students experience limitations in their academic
training
Contact information
Address: Christiania Torv 8, 0158 Oslo, Norway
Email: Legeforeningen@legeforeningen.no
Website: Legeforeningen.no
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POLISH CHAMBER OF
PHYSICIANS AND DENTISTS
Łukasz Jankowski
Leadership
President: Dr. Łukasz Jankowski
Vice Presidents: Dr. Paweł Barucha, Dr. Klaudiusz Komor,
Dr. Mateusz Kowalczyk
Secretary General: Dr. Grzegorz Wrona
Deputy Secretary: Dr. Paweł Doczekalski
Treasurer: Dr. Grzegorz Mazur
History in brief
The Polish (Supreme) Chamber of Physicians and Dentists
represents the professional self-government of physicians and
dentists at state level, while the regional medical chambers serve
at the regional level.
• 1921: the Chamber of Physicians established.
• 1938: the Chamber of Dentists established.
• 1952: reactivated in 1945, the Polish medical chambers were
dissolved by the communist government.
• the 1980s: democratic changes contributed to the restoration
of the joint self-government of all physicians and dentists in
Poland.
• 17 May 1989: the Law on the Chamber of Physicians and
Dentists was passed,the joint self-government was reactivated
• 2009: the 1989 Law was renewed.
Mission and objectives
The Polish professional self-government of physicians and
dentists determines the principles of professional ethics and
deontology binding all physicians and dentists. It monitors
compliance to the rules of professional ethical conduct and
supervises proper and conscientious exercise of both medical
professions. Other main tasks of the Polish Chamber of
Physicians and Dentists include:
• awarding the right to practise the profession
• keeping registries of physicians and dentists
• delivering opinions on matters concerning public health, state
health policy, and organisation of healthcare
• participating in legislative works regarding issues of the
medical profession
NMA Highlights
• supporting under- and post-graduate training of physicians
and dentists
• cooperatinginthefieldofcontinuingprofessionaldevelopment
National collaborations
The Polish professional self-government of physicians and
dentists cooperates with public central and local authorities,
administration agencies, scientific societies and associations,
universities and research organisations, trade unions, other
professional self-governments, and social organisations.
International collaborations
The Chamber actively collaborates with the Standing
Committee of European Doctors (CPME), European Union
of Medical Specialists (UEMS), European Forum of Medical
Associations (EFMA), World Health Organization (WHO),
Symposium of Medical Chambers of Central and Eastern
Europe (ZEVA), Council of European Dentists (CED), World
Dental Federation (FDI), and European Regional Organization
of the World Dental Federation (ERO/FDI).
Current Challenges
One of the challenges is the introduction of the no-fault system
(a solution aimed at improving medical treatment and safety)
within the Polish healthcare system. The Polish Chamber of
Physicians and Dentists has recently elaborated a draft of law
based on three pillars:
• exclusion of doctors and dentists from criminal liability (with
no exemption from liability in case of gross error or death of
patient) with binding civil and professional liability
• introduction of a registry of adverse events that will reduce
future medical errors
• implementation of a compensation fund
Contact information
Address: 110, Jana Sobieskiego Str., 00-764 Warsaw, Poland
Tel.: +48 22 559 13 00
Email: sekretariat@nil.org.pl; polishchamber@nil.org.pl
Website: https://nil.org.pl
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SERBIAN
MEDICAL CHAMBER
Miodrag Stanic
Leadership
Director of the Medical Chamber: Dr. Miodrag Stanic
History in brief
1901: the Serbian Medical Chamber founded. It is an
independent, professional organisation that was founded at
a time when chambers were established in other European
countries as professional associations that could self-regulate
and control their membership.
NMA Highlights
ROYAL DUTCH MEDICAL
ASSOCIATION
René Héman
Leadership
President: Dr. René Héman
History in brief
The Royal Dutch Medical Association (RDMA) was founded in
1849, to ensure that there was a quality requirement for doctors
and that the profession would be protected.The RDMA has been
committed to improving the quality of the medical profession
and public health, by supporting agreements and guidelines that
are relevant for all doctors. The RDMA represents a platform
for discussion and participates in the debate about developments
and bottlenecks in healthcare.
