The Halfway Mark – WMA President’s Report
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(05.04.13) One of the tasks of the World Medical Association (WMA) President, as is the case for most organizations, is to report periodically on his/her work on behalf of the Association. At the opening session of the 194th WMA Council meeting here in Bali, Indonesia I gave the following report of my stewardship in this role.
World Medical Association
Cecil B. Wilson, MD, MACP
April 4, 2013
It has been a great privilege for me over the past five months to represent the World Medical Association as your president.
I have found the responsibility sobering, the experience fascinating and the opportunity personally rewarding.
In my inaugural address at the General Assembly last October in Bangkok I shared with you the message that I would carry in my travels around the world on behalf of the WMA.
That message consisted of three parts:
- The moral imperative of ethics in medicine
- The challenge of noncommunicable diseases and their Siamese twins, the social determinants of health
- The threat of climate change
That message has gone with me as I have traveled to four continents,
To twelve countries and
Fifteen cities within those countries for a total of
Sixteen meetings and conferences in the past five months.
The countries include the United States, Canada, Taiwan, South Africa, Israel, Egypt, Singapore, China, Japan, Nepal, England and Latvia.
I would be remiss if I did not express my appreciation to the medical associations and others in each of those countries, many of which are here in this room today, for their warm hospitality to me and their expressions of support for the World Medical Association.
Thank you all.
Posted on the web last week is a list of all the events in which I have participated with a brief description of each.
In addition, following the meeting in Bangkok I started a president’s blog titled “Around the World with WMA President Cecil Wilson, MD”. The blog site is accessible from the WMA home page at www.wma.net. These blogs, a total of 38 to date, almost two a week.
In those blogs I have chronicled each of the events in which I have participated.
They have also dealt with other issues of importance to the WMA.
Each event in which I have participated has warranted at least one blog and there are some for which I wrote two – “two blog meetings” - if you will.
I will not describe each visit today in detail, but I would like to highlight some of the themes that were a part of the meetings and were only some among the many issues that caught my attention.
I will then conclude with some observations about the WMA based on my experience in this office to date.
The themes include:
- NCDs and the social determinants of health,
- Violence in the health sector,
- Revision of the Declaration of Helsinki,
- Medical students and junior doctors
- Leadership training for physicians.
First, the social determinants of health.
Two weeks ago at a conference in London organized by our Chair of the Socio- Medical Committee, Sir Michael Marmot, a new report was presented, “Working for Health Equity: The Role of Health Professionals in the Social Determinants of Health.
This report from the University College of London, Institute of Health Equity addresses what medical professionals can do to address this problem.
Twenty-one national professional organizations participated in the report.
Proof that when Sir Michael calls, people say yes.
I provided an international perspective based on WMA policy.
And Dr. Anna Reid, President of the Canadian Medical Association reported on a simultaneously released Canadian study based on a survey of Canadian physicians titled “Physicians and Health Equity Opportunities in Practice”.
At the Taiwan Health Forum held in Taipei in November Dr. Wen-Ta Chiu, Minister of Health emphasized the importance of the social determinants of health.
Dr. Chiu is credited with leadership in passing a bike helmet law in Taiwan a number of years ago.
During the time since passage of the law the number of people in Taiwan has increased, the number of motor bikes has increased exponentially and likewise the number of accidents.
However the number of deaths has decreased or at least remained relatively stable.
Since head injuries are the primary cause of deaths from bike accidents, this social determinant of health has been addressed in large part by the helmet law.
Estimates are this law saves approximately 4000 lives a year in Taiwan.
At the annual scientific conference in Beijing in January Dr. Chen Zhu, President of the Chinese Medical Association and Minister of Health for China reported on the status of health system reform in China and the influence of social determinants of health.
Dr. Zhu commented positively on my remarks to the conference about the importance of governments recognizing that all policy has health effects – that we should think not just about one minister of health but all ministers should be considered health ministers.
At the All Nepal Medical Conference in Kathmandu in March, Dr. Ram Baran Yadav, President of Nepal and a physician, described the threat of earthquakes in Nepal where buildings lack structural integrity.
He highlighted the increasing burden of communicable disease with its strains on the health care infrastructure.
He reported on the high incidence of accidents in a developing country with roads in a poor state of repair, the absence of street lights and only a few traffic lights in Kathmandu a city of roughly three million people where vehicles, bikes and pedestrians all share the same roadways.
All social determinants of health.
Next is the issue of violence in the health sector:
Last October Chair of Council Dr. Mukesh Haikerwal, Dr. Dana Hanson, former WMA president and I attended the third international conference on violence in the health sector in Vancouver, Canada.
Dr. Haikerwal gave the opening key note speech.
The evidence that this is a major problem of epidemic proportions was illustrated by the attendance of 482 health care workers from 43 countries who presented 189 papers documenting violence against health professionals in their countries.
An additional aspect of this problem is the increase in violence against health care professionals and facilities in areas of armed combat.
The WMA is working with the ICRC/Red Crescent Society on the Health Care in Danger Initiative seeking to develop ways to decrease the danger of violence in these circumstances.
Vivienne Nathanson and I were in Cairo, Egypt in December participating in one of the regional conferences to seek advice from those actually working in the field.
