Policy Tag: Protection

Adopted by the 217th WMA Council Session, Seoul (online), April 2021
and by the 72nd WMA General Assembly (online), London, United Kingdom, October 2021

 

The World Medical Association notes with increasing alarm, the continuing actions of the current police and Myanmar security forces including arbitrary arrests and detention of health personnel and other citizens, attacks against physicians and other health personnel and facilities, and continuing harassment and intimidation of protesters, human rights defenders and journalists. The WMA and its members are seriously disturbed by their terrorizing, arresting, kidnapping and murdering health care workers for treating protesters.

With a collapsed health system, the Covid pandemic is devastating Myanmar with lack of medical equipment and personnel and increasing deaths. Recent reports of forcing hundreds of physicians to secretly treat Covid patients and ambushing and arresting physicians after luring them to a non-existent Covid patient’s home, are cause for further dismay.

These activities are in total opposition to the international recommendations in the WMA Declaration on the Protection of Health Care Workers in situation of Violence, the WMA Statement on the Protection and Integrity of Medical Personnel in Armed Conflicts and Other Situations of Violence as well as the United Nations Declaration on Human Rights Defenders.

Thus, the WMA and its members demand that the Myanmar security forces take immediate action to:

  • Guarantee, in all circumstances, the physical and psychological integrity of protesters, including health personnel who are arrested;
  • Release protesters and personnel immediately and unconditionally, and drop all charges against them since their detention is arbitrary as it only aims at preventing freedom of expression and their human rights activities;
  • Put an urgent end to attacks against health personnel and facilities and ensure their protection to provide adequate health care provisions to all.
  • Stop all acts of harassment, intimidation, and killing, against protesters, human rights defenders and journalists and comply with all the provisions of the United Nations Declaration on Human Rights Defenders;
  • Ensure in all circumstances respect for human rights and fundamental freedoms in accordance with international human rights standards and international instruments, including the International Covenant on Economic, Social and Cultural Rights.
  • Cooperate with international fact-finding commissions.

 

Adopted by the 67th WMA General Assembly, Taipei, Taiwan, October 2016
and reaffirmed with minor revisions by the 218th Council session (online), London, United Kingdom, October 2021 

 

The World Medical Association notes with great concern the repeated attacks on health care facilities, health personnel and patients since the beginning of the war in Syria in 2011. These attacks have killed and injured civilian people, and the most vulnerable among them, children and patients. The WMA recalls that health care facilities and personnel must, according to the international law, be protected by all parties of the conflict. 

Therefore, the WMA 

  • Deeply regrets and condemns the recurring attacks on health care facilities, health personnel and patients, considering these as a violation of human rights; 
  • Calls on all countries to fully implement the UN Resolution 2286 (2016) which demands all parties to armed conflicts to fully comply with their obligations under international law, to ensure the respect and protection of all health and humanitarian personnel exclusively engaged in medical duties, of their means of transport and equipment, as well as hospitals and other medical facilities; 
  • Demands an immediate and impartial enquiry into the attacks against health care facilities and personnel, and actions taken against those responsible in accordance with domestic and international law. 

 

Adopted by the 47th WMA General Assembly, Bali, Indonesia, September 1995
and revised by the 57th WMA General Assembly, Pilanesberg, South Africa, October 2006
and by the 67th WMA General Assembly, Taipei, Taiwan, October 2016

 

The health of a community or population is determined by several factors that go beyond traditionally understood causes of disease. Social determinants of health include factors that affect behavioural lifestyle choices; the physical, psychosocial and economic environments in which individuals live; and the health services available to people. Public health involves monitoring, assessing and planning a variety of programs and activities targeted to the identified needs of the population, and the public health sector should have the capacity to carry out those functions effectively to optimise community health. A key tenet of public health policy should be inclusivity and health equity; public health agencies must pay specific attention to populations and communities whose social, economic, and political conditions put them at greater risk of poor health than the general population.

Physicians and their professional associations have an ethical and professional responsibility to act in the best interests of patients at all times. This involves collaboration with public health agencies to integrate medical care of individual patients with a broader promotion of the health of the public.