The RDMA is a leader for doctors and clinical care:
• in the quality of the profession by training, by (re)registering
doctors, providing peer support, and establishing rules of
conduct.
• when guiding doctors in ethical legal dilemmas, including
euthanasia, dementia or problematic substance use.
• in providing support, by sharing workplace dilemmas and
guidelines as well as providing a platform for strengthening
care.
• in taking control of important objectives, such as community
health promotion.
• by examining the intangible interests of more than 65,000
doctors and medical students.
National collaborations
The RDMA has eight members, our federation partners: seven
professional organisations for doctors (and their scientific
associations) and the association for medical students. Through
these federation partners more than 65.000 doctors are connected
with and have the possibility to give inside on the healthcare field
to the RDMA. Doctors can also share their experiences, views
and wishes through other channels,such as the RDMA Doctors’
Panel, district meetings and expert meetings. The RDMA has a
broad network of affiliated organisations in the Netherlands:the
Dutch Patient Federation, the Dutch Association of Mental
Health and Addiction Care the Dutch Healthcare Inspectorate
and the Ministry of Health, Welfare and Sport.
International collaborations
The RDMA collaborates with the World Medical Association
(WMA), the Standing Committee of European Doctors
(CPME), the World Health Organization (WHO), the
European Forum of Medical Associations (EFMA).
Current challenges
Current challenges include
• shortages in healthcare staff and medicines
• availability and sustainability of healthcare services
• growing number of older persons
• influence of digitalization and the use of artificial intelligence
in healthcare
Future vision
In the coming years, the RDMA wants to work together with
partners educators to ensure high-quality health care services to
support the nation.
Contact information
Address: ‘Domus Medica’, Mercatorlaan 1200, 3528 BL
Utrecht,the Netherlands
Email: wma@fed.knmg.nl
Website: Artsenfederatie | KNMG
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2006: it was re-founded and currently has around 38,000
members. Its status is defined by the Law on Chambers of
Health Workers, which prescribes obligatory membership in
the Serbian Medical Chamber for all physicians in Serbia who
perform health activities, as defined by the Health Care Law.
As entrusted tasks given by the Government of the Republic
of Serbia and the Ministry of Health of the Republic of Serbia,
the Serbian Medical Chamber performs the following activities:
• adopts the code of professional ethics
• registers physicians, under the conditions defined by law, and
maintains the Directory of all members of the Chamber
• issues, renews and revokes approval for independent work
licence to members of the Chamber and maintains a directory
of issued, renewed and revoked licence mediation in disputes
between members of the Chamber, that is between members
of the Chamber and users of health services
• organises courts of honour to determine violations of
professional duties and responsibilities of members of the
Chamber as well as imposes disciplinary measures for those
violations
• issues,for the needs of its members,various certificates,within
its jurisdiction
Mission
• Preserving the quality and efficiency in the performance of
entrusted tasks
• Ensuring the highest possible standard of medical ethics
• Fostering the best medical practice
• Representing and advocating all interests of members of the
Chamber in performing their profession
• Protecting the medical branch, the honour, and reputation of
medical profession
• Promoting continued medical education
• Counselling parliament and the government
Objectives
• Improve the status of medical doctors as well as to raise the
level of expertise and ethics within the profession
• Ensure full equality of public and private practice
• Give initiatives to policymakers in order to improve the
working conditions of medical doctors
• Propose to legislators a change of regulations in the field of
health care and health insurance that is in the best interest of
patients and health workers
National Collaborations
The Serbian Medical Chamber collaborates with the Ministry
of Health of Serbia, National Health Insurance Fund, National
Pension and Disability Insurance Fund, Institute for Public
Health of Serbia “Dr. Milan Jovanović Batut”, Health Council
of Serbia, Association of Patients, and other chambers of
healthcare professionals.
