WMJ_04_2025

Official Journal of The World Medical Association, Inc. Nr. 4, December 2025
vol. 71
Contents
Editorial   3
Valedictory Speech by the WMA President, Dr. Ashok Philip   4
Inaugural Address by the WMA President, Jacqueline Kitulu   6
WMA General Assembly Report, Porto, Portugal, 8–11 October 2025   8
WMA Statements and Resolutions 13
Information about the 232nd WMA Council Session, Belgrade 2025   28
Navigating the Dialogue on Using AI in Medical Practice
at the 76th WMA General Assembly   29
Potential Gains of Using AI in Primary Care Lie Beyond Technology Itself    34
Building AI Literacy for Physicians: Lessons from the WMA Medical Technologies
Working Group Webinar Series   38
AI Empowering Quality Primary Healthcare in China   40
Interview with the Family Medicine Expert in Patient Access to Records and Patient Safety    45
Health Privacy Law: Getting the Balance of Interests Right   48
WMA and WVA Reinforce Shared Commitment to One Health   52
Interview with the President of CONFEMEL   54
Trinidad and Tobago Medical Association’s Global Solidarity
in Climate Health and Resilience: A Small Island Perspective   57
Life-Course Vaccination: A Global Call to Action for Equity,
Resilience, and Strong Health Systems   59
Review of the Health Checkup System in Japan   63
Leading from the Frontline: A Junior Doctor’s Guide to EverydayLeadership   66
WMA Members Promote Disability-Inclusive Care for Global Health Systems 69
WORLD MEDICAL ASSOCIATION OFFICERS,
CHAIRPERSONS AND OFFICIALS
Dr. Jacqueline KITULU
President
Kenya Medical Association
KMA Centre, PO Box 48502,
Chyulu Road, 4th Floor, Upper Hill
Nairobi
Kenya
Dr. Otmar KLOIBER
Secretary General
World Medical Association
13 chemin du Levant
01212 Ferney-Voltaire
France
Dr. Philippe CATHALA
Chairperson,
Finance and Planning Committee
Conseil National de l’Ordre des
Médecins (CNOM) France
4 rue Léon Jost
75855 Paris Cedex 17
France
Dr. Jung YUL PARK
President-Elect
Korean Medical Association
37, Ichon-ro 46-gil, Yongsan-gu
04427 Seoul
Korea, Rep.
Dr. Tohru KAKUTA
Vice-Chairperson of Council
Japan Medical Association
113-8621 Bunkyo-ku, Tokyo
Japan
Dr. Zion HAGAY
Chairperson,
Socio Medical Affairs Committee
Israeli Medical Association
2 Twin Towers, 35 Jabotinsky St.,
P.O. Box 3566
52136 Ramat-Gan
Israel
Dr. Ashok PHILIP
Immediate Past President
Malaysia Medical Association
4th Floor, MMA House,
124 Jalan Pahang
53000 Kuala Lumpur
Malaysia
Mr. Rudolf HENKE
Treasurer
German Medical Association
(Bundesärztekammer)
Herbert-Lewin-Platz 1
(Wegelystrasse)
10623 Berlin
Germany
Dr. Julie BACQUÉ
Chairperson,
Associate Members
Conseil National de l’Ordre des
Médecins (CNOM) France
4 rue Léon Jost
75855 Paris Cedex 17
France
Dr. Jack RESNECK, Jr.
Chairperson of Council
American Medical Association
AMA Plaza, 330 N. Wabash,
Suite 39300
60611-5885 Chicago, Illinois
United States
Dr. Christofer
LINDHOLM
Chairperson,
Medical Ethics Committee
Swedish Medical Association
(Villagatan 5) P.O. Box 5610
SE-114 86 Stockholm
Sweden
www.wma.net
OFFICIAL JOURNAL OF THE WORLD
MEDICAL ASSOCIATION
Editor in Chief
Dr. Helena Chapman
Milken Institute School of Public Health, George Washington University, United States
editor-in-chief@wma.net
Assistant Editor
Mg. Health. sc. Maira Sudraba-Sangovica
Latvian Medical Association
lma@arstubiedriba.lv, editor-in-chief@wma.net
Journal design by
Erika Lekavica
dizains.el@gmail.com
Publisher
Latvian Medical Association
Skolas Street 3, Riga, Latvia
ISSN 0049-8122
Opinions expressed in this journal – especially those in authored contributions –
do not necessarily reflect WMA policies or positions
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Editorial
Editorial
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As we reflect on the past year, our global medical community
has consistently demonstrated excellence in patient care,
community health and research programs, and policy
development. They have acknowledged the urgent need to
raise awareness about the health consequences of climate
change, champion initiatives that address the risk factors
of noncommunicable diseases (including mental health
conditions), advocate for safe workplace environments,
strengthen local capacity to implement community-based
solutions, and improve accurate health messaging. With
the increased use of artificial intelligence (AI) and digital
technologies in health systems, physicians remain cautiously
optimistic of the effective and ethical use in clinical
diagnostics and patient care. Hence, as a global platform for
the comprehensive discussion of timely medical education
and ethics topics, we recognise the Sindicato Médico
del Uruguay (Medical Union of Uruguay) and the Ordem
dos Médicos (Portuguese Medical Association) for
their leadership to organise the 229th World Medical
Association (WMA) Council Meeting in April 2025, and the
76th WMA General Assembly in October 2025, respectively.
Over the past two months, global leaders have played a
pivotal role in preparing key reports and contributing to
events that directly shape health system resiliency. First, the
World Meteorological Organization published the Global
Status of Multi-Hazard Early Warning Systems 2025 report, with
119 countries reporting measurable progress to the UN Early
Warnings for All initiative. The World Health Organization
released up-to-date assessments of tuberculosis and malaria
epidemiology, emerging threats (including antimicrobial
resistance), and global progress toward achieving milestones.
Second, the UN Climate Change Conference (COP30),
held in Belém, Brazil, launched two initiatives (Global
Implementation Accelerator, Belém Health Action Plan)
to help nations develop national climate action plans and
adaptation policies. Although country representatives approved
financial support for climate adaptation, there were no official
agreements outlining roadmaps to end deforestation or fossil
fuel use. Finally, the launch of the Sentinel-6B mission, as a
collaboration between the European Space Agency (ESA),
European Organisation for the Exploitation of Meteorological
Satellites (EUMETSAT), U.S. National Aeronautics and
Space Administration (NASA), and the U.S. National Oceanic
and Atmospheric Administration (NOAA), will monitor
Earth’s oceans and sea level and support weather forecasting
for research and applications.
In this issue, Ms. Magda Mihaila summarised the WMA
proceedings with adopted statements and resolutions, and
Dr. Ashok Philip and Dr. Jacqueline Kitulu presented their
uplifting valedictory and inaugural speeches on WMA
milestones, respectively. Dr. Philip and colleagues summarised
key findings of the “Impact on AI in Medical Practice”
scientific session at the 76th WMA General Assembly in
Porto. Dr. Jacob Mathew and Dr. Jesse Ehrenfeld commented
on the five-part WMA webinar series that aimed to build
AI literacy for physicians. Similarly, Dr. Pablo Requena
highlighted potential benefits of using AI in primary care,
and Dr. Hui Yin and Weili Zhao described the incorporation
of AI into primary healthcare in China. Also, Dr. Richard
Fitton shared insight on patient access to records for shared
decision-making, and Dr. Edward Dove examined the health
privacy law and challenges related to protecting health
information.
Furthermore, Dr. Jack Resneck, Jr. and Dr. John de Jong
described the WMA’s and World Veterinary Association
(WVA)’s commitment to One Health. Dr. Jorge Coronel
reviewed the history and organisational pillars of the
Medical Confederation of Latin America and the Caribbean
(CONFEMEL, in Spanish), discussing the challenges
facing physicians in the region. Dr. Saksham Mehra described
global solidarity for climate health and resilience in Trinidad
and Tobago. Dr. Marta Lomazzi and colleagues analysed
the rationale and approach for implementing life-course
vaccination strategies in global health systems. Dr. Koji
Watanabe shared an overview of the health checkup system
in Japan. Dr. Merlinda Shazellene and colleagues provided
a summary report of the Junior Doctors Network (JDN)’s
webinar on early-career leadership in medicine.
The WMA, representing 118 national medical associations
(NMAs), prepared eight press releases that underscore the need
to protect health professionals during conflicts, invest in the
health workforce, and seek ethical, physician-led integration of
AI and climate-smart health systems. Also, WMA members
representing 15 countries of six regions emphasised their global
commitment to support disability-inclusive care, community-
based rehabilitation programs, and social protection for persons
with disabilities. Notably, WMA members can advance their
collective discussion and debate on timely topics in medical
education and ethics affecting health professionals at the
232nd WMA Council Session in Belgrade, Serbia, from
23-25 April 2026.
We are excited to connect at the 232nd WMA Council Session
in Serbia!
Helena Chapman, MD, MPH, PhD
Editor in Chief, World Medical Journal
editor-in-chief@wma.net
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My dear friends and colleagues, I would
like to thank you for the great honour
and privilege of representing the World
Medical Association (WMA) to the
world. It has been an interesting year
since our last General Assembly in
Helsinki, and the time has flown by.
I have attended many meetings, both
physical and virtual, with our members
and with other organisations and
partners. While we may have significant
differences, my feeling that doctors are
by and large deeply ethical and moral
has been reinforced. I guess those
entering the healing profession tend to
be more caring and self-sacrificing than
most people.
During the year, I have seen many
challenges and trials that face our
field. They are perhaps too numerous
to mention individually, but perhaps I
could focus on two issues, one external
and the other internal.
As I mentioned earlier, I was able
to attend meetings of some of
our constituent members. In early
June, I was at the meeting of the
American Medical Association (AMA)
in Chicago, and I was privileged to
hear “angry Bruce”. Not Bruce Banner,
so there was no smashing involved.
It was Bruce Scott who was angry,
and in his anger, he was eloquent and
passionate about interference in the
work of doctors. It struck me that
if we had taken him and put him
in front of doctors anywhere to
make the same speech, we would
all have understood the issues
involved. The fact that all of us, to
a greater or lesser degree, face these
interfering individuals and organisations
should be treated as a plague or
pandemic affecting the medical
profession.
We do not work on some isolated
Olympian plane. Healthcare needs
teams. There is no arguing with that.
However, teams need leaders, and
those leaders must be doctors. No
other healthcare professionals have the
breadth and depth of training to fill
this role better.
Unfortunately, it seems that everyone
wants to be a doctor – without going
through the studying and training
needed. Maybe we make the practice
of medicine look too easy. Whatever
the reason, the attempted inroads
are everywhere. The push to replace
doctors with “physician assistants” or
“physician associates” is widespread.
These people are supposed to support
doctors, but it seems that often
they begin to believe and act as if
they are the experts. They are not,
and such behaviour is unacceptable.
Unfortunately, administrators look
only at the immediate cost savings of
hiring less educated people, and do not
consider the much higher long-term
cost of missed and delayed diagnoses,
inappropriate or wrong treatments and
procedures, and complications. It is
incumbent on us as doctors to push
back against the dangerous aspects of
these policies. This is not turf protection
– it is patient care in the largest sense.
Similar impulses also seem to be at play
when we seek approval for treatment
from financing bodies – whether they
are private insurance companies or state
bodies which lay down guidelines for
management. Of course, guidelines are
needed, but we know that even the most
detailed flow charts will not be able to
encompass all clinical situations. The
first impulse of administrators, whether
in government bodies or in private
insurance companies, must not be to
deny care if guidelines are not adhered
to. They should seek clarification from
the doctors involved. It should go
without saying that the person seeking
the clarification must also be a suitably
qualified doctor. In many places, we
have to deal with medically illiterate
people asking us the same irrelevant
and often incoherent questions again
and again, delaying care and promoting
adverse outcomes. We need to stand
up, unite, and work together to bring
flexibility and rationality to this mess.
As to the internal issue – it will not
have escaped your notice that there
are many conflicts raging around
the world. Obviously, this leads to
attacks on healthcare professionals
and facilities. There will be
shortages of medicines and medical
supplies. Civilians will be injured or
killed. Food and medicines will be in
short supply. These are all matters that
we as doctors and as an association
of doctors must address – and we
have. Generally, our statements are
based on facts, our expertise, and our
ethical principles. They are usually
uncontroversial, though not necessarily
popular. In one conflict, however,
we can seem to do no right. When
we make statements using our usual
principles, we are assailed for not saying
more or being too nuanced.
I can understand this. Individuals see
what is reported and are distressed,
upset, and angry. However, the WMA
does not make statements based on the
feeling of individuals – certainly not
Ashok Philip
Valedictory Speech by the WMA President, Dr. Ashok Philip
Porto, Portugal, 10 October, 2025
Valedictory Speech by the WMA President
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my feelings. First, we have to be made
aware of what is happening. Then, to
the extent possible in war zones, we
have to confirm the facts. For both
of these, we rely on our members and
partners for help. If we feel that the
events occurred substantially as reported,
we need to determine if they fall within
our area of expertise – medicine and its
ethical principles. If they do, then we
can make a statement.
This rather careful process is necessary
to maintain our credibility, but it does
mean that sometimes it may be quite
some time before we respond. Again,
to some extent, it does depend on our
partners and members. We have a small
Secretariat, and it may not be able to
keep current on everything going on.
When we make statements, some
people are angered by them, or disagree
vocally with what we say. This is
fine – we do not expect everyone to
agree with us, and we can understand
emotional or angry responses. What
I personally deplore, though, is what I
refer to as the terrible moral certainty
of some individuals. By this, I do
not mean the certainty that you are
right – I believe most sane people act
on what they believe to be true and
right. Rather, I refer to the conviction
of some that those who disagree with
them are wrong. This is not a logical
conclusion. In such complex matters,
it is quite possible for both sides to
be right, because we consider different
facts differently, and come to different
conclusions. What is worse, though,
is then deciding to stop talking
to those you disagree with. I have
little use for Oliver Cromwell, but I
agree with his statement to the Church
of Scotland – “I beseech you, think it
possible that you may be mistaken.”
If you stop talking to those with whom
you disagree, you will find yourself
in an echo chamber, and never learn
anything new or correct old errors.
Please do not cut ties with other
associations. The actions of the country
are not the actions of the association.
In many cases, the association speaks
out against the actions of their
government. We should support them,
not cut off contact. We belong to a
profession which prioritises lifelong
learning. This should apply equally to
ethical matters. My appeal to you,
therefore, is to talk most with those
with whom you disagree most. You may
convert them to your point of view,
learn that you are wrong, or come to
some more accurate synthesis of your
viewpoints. We do not refuse to treat
patients on ideological grounds. Why
should we treat our colleagues worse?
Let me end my lecture here. What is
left is the pleasant task of thanking the
Executive Committee and Secretariat.
We are truly fortunate at the WMA
that we have a small but passionate,
dedicated and extremely competent
group working for us. It has been a
great pleasure working with them – and
with all of you. Of course, I cannot
forget to thank the most important
person here – my wife Premah. She
has put up with my frequent late-night
meetings and trips to other countries.
Her support has been invaluable.
Ashok Philip, MBBS, MRCP(UK)
Past President (2024-2025),
World Medical Association
Past President, Malaysian
Medical Association
ashokphilip17@gmail.com
Valedictory Speech by the WMA President
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Distinguished colleagues, esteemed
delegates, honored guests, and fellow
physicians around the world,
It is with profound humility and deep
gratitude that I accept the presidency
of the World Medical Association
(WMA).
