Dr Mandell, who is head of the orthopaedic department at the Cecilia Makiwane Hospital in Mdantsane, East London, becomes the first South African to be elected president of the WMA since its foundation in 1947.

In his inaugural speech to delegates from almost 70 national medical associations, Dr Mandell said the WMA faced a challenge of facilitating and helping doctors cope with massive changes now taking place. These included the information explosion, political and economic pressures and the growth in consumerism.

He said the WMA should seek to strengthen its membership and build relationships with governments and communities to help solve the problems of health care. It should also advise on the rationale of health care as against the rationing of health care. "I sincerely believe that there is a global need for the WMA", said Dr Mandell. "We cannot allow that decisions about the interest of the communities we serve and our profession are taken by others." He added: "I see the World Medical Association of the future as a global organisation in the truest sense of the word; as custodian of standards, be they ethical, clinical, legal or educational and as a knowledge-broker, generating, processing and disseminating knowledge to national medical associations and colleagues all over the globe. In assuming this responsibility the WMA will empower doctors to bring health to all the people of the world."

The Medical Association of South Africa was readmitted to the WMA in the early 1980s after it withdrew in 1977 following international pressure as a result of the death of the black consciousness leader Steve Biko. Note to editors: The World Medical Association is an independent confederation of professional national medical associations from more than 60 countries.