They have representatives in many professional and advisory
bodies, working groups, and commissions.
International collaborations
The Serbian Medical Chamber collaborates with numerous
regional and European professional organisations and
associations, such as the World Medical Association (WMA),
European Association of General Practitioners (UEMO),
European Association of Specialist Doctors (UEMS), Standing
Committee of European Doctors (CPME), European Forum
of Medical Associations (EFMA), ZEVA – Symposium of the
Central and EasternEuropean chambers of physicians, and
Southeast European Medical Forum (SEEMF).
Current challenges
• Serbia faces an upward trend in the migration of medical
doctors to developed countries and internal migration towards
large cities, which leads to human resource sustainability
problems in general hospitals in smaller towns.
• Large private sector resources and over 5,000 medical doctors
working in the private healthcare system of Serbia are not
yet recognised, while the inclusion of the private healthcare
system into the state system could raise the quality of
healthcare services in Serbia.
Future vision
The Serbian Medical Chamber aims to position itself in the
future as a sincere and indispensable partner to main institutions
in the public health system and to be actively involved in the
construction of the Serbian health system. Our goal is to
continue working with fellow doctors on raising the reputation
of the Serbian Medical Chamber in public and among the
membership, and to continue to cooperate with the media on
creating a good image of the medical profession.
• We will deepen our cooperation with patient associations in
order to strengthen the patient’s trust in medicine, and also
with the private sector, the Association of Private Health
Institutions and private practices, as well as with other
chambers of our colleagues, health workers with whom we
work intensively.
• We will work on maintaining and strengthening international
collaborations with international organisations and
associations in the process of harmonising legal acts,education,
recognition of diplomas.
• Furthermore, we will work on the creation of an efficient,
functional, sustainable health care system that cares for
patients and their needs and encourages mutual respect
between patients and doctors.
Contact information
Address: Kraljice Natalije 1-3, 11000 Belgrade, Serbia
Email: info@lks.org.rs
Website: https://www.lks.org.rs/
NMA Highlights
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NMA Highlights
SLOVENIAN MEDICAL
ASSOCIATION
Radko Komadina
Leadership
President: Prof. Dr. Radko Komadina
Vice President: Dr. Breda Trzan Grozdanov
Secretary: Dr. Leon Herman
History in brief
The Slovenian Medical Association (SMA) was founded in
1861, it was formed from the Reading Society. It is one of the
oldest Central European medical organisations. It serves as the
cornerstone of civil society, acts in the public interests, and is
not subject to political pressure. It was awarded the Golden
Order of Merit, the highest award given by the President of the
Republic of Slovenia, for its contribution to the development of
the medical profession. It has also awarded the highest prizes to
individuals for their work in medicine.
Mission
Transfer the professional doctrine and knowledge through
professional sections, societies, and associations, which bring
together experts in specific sub-specialities and through a
regional network of societies by:
• monitoring developments in medicine and health policy, and
developing guidelines for specific fields of medicine
• proposing new methods of diagnosis, treatment, and
rehabilitation for specific fields of medicine
• preparing expert opinions,analyses,proposals and assessments
for administrations,institutions and organisations,in line with
the latest recommendations from the profession transferring
professional knowledge and modern medical doctrine to
Slovenian doctors linking Slovenian medical science with the
international environment;
• presenting key achievements, insights, innovations and
relevant topics in the field of medicine to the general public
• highlighting the issues facing the medical profession
• networking with patient associations and other relevant
organisations in Slovenia
• publishing Zdravniški vestnik, a professional medical journal
in Slovenian
Objectives
• Maintain and promote the transfer of knowledge between the
different health disciplines
• Support the publication of the medical journal Zdravniški
vestnik
• Preserve its independence and fostering professional networks
of doctors from all medical disciplines
National collaborations
SMA collaborates with the Slovenian Academy of Medicine,
Medical Chamber of Slovenia, FIDES – Union of Doctors and
Dentists of Slovenia,Professional Association of Private Doctors
and Dentists of Slovenia,Commission for Medical Ethics of the
Republic of Slovenia, Slovenian Ministry of Health, University
of Ljubljana and University of Maribor’s Faculties of Medicine,
and Slovenian Research Agency (ARRS).