This moment is not mine alone. It
reflects the collective commitment
of physicians across every continent
who devote their skill, intellect, and
compassion to improving human health.
I begin by honoring those who have
gone before me. I pay special tribute
to Dr. Margaret Mungherera, the first
African woman to serve as President
of the WMA. Her courage and vision
lit the path that I now walk, and she
remains a constant inspiration on this
journey.
I extend thanksgiving to my village,
my husband and sons, my parents
and siblings, and my extended family
who are present here today. Your love
and support have carried me to this
moment. I also give special thanks to
the Kenya Medical Association (KMA),
which nominated me, supported me,
and continues to walk alongside me.
And above all, I thank God–who sets
all things in His time, and who has
positioned me for this role, for impact,
for the people of the world.
This inauguration is not ceremonial–it is
a call to action. During my presidency, I
will advocate for three central priorities:
fostering inter-regional collaboration,
strengthening mentorship and capacity
building, and championing global policy
advocacy for primary healthcare.
Fostering Inter-Regional
Collaboration
The WMA represents 115 member
associations across diverse systems and
realities. Yet our challenges –pandemics,
non-communicable diseases, climate
change, and workforce migration – are
shared.
Inter-regional collaboration is not an
option… it is an ethical imperative.
When Ebola struck West Africa, the
world learned that siloed responses
cost lives. During COVID-19,
knowledge-sharing across continents
saved lives: clinical lessons from
Asia informed European and American
hospitals, while vaccination strategies
from South America guided African
programs. These examples remind us
that no region holds a monopoly on
wisdom.
I will advocate for:
• Global Learning Hubs to rapidly
share best practices on preparedness,
digital health, and resilience.
• Virtual exchange platforms
connecting physicians and young
doctors across continents.
• Unified advocacy at the WHO, the
UN, and multilateral organisations
so our voice influences global health
policy.
Importantly, I will also work toward
an active and operational Coalition of
African National Medical Associations
(CANMA). A strong, united CANMA
will not only strengthen Africa’s role
within the WMA but also enrich
global dialogue by bringing forward the
lessons, innovations, and perspectives
from African physicians.
Mentorship and Capacity Building
Mentorship has been transformative in
my own life – from being one of only
10 women in a class of 100 medical
students, to serving as the first female
President of the KMA. I am here today
because of the mentors who believed
in me, guided me through moments of
doubt, and helped me reach this apical
point.
I will advocate for:
• Expanding the Junior Doctors
Network so every young physician
has access to structured mentorship.
• Leadership and advocacy training –
in policy, negotiation, and systems
thinking.
• Regional exchange fellowships to
foster cross-border learning and
innovation.
Mentorship is a two-way street: senior
doctors share wisdom, while younger
colleagues bring fresh perspectives.
Together, we secure the future of
medical leadership.
Global Policy Advocacy for Primary
Healthcare
Primary healthcare remains the
cornerstone of resilient systems,
yet it is under-resourced in many
countries. Policies adopted in Geneva
or New York hold little value unless
they translate into stronger clinics,
more equitable healthcare access, and
Jacqueline Kitulu
Inaugural Address by the WMA President, Jacqueline Kitulu
Porto, Portugal, 10 October 2025
Inaugural Address by the WMA President
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healthier communities.
I will advocate for:
• Investment in the health workforce
– fair pay, training, and safe working
conditions.
• Inclusion of physicians’ voices in
primary healthcare reform, ensuring
policies reflect realities on the
ground.
• Linking global commitments to
local action, supporting member
associations to hold governments
accountable.
A motivated, empowered workforce
is our greatest defense against the
challenges of today and tomorrow.
Looking Ahead
Even as we focus on these three
pillars, we must also prepare for wider
challenges:
Health in conflict zones: In Gaza,
Myanmar, Sudan, and Ukraine, health
facilities and workers are under direct
attack. These are grave violations of
international humanitarian law and
affronts to the principle of medical
neutrality. The WMA must remain
steadfast in defending this principle and
amplifying the voices of colleagues who
serve under fire.
Ethical leadership as artificial
intelligence and digital health reshape
medicine.
Climate change as a determinant of
health that demands physician advocacy.
Digital innovation that must be guided
by equity and privacy principles.
As physicians, our highest calling
is to the art of medicine and the
healing of those in need. It transcends
politics and the divisions that polarise
societies worldwide. In these times of
uncertainty, let us remember that our
strength lies in unity, collegiality, and
shared purpose. Under the umbrella
of the WMA, we stand together as
one global community, committed not
to political agendas but to the
enduring values of compassion,
science, and care. Let us move
forward united and steadfast in
our mission.
Closing Call to Action
Colleagues… we became physicians to
serve humanity. The challenges before
us are formidable – but so is our
collective strength.
Let us:
• Build stronger regional and
global collaborations, including an
operational CANMA.
• Mentor the next generation
generously.
• Advocate for primary healthcare as
the foundation of equitable health.
History will not judge us by the offices
we held – but by the lives we touched
and the systems we strengthened.
Together, let us ensure that the WMA
remains a beacon of ethics, solidarity,
and advocacy – serving humanity with
integrity and hope.
Jacqueline Kitulu,
MBS, OGW, MD, MBA, FCMA
President (2025-2026),
World Medical Association,
Past President,
Kenya Medical Association
jkitulu@gmail.com
Inaugural Address by the WMA President
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The 78th General Assembly of the
World Medical Association (WMA),
which took place from 8-11 October
2025, and hosted by the Portuguese
Medical Association (Ordem dos
Médicos), brought together delegates
from 53 national medical associations
(NMAs) (Photo 1).
Wednesday, 8 October
Council Session
The 230th Council Session was called
to order by the Chair of Council,
Dr. Jack Resneck Jr., who welcomed
delegates and expressed gratitude to
the Portuguese Medical Association for
hosting the event.
The Secretary General, Dr. Otmar
Kloiber, announced the appointment
of the Credentials Committee,
composed of Dr. Brian Chang (Taiwan
Medical Association), Dr. Yves Louis
(Association Belge des Syndicats
Médicaux), and Dr. Pablo Requena
(Vatican Medical Association),
representing the three official WMA
languages–English, French, and
Spanish.
President’s Report
The WMA President, Dr. Ashok Philip,
reiterated the central importance of
the WMA’s ethical mission, noting
that despite the challenges of global
division and multiple armed conflicts,
physicians remained united by shared
professional values. He condemned
ongoing violations of medical
neutrality, particularly the targeting
of healthcare professionals and
facilities, and highlighted the WMA’s
continuing advocacy on these issues
through public statements and
resolutions.
He reflected on his presidency as
a period of significant renewal for
the Association, marked by the
adoption of the revised Declaration
of Helsinki and the publication of
its 60th anniversary commemorative
edition. He expressed gratitude to
the Finnish Medical Association for
hosting the 75th WMA General
Assembly in Helsinki, Finland,
and to all constituent members for
their hospitality and engagement during
his visits throughout the year.
During his presidency, Dr. Philip
attended several national and
international events on behalf of the
WMA, including meetings in France,
Taiwan, Austria, Indonesia, Germany,
Norway, the United States, and the
United Kingdom, as well as the 110th
anniversary of the Chinese Medical
Association. He also represented the
WMA at major external events such
as the Vienna Conference, the Asian
Development Bank’s Global Patient
Safety Meeting, the World Health
Assembly, and the International
Federation of Medical Students’
Associations Meeting, where he
addressed physician well-being and
psychological safety.
In closing, Dr. Philip reflected on the
forthcoming retirement of the WMA
Secretary General, expressing confidence
in the continuity of leadership and
thanking the Secretariat for its
dedication.
Secretary General’s Report
The WMA Secretary General,
Dr. Kloiber, reported on the continuing
development of the Association’s
work and collaboration with partner
organisations. He highlighted the close
cooperation between the WMA and
the World Federation for Medical
Education (WFME), following a
highly successful joint conference held
in Bangkok, Thailand, which gathered
more than 1,000 participants from
across the world. He also drew
attention to the Bangkok Declaration
on Support for Learners, adopted at
the conference, calling for improved
working and living conditions for
medical students and trainees,
including those engaged in continuing
professional development.
Dr. Kloiber also provided updates on
the WMA’s ongoing advocacy for the
protection of healthcare in conflict
zones, its collaboration with the World
Health Organization (WHO) and the
World Health Professions Alliance
(WHPA), and preparations for the First
Expert Meeting on the Revision of the
WMA Declaration of Taipei, to be held
in Taipei, Taiwan, from 4-6 December
2025.
He concluded by expressing sincere
gratitude to the Council, the Secretariat,
and all members for their trust and
collaboration during his tenure, and
reaffirmed his commitment to ensuring
a smooth transition in the leadership of
the WMA Secretariat.
Magda Mihaila
WMA General Assembly Report
Porto, Portugal, 8–11 October 2025
WMA General Assembly Report
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Chair of Council’s Report
The WMA Chair of Council,
Dr. Resneck Jr., expressed his
appreciation to the Council members,
the Secretariat, and the Portuguese
Medical Association for their
commitment to ensuring that the
meetings in Porto were conducted
with efficiency and collegiality. He
acknowledged the considerable work
undertaken by all committees since the
Council’s last session in Montevideo,
noting the breadth of issues considered–
from physician well-being and scope
of practice to the ethical implications
of artificial intelligence and the revision
of core WMA policies.
He highlighted the WMA’s continuing
role as the global voice for the medical
profession in defending ethical practice
and human rights, particularly amid
growing humanitarian crises and
threats to medical neutrality. The
Chair commended NMAs for their
constructive engagement and reaffirmed
the importance of unity and respect in
addressing sensitive global issues.
Dr. Resneck Jr. drew special attention
to the WMA’s financial stability,
its progress on policy revision, and
the strength of its partnerships with
international bodies such as WHO,
WFME, and WHPA. He also
recognised the outstanding service
of Dr. Kloiber, who will conclude
his tenure as Secretary General with
the Council Session in April 2026,
and expressed the Council’s gratitude
for his decades of leadership and
dedication to the Association.
In closing, Dr. Resneck Jr. reiterated
his confidence in the WMA’s capacity
to meet future challenges through
collaboration, transparency, and the
shared ethical principles that bind
physicians worldwide.
Thursday, 9 October
Committee Reports
Finance and Planning Committee
The Finance and Planning
Committee, chaired by Dr. Philippe
Cathala (Conseil National de l’Ordre
des Médecins, France), approved the
Audited Financial Statement for
2024 and the proposed WMA Budget
for 2026, and both were forwarded to
the General Assembly for adoption.
The WMA Treasurer, Dr. Rudolf
Henke (German Medical Association),
presented the financial report, noting
continued fiscal stability and sound
financial oversight.
WMA Strategic Plan 2026–2030
Dr. Otmar Kloiber, Secretary General,
reported that the Association’s activities
remained aligned with the 2020–2025
plan and that the WMA Strategic
Plan 2026–2030 had been finalised
after extensive consultation. Dr. Henke
underlined that the plan provides a
strong basis for continued operational
stability and growth.
WMA Statutory Meetings
Dr. Jack Resneck Jr. announced that
the next Council Session will be held
in Belgrade, Serbia, from 23-25 April
2026, hosted by the Serbian Medical
Chamber. He also shared that the
77th WMA General Assembly will
take place in Rotterdam, the
Netherlands, in October 2026, hosted
by the Royal Dutch Medical
Association (RDMA).
WMA Special Meetings
Dr. Kloiber informed the committee
that preparations are underway for the
First Open Expert Meeting on the
Revision of the WMA Declaration of
Taipei, to be held in Taipei, Taiwan,
from 4-6 December 2025. He thanked
all member associations and experts who
have participated in the consultation
process and expressed appreciation to
the Taiwan Medical Association for its
support in hosting the meeting.
World Medical Journal
The Editor-in-Chief, Dr. Helena
Chapman, shared her report and
thanked contributors to the most
recent issues of the World Medical
Journal. She highlighted three specific
WMA achievements in the past two
issues: article from Asia and Eastern
Mediterranean Region NMA leaders
(seven countries), scholarly articles
from WMA members (14 countries),
and two collective articles from
WMA members that described
national policies and activities
supporting International Nurses
Day and World Mental Health Day
(21 countries). She encouraged
members to actively share their articles
and national reports to showcase the
work of their Associations in future
editions.
Public Relations
The WMA Communication and
Information Manager, Ms. Magda
Mihaila, presented the report on
the Association’s public relations
and communications activities. She
informed the committee that the
Secretariat continues to disseminate
press releases, newsletters, and digital
updates on the WMA’s policy work
and statements adopted by Council
and the General Assembly. She also
reported on the regular publication
of information through the WMA
website, the World Medical Journal,
and the Association’s social media
channels.
WMA General Assembly Report
10
Medical Ethics Committee
The Medical Ethics Committee
(MEC), chaired by Dr. Christofer
Lindholm (Swedish Medical
Association), reviewed key policy
documents and updates. The WMA
Statement on Conflict of Interest
and the WMA Statement on the
Protection of Medical Neutrality in
Times of Armed Conflict and Other
Situations of Violence were adopted and
forwarded to the General Assembly
for approval. The WMA Statement
on Ethical Issues Concerning Patients
with Mental Illness was circulated for
comments, while the Declaration of
Lisbon on the Rights of the Patient
was deemed to require a major revision,
and a workgroup was established.
Socio-Medical Affairs Committee
The Socio-Medical Affairs Committee
(SMAC), chaired by Dr. Zion Hagay
(Israeli Medical Association), adopted
several key policy updates reflecting
global medical and public health
priorities covering six areas: Scope
of Practice, Task Sharing and Task
Shifting, Ageing, Physician Well-
Being, Trans People, and Augmented
Intelligence in Medical Care. The
committee also received progress
reports on the revision of the
WMA Declaration of Delhi on
Health and Climate Change and the
Statement on Divestment from Fossil
Fuels, as well as updates on WMA
participation in preparations for
COP 30 in Belém, Brazil.
Associate Members
The meeting elected Dr. Julie Bacqué
(France) as Chair of the Associate
Members for the 2025–2027 term,
succeeding Dr. Jacques de Haller
(Switzerland), who was thanked for
his service and commitment.
The meeting also elected Dr.
Thirunavukarasu Rajoo (Malaysia) as
Independent Member-at-Large and
Dr. Uchenna Ojukwu (Nigeria) as
Student Member-at-Large, following
the electronic ballot held in September
2025.
The Report of the Outgoing Chair,
Dr. Jacques de Haller, was received,
along with the reports of the Junior
Doctors Network (JDN) and the
Past Presidents and Chairs Network
(PPCN). The meeting appointed Dr.
Caline Mattar (United States) and
Dr. Ankush Bansal (United States)
as representatives of the Associate
Members to the 2025 General Assembly,
with Dr. Dersim Dagdeviren (Türkiye)
and Dr. Elizabeth Gitau (Kenya) as
alternates.
Rules Applicable to WMA Associate
Membership
The meeting noted that the Council
and General Assembly had endorsed
the revision of the Rules Applicable
to WMA Associate Membership,
which removes the category of
medical students from future
Associate Membership. Existing
student members will retain their
membership, while future engagement
will occur through collaboration
with student organisations.
