World Medical Association General Assembly

At its annual General Assembly in Copenhagen, Denmark (October 3-6), the World Medical Association discussed a number of issues, including the following:

HEALTH HAZARDS OF TOBACCO PRODUCTS
The meeting called for tobacco cessation medications with established efficacy to be added to the World Health Organisation's Model List of Essential Medicines. Dr Edward Hill, chair of the WMA, said: 'The current WHO list of minimum medicine needs for a basic health care system contains a number of medications for treating cancer, but nothing for cost effective smoking cessation. This makes no sense at all.'
The meeting called for a series of measures to combat the health hazards of tobacco products, including asking all medical schools, biomedical research institutions, hospitals, and other health care facilities to prohibit smoking on their premises and to refrain from accepting any funding or educational materials from the tobacco industry. Delegates approved a statement warning that if current smoking patterns continue, there will be around 10 million deaths each year by 2020 and 70 per cent of these will occur in developing countries. Tobacco use had been responsible for 100 million deaths in the 20th century and would kill one billion people in the 21st century unless effective interventions were implemented. The meeting also urged national medical associations to speak out against the shift in focus of tobacco marketing from developed nations to less developed nations.

HEALTH AND HUMAN RIGHTS ABUSES IN ZIMBABWE
National medical associations were urged to publicly denounce all human rights abuses and violations of the right to health in Zimbabwe and to actively protect physicians there who are threatened or intimidated. In a statement referring to the 'collapsing health care system and public health crisis in Zimbabwe', the meeting urged the WMA to engage with the Zimbabwean Medical Association to ensure the autonomy of the medical profession in Zimbabwe. It called on ZiMA to invite an international fact finding mission to the country to facilitate urgent action to address the health and health needs of Zimbabweans. The statement also encouraged ZiMA to commit to eradicating torture and inhumane, degrading treatment of citizens in Zimbabwe, and reaffirm support for the clinical independence of physicians treating any citizen of Zimbabwe.

LATIN AMERICA
The meeting expressed concern about reports of arrangements between the Cuban Government and certain Latin American and Caribbean governments to supply Cuban health workers as physicians to these countries, bypassing systems established to protect patients, that were set up to verify physicians' credibility and competence. Delegates approved a resolution calling on governments in Latin America and the Caribbean to work with the medical associations on all matters related to physician certification and the practice of medicine and to respect the role and rights of these medical associations and the autonomy of the medical profession.

ETHICAL GUIDANCE ON TELEMEDICINE
New ethical guidance on the practice of telemedicine was approved. This said that telemedicine - 'the practice of medicine over a distance, where interventions, diagnostic and treatment decisions and recommendations are based on data, documents and other information transmitted through telecommunication systems' - should ideally be employed only in cases where a prior in-person relationship existed between a patient and a physician involved in arranging or providing the telemedicine service. It called for national legislation and international agreements on telemedicine, such as e-prescribing, physician registration, liability and the legal status of electronic medical records.

TISSUE TRANSPLANTATION
Financial incentives for donating tissue for transplantation should be rejected, the meeting decided. It said tissue must always be procured with due consideration for human rights and the principles of medical ethics. All other steps, such as the procurement, testing, processing, conservation, storage and allocation of tissue transplants, should likewise not be commercialised. International exchange of tissue for transplantation should be properly regulated according to agreed upon standards.

Other decisions were reached on:

• A UN rapporteur on the independence and integrity of health professionals
• Family planning and the right of a woman to contraception
• Noise pollution

ELECTIONS

• Dr Jon Snaedal, a geriatrician from Iceland, was installed as President of the WMA for 2007/8
• Dr Yoram Blachar, president of the Israel Medical Association, was elected president elect for 2008-9
• Dr Mukesh Haikerwal, past president of the Australian Medical Association, was elected chair of the Finance Committee.