International collaborations
SMA collaborates with the World Medical Association
(WMA), European Forum of Medical Societies (EFMA),
World Health Organization (WHO), and European Union of
Medical Specialists (UEMS).
Current challenges
• Maintain professional standards and norms while facing
workforce shortage
• Establish and monitor comparable quality indicators with the
European Union countries
• Update specialisation curricula
• Transpose the international guidelines and recommendations
at national level
Future vision
• Maintain its prestigious status as one of the oldest Central
European medical organisations, continuously operating since
1861
• Remain continuous agents for the renewal of the health
profession
• Increase the number of affiliated doctors
• Increase visibility among the general public
• Facilitate the transfer of knowledge to all members via an
online platform
Contact information
Address: Domus Medica, Dunajska 162,
1000 Ljubljana, Slovenia
Email: info@szd.si, tajnistvo@szd.si,
Website: www.szd.si
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NMA Highlights
SOUTH AFRICAN MEDICAL
ASSOCIATION
Mvuyisi Mzukwa
Leadership
President: Prof. HM Coovadia
Chairperson: Mvuyisi Mzukwa
History in brief
• 19th century: the history of the South African Medical
Association (SAMA) starts when doctors practising in
Cape Town, Grahamstown, Durban, Pietermaritzburg, and
Kimberley Formed their own medical associations as branches
of the British Medical Association.
• 1927: these branches came together and constituted the
National Medical Association of South Africa.
• 21 May 1998: the unification of the pre-democracy medical
groups in the formal reconstitution of the SAMA. Its new
name was registered,under the same 1927 registration number,
and is known as a Section 21 (non-profit) association in
terms of the 1973 Companies Act. SAMA is a non-statutory
professional association for public and private sector medical
practitioners.
Mission
SAMA is a voluntary membership association, existing to serve
its members’ best interests and needs in all healthcare-related
matters, the custodian of a growing advocacy platform that will
unite, guide, and support members for the health of the nation.
Vision
To be the leading and preferred membership organisation
advocating and supporting medical practitioners in South Africa.
Key strategic objectives
SAMA faces changed realities due to the pandemic and the
piercing needs of our members and strategic stakeholders
because of the shifting global, professional and lifestyle trends.
The association needs to embrace the necessary changes by
focusing on six key pivotal business objectives:
• preserving the medical profession by leading national and
strategic engagements for the Re-engineering of Healthcare
in South Africa.
• corporately and legally representing our doctors in clinical
challenges faced academically and professionally.
• future-proofing the profession by spearheading the
transformational changes required in the regulatory
environment.
• supporting doctors to navigate the digital healthcare
landscape, understanding its challenges while leveraging its
opportunities.
• focus on becoming a digitally led organisation,by transforming
SAMA into an organisation that uses technology to
continuously evolve all aspects of its business model (what it
offers, how it interacts and operates).
• building a high-performing organisation, embedding a fit-
for-purpose organisational blueprint that attracts, engages,
and retains employees who will assist in transforming the
business to reach new heights.
National collaborations
SAMA continues to pay attention to and maintain its partner
and stakeholder relationships, to synergistically combine assets
on an ongoing basis to achieve common goals.
• Regulatory institutions: National Department of Health
(NDoH), Health Professionals Council of South Africa
(HPCSA), Council for Medical Schemes (CMS), South
African Health Products Regulatory Authority (SAHPRA),
Board of Healthcare Funders (BHF).
• Private sector organisations: Medical Protection Society
(MPS), Professional Provident Society (PPS), Health Quality
Assessment (HQA), South African Dental Association
(SADA), Foundation for Professional Development (FPD).
• Specialist and General Associations: South African Private
Practitioners Forum (SAPPF), South African Society
of Anaesthesiologists (SASA), South African Society
of Obstetricians and Gynaecologists (SASOG), Unity
Forum for Family Practitioners (UFFP), Alliance of South
Africa Independent Practitioners Association (ASAIPA),
Independent Practitioners Association Foundation (IPAF).