Scientific Session
The Scientific Session incorporated
the “Impact of Artificial Intelligence
(AI) on Medical Practice” theme.
The session opened with welcoming
remarks from Dr. Philip and the
President of the Portuguese Medical
Association, Dr. Carlos Cortes, who
highlighted the growing importance
of digital transformation in medicine
and the need for strong ethical
foundations to guide innovation.
The keynote lecture, “AI in Health,”
was delivered by Prof. António
Vaz Carneiro (Portuguese Medical
Association, University of Lisbon).
He provided an overview of current
definitions and methodologies of AI
in medicine, reviewing its expanding
applications in diagnostics, clinical
reasoning, research, and public health.
Prof. Vaz Carneiro emphasised the
importance of rigorous evaluation,
transparency, and ethical oversight to
ensure that technological advances
enhance, rather than undermine,
medical professionalism and patient
safety.
The first session, “Practical Aspects
of Implementing AI,” was moderated
by Dr. Philip. Dr. Ana Ribeiro
da Cunha (Portuguese Medical
Association) presented on international
consensus and guidelines for
trustworthy and deployable AI in
healthcare, outlining the frameworks
that ensure safety and reliability
in clinical use. Dr. Mzulungile
Nodikida (South African Medical
Association) shared experiences from
South Africa’s national digital health
strategy, describing efforts to overcome
challenges related to fragmented
health data and equitable access.
Dr. Tomás Cobo (Spanish General
Medical Council) offered reflections on
the professional and ethical challenges
of AI in clinical practice, especially
regarding its impact on the doctor–
patient relationship. The session
concluded with an engaging panel
discussion among the speakers.
The second session, “Ethics of AI
in Medicine,” was moderated by
Dr. Cathala. Dr. Bernardo Duque Neves
(Portuguese Medical Association)
discussed accountability and risk
governance in AI-assisted clinical
decision-making, highlighting the
concept of shared responsibility between
human and machine. Prof. Rui Nunes
(Head, International Chair in Bioethics)
examined the ethical principles that
should guide AI’s integration into
medical care, while Dr. Ramin Parsa-
Parsi (German Medical Association)
analysed the evolving dynamics of
trust, confidentiality, and professional
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WMA General Assembly Report
11
integrity within the patient–doctor–
AI relationship. The presentations
were followed by a thoughtful panel
debate on the ethical boundaries
and opportunities presented by these
emerging technologies.
The final session, “AI in Practice,” was
moderated by Dr. Bobby Mukkamala
(American Medical Association).
Dr. Ana Pina (Portuguese Medical
Association) explored the notion of
“collective intelligence,” emphasising the
value of interdisciplinary collaboration
and shared accountability in
AI-enabled medical teams. Dr. Pablo
Requena (Vatican Medical Association)
reflected on the potential of AI to
enhance communication and strengthen
the doctor–patient relationship in
primary care settings. A concluding
panel discussion gathered all speakers
to reflect on how physicians can guide
the responsible and human-centred
integration of AI in healthcare.
The session closed with concluding
remarks by Prof. Alberto Caldas Afonso
(Portuguese Medical Association),
who summarised the discussions
and reaffirmed the need for ethical
vigilance and continuous education as
AI reshapes medical practice.
Friday, 10 October
Ceremonial Session
Dr. Carlos Cortes, who welcomed
delegates to Porto on behalf of the
Portuguese Medical Association,
highlighted the unity of physicians
through shared ethical values and
the responsibility of the profession to
promote peace and protect medical
neutrality. He referred to the “Medicine
for Peace: An Ethical and Professional
Imperative” manifesto, endorsed by over
50 organisations, calling for empathy,
professional judgment, and respect for
human dignity to remain central to
medical practice. He also emphasised
that while innovation and technology are
transforming medicine, they must always
serve the physician–patient relationship.
Prof. Ana Povo (Secretary of State
for Health, Portugal) underlined the
importance of ethics, professionalism,
and trust in medicine during an era of
technological change.
Dr. Ashok Philip delivered his
Valedictory Address, where he reflected
on a year of global engagement with the
WMA, noting the ethical dedication
of doctors worldwide and the many
challenges that continue to confront the
profession — from threats to physician
leadership roles and encroachment
by non-physician practitioners, to the
protection of healthcare personnel and
facilities in war-zones. He emphasised
that the WMA issues statements based
on facts and expertise, not emotion,
and called for ongoing dialogue even
with those who hold opposing views:
“Talk most with those you disagree with
most.” He concluded by thanking the
Secretariat, the Executive Committee,
his wife Premah, and all his colleagues
for their support.
Installation of the New President
Dr. Jacqueline Kitulu (Kenya Medical
Association) was installed as the 76th
President of the WMA by Dr. Jack
Resneck Jr. She delivered her Inaugural
Address, where she expressed deep
gratitude as she accepted the presidency
of the WMA. She paid tribute to her
predecessor and to pioneering leaders,
especially African women physicians,
and acknowledged her family and home
country for their support.
She laid out three key priorities for
her term: strengthening inter-regional
collaboration, building mentorship and
leadership capacity (especially among
junior doctors), and advancing physician-
led policy advocacy for primary
healthcare. She further emphasised
the global ethical responsibilities of
the profession, including protection
of healthcare professionals in
conflict zones, climate-linked health
challenges, and the equitable and
ethical integration of digital
innovation. The address concluded
with a call to action: to mentor the
next generation, advocate for primary
care, and remain united as physicians
serving humanity.
Saturday, 11 October
General Assembly
The General Assembly elected
Dr. Jung Yul Park (Korean Medical
Association) as President of the
WMA for 2026–2027, to succeed
Dr. Jacqueline Kitulu upon completion
of her term.
The General Assembly adopted,
without amendment, all reports and
policies forwarded by the Council.
The adopted policies include the
revised WMA Statements on Scope
of Practice, Ageing, Physician Well-
Being, Physician Mental Health
Care, Trans People, and Augmented
Intelligence in Medical Care, as well as
the Statement on Conflict of Interest
and the Statement on the Protection
of Medical Neutrality in Times of
Armed Conflict and Other Situations of
Violence.
The Assembly also adopted the
Resolution on Health Workforce at
the WHO, confirming the WMA’s
commitment to strengthening health
systems through sustainable workforce
investment.
Session on the Gaza Conflict and Medical
Neutrality
One of the most substantive discussions
of the General Assembly focused on
the situation in Gaza and the broader
question of medical neutrality in
armed conflicts. Delegates expressed
grave concern about reports of attacks
on hospitals, the detention of health
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WMA General Assembly Report
12
personnel, and the denial of access to
essential medical services.
The General Assembly adopted the
WMA Resolution Calling on the
Israeli Government to Comply
with the Geneva Conventions and
Other Applicable Instruments of
Humanitarian Law, reaffirming the
fundamental principles of medical
ethics, humanitarian law, and the
duty of physicians to treat all patients
impartially. During the discussion,
several delegates underlined that
physicians must be allowed to perform
their professional duties without
intimidation or interference. The
General Assembly recalled that the
protection of health personnel and
facilities is a non-negotiable obligation
under international humanitarian law,
and urged all parties to ensure safe and
unhindered access to care.
In adopting the resolution, the
Assembly reiterated the WMA’s
longstanding commitment to the
neutrality and independence of the
medical profession in all conflicts.
Membership
The General Assembly confirmed the
admission of the Medical Council of
the Islamic Republic of Iran (IRIMC),
the Lebanese Order of Physicians
(LOP), and the Canadian Medical
Association (CMA), with the latter as
a returning Constituent Member. The
Assembly received presentations from
Dr. Catharina Boehme (WHO), Dr.
Christian Keijzer (Standing Committee
of European Doctors, CPME), and
Dr. John de Jong (World Veterinary
Association, WVA), highlighting
international collaboration and ethical
leadership.
In the Open Session, reports were
shared by Dr. Pablo Estrella Porter,
Dr. Caline Mattar, Dr. Uchenna
Ojukwu, and Dr. Thirunavukarasu
Rajoo, reflecting the growing
engagement of junior physicians and
Associate Members. In his closing
remarks, Dr. Resneck Jr. thanked
all delegates, committees, and the
Secretariat for their collaboration
and commitment to the WMA’s
mission.
The 78th WMA General Assembly
in Porto was a defining moment for
global medical ethics. The adoption
of new and revised statements on
physician well-being, mental health,
ageing, and AI reaffirmed the
WMA’s leadership in guiding medical
professionalism through rapid societal
and technological change.
Magda Mihaila, BS
Communication and
Information Manager,
World Medical Association
magda.mihaila@wma.net
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Photo 1. Group photo at the Pestana Douro Riverside during the 78th General Assembly in Porto. Credit: WMA
WMA General Assembly Report
13
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WMA STATEMENT ON ARTIFICIAL AND
AUGMENTED INTELLIGENCE IN MEDICAL CARE
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
1. The World Medical Association
(WMA) recognizes that artificial
intelligence (AI) is rapidly transforming
all sectors, including healthcare. In
this statement, the WMA reaffirms
its commitment to patient-centered,
physician-led care by emphasizing the
concept of augmented intelligence – a
framing that highlights AI’s role in
augmenting human judgment – by
strengthening rather than supplanting
it, while recognizing that in specific,
well-defined tasks AI may perform
independently but always under human
accountability. Through augmentation,
AI is supporting rather than replacing
human judgment, empathy, and
accountability.
2. Building on lessons learned from
early deployments, the WMA sets out
principles that maximize AI’s benefits
while mitigating its risks, ensuring that
its development, regulation and use
remain consistent with medical ethics,
international human-rights standards
and the public’s trust in the profession.
DEFINITIONS AND SCOPE
3. To promote clarity across jurisdictions
while embedding the augmented
intelligence perspective, the WMA uses
the following working definitions in the
healthcare ecosystem:
• Artificial Intelligence (AI): Computer
systems designed to perform tasks that
normally require human intelligence
– such as learning, problem-solving,
understanding language, and recognizing
patterns.
• Augmented Intelligence: Use of artificial
intelligence designed to support –
not replace – human capabilities in
healthcare.
• Physician-in-the-Loop (PITL): an
extension of the general “human-in-
the-loop” principle whereby a licensed
physician – rather than any user –
must review and retain final authority
over all AI outputs before they shape
clinical care. Where clinical care
involves multidisciplinary teams, PITL
implementation should ensure that
all relevant licensed professionals are
adequately consulted, while the physician
retains ultimate clinical responsibility.
4. Emphasis on “augmented”
• The term signals a human-centered
approach to AI – one that reinforces
the physician’s role as the final decision-
maker. Rather than viewing AI as a
replacement, augmented intelligence
frames these tools as extensions of
clinical expertise, designed to support
– not replace – professional judgment,
empathy, and responsibility.
• While “AI” is widely understood as
artificial intelligence, emphasizing the
augmented perspective helps ensure
that systems are designed, validated,
regulated, and trusted with the right
ethical priorities.
• For the medical profession, this
framing also enables more effective
advocacy – especially when engaging
with policymakers, regulators, and
stakeholders who default to the broader
term AI. It equips physicians to promote
technologies that truly align with the
goals of ethical, patient-centered care.
5. Scope and audience
• This statement aims to apply to all uses
of AI in medicine, including clinical
care and research, where AI primarily
augments human decision-making.
AI systems in administrative and
educational contexts should be applied
responsibly and with appropriate human
oversight.
• Its principles address physicians, other
healthcare professionals, healthcare
organizations, developers, regulators,
payers, academic institutions, and
industry partners, each of whom shares
responsibility for ensuring that AI
remains a safe, equitable, transparent,
and ethically-governed tool in the
delivery of healthcare worldwide.
GUIDING PRINCIPLES FOR AI IN
HEALTHCARE
6. Human-centricity: Human-centricity
in AI prioritizes human needs, values,
and wellbeing above technological
capabilities or performance metrics. This
principle includes:
• Maintaining and respecting patient
dignity, autonomy, and rights through
meaningful consent for AI use.
• Preserving patient health and well-
being, and the human connection as the
paramount considerations.
• Embedding cultural competence to
ensure AI systems respect diverse
patient values, clinical needs, languages,
and health beliefs.
7. Physician well-being: The well-being of
physicians and other clinicians must be
safeguarded, recognizing that reducing
administrative burden and avoiding
unnecessary cognitive load are essential
WMA Policies
14
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not only for supporting healthcare
professionals but also for ensuring the
quality and safety of patient care.
8. AI is a Tool: AI should serve as a
means to support healthcare goals rather
than an end in itself. Unlike traditional
medical tools, AI systems may appear
to learn and adapt without continuous
human input, making it essential to pair
their use with strong human oversight
and ethical governance.
9. Accountability: AI integration does not
diminish physician responsibility for
patient welfare and advocacy. Consistent
with the PITL principle, physicians
must continue exercising professional
judgment, and the final responsibility
and accountability for diagnosis,
indication, and therapy must always
lie with the physician. At the same
time, the growing prevalence of these
tools necessitates clearly distributed
accountability. Responsibility should
be appropriately allocated among all
stakeholders, including but not limited
to developers, healthcare organizations,
regulators, researchers and clinicians.
10. Transparency, Explainability, and
Trustworthiness:
• AI systems must be designed and
developed in ways that ensure their
outputs and recommendations can
be meaningfully understood by their
intended end users – whether physicians,
other healthcare professionals,
or patients – within the relevant
clinical context. Transparency extends
beyond the “black box” paradigm,
while explainability provides insight
into the basis for specific outputs,
thereby fostering trust and enabling
responsible use. Transparency
requirements and disclosures must be
tailored to the needs of physicians and
patients without adding paperwork or
extra administrative tasks. Ensuring
these qualities is a shared responsibility
across all stakeholders, including
developers, healthcare organizations,
regulators, researchers, and clinicians.
• Mechanisms should exist for meaningful
challenges of healthcare AI outputs,
enabling patients and clinicians –
including physicians – to question,
review, or override AI recommendations
when appropriate. This capacity is
essential for building clinical trust,
without which clinicians may reject
valuable AI tools or overly rely on
opaque systems.
• Explainability exists on a spectrum,
with some complex models functioning
as “black boxes” where only input/
output relationships can be observed.
The level of explainability required
should generally be proportional to the
clinical risk involved and the degree
of autonomy granted to the system.
In high-stakes contexts such as life-
and-death decision-making, additional
safeguards and oversight must be in
place whenever full explainability cannot
be achieved.
11. Safe deployment: Safe deployment of
AI in healthcare requires real-world
validation demonstrating consistent
performance, clinical efficacy, and
usability before widespread adoption.
Before clinical deployment, AI systems
must also undergo rigorous ethical
and health equity impact assessments
that are context-sensitive and adapted
to the specific healthcare setting and
population, with particular attention to
vulnerable and underrepresented groups.
Implementation must include continuous
performance monitoring, feedback
mechanisms, and iterative improvement
protocols to ensure sustained benefit and
global accessibility. Risks and harmful
consequences, including bias, must be
properly understood, anticipated, and
mitigated.
12. Equitable implementation: New and
beneficial AI healthcare tools must be
developed and deployed equitably, with
the goal of being accessible worldwide.
Equitable implementation should
ultimately bridge gaps in healthcare
access, treatment, and outcomes., while
expanding access to technology across
disparate health care facilities.