The meeting included 70 physicians from areas of armed conflict in Egypt, Libya, Syria, Yemen, Kenya, Pakistan and Afghanistan.
These true heroes of medicine described in dispassionate professional detail the work they are doing and measures that can help decrease danger based on their experience.
In February I spoke to the Syrian American Medical Society (SAMS) Conference in Clearwater, Florida in the US and described the WMA’s work with the ICRC and our publically calling on President Assad of Syria to protect health care workers and facilities.
SAMS is involved in a major effort to provide medical relief to wounded Syrian citizens in Turkey, in border refugee camps and inside Syria.
Of their 10 chapters nationwide, over 100 volunteer physicians to date have traveled across the Turkish border to reach field hospitals.
Once there, these doctors treat hundreds of casualties while under the constant threat of attacks by Syrian military artillery and airstrikes.
SAMS has established eleven hospitals in Syria, supported twenty-five already existing medical facilities, and has appropriated over $2 million to specific relief projects since April 2012.
In the area of ethics, it was my privilege to attend and present opening remarks at the two expert conferences our workgroup on the Declaration of Helsinki has held since we met in Bangkok.
I was impressed by the quality of the conferences and the input received.
I believe the work group was similarly impressed and appreciative.
I was also impressed by the hospitality and arrangements of our host countries – the South African Medical Association hosting the conference in Cape Town, South Africa in December and the Japanese Medical Association serving as host for the conference in Tokyo in February.
Thank you both.
Some of you may know, others not, that at the conference in Tokyo I gave my opening remarks in Japanese.
Dr. Yoshitake Yokokura, JMA President, and Dr. Massami Ishii, vice chair of the WMA Council were kind in complimenting me on my efforts.
In fact when I asked Dr. Yokokura how I had done he said “perfect!”
Yokokura san, Ishii san, thank you very much for your most generous assessment of my performance.
Doomo Arrigato Gozaimasu.
Now to medical students.
The WMA is a strong supporter of medical students through the International Federation of Medical Student Associations (IFMSA).
In March I gave the opening speech to their annual meeting held in Baltimore, Maryland in the US.
I focused on optimism about the future of the profession tempered by an understanding of the major challenges we face.
During the conference I led a president’s session on conflicts of interest physicians face particularly in their interaction with commercial interests.
I also spoke to the alumni section and Junior Doctors group on worldwide health care systems and the future of medicine.
The group meeting in Baltimore, the medical student association, is most favorably impressed with the support of the WMA and eager to continue a positive relationship.
Next is leadership training:
The INSEAD/WMA sponsored weeklong leadership-training course was held this year in January in Singapore.
Our Secretary General Dr. Otmar Kloiber, Dr. Yank Coble, former WMA President, Leah Wapner, Secretary General Israeli Medical Association and I participated in the course along with the faculty of INSEAD.
32 medical association leaders from 20 countries were enrolled in this course, which began initially in 2006.
A superb faculty and an enthusiastic, engaged group of physician leaders highlighted the week.
This effort to provide leadership training for physicians is truly a star in the WMA crown.
Over the years I have had the opportunity to attend similar courses in premier institutions in my country – Kellogg Business School in Chicago, Harvard Kennedy School of Government in Massachusetts and Stanford University School of Business in California.
I can say based on my experiences, and in comparison, that the WMA course in Singapore is the gold standard.
I would recommend WMA member associations take advantage of this outstanding opportunity for their rising leaders to receive training.
Let me conclude with some thoughts based on my initial experiences as your president.
The WMA has a powerful positive message to share with the world.
It is a message based being a voice for ethics, good health policy and seeking to support physicians to achieve the best of health care for patients around the world.
We are speaking out on matters of importance.
We are pointing out violations of health related human rights - violations against health care workers and patients.
We are fortunate to have a professional, creative, energetic staff led by our Secretary General Otmar Kloiber.
My thanks to them for what they do and for their support of my efforts over the past months, especially facilitating work on the president’s blog.
Nigel Duncan, our communications director, is working diligently and creatively moving into social media to expand communication of our message to the world.
Those around the world who know of the WMA’s work and interact with us appear to hold the WMA in high regard.
For those around the world who do not know the WMA, just our name the World Medical Association suggests to them an organization of importance.
After all, we are not just another medical association.
We are The World Medical Association.
That being said, organizations thrive and endure if they continue to grow.
Our resources are limited and as everyone in this room knows, come primarily from dues income.
Therefore it is important in preserving those resources that our member organizations, which provide the dues income, are aware of the importance of the WMA.
And it is incumbent on us as leaders to keep our associations aware so that they continue to support the WMA.
The achievements of the WMA, which are considerable, are accomplished with extremely limited resources for an organization so important to world medicine.
It is a credit to our staff that they are able to achieve so much given the limited resources.
Going forward I believe the existing dues income structure is inadequate to support the significant role the WMA should play in representing the medical profession on the world stage.
I understand that we have struggled for a number of years with how to increase income while remaining true to the ethical principles that are the foundation of this association.
However, I believe it is important for us to continue to look for ways to expand the power of our voice by increasing our interaction with other international organizations - and by finding more resources (translation – more money).
Thank you for the opportunity to share this report with you.
Cecil B. Wilson, MD, MACP
World Medical Association