Adopted by the 50th World Medical Assembly, Ottawa, Canada, October 1998
and amended by the 60th WMA General Assembly, New Delhi, India, October 2009
The health of our countries depends upon keeping the population healthy. Health care is a key right of individuals. This care is dependent upon access to highly-trained medical and other healthcare professionals. Well-functioning health care systems depend upon these sufficient human resources. Comprehensive and extensive planning on a national level is required in order to ensure that a country has a medical workforce in all fields of medicine that meets the present and future health needs of the entire population of that country.
There are currently significant shortages in the area of health human resources. These shortages are present in all countries but are especially pronounced in developing countries where health human resources are more limited.
The problem is made more severe by the fact that many countries have not invested adequately in the education, training, recruitment and retention of their medical workforce. The ageing population in developed countries has also been reflected by an ageing medical workforce. Many developed countries address their medical workforce shortages by employing health care professionals from developing countries to bolster their own health care systems.
The migration of health care professionals from developing countries to developed countries has, over the past ten years, impaired the performance of health systems in developing countries. Economic realities of insufficient investments in health care and inadequate facilities and support for health care professionals have continued to be responsible for this migration.
The World Health Organization has recognized that the crisis of health workforce shortages is impeding the provision of essential, life-saving interventions. It has therefore established structures such as the Global Health Workforce Alliance, a partnership dedicated to identifying and implementing solutions to the health workforce problems. The WHO is promoting the development of a cadre of medical/clinical assistants who propose to join the medical workforce to partially address these shortages.
Recognizing that health care systems require adequate numbers of qualified and competent health care professionals, the World Medical Association asks all National Medical Associations to participate and be active in addressing these requirements and to:
1. Call on their respective governments to allocate sufficient financial resources for the education, training, development, recruitment and retention of physicians to meet the medical needs of the entire population in their countries.
2. Call on their respective governments to ensure that the education, training and development of healthcare professionals meets the highest possible standards including:
- The training and development of medical/clinical assistants where this is applicable and appropriate and
- Ensuring clear definitions of scope of practice and conditions for adequate support and supervision;
3. Call on governments to ensure that appropriate ratios are maintained between population and the medical workforce at all levels, including mechanisms to address reduced access to care in rural and remote areas, based on accepted international norms and standards where these are available;
4. Take measures to attract and support individuals within their countries to enter the medical profession and also call on their respective governments to take such action;
5. Actively advocate for programs that will ensure the retention of physicians within their respective countries and ensure governments’ recognition of this need;
6. Call on governments to improve the health care working environment (including access to appropriate facilities, equipment, treatment modalities and professional support), physician remuneration, physician living environment and career development of the medical workforce at all levels;
7. Advocate for the development of transparent memoranda of understanding between countries where migration of trained health care professionals is an issue of concern and enlist where possible the NMA of origin and receiving NMA’s to support these physicians.