13. Data governance: All stakeholders
must maintain the highest standards
of data collection, storage, processing,
and sharing to protect patient privacy,
and institutional trust. This principle
is foundational because healthcare AI
depends on data access. Transparency
around data provenance – including the
origin, diversity, and quality of datasets
used to train AI systems – must also be
ensured to build trust and verify that
data appropriately represents the patients
being served.
14. Environmental impact: Effective
implementation of AI in healthcare
requires careful consideration of
its environmental impact and a
strong commitment to sustainability.
Environmental responsibility must be
integrated alongside clinical validation
to ensure that new technologies improve
care while minimizing harm to the
planet.
PHYSICIAN ROLES AND
RESPONSIBILITIES
15. Clinical Judgment and Accountability:
As emphasized in the PITL principle,
physician judgment remains essential
when using AI in healthcare, serving
as both an ethical imperative and a
practical necessity. Physicians must
maintain professional autonomy and
clinical independence to act in the best
interests of patients, consistent with the
WMA Declaration of Seoul.
16. Patient Advocacy: Physicians must
safeguard patient health, well-being,
and safety, ensuring that AI tools are
only used in ways that genuinely benefit
patients. Patient safety must remain a
fundamental priority, whether or not
augmented intelligence is applied.
17. AI tool development: Physicians should
be involved throughout the development
and implementation of AI technologies
in healthcare. They must participate
in decision-making processes about
WMA Policies
15
technology and its use from the outset
and be empowered to scrutinize new
innovations, including for usability.
18. Maintenance of competencies:
Physicians must maintain core clinical
expertise while also being educated
and trained to work responsibly with
AI systems. Delegation of tasks to AI
must not erode the human capability
required for safe, safety-critical care
or for continuity when AI systems are
unavailable or unreliable. Healthcare
organizations should support this
through ongoing education, simulation-
based refreshers, periodic skills
maintenance, and documented failover
procedures that enable clinicians to
critically appraise, override, and – when
necessary – perform essential tasks
independently.
19. Incident reporting: Physicians must
be empowered to report incidents and
question outcomes resulting from the
use of AI in healthcare.
PATIENT RIGHTS AND
ENGAGEMENT
20. While core patient rights are covered in
existing WMA policies, AI introduces
new risks – especially due to its reliance
on data – that require focused ethical
attention.
21. Informed consent: Given AI systems’
reliance on patient health information,
appropriate safeguards for data use
are crucial. The principles of informed
consent and transparency, building
upon the WMA Declaration of
Lisbon’s affirmation of patients’ rights
to information and self-determination,
must be rigorously applied in healthcare
involving AI. Where possible, patients
should be informed about the role
AI plays in their care in ways that
are understandable and meaningful,
while physicians retain responsibility
for ensuring safe and appropriate use
of AI. In circumstances where full
technical comprehension is impractical,
informed consent may reasonably extend
to a ‘consent for governance’ model,
whereby patients place justified trust in
physicians, healthcare institutions, and
regulatory oversight to uphold their
rights, safety, and welfare.
22. Data rights: Patients must be informed
about AI systems’ limitations and
potential for error, as well as how
physician oversight helps to ensures
their protection. Patients should retain
the right to request removal of their
data from AI systems where feasible
and legally permissible, and the right to
understand how their data contributes to
their care.
23. Patient autonomy and explanation
rights: Patient autonomy must be
preserved through meaningful consent
processes. Patients should retain the
right, where feasible, to refuse AI-
mediated interventions and request
human-only assessment. Where such
refusal is not possible due to systemic
integration of AI, safeguards must
ensure that patients’ data remain
anonymous and non-traceable. Patients
must have access to understandable
and non-biased explanations of how AI
contributes to their care, tailored to their
information needs and preferences. They
must also retain the right to dispute AI-
generated recommendations they believe
to be erroneous and to seek appropriate
redress. This must extend to health
insurer use of AI to determine patient
care, payment, and coverage.
24. Vulnerable patient population:
Vulnerable patient cohorts, such as
those with reduced decision-making
capabilities, must not be disadvantaged
or harmed through the use of AI in
healthcare. Safeguards must include
proactive bias mitigation, inclusive
dataset development, and tailored
consent or governance procedures to
protect those unable to fully exercise
autonomy. Particular attention must be
given to ensuring that informed consent
and data rights principles are applied
in ways that do not reinforce structural
inequities or exclude vulnerable groups
from fair access to care.
GOVERNANCE, REGULATION, AND
LIABILITY
25. Up-to-date standards: Regulation,
standards, and guidance must be suitably
robust to safeguard patient safety and
to ensure that the ethical rules of the
medical profession are considered, with
regulators empowered to stay up to
date with developments and enforce
legislation. Health care AI policies
should be coordinated and consistent
across government entities.
26. Liability: Clear lines of legal liability
must be established, including the AI
developers, as well as physicians, and
healthcare organisations. Accountability
should be shared and proportional,
reflecting each actor’s role in design,
deployment, and use, rather than
defaulting to a single actor alone.
27. Continuous audit: There should be
regular reviews and audits of regulatory
processes and bodies surrounding AI in
healthcare, including bias audits, ethical
reviews, and participatory governance
with physician input.
CLINICAL INTEGRATION AND
IMPLEMENTATION OF HEALTH AI
28. Tool evaluation and governance
support: AI systems implemented
in clinical settings must be validated
for clinical relevance, safety, and
effectiveness. Regular updates must be
implemented to maintain security and
ensure systems remain compatible with
evolving clinical practices. In complex
delivery environments, AI adoption
must also be supported by appropriate
governance structures that align clinical
teams, leadership, and technology
teams to ensure safe and responsible
implementation.
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WMA Policies
16
29. Workflow integration: AI tool
implementation requires seamless
integration within existing workflows
to enhance usability and function
as supportive additions rather than
disruptive elements that impede
efficient care delivery. Mechanisms
should be established for tracking AI
recommendations and their relationship
to final clinical decisions.
30. Post-deployment monitoring: Robust
post-deployment monitoring is critical to
ensure AI systems continue performing
as intended. AI systems can drift from
initial performance parameters when
encountering new patient populations
not represented in training data, as
clinical practices evolve, or even within
the same populations over time. Special
attention should be directed toward
monitoring outcomes in patient groups
not adequately represented in training
datasets.
DATA GOVERNANCE
IMPLEMENTATION
31. Patient data: All patient-identifiable
information used or generated by AI
systems must be collected, stored, and
processed in strict accordance with
the WMA Declaration of Taipei on
Ethical Considerations Regarding Health
Databases and Biobanks, as well as all
applicable laws and regulations. Security
safeguards are mandatory to preserve
confidentiality, prevent unauthorised
access, and uphold the therapeutic
trust that underpins the patient–
physician relationship. Additionally,
patient data use must follow the same
ethical safeguards applied to clinician
data, including purpose limitation,
transparency and consent, protection
against misuse, and, where feasible,
anonymisation and minimisation of data
collected.
32. Clinician data: AI systems are
increasingly capturing granular data
about clinicians (e.g., keystrokes,
voice recordings, workflow metrics,
prescribing patterns). Such information
can support quality improvement and
safety, but it also carries a risk of
surveillance, punitive misuse, or erosion
of professional autonomy. Therefore:
• Purpose limitation: Clinician-identifiable
data may be used only for clearly
defined clinical, educational, or quality-
improvement objectives that have been
disclosed to – and agreed by – those
clinicians.
• Transparency and consent: Physicians
must be informed, in advance and in
comprehensible terms, what data are
collected, how they will be analyzed, and
who will have access. Explicit consent is
required for uses beyond direct patient
care or clinician-requested feedback.
• Protection against misuse: Data must not
be repurposed to penalize clinicians,
set unrealistic performance quotas,
or otherwise undermine the patient-
physician relationship. Any secondary
use (e.g. commercial analytics,
administrative oversight) requires
separate ethical review and consent.
• Anonymization and minimization: Where
feasible, clinician data should be de-
identified or aggregated, and collection
limited to the minimum necessary to
achieve the stated purpose.
33. Governance and oversight: Healthcare
organisations must establish independent
oversight mechanisms – such as, and
not limited to, data protection officers,
ethics committees, and periodic external
audits – to verify compliance with
safeguards for both patient and clinician
data. Breaches or unauthorised uses
must trigger transparent disclosure,
remediation, and, where appropriate,
sanctions. In addition, AI system
developers must implement and support
robust cybersecurity policies and
controls to protect the confidentiality,
integrity, and availability of health data
throughout the AI system’s lifecycle.
MEDICAL EDUCATION AND
CAPACITY BUILDING
34. AI literacy requirements: Physicians
must maintain appropriate AI literacy
in the rapidly evolving AI landscape,
including the knowledge and skills to
use AI tools properly and the ability
to critically understand and assess
AI literacy must be systematically
integrated into undergraduate medical
curricula to ensure all physicians acquire
a foundational understanding of these
technologies. In addition, AI literacy
should be reinforced through mandatory
continuing professional development
programs, enabling physicians to keep
pace with evolving tools and to ensure
their safe, ethical, and informed use in
practice.
35. Global equity: Focused attention must
be directed toward bridging AI education
gaps between regions, with particular
emphasis on enhancing capacity in low-
and middle-income countries (LMICs).
Equitable distribution of educational
resources and opportunities is essential
to prevent widening disparities in AI
implementation and ensure global
benefit from these technological
advances.
RESEARCH, INNOVATION AND
EVALUATION
36. Medical research standards: Any
medical research involving AI, whether
as the tool or object of study, must abide
by accepted international standards of
medical research, including, but not
limited to, Good Clinical Practice, the
WMA Declaration of Helsinki, and the
WMA Declaration of Taipei.
GLOBAL CONSIDERATIONS AND
COLLABORATION
37. Cross-jurisdiction applicability: AI
policies and infrastructures should,
as far as possible, be aligned to have
applicability across jurisdictions.
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38. Diverse healthcare environments:
Appropriate AI solutions must be
pursued across diverse healthcare
environments, including low-resource
settings. This requires supporting locally
developed, context-sensitive innovations
to ensure AI systems are responsive
to local needs, realities, and resource
constraints.
39. Cultural Sensitivity: AI policies should
respect varied cultural approaches while
ensuring alignment with fundamental
ethical principles, such as respect for
human dignity, rights, and wellbeing.
RECOMMENDATIONS
40. For physicians and medical
associations: Medical professionals
and their representative organizations
should promote the development of
comprehensive AI literacy programs,
actively engage in AI governance
structures – including contributing
to the development of best practices
for AI use in medicine – and uphold
rigorous ethical standards to ensure
quality patient care in an AI-
enhanced healthcare environment.
They should also consider creating
educational materials for patients to
support transparency and informed
understanding of AI in healthcare.
41. For healthcare facilities: Healthcare
institutions must establish robust
governance frameworks for the safe
adoption of AI technologies and
implement continuous monitoring
processes. Organizations should balance
innovation with safety considerations
and maintain respect for clinical
judgment when deploying AI systems.
Importantly, AI implementation should
be pursued when it demonstrably serves
patients’ interests, without mandating
AI use as a condition for licensure,
participation, or reimbursement.
42. For technology developers: Technology
companies and AI developers must
prioritize co-design approaches with
practicing physicians and provide
transparency in system development,
deployment and use. Sustained
collaboration between clinical and
technical experts throughout the entire
development lifecycle is essential to
create tools that enhance healthcare
quality and equity and that effectively
support clinical activity.
43. For regulators and policymakers: In
consultation with medical associations
(and other health professions
organisations), craft physician-informed
regulations and foster international
cooperation.
44. For educational institutions: Embed
AI training in curricula and support
global capacity building.
45. For researchers and innovators: Pursue
ethical, equitable, and evidence-based
AI advancements.
APPENDIX
Narrow AI:
Domain-specific applications confined to
clearly defined clinical or administrative
objectives.
Generative AI:
Models, often large-language models,
that create new clinical content – such as
documentation drafts or treatment-plan
suggestions – based on training data.
Foundational Models:
Broad, continuously trained models that
underpin multiple healthcare applications
and therefore require ongoing domain-
specific oversight.
Machine learning:
A subset of artificial intelligence in which
computer algorithms autonomously improve
their performance at a specific task by
learning complex relationships or identifying
patterns in data, rather than by following
explicit, pre-programmed instructions.
Patient-Physician Relationship:
Trust can be enhanced in the patient-
physician relationship when:
• Physicians transparently discuss the role
of AI in patient care
• AI systems demonstrably improve quality
or safety outcomes
• Patients clearly understand how their
data is used and protected and how data
governance is organized.
• Patients are offered more time with their
physician
WMA Policies
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WMA STATEMENT ON DEMENTIA
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
Dementia is a syndrome caused by many
different diseases, which collectively form
an increasing part of non-communicable
conditions globally. According to the World
Health Organization (WHO), “Dementia
is an umbrella term for several diseases
affecting memory, other cognitive abilities
and behavior that interfere significantly with
a person’s ability to maintain their activities
of daily living. Although age is the strongest
known risk factor for dementia, it is not a
normal part of ageing.”
Dementia is primarily a condition of older
people but one in ten affected individuals
show signs before the age of 65. As the
actual number of older people is increasing
steadily around the globe, there is a rising
number of cases of dementia. In 2023 the
WHO estimated the number of individuals
with dementia to be 55 million worldwide
and this is expected to rise to 139 million
by 2050. Currently, 60% of people with
dementia live in low and middle-income
countries, but by 2050 this is predicted to
rise to 71%.
Dementia incidence and outcome are
influenced not only by biological factors
but also by social determinants such as
education, socioeconomic status, and access
to healthcare, which vary widely across
regions and populations.
The annual global cost of dementia was
estimated in 2019 to be more than 1.3
trillion US$ and is expected to rise to 2.8
trillion US$ by 2030. This figure includes
costs attributed to informal care (unpaid
care provided by family and other informal
caregivers) and direct costs of social and
medical care.
Non-communicable diseases (NCDs),
including heart disease, stroke, cancer,
diabetes and chronic lung disease, are
collectively responsible for 74% of all
deaths worldwide according to the WHO.
Dementia is not listed as a major NCD
despite its major effects on individuals and
families as well as its rising contribution
to societal cost. However, dementia risk
increases with the five major risk factors
on the NCD list of WHO: tobacco use,
physical inactivity, harmful use of alcohol,
unhealthy diets and air pollution.
Alzheimer´s disease, the most common
disease causing dementia, is the seventh
most common causes of death globally,
but the fourth in high-income countries.
Alzheimer´s disease is the only one of the
ten most prevalent causes of death with no
effective prevention or cure and only limited
treatment possibilities.
Women are disproportionately affected
by dementia, with greater prevalence rates
than men in all age groups and a higher
proportion of deaths. Women are also
responsible for providing roughly 70%
of informal care hours globally, with the
highest proportions being in low- and
middle-income countries.
Dementia leads to increasing dependency in
daily life and decreasing quality of life. As
the burden of care increases, the quality of
life of the caregiver, typically a close family
member decreases as well. Individuals with
moderate and severe dementia ultimately
need to move to a service or nursing home
but in many countries, particularly low- and
middle-income countries, this possibility
is not available. Nursing home costs are
putting an increasing strain on economies,
whether inside or outside a national health
service.
There is increasing evidence that up to 45%
of cases of dementia might be preventable
to some extent. This has been supported by
the actual decrease in dementia prevalence
in the last three decades, but due to the
rising number of older individuals, the total
number of cases of dementia continues to
rise.