• Medical Schemes: Discovery Health,Government Employees
Medical Scheme (GEMS), Medscheme.
International collaborations
SAMA collaborates with the World Medical Association
(WMA),American Medical Association (AMA),and Coalition
of African National Medical Associations (CANMA).
Current challenges
Among the plethora of global and national challenges, a few
challenges facing SAMA include:
• the recovery and building of a new future post the
COVID-19 pandemic
• the challenges against the commercialisation and
corporatisation of the medical profession that is directly
encroaching on the healthcare practitioners’ clinical space
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SWEDISH MEDICAL
ASSOCIATION
Sof ia Rydgren Stale
Leadership
President: Dr. Sofia Rydgren Stale
Vice Presidents: Dr. Lars Rocksén, Dr. Marina Tuutma
CEO: Mrs. Anna Ingmanson
History in brief
The Swedish Medical Association (SMA) was established in
1903. It serves as a trade union and professional organisation
for physicians.The SMA aims to support physicians throughout
their careers and enters into collective agreements on behalf of
its members regarding employment conditions such as salaries,
working hours, sick and parental leave, and pensions. The SMA
also plays a key role in society in providing the physicians´
perspective on health and health care related issues, and thus
fostering positive developments in health care for patients’
benefits.
Current policy areas
• Physician status and working conditions
• Research and education
• Health care policy
National collaborations
Nationally, the SMA collaborates with the Swedish associations
focusing on health professionals’ career development, including
the Swedish Confederation of Professional Associations
(SACO).
International collaborations
Internationally, the SMA has a long-standing cooperation with
the medical associations from other Nordic countries as well as
the World Medical Association (WMA), Standing Committee
of European Doctors (CPME), and the European Union of
Medical Specialists (UEMS).
NMA Highlights
• the negative effect of managed healthcare and medical scheme
rules on healthcare practitioners
• the mental and behavioural well-being of healthcare
practitioners, as this has a significant and under-recognised
burden on their social needs, and their basic human rights,
further weakening public and private healthcare systems
and the economy reimagining healthcare delivery as health
systems nationwide are struggling with skyrocketing patient
numbers, employee burnout, workforce shortages, supply
chain disruptions, equipment scarcities, and insufficient and/
or outdated facilities
Future vision
As the six strategic objectives underpin all the work that
drives the association, the future is embedded in establishing
a new growth trajectory by reorienting our operating model
for maximal effectiveness and leveraging digital technology
to deliver results with maximum efficiency. Over the next few
years, SAMA continues to be a thought leader, advocate for
change, and industry pioneer. The association is cementing the
foundations of being a digitally-led institution, by developing a
deep capability in member intelligence and the science of data
to deliver an exceptional value proposition for our members and
stakeholders.
Contact information
Address: Block F Castle Walk Corporate Park, Nossob Street,
Erasmuskloof Ext 3, 0181
Email: online@samedical.org
Website: www.samedical.org
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freedom of collective bargaining and digitization, in order to
benefit patients and health professionals.
National collaborations
As the umbrella organisation of Swiss physicians’ societies, the
FMH works with all national stakeholders in the Swiss health
care system – patient organisations, professional associations,
interest groups or representatives of insurance associations, or
politicians or governing authorities.
International collaborations
The FMH is in close exchange with other national physician
organisations and is involved in the World Medical Association
(WMA) and the Standing Committee of European Doctors
(CPME).
