Adopted by the 40th World Medical Assembly Vienna, Austria, September 1988 and
Revised by the WMA General Assembly, Pilanesberg, South Africa, October 2006

Introduction

1. The effective practice of medicine increasingly requires that physicians and their professional associations turn their attention to environmental issues that have a bearing on the health of individuals and populations.
   
2. More than ever, due to diminishing natural resources, these problems relate to the quality and protection of resources necessary to maintain health and indeed sustain life itself. In concrete terms, the key environmental issues are as follow:
   1. The degradation of the environment, which must be halted as a matter of urgency so that resources essential to life and health - water and pure air - remain accessible to all.
      
   2. The ongoing contamination of our reserves of fresh water with hydrocarbons and heavy metals, along with the contamination of ambient and indoor health by toxic agents, which have serious medical consequences, especially in the poorest segments of the globe. Moreover, the greenhouse effect with its concomitant proven rise in temperature should drive our discussions forward and prepare us for increasingly serious environmental and public health consequences.
      
   3. The need to control the use of non-renewable resources such as topsoil, which should constantly be at the forefront of our minds, as should the importance of safeguarding this vital heritage so that it can be passed on to future generations.
      
   4. The need to mobilise resources beyond national frontiers and to co-ordinate global solutions for the planet as a whole, so as to formulate a unified strategy to confront these worldwide medical and economic problems.
      
   5. The foremost objective is to increase awareness of the vital balance between environmental resources on the one hand, and on the other, biological essentials for the health of everyone everywhere.
3. Our growing awareness of these issues today has, however, failed to prevent an increase in our societies' negative impact on the environment, e.g., melting of glaciers and increasing desertification, nor has it halted the over-exploitation of natural resources, e.g. pollution of rivers and seas, air pollution, deforestation and diminishing arable land. In this context, the migration of people from disadvantaged or developing countries, together with the emergence of new diseases, exacerbates the lack of socioeconomic policies in many parts of the world. From a medical point of view, growth of the population and irresponsible destruction of the environment are unacceptable, and medical organisations throughout the world should redouble their efforts, not only to speak out about these problems, but also to suggest solutions.

Principles

4. In their role as representatives of physicians, medical associations are duty bound to grapple with these environmental issues. They have a duty to produce analytical studies that include the identification of problems and current international regulations on environmental issues, as well as their impact on the field of health.
   
5. As physicians operate within the framework of ethics and medical deontology, the environmental regulations advocated should not seek to limit individual autonomy, but rather to enrich the quality of life for all and to perpetuate life-forms on the planet.
   
6. The WMA should therefore act as an international platform for research, education, and advocacy to help further sustain the environment and its potential to promote health.
   
7. Thus, when new environmental diseases or syndromes are identified, the WMA should help coordinate the scientific/medical discussions on the available data and their implications for human health. It should foster the development of consensus thinking within medicine, and help to stimulate preventive measures, accurate diagnosis and treatment of these emerging disorders.
   
8. The WMA should therefore provide a framework for the international co-ordination of medical associations, NGOs, research clinicians, international health organisations, decision-makers and funding providers, in their examination of the human health effects of environmental problems, their prevention, remediation and treatment for individuals and communities.

14.10.2006