Dementia does not generally belong to
any one specialty of medicine but is most
often the responsibility of either neurology,
psychiatry (often senior psychiatry),
geriatrics or family medicine. It involves
a multidisciplinary approach requiring
collaboration across various healthcare fields.
However, individuals with dementia are
more frequently admitted to hospital than
those without dementia independent of
physical comorbidities with generally poorer
prognosis than non-demented individuals.
Research into treatment options for diseases
causing dementia has been lagging compared
to other major NCDs and has been mostly
futile. New biological treatments for
Alzheimer’s disease are very costly and most
societies, even the wealthiest, are having
difficulties handling the financial burden. In
addition, these medications have a limited
effects as they are not halting the process
of increasing cognitive impairment but only
slowing it.
The WHO global actions plan for dementia
2017-2025 states that countries need to
develop practical and ambitious national
strategies. The plan includes a set of seven
global targets such as viewing dementia as a
public health priority to improve diagnosis,
support for dementia carers and increased
funding for research.
RECOMMENDATIONS
The World Medical Association (WMA)
calls on the following stakeholders to:
The World Health Organization (WHO)
1. List dementia as one of the major
NCDs globally.
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2. Increase its focus on dementia and its
causes, particularly in low and middle-
income countries since they are expected
to face the greatest increase in the
number of dementia cases in coming
decades.
3. Collaborate with governments,
international Alzheimer´s disease bodies
as well as the WMA in enhancing
global awareness of dementia.
National Governments
4. View dementia as a public health
priority.
5. Work along the lines of the WHO
global action plan for dementia.
6. Develop comprehensive national
dementia strategies including clear
targets and measurable indicators, with
allocated funding and a clear monitoring
and evaluation process.
7. Support risk reduction programs,
especially through public health
initiatives. Such programs will also help
countering other major NCDs.
8. Increase awareness of dementia and
support dementia friendly initiatives.
9. Develop programs to support caregivers,
including access to respite care, financial
support, and mental health services,
recognizing their critical role in
dementia care.
10. Increase funding for dementia research
nationally and through international
partnerships with a focus on effective,
accessible treatments and care.
Medical Associations and the Scientific
Community
11. Promote initiatives to increase
physicians´ knowledge about dementia,
in order to promote early identification
and accurate diagnosis of cognitive
impairment, thereby enabling appropriate
treatment and care to be provided.
12. Increase awareness that individuals
with dementia have special needs when
seeking health care for other ailments.
13. Work with other stakeholders to
promote high quality care and good
quality of life for individuals with
dementia.
14. Increase enrollment in clinical trials of
appropriate patients with Alzheimer’s
disease and related dementias, and
their families, to better identify sex-
differences in incidence and progression
and to advance a treatment and cure
of Alzheimer’s disease and related
dementias.
15. Encourage studies to determine how
best to provide stable funding for
the long-term care of patients with
Alzheimer’s disease and other dementing
disorders.
16. Make available information about
community resources to facilitate
appropriate and timely referral to
supportive caregiver services.
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WMA STATEMENT ON OBESITY
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
The World Medical Association recognizes
obesity as a widespread, long-term chronic
disease and a global concern. The WMA
notes that obesity is increasing among
all age groups. Still, the rise in children
including adolescents is of particular concern
as earlier onset leads to worsened chronic
disease burden over the life course. Obesity
can affect both mental and physical health
and can lead to discrimination, stigma, and
bullying.
Obesity is a major health problem affecting
all countries and all social and economic
groups. It puts much pressure on healthcare
resources. It is not an aesthetic problem, it
is a medical problem that increases the risk
of many other illnesses and health problems
and, due to its scale and consequences, it
is a public health problem of the highest
priority.
Obesity’s causes are complicated and relate
to changes in society and the economy,
including the environment that encourages
obesity. The causes of obesity may be
multifaceted, encompassing various factors
such as environmental influences on physical
activity, biological and medical conditions,
psychological factors, maternal and
developmental aspects, dietary habits, and
economic and social elements.
The WMA acknowledges that social
determinants of health significantly
contribute to obesity. These determinants
partially account for the disparities observed
in racial and ethnic minority groups.
Physicians can be instrumental in both
preventing and treating obesity. However,
their potential may be hindered by
insufficient education regarding obesity or
subconscious and conscious biases toward
patients with obesity. This may subsequently
affect the quality of care offered to patients
with obesity.
The WMA emphasizes the need to
stimulate and support multisectoral country-
level action on obesity across the globe.
The prescription of drugs for the treatment
of obesity should be based on a medical
diagnosis with strictly scientific criteria.
The WMA recalls its policies on Free
Sugar Consumption and Sugar-sweetened
Beverages, the Global Burden of Chronic
Non-Communicable Disease, and Primary
Health Care. These policies provide
important context and guidance for
addressing the obesity epidemic.
RECOMMENDATIONS
1. The WMA recommends all Medical
Associations to call for policies that
reduce the incidence of obesity,
including:
• Learning about healthy diets in school
curricula;
• Facilitating access to physical activity
and sports for all parts of the population;
• Actively using consumer protection
regulations to restrict marketing and
raise prices of unhealthy products.
2. The WMA urges all Medical
Associations to advocate for the
recognition of obesity as a chronic
disease requiring medical care and
appropriate support, and the integration
of obesity prevention, management, and
treatment into national health services.
All stakeholders must work together to
address this global health concern.
3. The WMA calls for integrating obesity
prevention, management, and treatment
into Universal Health Coverage as an
‘essential health service.’ This includes
access to evidence-based therapies
and treatments for obesity, ensuring
these services are universally available,
accessible, affordable, and sustainable.
4. The WMA encourages physicians to use
their leadership roles to push for obesity
reduction to be a priority for national
health authorities and to advocate for
policies suitable for different cultures
and ages, involving physicians and other
key stakeholders.
5. The WMA acknowledges that there
are various treatment options for
patients with obesity. These range from
lifestyle and behavioral changes to
pharmacotherapy, medical devices, and
metabolic and bariatric surgery.
6. Primary prevention is a crucial objective
for physicians in addressing obesity,
but only limited effective methods
to achieve it are currently available.
While progression of and complications
associated with obesity can be prevented
and treated, there is a need to develop
and support additional effective
strategies to reduce its incidence. We
must promote health information and
education based on sound scientific
criteria that inform, help and support
the population in the prevention and
management of this disease.
7. Physicians need thorough education
on obesity to fully understand the
disease. This will enable them to treat
it effectively, minimize prejudice and
stigma, advocate for relevant policies,
and lead treatment teams efficiently.
8. Physicians attending to pediatric
patients should understand the specific
details associated with childhood
and adolescent obesity, especially the
necessity for prevention and early
intervention. They should be able to
identify rare types of obesity, as failure
to do so can result in detrimental health
consequences.
9.
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21
10. The WMA recommends a multisectoral
approach, based on the principles of
primary health care, to prevent, treat,
and manage obesity. This approach
involves various sectors, including health,
education, and social services, with
physicians playing a crucial role in this
multisectoral approach.
11. The WMA encourages its Constituent
Members and physicians to advocate
for healthy diet, to promote regular
physical exercise and to combat diet
and nutrition misinformation spread
particularly on social networks.
12. The WMA calls for firm action against
self-proclaimed therapists and unproven
therapies.
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WMA Policies
WMA STATEMENT ON PHYSICIAN
MENTAL HEALTH CARE
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
Good mental health of physicians and
other health and care professionals is a
prerequisite for high quality medical care
and patient safety.
The WHO Working for Health Action Plan
2022-2030 emphasizes that many challenges
faced by health and care professionals
around the world, including i.a. labor market
failures and substantial underinvestment
that have a “direct effect on physical and
mental health and worker well-being as they
undermine their health, social and economic
contribution to society.”
Physicians and other health and care
professionals may experience mental health
conditions that are linked to burnout, long
working hours, high-stakes decision-making,
and emotional burdens specific to their
profession. If not addressed in time, mental
health conditions can become chronic and
have serious consequences in all areas of life.
They can even lead to an increased risk of
suicidal ideation among physicians.
The prevalence of mental health conditions
among physicians and other health and care
professionals worldwide highlights the need
for greater attention to their psychosocial
well-being.
Pressure from employers, extended working
hours, or experiences of violence, combined
with access to drugs and medication,
can also give rise to situations in which
physicians require help and support. These
and other factors can also contribute to an
increased risk of substance abuse among
medical professionals. Since the mental
health of physicians impacts on the quality
of health care and patient safety, ensuring
the well-being of physicians is essential.
Promoting physician mental health
requires comprehensive action that ensures
appropriate treatment and rehabilitation
without stigmatization.
Several countries have implemented
specific programs that have demonstrated
effectiveness in providing comprehensive
care to physicians affected by mental health
conditions.
A history of mental health conditions does
not inherently preclude a physician from
providing valuable, high-quality patient care.
Physicians should be supported through
return-to-work programs and reasonable
workplace accommodations to ensure their
successful reintegration and continued
contribution to patient care.
Further research regarding mental health of
physicians is needed to better understand
the problem and identify best practices
in terms of mental health promotion and
treatment, including attention to diversity
and equity among physician populations.
RECOMMENDATIONS
The World Medical Association reaffirms its
Statement on Physician Well-being, calls on
the relevant authorities to collaborate with
healthcare professional organisations on the
issue of physician mental health and urges
its constituent members and physicians to:
1. Advocate for the development of
effective policies that protect the mental
health of physicians and ensure sufficient
resources to enable appropriate care.
2. Encourage concerted efforts for the
prevention and early detection of
mental health conditions among
physicians, ensuring confidential
access to evaluation, treatment, and
follow-up without fear of professional
repercussions. Promote physicians’
physical and mental well-being through
specific strategies, including during
higher education and postgraduate
training. These strategies should provide
support for those experiencing mental
conditions and ensure that resources
to promote positive mental health are
available to all clinicians, including those
at risk.
3. Promote the development of specific
mental health intervention programs
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and protocols for physicians that address
the problem from a healthcare, social
and professional point of view, with
confidentiality and without stigma and
encouraging physical and psychological
rehabilitation. This should include
programs to support physicians to
overcome addictions, which could be
caused by occupational psychosocial
risk factors. Medical associations should
promote programs helping physicians
return to practice after treatment and
recovery.
4. Ensure the destigmatization of mental
health and substance use disorders
in physicians by ensuring access to
treatment and follow-up without
disproportionate risk of adverse licensure
or certification actions. Any restrictions
on medical practice should be based on
an objective, case-by-case assessment
involving relevant regulatory bodies,
with full consideration of patient safety,
clinical recovery, and the rights of the
physician.
5. Duly consider the experience acquired
by physicians recovered from mental
health disorders in efforts to overcome
stigmatization, discrimination and to
reduce inequalities.
6. Support and expand physicians’ mental
health research and education to identify
and implement best practices.
7. Increase awareness and promote
comprehensive training on physician
mental health across healthcare,
academic, and institutional settings and
at all stages of medical education.
8. Encourage research on the prevalence
and impact of psychosocial risks factors
in the medical profession.
9. National medical associations should
promote the establishment of
mechanisms such as observatories or
dedicated monitoring initiatives to
recognize, assess, and track mental
health challenges among physicians, and
to develop evidence-based proposals for
their prevention and resolution.
10. Consider and promote measures to
create positive and supportive workplace
cultures that foster open communication,
teamwork and a sense of belonging
where physicians feel valued and
respected, including leadership training,
peer support initiatives, and confidential
channels for raising concerns without
fear of retribution.
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WMA Policies
WMA STATEMENT ON THE PROTECTION
OF REPRODUCTIVE HEALTH RIGHTS
OF WOMEN AND GIRLS
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
The WMA notes with concern that
reproductive health[1] is underprioritized in
many regions of the world.
The WMA recognizes that access to
reproductive health services may be
influenced by local moral, cultural and
religious beliefs, traditions and practices.
The WMA affirms that such beliefs,
traditions and practices should not constitute
a barrier to access to health services.
The WMA opposes laws, policies, and
juridical practices that unreasonably restrict
or criminalize the termination of pregnancy.
The WMA underlines that physicians are
responsible for protecting their patients’
privacy and maintaining physician-patient
confidentiality.
The sexual and reproductive rights of
women and girls are human rights that
must be respected to ensure their full
development in all spheres of life.
The WMA reaffirms its Statement on
medically-indicated termination of pregnancy.
RECOMMENDATIONS
The WMA recommends its constituent
members to:
1. Address reproductive health in public
debate in order to promote greater
societal knowledge and understanding of
the issues at stake.
2. Consider reproductive health as an
individual and public health issue in the
same way as other health needs.
3. Promote universal accessibility, with a
focus on affordability to health services,
including reproductive health services.
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4. Oppose criminal and civil penalties
for the provision of reproductive
health services, including access to
contraception.
5. Advocate for legal protection for
physicians and patients who provide
and receive reproductive health services,
including contraception.
6. Oppose criminal and civil penalties for
the provision of voluntary termination
of pregnancy and advocate for legal
protection for physicians who provide
voluntary termination of pregnancy and
for their patients.
7. Facilitate development of and access
to knowledge related to reproductive
health.
8. Promote health and sexual information
and education for girls and women in
order to develop adequate and healthy
reproductive health.
The WMA recommends physicians to:
9. Ensure that patients’ health and
well-being are prioritized without
discrimination.
10. Treat all patients with respect for their
autonomy and dignity.
11. Ensure that where conflicts of
conscience prevent the physician from
providing reproductive health services,
sufficient information is provided about
alternative care givers and timely access
to care is ensured for every patient.
12. Assist patients with information and
products that support their autonomy
with regard to family planning.
13. In obstetric care, always facilitate safe
childbirth and post-partum care.
[1] The term “reproductive health” in this statement
includes maternal and neonatal care, contraception,
fertility treatments and family planning.
WMA Policies
WMA RESOLUTION CALLING ON THE ISRAELI
GOVERNMENT TO COMPLY WITH THE GENEVA
CONVENTIONS AND OTHER APPLICABLE
INSTRUMENTS OF HUMANITARIAN LAW
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
The WMA reaffirms the WMA Resolution
on the Protection of Healthcare in Israel and
Gaza, including the call for immediate and
safe release of all hostages.
The World Medical Association (WMA)
expresses its profound concern over the
attacks on patients, health professionals,
medical facilities, and humanitarian aid
convoys in Gaza in violations of the Geneva
Conventions and applicable international
humanitarian law.
Gaza is facing a deepening humanitarian
and public health crisis. More than half
a million people in Gaza are trapped in
famine, marked by widespread starvation,
destitution and preventable deaths,
according to an Integrated Food Security
Phase Classification (IPC) analysis. Medical
supplies and intervention are vital to treat
the effects of malnutrition.
The opportunities for international
organisations and actors providing medical
humanitarian aid to operate in the region
are limited.
It is imperative that all governments, armed
forces, and entities in positions of authority
strictly adhere to international humanitarian
law, including the provisions of the Geneva
Conventions, thereby guaranteeing access
to humanitarian aid, and that physicians
and other health professionals can safely
deliver essential care to all individuals in
need, particularly within contexts of armed
conflict.
Furthermore, physicians must be afforded
unimpeded access to patients, medical
infrastructure, essential medicines, and
critical equipment and must be provided
with comprehensive protection to execute
their professional duties without hindrance.