Current challenges
• Transnational problems, such as shortages of specialists and
drugs, have been exacerbated by one-sided cost-oriented
policies in Switzerland
• Political activism has increased the density of regulation and
administrative tasks
• The need to ensure workplace safety and reduce health care
expenditure for patients remains a significant priority
Contact information
Address: Elfenstrasse 18, Postfach 300,
3000 Bern 15, Switzerland
Email: info@fmh.ch
Website: www.fmh.ch
THAILAND MEDICAL
ASSOCIATION
Sukhum Karnchanapimai
Leadership
President: Dr. Sukhum Karnchanapimai
President Elect: Prof. Dr. Prakitpunthu Tomtitchong
VicePresident: Prof. Dr. Krisada Ratana-Olarn
NMA Highlights
SWISS MEDICAL
ASSOCIATION
Yvonne Gilli
Leadership
President: Yvonne Gilli, MD
VicePresidents: Christoph Bosshard, MD, Philippe Eggimann, MD
General Secretary: Stefan Kaufmann, MBA, PMP
History in brief
Similar to the Swiss federal state, the Swiss Medical Association
(Foederatio Medicorum Helveticorum, FMH) originated from a
federation of cantonal societies.
• 18th century: by the end of the century, the first cantonal
medical societies were established.
• 1901:thesocietiesunitedtoformtheSwissMedicalAssociation.
• 1920: the FMH revised the statutes and established its own
journal.
• 1923:the General Secretariat was established.
Mission
As an independent organisation, the FMH represents physicians’
interests and supports their professional activities.It is committed
as a credible partner in cooperation with other actors to a forward-
looking and sustainable improvement of the health care system.
The FMH is committed to ensuring that all patients have access
to high-quality and financially-sustainable health care.
Objectives
As the voice of the medical profession, the FMH successfully
campaigns for strong patient care and optimal population health.
As it actively shapes the framework and future of the medical
profession, it is committed to transparent high-quality work and
Contact information
Address: Swedish Medical Association, Box 5610, 114 86
Stockholm, Sweden
Email: info@slf.se
Website: www.slf.se
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TUNISIAN NATIONAL
MEDICAL ASSOCIATION
(LE CONSEIL DE L’ORDRE DES
MÉDECINS DE TUNISIE)
Ridha Dhaoui
Leadership
President: Dr. Ridha Dhaoui
First VicePresident: Dr. Mehdi Jaidane
Second VicePresident: Dr. Alaeddine Sahnoun
Secretary General: Dr. Nizar Ladhari
Secretaire General Adjoint: Dr. Samia Ghouila Trabelsi
Treasurer: Dr. Khalil Boukhris
Treasurer Adjoint: Dr. Sonia Gloulou
History in brief
• 1958: the Tunisian Medical Council was founded. It oversaw
the medical practice of 120 physicians. Since then, it was
instrumental to the development and regulation of the practice
of medicine in Tunisia.
• 1973: the elaboration of the Tunisian Code of Medical Ethics
(Code de Déontologie Médicaleas well as reforms in the field
of medical insurance and medical responsibility.
Mission
The Council regulates the practice of medicine in accordance
with deontological and ethical rules. It ensures the highest
quality of care through the continued formation and information
of physicians and their certification.
NMA Highlights
Secretary General: Prof. Dr. Keerati Charoencholvanich
Deputy Secretary: Prof. Dr. Thawatchai Akaraviputh
Treasurer: Assoc. Prof. Dr. Juvady Leopairut
Public Relations: Assoc. Prof. Dr. Sakda Arj-Ong Vallibhakara
History in brief
• 25 October 1921: the Medical Association of Siam was first
initiated.
• April 1, 1928: the Medical Union Club organised the first
scientific meeting, focusing on scientific and social issues.
Mission and objectives
• Promote welfare and the welfare of members
• Promote unity and uphold the honour of the members
• Promote education, research, and knowledge of medicine and
modern public health among its members
• Support members Practise the medical profession according
to the ethics of the profession
• Support medical education
• Support the standardisation of national medical and public
health systems
• Cooperate with government agencies and private sectors in
developing medical system standards and public health of the
country to be at the up-to-date international level
• Disseminate medical and public health knowledge so that
people can take care of their own health,family,and community
• Give opinions to the government on medical and public
health problems in the country.