The key functions of public health agencies are:

1. Health promotion:

  • Working with health care providers to inform and enable the general public to take an active role in preventing and controlling disease, adopting healthful lifestyles, and using medical services appropriately;
  • Assuring that conditions contributing to good health, including high-quality medical services, safe water supplies, good nutrition, an unpolluted atmosphere, and opportunities for exercise and recreation are accessible for the entire population;
  • Working with the responsible public authorities to create healthy public policy and supportive environments in which healthy behavioural choices are the easy choices, and to develop human and social capital.
  • Prevention: assuring access to screening and other preventive services and curative care to the entire population.

2. Protection: monitoring and protecting the health of communities against communicable diseases and exposure to toxic environmental pollutants, occupational hazards, harmful products, and poor quality health services. This function includes the need to set priorities, establish essential programs, obtain requisite resources and assure the availability of necessary public health laboratory services.

3. Surveillance: identifying outbreaks of infectious disease and patterns of chronic disease and injury and establishing appropriate control or prevention programs;

4. Population Health Assessment: assessing community health needs and marshalling the resources for responding to them, and developing health policy in response to specific community and national health needs.

The specific programs and activities carried out in each jurisdiction (local or national) will depend on the problems and needs identified, the organization of the health care delivery system, the types and scope of the partnerships developed and the resources available to address the identified needs.

Public health agencies benefit greatly from the support and close cooperation of physicians and their professional associations. The health of a community or a nation is measured by the health of all its residents, and the preventable health problems that affect an individual person affect the health and resources of the community. The effectiveness of many public health programs, therefore, depends on the active collaboration of physicians and their professional associations with public health agencies and other governmental and nongovernmental agencies.

The medical sector and the public health sector should effectively co-operate on the dissemination of public health information and education programs that promote healthful lifestyles and reduce preventable risks to health, including those from the use of tobacco, alcohol and other drugs; sexual activities that increase the risk of HIV transmission and sexually transmitted diseases; poor diet and physical inactivity; and inadequate childhood immunization levels. For example, health education can substantially reduce infant morbidity and mortality (e.g. through the promotion of breast-feeding and providing nutrition education to parents together with providing supportive conditions, both at work and in the community).

The formal responsibility of public health agencies is primarily disease surveillance, investigation and control. These activities cannot be conducted effectively, however, without the active cooperation and support of physicians at the community level who are aware of individual and community illness patterns and can notify health authorities promptly of problems that might require further investigation and action. For example, physicians can help identify populations at high risk for particular diseases, such as tuberculosis, and report cases of communicable diseases such as measles, whooping cough, or infectious causes of diarrhoea, as well as cases of exposure to lead or other toxic chemicals and substances in the community or work place. Close collaboration between public health agencies and physicians as well as other health professionals is critical for an efficient disease monitoring system.

Regardless of the effectiveness of existing public health programs in a jurisdiction, professional medical associations should be aware of unmet health needs in their communities and nations and advocate for activities, programs and resources to meet those needs. These efforts might be in areas of public education for health promotion and disease prevention; monitoring and controlling environmental hazards; identifying and publicising adverse health effects resulting from social problems, such as interpersonal violence or social practices that affect health; or identifying and advocating for services such as improvements in emergency treatment preparedness.

In jurisdictions in which basic public health services are not being provided adequately, medical associations must work with other health agencies and groups to establish priorities for advocacy and action. For example, in a country or area with limited resources in which potable water and sewage facilities are not available to most residents, these needs should be given priority over medical technologies that would provide service to only a small portion of the population.

Some health-related issues are extremely complex and involve multiple levels of response. For example, those diagnosed with high blood lead levels need not only appropriate medical treatment, but the source of contamination must also be determined, and measures need to be taken to eliminate the danger. At times policies that promote public health create concern because of their potential economic impact. For example, strong opposition to the potential economic impact of tobacco control policies could come from regions or groups that derive significant revenue from growing or processing tobacco. However, economic concerns should not deter a strong public health advocacy program against the use of tobacco products. The promotion of tobacco products should be rigorously opposed, and every effort should be made to reduce tobacco consumption in both developed and developing countries.

Physicians and their associations should collaborate with political authorities and other organizations to encourage the media to send positive messages for health education regarding diet, drug use, sexually transmitted diseases, cardiovascular risk, etc.

Medical associations should ask their members to educate their patients on the availability of public health services.