RECOMMENDATIONS
1. The WMA emphatically calls upon the
Government of Israel to:
• Instantly halt all forms of attacks on
healthcare personnel, patients, healthcare
facilities, and food and medical aid
logistics in accordance with the Geneva
Conventions and applicable international
humanitarian law.
• Ensure delivery of humanitarian aid and
access to food to all in need.
• Guarantee respect for the principle of
medical neutrality and proceed with the
immediate and unconditional release of
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all health personnel arbitrarily detained.
• Ensure that health professionals can
perform their duties safely, without
obstruction or interference.
• Grant necessary permissions for the
unhindered entry and distribution of
medical aid and ensure the safe delivery
of essential equipment and medicines to
healthcare services.
• Fully honour and adhere to the principles
enshrined in the Geneva Conventions
and other applicable international
humanitarian instruments.
• Facilitate access for independent
investigators and ensure that all
individuals responsible for criminal acts
are held accountable under international
law.
2. The WMA calls upon its Constituent
Members to unequivocally condemn
attacks on healthcare personnel and
facilities during the ongoing conflict in
line with the Geneva Conventions and
international humanitarian law.
3. The WMA calls on the World Health
Organization (WHO) to undertake a
comprehensive study to determine the
full extent of the damage caused to
health services, physicians, and other
health professionals in Gaza and to
identify the measures necessary for their
full restoration and compensation.
4. The WMA urges governments to
support peace initiatives and constructive
frameworks to bring an end to the
hostilities in Gaza and the region.
WMA STATEMENT ON AGEING PHYSICIANS
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
The increasing number of physicians at
or near retirement age plays a great role
in contemporary medical practice. They
provide competent care as well as improve
patient access to medical care. This
resolution supports professional autonomy,
and addresses the matter of continued
competency evaluation, to preserve patients’
access to care, patients’ right to freedom of
choice, as well as patient safety and medical
care standards.
The number of physicians at or near
retirement age is increasing in many parts
of the world, and many of these physicians
still play an active and leading role in their
respective fields.
Ageing physicians can play a valuable role
contributing their experience and knowledge
of the healthcare environment, of their
patients, and of the interpersonal dynamics
and the patient-physician relationship.
The World Medical Association believes
that when there is concern about a
physician’s competence, the physician’s
colleagues and internal management should
examine whether the concern is well-
founded and if so, whether the issue can
be resolved quickly and through internal
processes without risk to patient safety. If
such efforts do not resolve the problem, it
may be necessary to report the physician
to the relevant authorities in good faith
and in the best interests of the physician
and of their patients. It is imperative that
this approach be marked by the utmost
benevolence and collegiality. Appropriate
personal support to the physician should be
ensured.
RECOMMENDATIONS
1. The World Medical Association urges
avoidance of policies that mandate age-
specific retirement for physicians.
2. The World Medical Association invites
its Constituent Members to:
• Foster the principles of evidence-based
competency evaluation of the individual
physicians and strive for professional
autonomy in this matter.
• Seek to ensure appropriate and balanced
evaluation of the working ability of
ageing physicians that wish to continue
their medical practice.
• Promote tailored continuing professional
development activities to support ageing
physicians and the maintenance of their
professional aptitude, for them to provide
high quality care throughout their
practice careers.
• Promote ways for ageing physicians to
remain active after retirement, including
through volunteer opportunities.
3. Physicians should report to the
appropriate authorities conditions or
circumstances which impede a physicians
from providing care of the highest
standards, as set forth in the WMA’s
International Code of Medical Ethics.
4. The World Medical Association invites
its members and health authorities to
secure appropriate pathways when there
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25
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is concern about a physician’s competence
or circumstances which impede a
physician from providing care of the
highest standards, as set forth in the
WMA’s International Code of Medical
Ethics.
5. The World Medical Association invites
its members and health authorities to
secure appropriate pathways when there
is concern about a physician’s competence
or circumstances which impede a
physician from providing care of the
highest standards, as set forth in the
WMA’s International Code of Medical
Ethics.
6. In these circumstances, the physician’s
colleagues and internal management
should examine whether the concern
is well-founded and if so, whether the
issue can be resolved quickly and through
internal processes without risk to patient
safety.
7. If such efforts do not resolve the
problem, it may be necessary to report
the physician to the relevant authorities
in good faith and in the best interests
of the physician and of the patients.
It is imperative that this approach be
marked by the utmost benevolence and
collegiality. Appropriate personal support
to the physician should be ensured.
8. The World Medical Association
recommends physicians to:
• Have their health and work ability
regularly evaluated by another physician.
• Maintain professional skills with
appropriate continuing professional
development activities, in order also to
adapt to new technologies, treatments
and healthcare protocols and ensure up-
to-date and safe medical care.
WMA RESOLUTION ON HEALTH WORKFORCE AT
THE WORLD HEALTH ORGANIZATION (WHO)
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
The health workforce is the backbone of
health systems. Effective healthcare service
delivery necessitates adequately resourced,
educated, ethically recruited and employed
health professionals in decent working
conditions.
The world is facing an 11 million health
worker shortage by 2030 to achieve
universal health coverage. Now more than
ever, a strong global leadership at the WHO
is necessary to effectively support and
strengthen the health workforce through
developing evidence and normative guidance
to support member states in planning,
employing, and retaining their national
workforce.
Member states have reiterated their support
by adopting yet another resolution at
the 78th World Health Assembly titled
“Accelerate implementation of the Global
strategy on human resources for health:
Workforce 2030.”
The WHO is currently undergoing a
restructuring process, planning to downsize
the Health Workforce Department and
move its staff to the WHO Academy.
The World Medical Association expresses
its concern about the currently planned
restructuring process, which will significantly
impede the WHO’s ability to continue its
leadership in accelerating global progress on
the health workforce.
RECOMMENDATIONS
1. The WMA calls urgently on the World
Health Organization’s Director-General
to prioritise the health workforce
by upholding its Health Workforce
Department as a separate entity, ensuring
it continues to be adequately staffed with
strong leadership.
2. Additionally, we request that the
department remain in its headquarters
in Geneva to ensure cross-collaboration,
particularly with the Health Systems,
Universal Health Coverage, Non-
Communicable Diseases departments
among others, as well as with the Health
Professional Associations, which are
largely headquartered in the Geneva
region.
WMA Policies
26
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WMA RESOLUTION ON PUBLIC HEALTH
FUNDING WORLDWIDE
Adopted by the 76th WMA General
Assembly, Porto, Portugal, October 2025
PREAMBLE
Health care all over the world is under
threat. Funding that has improved health
by securing vaccines, medicines and health
care professionals is being cut back or
even completely dismantled. This creates
a huge health risk, not only for those that
cannot afford the costs themselves but also
because this will increase the spread of
communicable diseases like HIV, TB and
malaria, and so puts everyone at risk. This
is in addition to the threat that is caused by
armed conflicts.
The WMA calls upon the leaders of the
world to restore basic health care funding
together. If the world sits back, we shall be
confronted with a large increase of diseases
and deaths.
Countries like the USA have made huge
efforts in the last decades. Now, all nations
shall have to contribute together to rescue
our basic health system for those in need.
RECOMMENDATIONS
The World Medical Association urges world
leaders to contribute together to the funding
of public health facilities that improve
health by securing vaccines, medicines and
health care professionals and by doing
so, help prevent a potential increase in
the spread of communicable diseases like
HIV, TB and malaria, which pose a risk
to everyone. Nations have to contribute
together to rescue basic healthcare systems
for those in need.
WMA Policies
WMA RESOLUTION ON THE ROLE OF
PHYSICIAN ASSOCIATES AND OTHER NON-
PHYSICIAN PROVIDERS IN THE UNITED
KINGDOM AND OTHER COUNTRIES
Adopted by the 229th Council session,
Montevideo, Uruguay, April 2025
and by the 76th WMA General Assembly,
Porto, Portugal, October 2025
PREAMBLE
The World Medical Association and its
constituent members share the British
Medical Association’s concerns about the
way in which non-physician practitioners
including PAs (physician associates or
physician assistants) and AAs (anaesthesia
associates) have been introduced in the
United Kingdom and other countries and
makes the following recommendations in
light of the independent ‘Leng Review’ into
PAs and AAs commissioned by the UK
government and other similar reviews.
RECOMMENDATIONS
In the interest of patient and clinician safety
and to ensure broad clarity of understanding,
the WMA affirms that:
1. The terminology used for physician
associates and anaesthesia associates is
confusing. These roles must be titled
‘assistants’ rather than ‘associates’ to make
it clear that they assist physicians.
2. Terms previously used for physicians such
as ‘medical professionals’ and ‘medical
practitioners’ should not be expanded to
include PAs and AAs, nor should they
be described as being ‘medically trained’
or ‘trained to the medical model’. This is
because it is proving to be confusing for
the public and misleading for physician
supervisors and other members of
the multi-disciplinary team who may
wrongly presume that assistants have the
same knowledge, skills and expertise of a
physician, with adverse consequences for
patients.
3. PAs and AAs should work under the
supervision of physicians and within
clearly defined scopes of practice
with clear limits, and should undergo
regular quality assurance and appraisal.
Physicians and their representative bodies
should be properly consulted on any
proposed changes to these scopes given
such roles utilise a limited subset of skills
and knowledge of physicians.
4. PAs and AAs should be deployed to
assist rather than replace physicians.
5. The training of PAs and AAs should not
be prioritised at the expense of training
for physicians and medical students,
including the funding for such training.
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WMA RESOLUTION TO UPHOLD THE
ETHICAL FRAMEWORK OF HEALTHCARE
Adopted by the 229th WMA Council
Session, Montevideo, Uruguay, April 2025
and by the 76th WMA General Assembly,
Porto, Portugal, October 2025
PREAMBLE
Pillars of medicine which were until
recently considered unquestionable, such
as scientific evidence, human dignity and
solidarity, are being increasingly challenged
by the expansion of ideologies and political
positions that reject or deny them
In this context, the ability of physicians to
work ethically and to follow the rules of
the profession is threatened, as is also the
autonomy of the profession; the intervention
of politics, of the judiciary system or of the
police in the care process is increasingly
becoming a reality in many parts of the
world.
The pressure exists on physicians being
forced by their governments to treat
detained patients in an unethical manner.
There is also outright violence against
healthcare personnel and healthcare facilities
in areas with armed conflicts and other
emergencies.
Pressure put on the professional autonomy
of the physicians and on their ability to
follow their ethical rules can negatively
impact the quality of the care provided, and
can finally compromise the population’s trust
in the profession.
The World Medical Association was
founded with the explicit aim of setting the
highest ethical and humanist standards for
medicine throughout the world.
These standards are being challenged by
ideologies and political stances that reject
the societal achievements of the last 80
years.
These high ethical and humanist standards
must, however, forcefully continue to be
upheld by the medical profession with clear
determination and strength.
RECOMMENDATIONS
1. The World Medical Association and all
its Constituent Members are strongly
committed to upholding the ethical
standards of the medical profession,
as they have been established by the
profession itself during the last 80 years.
2. It is an essential role of the WMA and
of its Constituent Members to advocate
for a legal framework for healthcare
in all our countries, which respects the
ethical rules of our profession and allows
practicing medicine according to them.
3. The WMA urges governments to
secure the safety and lives of health
care personnel whatever the actual
circumstances, thereby enabling them to
fulfill their duty to help any patient in
need and act according to their ethical
principles.
4. The WMA must actively advocate for
the honor of the medical profession and
the rights of medical personnel and of
the patients wherever these are under
threat.
5. It is the duty of the WMA and
of all its Constituent Members to
support individual physicians and their
organizations whenever their ability
to follow the ethical rules set by the
WMA is threatened or limited by undue
political or judiciary pressure.
6. The World Medical Association and
all its Constituent Members strongly
support and foster scientific, fact-based
medicine, including evidence-based
therapeutic and public health measures.
7. The World Medical Association calls for
respect for the independence of research,
in accordance with the ethical principles
imbedded in its Declaration of Helsinki.
WMA Policies
28
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232nd WMA Council Session, Belgrade 2025
Information about the 232nd WMA
Council Session, Belgrade 2025
Dear colleagues of the World
Medical Association,
On behalf of the Serbian Medical
Chamber (Лекарска комора Србије),
we cordially invite you to participate
in the 232nd Council Session of the
World Medical Association, which
will be held on 23-25 April 2026, in
Belgrade, Serbia. The Serbian Medical
Chamber, founded in 1901, is pleased
to serve as the host for this event and
share the promotional video (https://
www.youtube.com/watch?v=0aJ7vJti23w).
Our team has prepared a robust
agenda of key themes related to our
medical profession, as well as leisure
activities to learn about our city, its
culture, and its hospitality.
Please mark your calendars and
join us in Belgrade for this exciting
event.
Serbian Medical Chamber
Лекарска комора Србије
Belgrade, Serbia
https://www.lks.org.rs/
info@lks.org.rs
29
Using AI in Medical Practice
With the rise of technological
development, the incorporation of
artificial intelligence (AI) and language
model tools in medical practice is
inevitable and will require that these
systems are tested and validated into
existing workflow related to clinical
documentation, decision support,
and patient communication. Physicians
should be prepared to effectively use
this technology to enhance diagnostics
and strengthen training, while being
alert for risks to patient safety, health
and well-being, and autonomy [1].
Incorporating AI capabilities into
health system processes, however,
is constrained by established regulatory
and governance frameworks that are
based on traditional (not adaptive)
models and algorithms, which
hinder the immediate implemen­
tation
of AI tools [2].
The World Health Organization
(WHO) published the Ethics and
Governance of Artificial Intelligence
for Health report in 2021, as a guide
to support emerging technologies
for health systems and governments
[3,4]. The report outlines six key
ethical principles for its design and
successful application: 1) protect
autonomy; 2) promote human well-
being, human safety, and public
intertest; 3) ensure transparency,
explainability, and intelligibility; 4)
foster responsibility and accountability;
5) ensure inclusiveness and equity; and
6) promote AI that is responsive and
sustainable [3,4]. This report catalysed
the United Nations (UN) launch of
the Global Initiative on AI for Health
(GI-AI4H) in 2023, led by the WHO,
International Telecommunication Union
(ITU), and the World Intellectual
Property Organization (WIPO), as a
long-term structure to facilitate the
ethical implementation of AI in across
health systems [5].
The World Medical Association
(WMA) recognises that AI has
the ability to transform the
healthcare sector, and advocates for
physician-led incorporation of AI
in medical practice [6]. To open
the global dialogue, the WMA
supported the five-part webinar
series focusing on AI from January
to May 2025 (https://www.youtube.
c o m / w o r l d m e d a s s o c i a t i o n ) .
The specific topics included:
1) Introduction to AI in medicine;
2) Ethical, legal, and regulatory
aspects of AI in healthcare;
3) Current and future applications
of AI in medicine; 4) Best practices
in medical AI development; and
5) AI for health equity: Bridging
the global divide [7]. This
professional development series
offered an opportunity to explore
five dimensions of AI applications
in healthcare, support the
physicians’ role in bridging the effective
and ethical implementation to medical
practice, and ensure trustworthy and
transparent processes with patients and
the public.