• Cooperate with civilised nations in the development of
modern medical and public health systems
• Liaise with international medical associations and the World
Medical Association
• Run or cooperate with charitable organisations for charity and
public benefit
National collaborations
The Thailand Medical Association collaborates with the
Thai Medical Council, Ministry of Public Health, Medical
Association of Thailand, and the Private Hospital Association
of Thailand.
International collaborations
The Thailand Medical Association collaborates with the Medical
Association in ASEAN Countries (MASEAN), Confederation
of Medical Associations in Asia and Oceania (CMAAO), and
the World Medical Association (WMA).
Current challenges
• Cooperation among members
• Budget support
• Collaboration among medical stakeholders
Contact information
Address: 6th Floor Chalermprabaramee Building, Soi Soon
Vijai, New Phetburi Road, Hui Kwang, Bangkok 10310,
Thailand
Email: mat.thailand2464@gmail.com
Website: mat-thailand.org
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Objectives
The Council aims to monitor and promote scientific advances in
the medical field as well as ensuring that physicians can practise
medicine in the best conditions possible, offering legal and
financial assistance when needed.
National collaborations
The Council collaborates with the Comité National d’Ethique
Médicale, Instance Nationale d’Accréditation, Instance
Nationale de protection des Données Personnelles, Syndicat
Tunisien des Médecins Libéraux, and Union des Médecins
Spécialistes Libéraux.
International collaborations
The Council collaborates with the Federation Maghrebine des
Ordres Médicaux, Union des Médecins Arabes (UMA) (Arab
Medical Union), Union Européenne Des Médecins Spécialistes
(UEMS) (European Union of Medical Specialists), World
Medical Association (WMA).
Current challenges
The rise of telemedicine highlights the need for fast regulation
and international harmonisation of medical ethics, as well as the
urgency of the protection of personal data use in the medical
field.
Future vision
Continued studies and international certifications would allow
for the latest scientific development to be shared across the
medical profession and ease access to the highest quality care
for all patients.
Contact information
Address: Maison du médecin, Rue Malaga El Manar 1,
2092 Tunis,Tunisia
Email: cnom@ordre-medecin.tn
Website: https://www.ordre-medecins.org.tn/
NMA Highlights
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Teach Your Patients the Dangers of Gas Stoves: Free Education Webinar
BACK TO CONTENTS
Gas cooking can expose individuals
to harmful pollutants, like nitrogen
dioxide, that can increase risk of
asthma, respiratory irritation, and
cardiovascular disease, especially
among children and the elderly.
This month, the World Medical
Association (WMA)’s My Green
Doctor provides a free 1-hour
education webinar (https://bit.
ly/WMAStovesCME), approved
by the (Accreditation Council for
Continuing Medical Education
(United States) at three different
times on Thursday, 13 July 20213.
Please learn more about this webinar
by reviewing a brief article (https://
mygreendoctor.org/learn-the-health-
risks-of-gas-stoves/ or scan the QR
code below) on this vital topic.
My Green Doctor is a free money-
saving membership benefit from the
WMA. Members use the “Meeting-
by-Meeting Guide” to learn how to
adopt environmental sustainability,
save resources, and help create
healthier communities. The program
adds just five minutes to each regular
clinic staff meeting or weekly office
“huddle”, making small changes at
each meeting that over time really
add up.
Everyone in your practice can register
as Partner Society members by
visiting the websites in English (www.
MyGreenDoctor.org) or Spanish
(www.MyGreenDoctor.es). By using
the discount code MGDWMA,
your team will to receiveget full free
lifetime access to My Green Doctor,
save US$60 instantly, and save
US$1000s in the first year. Ask your
clinic manager to register today and
add My Green Doctor on to your next
agenda. My Green Doctor can help
your practice educate your patients
about emerging health risks!
Todd Sack, MD, FACP
Executive Director, My Green
Doctor Foundation
Clinical Associate Professor, Herbert
Wertheim College of Medicine,
Florida International University
Miami, Florida, United States
tsack8@gmail.com
Todd Sack
Teach Your Patients the Dangers of Gas Stoves:
Free Education Webinar