WMA Resolution on the Repression of Nicaraguan Doctors

Adopted by the 72^nd WMA General Assembly (online), London, United Kingdom, October 2021
and revised by the 77^th WMA General Assembly, Rotterdam, the Netherlands, October 2026

The World Medical Association (WMA)

Notes with extreme concern:

• The numerous national and international reports documenting restrictions on professional freedom, dismissals, forced exile of doctors, a shortage of healthcare personnel, obstacles to professional training and limitations on the free practice of medicine in Nicaragua.
• That the aforementioned reports state that more than 400 doctors have been dismissed or forced to resign since 2018, that more than 200 have been forced into exile, and that the health system faces a critical shortage of healthcare workers.
• That these actions have put the lives of the population and healthcare staff at risk.

Recalls its policies on the Independence of National Medical Associations and on the Protection and Integrity of Medical Personnel in Armed Conflicts and Other Situations of Violence.

Reaffirms that:

• Professional independence, clinical autonomy, freedom of scientific expression and the ethical duty of doctors to act in defence of their patients’ health constitute fundamental and inalienable principles of the medical profession.
• Condemns any government interference that undermines the freedom of professional practice and expression of any doctor.
• Expresses its solidarity with Nicaraguan doctors affected by the situation in their country.

RECOMMENDATIONS 

While standing ready, within the scope of its mandate, to support and assist Nicaraguan doctors in the reorganisation of the Nicaraguan Medical Association, the WMA

1. Urges the Nicaraguan government and members of parliament to:

• Protect all healthcare professionals.
• Re-establish the Nicaraguan Medical Association, which, by representing the views of the medical profession in the country, will be able to ensure the ethical practice of medicine, the provision of high-quality medical care and adherence to high standards by all professionals.
• Protect the right of Nicaraguan doctors to practise their profession without discrimination, intimidation or undue interference, as well as their right to provide accurate information on the health situation and to participate in safeguarding the health of the Nicaraguan people.
• Review and repeal all regulations used to silence, intimidate or criminalise doctors and healthcare professionals who act in accordance with their ethical duty to protect public health, including provisions such as the Cybercrime Act when applied to unduly restrict scientific or professional freedom of expression. This also applies to any legal regulation that undermines the professional autonomy of doctors.

2. Calls on the Medical Associations to:

• Report the situation facing doctors and the healthcare system in Nicaragua, in coordination with CONFEMEL and the WMA, and to promote mechanisms that facilitate contact with Nicaraguan medical professionals both within and outside the country.
• Raise public awareness of the situation facing Nicaraguan doctors through institutional communications, academic activities and contacts with the media.
• Formally convey their concerns to the ministries of foreign affairs, foreign offices and other relevant authorities in their respective countries, requesting that the situation of doctors and healthcare professionals in Nicaragua be considered within the framework of bilateral relations and international human rights mechanisms.
• Communicate this Resolution to the diplomatic missions of the Republic of Nicaragua accredited in their respective countries, expressing the international medical community’s concern regarding the restrictions on the practice of medicine and their consequences for the healthcare of the population.