Navigating the Dialogue on Using Artificial Intelligence in
Medical Practice at the 76th WMA General Assembly
Carlos Cortes Ashok Philip Philippe Cathala
Bobby Mukkamala Helena Chapman
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30
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As part of the 76th WMA
General Assembly, the Portuguese
Medical Association’s Organizing
Committee coordinated the “Impact
of AI in Medical Practice” scientific
session on 9 October 2025, in Porto,
Portugal. This session aimed to raise
awareness and encourage discussion on
implementing AI in health systems,
understanding ethical considerations
of AI in fostering physician–
patient rapport, and applying AI
in collaborative healthcare teams in
clinical practice. Navigating AI will
require innovative solutions to help
prepare health professionals and
health systems to manage emerging
technologies and recognising their
strengths and challenges to clinical
practice.
The Opening Session provided an
opportunity to learn how AI has
evolved and incorporated into medical
education, training, and practice.
Then, experts offered their insight and
perspectives related to incorporating AI
into clinical practice in three scientific
sessions, entitled, “Practical Aspects of
Implementing AI” (Session 1), “Ethics of
AI in Medicine” (Session 2), and “AI in
Practice” (Session 3). Finally, the WMA
and Portuguese Medical Association
leaders concluded with a session
summary and recommendations for
the collective WMA call to action.
Opening Session
As part of the Opening Session,
Dr. Ashok Philip (WMA President),
Dr. Carlos Cortes (President,
Portuguese Medical Association),
and Dr. Alberto Caldas Afonso
(Immediate Past Treasurer, National
Council of the Portuguese Medical
Association) welcomed the members
to the 76th WMA General Assembly
(Photo 1). They shared their
enthusiasm to organise this timely
scientific session for this event, where
they hoped to encourage collective
dialogue with global physicians
representing 53 countries in attendance.
They introduced the moderators
and invited speakers, who offered
their perspectives related to AI in
medical practice across eight countries.
As the keynote speaker, Professor
António Vaz Carneiro (Coordinator,
Portuguese Medical Association’s
Artificial Intelligence Commission)
outlined how AI has become a
central force in modern healthcare.
He noted that over the past five
decades, computer technology has
increased exponentially, especially in
terms of volume, velocity, and variety
of processed data. Defining AI as a
“field which combines computer science
and robust datasets to enable problem
solving,” he provided key examples –
clinical reasoning evaluation, pattern
recognition (e.g. radiology), and
clinical research (e.g. design and trial
enrolment, adverse effects). Finally, he
concluded that AI can facilitate
predictive models and precision
medicine, and caution is essential
to ensuring a strict research and
development approach.
Session 1: Practical Aspects of
Implementing AI
“AI is already playing a role in
diagnosis and clinical care, drug
development, disease surveillance,
outbreak response, and health
systems management … The future
of healthcare is digital, and we
must do what we can to promote
universal access to these innovations
and prevent them from becoming another
driver for inequity.”
– Dr. Tedros Adhnom Ghebreyesus,
WHO Director-General
Using AI in Medical Practice
Photo 1. Dr. Carlos Cortes, President of the Portuguese Medical Association, delivers welcoming remarks at the Scientific
Session of the WMA 76th General Assembly. Credit: WMA
31
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In the first session, panellists
shared diverse perspectives on the
implementation of AI in practical
applications in Portugal and South
Africa. Dr. Philip moderated the
session, reiterating that AI is
already being rapidly incorporated
into medical education, training,
and practice, and physicians
should be ready to effectively
apply this technology to improve
patient care. He reminded
participants that although this
technology delivers on its promise
of innovation, it remains sensitive
to health system’s strengths and critical
vulnerabilities.
Dr. Ana Ribeiro da Cunha
(Member, Portuguese Medical
Association’s Artificial Intelligence
Commission) described the FUTURE-
AI Consortium (https://future-ai.eu/),
which was founded in 2021, with a
total of 117 scientific experts from 50
countries, as an international consensus
guideline for the trustworthy and
deployable application of AI in
healthcare. She stated that the
underlying principles to guide its
application include explainability,
fairness, robustness, traceability,
universality, and usability. She
provided a historical overview of
technological advancements, starting
from Hippocratic traditional medicine,
advancing to evidence-based medicine
and clinical trials, following to explicit
personalised medicine (visualizable
algorithms), and finally with implicit
personalised medicine (AI-based).
She noted that health professionals
remain challenged to widely implement
AI technology into clinical and
research practice, due to ethical
considerations and limited trust.
Dr. Mzulungle Nodikida (Chief
Executive Officer, South African
Medical Association) highlighted
examples of AI applications used
in Obstetrics and Gynaecology and
the wider South African health system.
He described the plethora of electronic
health records and health information
systems in operational use across
the South African provinces and in
the private sector. He emphasised the
need to build institutional capacity,
invest in team training, and foster
collaboration between clinicians and
engineers. He concluded that the
South African Medical Association
(SAMA) has demonstrated their
important role in clinical and ethical
leadership across the nation, building
international collaboration and
partnerships and providing professional
development opportunities for
physicians.
Dr. Tomás Cobo (President, Spanish
General Medical Council) provided a
historical context behind the foundation
of the WMA in 1947, following
concern for medical ethics during the
post-World War II period, and the
drafting of key ethical documents
like the Universal Declaration
of 1948. He reflected on AI as a
scientific, diagnostic, and learning
support tool for four powerful
technologies (diagnostics, therapeutics,
big data, clinical logistics), noting that
overreliance on AI in clinical practice
can create substantial challenges
and risks. He commented that some
ethical dilemmas include consent,
fairness and job displacement,
deterioration of the physician–patient
relationship, and AI model errors in
unfamiliar contexts.
Session 2: Ethics of AI in Medicine
“Like all new technology, artificial
intelligence holds enormous
potential for improving the health
of millions of people around
the world, but like all technology
it can also be misused and cause
harm.”
– Dr. Tedros Adhnom Ghebreyesus,
WHO Director-General
In the second session, panellists
reflected on AI’s growing role in
daily medical practice, raising new
questions about trust, accountability,
and the physician–patient relationship.
Moderated by Dr. Philippe Cathala
(WMA Finance and Planning
Committee Chair), he recapped that AI
must be incorporated to strengthen, not
replace, the array of clinical services in
the health system. He also highlighted
the need to ensure that technological
progress is directly connected to the
service of clinical expertise and human
responsibility.
Dr. Bernardo Duque Neves (Portuguese
Medical Association) described
strategies for addressing ethics and
accountability issues in superhuman AI
for clinical decisions in order to prevent
single-point failures. He emphasised
that clear regulation and responsible
implementation, coupled with advances
in governance and education, are
essential to preserve trust. With
the expanding range of AI applications
in medical practice, it is crucial to
adopt adequate protections that prevent
overreliance and excessive dependence
on these AI-driven decision-making
systems.
Professor Rui Nunes (Portuguese
Medical Association) stressed that
AI applications will profoundly and
irreversibly transform every aspect of
medicine, including medical education,
clinical practice, and scientific research.
He advocated for the creation of a
supranational AI regulatory system that
evaluates and manages AI applications
and their level of risk to patient health
and safety. He commented that only a
high level of AI literacy among health
professionals will ensure that the
transformative shift driven by AI in
healthcare leads to improved patient
care.
Dr. Ramin Parsa-Parsi (German
Medical Association) highlighted the
importance of the physician–patient-
AI relationship and emphasised
the benefits of integrating AI into
healthcare, including improved
Using AI in Medical Practice
32
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diagnostic accuracy, more personalised
care, and reduced administrative
workload for health professionals.
He presented research findings
showing physicians’ perceptions that
AI applications can enhance clinical
practice by improving diagnostic
accuracy and influencing physician-
patient rapport. To safeguard the
effective use of AI in medical
practice, the design and utilisation must
be guided by the ethical principles
that uphold trust, empathy, and respect
in medical practice, which preserve
transparency and the human connection.
He cautioned WMA members to be
aware of the risks of overreliance on AI
in healthcare, including the potential
loss of patient trust, challenges related
to liability and privacy, perils of bias in
algorithms.
Session 3: AI in Practice
“As AI becomes more sophisticated and its
health applications expand, so must our
efforts to make them safe, effective, ethical,
and equitable.”
– Dr. Tedros Adhanom Ghebreyesus,
WHO Director-General
In the third session, panellists
offered concrete examples of how
AI use could and should look in
the day-to-day lives of physicians
and patients. Dr. Bobby Mukkamala
(President, American Medical
Association) moderated the session,
demonstrating that AI has the potential
to positively impact the practice of
medicine. However, the extent of AI’s
success in healthcare will depend largely
on how physicians help implement,
monitor and complement the
technological tools.
Dr. Ana Pina (Portuguese Medical
Association) commented that
interdisciplinary health can galvanise
AI technology toward collective
intelligence in clinical practice. She
noted three significant constraints
– increased demand (e.g. non-
communicable diseases represent 74%
of global deaths), workforce shortage,
and decreased sustainability. Managing
AI tools effectively to navigate
constraints is best achieved through
team-based models that leverage
diverse expertise to collectively oversee
the monitoring and governance
of AI in medical practice. She
concluded that these collaborative
teams, which may feature new roles and
specialised skill sets, can help address
AI mistrust and facilitate patient-
centred care by ensuring that robust
expertise guides the ethical applications
of AI algorithms for health systems.
Dr. Pablo Requena (Vatican Medical
Association) shared insights exploring
the potential of AI technology to
strengthen the physician–patient
relationship in primary care by
alleviating physicians’ administrative
burdens, supporting clinical decision-
making, and improving diagnostic
accuracy. He accentuated that
AI can never satisfactorily replicate
the human connection – such
as empathy, compassion, and
communication – as defining hallmarks
of the physician profession. The rapid
development and implementation of AI
technology will require physicians to
seek continuing education to ensure that
they maintain relevant competencies
and understand the technology’s
limitations toward optimised patient
care.
Conclusion
As part of the Closing Session, Dr.
Caldas Afonso and Dr. Otmar Kloiber
(WMA Secretary General) shared their
appreciation for the session organisers,
expert panellists, and the audience.
Dr. Caldas Afonso summarised the
key point that AI applications will
transform medical practice by helping
translate evidence-based scientific
findings into clear language, improving
clinical diagnostic accuracy, supporting
shared physician–patient decisions in
healthcare, and reinforcing patients’
autonomy and health literacy. He
emphasised that AI applications
in healthcare must adhere to core
ethical principles, such as respect for
patient autonomy, promotion of justice,
protection of privacy, and increased
protection for vulnerable populations.
Finally, he reminded WMA members
that AI technology must be human-
centred and enable effective human
oversight, where modern regulations
must evolve alongside innovation,
to prevent the violation of
fundamental human rights.
As the Portuguese Medical Association’s
Organizing Committee successfully
hosted the 76th WMA General
Assembly, it reaffirmed the valuable
role of national medical associations
as essential leaders, learning about
novel technologies, contributing their
scientific expertise, and expanding
regional networks and partnerships to
advance health priorities and promote
physician solidarity worldwide. The
final proceedings of the 76th WMA
General Assembly resulted in the
adoption of the WMA Statement
on Artificial and Augmented
Intelligence in Medical Care, which
outlined ethical principles to guide
the safe and responsible use of AI
in health systems as well as the need
for continuous evaluation to ensure
transparency and shared accountability
[8,9]. Given the complexity of global
health challenges, AI technology has
the potential to support (not replace)
physicians, who are uniquely positioned
to lead cross-disciplinary efforts to
evaluate, validate, and monitor these
systems.
Acknowledgments
The authors appreciate the dedicated
efforts of the Portuguese Medical
Association’s Organizing Committee,
especially Dr. Alberto Caldas
Afonso (Immediate Past Treasurer,
Using AI in Medical Practice
33
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National Council of the Portuguese
Medical Association), to coordinate
a comprehensive scientific session
focused on AI in clinical practice.
They recognise the panellists for their
time to present insightful presentations
that enabled an in-depth collective
discussion. Finally, they are indebted to
the WMA staff, particularly Dr. Otmar
Kloiber (WMA Secretary General), for
their support of this scientific session.
References
1. World Health Organization.
Artificial intelligence for health. Ge-
neva: WHO; 2024. Available from:
https://www.who.int/publications/m/
item/artificial-intelligence-for-health
2. World Health Organization. WHO
calls for safe and ethical AI for health
[Internet]. 2023 [cited 2025 Oct 25].
Available from: https://www.who.int/
news/item/16-05-2023-who-calls-
for-safe-and-ethical-ai-for-health
3. World Health Organization. WHO
issues first global report on Artificial
Intelligence (AI) in health and six
guidingprinciplesforitsdesignanduse
[Internet]. 2021 [cited 2025 Oct 25].
Available from: https://www.who.int/
news/item/28-06-2021-who-issues-
first-global-report-on-ai-in-health-
and-six-guiding-principles-for-its-
design-and-use
4. World Health Organization.
Ethics and governance of
artificial intelligence for health.
Geneva: WHO; 2021. Available
from: https://www.who.int/publica-
tions/i/item/9789240029200
5. World Health Organization. Global
Initiative on AI for Health [Internet].
2023 [cited 2025 Oct 25]. Available
from: https://www.who.int/initiatives/
global-initiative-on-ai-for-health
6. World Medical Association.
Policy tag: artificial intelli-
gence. 2025 [cited 2025 Oct 25].
Available from: https://www.wma.
net/policy-tags/artificial-intelligence/
7. World Medical Association. WMA
AI webinar series: summary notes
[Internet]. 2025 [cited 2025 Dec 8].
Available from: https://www.wma.
net/wp-content/uploads/2025/12/AI-
Webinars-1-5-Dated.pdf
8. World Medical Association.
World physician leaders call
for ethical, physician-led
integration of artificial and
augmented intelligence in
healthcare [Internet]. 2025
[cited Oct 25]. Available
from: https://www.wma.net/
news-post/world-physician-lead-
ers-call-for-ethical-physician-led-in-
tegration-of-artificial-and-augment-
ed-intelligence-in-healthcare/
9. World Medical Association.
WMA Statement on Artificial
and Augmented Intelligence
in Medical Care [Inter-
net]. 2025 [cited 2025 Oct 25].
Available from: https://www.
wma.net/policies-post/wma-state-
ment-on-artificial-and-augment-
ed-intelligence-in-medical-care/
Authors
Carlos Cortes, MD
President, Portuguese
Medical Association
Lisbon, Portugal
cfcortes@gmail.com
Ashok Philip, MD
Immediate Past President,
World Medical Association
Kuala Lumpur, Malaysia
ashokphilip17@gmail.com
Philippe Cathala, MD, PharmD
Finance and Planning Committee Chair,
World Medical Association
General Delegate for European
and International Affairs,
Conseil National de l’Ordre des Médecins
Paris, France
cathala.philippe@ordre.medecin.fr
Bobby Mukkamala, MD
President,
American Medical Association
Chicago, Illinois, United States
bobby.mukkamala@ama-assn.org
Helena Chapman, MD, MPH, PhD
Professorial lecturer,
Milken Institute School of Public Health,
George Washington University
Washington, DC, United States
hjchapman@gwu.edu
Using AI in Medical Practice
34
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Using AI in Primary Care
The biomedical literature increasingly
emphasises the advantages that artificial
intelligence (AI) could bring to
medical practice, particularly in primary
care. However, significant challenges
accompany its implementation,
generating concerns among healthcare
professionals and patients alike.
In this brief essay, I argue that
the benefits of AI in primary care
ultimately depend on structural and
human factors rather than on the
technology itself. While AI can
become a valuable tool in primary
care, its potential can only be realised
once the serious problems of staff
shortages and professional burnout are
adequately addressed. Furthermore, AI’s
potential contribution to improving the
doctor–patient relationship depends on
professionals continuing to prioritise
training in empathy, compassion, and
communication skills. These elements
distinguish clinical encounters from
mere service provision.
1. AI in Primary Care: Possibilities
and Concerns
Wiedermann and colleagues (2023)
examined perceptions of both
physicians and patients regarding
AI use in symptom checking within
primary care in the Italian health
system [1]. They used a provocative
title, “Redesigning Primary Care:
The Emergence of Artificial
Intelligence-Driven Symptom
Diagnostic Tools,” suggesting that
AI would bring about, if not a complete
redefinition of primary care, at least a
fundamental redesign. As this concept
has become of particular interest to
global physicians, it has been analysed
in other recent publications.
Sarkar (2024) addressed AI’s potential
benefits in primary care by examining
the added workload associated with
electronic health records in the United
States [2]. The literature frequently
links these systems to increased
physician burnout. In this context,
AI could provide support in four key
areas: a) managing electronic patient
message inboxes, b) handling clinical
documentation, c) monitoring patients
between visits, and d) supporting
diagnostic and therapeutic decision-
making [2]. Also, Martínez (2025)
argued that AI has already substantially
improved several areas of medical
practice, highlighting advances in
diagnostic accuracy, image interpretation,
and personalised medicine [3].
Concerns identified in the medical
literature include risks to data
privacy and security, doubts about
diagnostic and therapeutic accuracy,
and potential AI algorithm biases [3-5].
Allen and colleagues (2024) highlighted
how primary care physicians discussed
both benefits and concerns related to
AI [4]. Some feared that introducing
this technology might increase,
rather than reduce, their workload.
One participant stated clearly: “My
concern is that like everything else we
have tried to do to make things better
in medicine, it actually makes things
harder on the physician and creates
more work for us instead of less work” [4].
This observation raises a crucial
question: does AI genuinely save
physicians time? Theoretically, the
answer is affirmative [6-8]. Practically,
however, the situation may differ. Allen
and colleagues (2024) highlighted that
another participant feared that any
time saved through AI would simply
result in increased patient loads [4].
Wiedermann and colleagues (2023)
confirmed that neither physicians
nor patients perceived significant time
savings in consultations [1].
Bias in AI training represents another
frequent concern, extending beyond
medicine to broader technology
applications, often referred to the “black
box” problem. Some authors, including
Chan (2023), have argued that AI
tools should not be used unless their
algorithms are fully understood, except
when functioning as “copilots” or when
diagnostic and therapeutic resources are
severely limited [9]. Gordijn and Ten
Have (2023) adopted a less restrictive
view, suggesting that physicians
themselves can be considered “black
boxes” when making diagnostic and
therapeutic decisions [10].
Although this open debate cannot be
fully explored here, it underscores the
need for continued theoretical reflection
on AI use in medicine. Mache and
colleagues (2025) concluded that
healthcare professionals tend to adopt
an attitude of “cautious optimism” [5].
As most authors point out, alongside
their enthusiasm for the potential
benefits of AI, they stress that the
possible dangers of its application
should not be underestimated.
Potential Gains of Using Artificial Intelligence in
Primary Care Lie Beyond Technology Itself
Pablo Requena
35
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2. AI and the Doctor–Patient
Relationship
AI’s significant impact on the physician-
patient relationship, particularly in
primary care, is widely acknowledged
in the cited literature. This relationship
lies at the heart of medical
anthropology and ethics, requiring
careful consideration. A fundamental
question emerges: is AI simply another
tool, like the stethoscope or MRI, or does
it fundamentally alter the doctor–patient
relationship? Throughout medical
history, discoveries such as antibiotics
and X-rays revolutionised practice
without changing the essential nature of
the doctor–patient relationship.
AI, however, raises questions about
whether the relationship itself is being
reshaped. Lorenzini and colleagues
(2023) argued that AI transforms the
doctor–patient relationship from a
dyadic to a triadic one [11]. While this
view seems overly radical, it suggests
that AI transcends the role of a neutral
tool at the physician’s disposal. In
my view, AI is not merely another
instrument added to the diagnostic
and therapeutic arsenal. Its use will
increasingly influence how medicine
is practiced. However, I do not believe
it necessarily changes the essential
configuration of the physician-patient
relationship.
Some question whether AI could
replace physicians entirely. However,
this seems unlikely. AI may reduce
the need for physician consultations
for minor health issues, but patients
with moderate or severe conditions
will always require medical care from
a human physician. Ilan (2024) argued
that physicians cannot be replaced by
AI for technical reasons related to
human brain complexity: “There
will always be tasks where humans
are faster, more reliable, and cheaper”
[12]. Beyond these technical arguments
lie deeper human dimensions. Patients
are people who, in fundamental life
moments such as birth, illness, and
death, require the presence and care of
other people [13]. While machines may
offer precise diagnoses and effective
treatments, they will never possess
personal subjectivity, even if they can
simulate it. Replacing physicians with
increasingly sophisticated AI would not
enrich medicine–it would impoverish
it.
The doctor–patient relationship
extends beyond technical outcomes. It
represents an encounter between two
subjectivities (two life stories) that
seeks therapeutic results and carries
existential meaning. Research has long
demonstrated correlations between
positive doctor–patient relationships
and improved therapeutic outcomes
[14]. Hindocha and Badea (2022) not
only rejected the possibility of AI
replacing physicians, but also argued
that physicians must “ethically educate”
algorithms [15].
Several authors highlighted empathy
as a uniquely human quality that is
difficult to replicate algorithmically
[3,16]. Extensive literature exists on
“empathetic robots” – machines capable
of recognising human emotions and
responding in ways that generate
positive feelings [17]. However, this
raises additional debates. Sirgiovanni
(2025) recently questioned the clinical
value placed on empathy, noting that
it may sometimes conceal judgments
or biases that do not actually support
positive doctor–patient relationships
[18]. Nonetheless, while healthcare
robots may be programmed to display
empathy, they are not persons. Behind
these programmed responses exists no
real subjectivity, no genuine “you” who
truly shares the patient’s suffering.
Patients are acutely aware of this
distinction.
Wiedermann (2023) observed little
possibility of AI replacing physicians,
emphasising the need to “carefully
integrate digital innovations while
preserving essential human contact in
healthcare” [1]. This introduces another
important dimension of the doctor–
patient relationship: physical contact.
Both procedural and expressive touch
communicates beyond words. Studies
have highlighted the importance of
such nonverbal communication, though
modern medicine often overlooks it. As
one physician interviewed by Cocksedge
(2013) noted: “Even if it’s just putting
a hand out… I think touch often can say
much more than words; it can be very
reassuring” [19].
3. The Real Help AI Can Offer in
Primary Care
We must now return to central
questions: can AI actually help primary
care physicians in their work, and
can it improve therapeutic outcomes
in this setting? While no one doubts
AI’s many benefits in diagnostic and
therapeutic domains, these issues must
move beyond theory and be tested
in the daily practice of health centres
and hospitals. Studies must provide
statistically supported answers within
real-world contexts. The response to
our original question appears to move
in two directions: institutional and
personal. Currently, primary care faces
professional shortages and growing
burnout levels. As noted earlier, the
implementation of electronic health
records has exacerbated this problem.
Family physician Dr. Steven Kanner,
now retired, responded convincingly
to Sarkar’s analysis of how AI could
improve primary care. He argued
that no improvement would occur
without structural changes to the U.S.
healthcare model, which for 30 years
has made each physician responsible
for approximately 2,500 patients [20].
Addressing this problem requires
medium and long-term primary care
reorganisation aimed at increasing the
Using AI in Primary Care
36
Using AI in Primary Care
BACK TO CONTENTS
number of physicians dedicated to this
work. AI offers little assistance here
without political will for structural
reform.
Conversely, care quality – in both
primary and specialised settings –
will always depend on healthcare
professionals’ attitudes and virtues.
From its inception, ethical reflection
on AI in medicine has used principlism
as its reference model. However, the
four principles of bioethics – autonomy,
non-maleficence, beneficence, and
justice – quickly proved insufficient for
addressing AI’s ethical challenges [21].
An alternative model, virtue ethics, has
long proposed integrating principles
with personal virtues. Although
research on AI and virtue ethics
remains in early stages, several studies
are beginning to explore this area
[22]. Of particular interest is Paladino
(2023)‘s ethical evaluation of AI
in medicine, drawing on Edmund
Pellegrino’s proposal, where she
emphasised the need for a perspective
rooted in praxis rather than reducing
analysis to poiesis alone [23].
Hagendorff (2022) published a proposal
for applying virtue ethics to AI in
medicine, identifying four basic AI
virtues: justice, honesty, responsibility,
and care. He also suggested two
second-order virtues – prudence
and courage – which represents an
interesting contribution deserving
further consideration and study [24].
Conclusion
The benefits that AI could bring to
primary care are undeniable, particularly
in diagnostic, administrative, and
decision-support contexts. However,
experience demonstrates that these
improvements do not automatically
translate into enhanced clinical practice.
AI’s real impact depends on two
inseparable dimensions: structural and
human.
Regarding the structural dimension,
as long as professional shortages
and overload caused by inefficient
organisational systems persist,
AI cannot compensate for these
deficits. Healthcare reorganisation–
with increased human resources and
fairer responsibility distribution–
is a prerequisite for technology to
function as genuine support rather
than an additional burden. Regarding
the human dimension, primary care
quality is closely tied to the doctor–
patient relationship. While AI may be
a valuable tool, it will never replace
subjectivity, empathy or the personal
care required in clinical encounters.
Training professionals in communication
skills and virtues, such as responsibility,
prudence, and compassion, is essential
for integrating AI without undermining
medical practice’s essence.
Therefore, effective AI use in primary
care does not depend primarily on
algorithmic sophistication, but rather it
depends on decisions made by
governments, institutions, and
professionals. Healthcare must innovate
organisationally while preserving
the centrality of the doctor–patient
relationship. Only under these
conditions can AI become a tool that
serves medicine rather than represents a
force of dehumanisation.
Acknowledgments
The author would like to thank Tobias
Hoonhout for his editorial feedback
and grammar review of this article.
References
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A, Piccoliori G, Engl A.
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Rojo-Huertas B, Reynolds-
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4. Allen MR, Webb S, Mandvi
A, Frieden M, Tai-Seale M,
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DA. Artificial intelligence in
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6. Nilsen P, Sundemo D, Heintz F,
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al. Towards evidence-based practice
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2024;4:1368030.
7. Čartolovni A, Malešević A, Poslon
L. Critical analysis of the AI
impact on the patient-physician
relationship: a multi-stakehold-
er qualitative study. Digit Health.
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8. Sauerbrei A, Kerasidou A,
Lucivero F, Hallowell N. The
impact of artificial intelligence
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patient relationship: some
problems and solutions. BMC Med
Inform Decis Mak. 2023;23(1):73.
9. Chan B. Black-box assisted
medical decisions: AI power
vs. ethical physician care.
Med Health Care Philos.
2023;26(3):285-92.
10. Gordijn B, Ten Have H. What’s
wrong with medical black box
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2023;26(3):283-4.
11. Lorenzini G, Arbelaez Ossa L,
Shaw DM, Elger BS. Artificial
intelligence and the doctor-
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the paradigm of shared decision
making. Bioethics. 2023;37
(5):424-9.
12. Ilan Y. The co-piloting mod-
el for using artificial intelligence
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13. MacIntyre AC. Dependent
rational animals: why human
beings need virtues, 6th ed.
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15. Hindocha S, Badea C. Moral
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Pablo Requena, MD, STD
School of Theology,
Department of Moral Theology,
Pontifical University of the Holy Cross
Clinical Ethics Commission,
Bambino Gesù Pediatric Hospital
Pontifical Academy for Life
Rome, Italy
requena@pusc.it
38
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Building AI Literacy for Physicians
Artificial intelligence (AI) has moved
quickly from a distant concept to a
daily topic in medical practice. As AI
tools are already being integrated into
clinics, hospitals, and health systems,
clinicians around the world remain
optimistic, wondering how this shift
will impact patient care, professional
judgment, and the future of our work.
Three specific reflections remain: How
safe and accurate are AI tools, and
how will they fit into real-time clinical
workflows? Will AI help reduce the
pressures that physicians face, or will
it introduce new complications? How
can we make sure that AI strengthens,
rather than weakens, the physician-
patient relationship?
With this growing need in mind, the
World Medical Association (WMA)’s
Medical Technologies Working Group
organised a five-part webinar series
from January to May 2025 (https://
www.youtube.com/worldmedassociation).
The series was co-hosted by Dr.
Jesse Ehrenfeld (American Medical
Association) and Dr. Jacob Mathew
(Kuwait Medical Association), with
support from Michelle Glekin (Israeli
Medical Association) and the Medical
Technologies Working Group team,
along with Clarisse Delorme, Magda
Mihaila, and Marie Ferreira from
the WMA Secretariat. The sessions
began with foundation concepts and
then progressed to clinical use, legal
considerations, development practices,
and global equity. They aimed to help
clinicians build confidence as well as a
grounded understanding of AI amidst a
rapidly changing landscape. Notably, the
Working Group invited global experts
for a roundtable-style conversation,
rather than comprehensive lectures,
allowing experts and participants to
think through the issues together and
encourage questions, dialogue, and
reflection on practical uses of AI in
clinical practice [1].
Webinar 1: Introduction to AI in
Medicine
The first session opened with remarks
from Dr. Ashok Philip (WMA
President), who set the tone by
acknowledging both the opportunities
and the responsibilities that come
with incorporating AI in medical
practice [2]. The discussion period
focused on making AI terminology
understandable for physicians, especially
typically interchangeable terms of
machine learning, deep learning, and
large language models. It offered
a comprehensive summary of each
concept and offered examples of how
they are being used in healthcare
today. As participants raised concerns
about black box systems, hallucinations,
and the limits of current models, the
message was clear: AI still requires
clinical oversight. The session closed
with a brief look at prompt engineering
and why the wording of a query will
shape the quality of AI’s response.
Webinar 2: Ethics, Legal, and
Regulatory Aspects of AI in
Healthcare
The second webinar brought in
Professor Barry Solaiman (Hamad
Bin Khalifa University), who focused
on the legal and ethical challenges
of AI that are becoming increasing
complex [3]. The accountability of this
tool raised concerns, especially on the
identification of the responsible party
if an AI system contributes to a clinical
error. Although physicians frequently
assume the responsibility of liability,
even when technology plays a direct
role, this imbalance will not be
sustainable. The discussion covered
informed consent, bias, privacy,
data security, and the pace at which
regulation needs to evolve. The session
finalised with the emphasis that AI
should be governed across its entire
lifecycle, rather than just at the point of
deployment.
Webinar 3: Current and Future
Applications of AI in Medicine
The third session featured Dr. Michael
Krauthammer (Professor of Medical
Informatics, University of Zurich), who
walked through how AI is being used
in areas ranging from rheumatology to
radiology, and how these tools attempt
to approximate expert reasoning
[4]. He highlighted an example of
how AlphaFold (https://alphafold.
com/) has changed protein structure
prediction. It demonstrated a clear
case of how far-reaching AI can be,
influencing beyond clinical diagnostics
and expanding to biomedical research
Building Artificial Intelligence Literacy for
Physicians: Lessons from the WMA Medical
Technologies Working Group Webinar Series
Jacob Mathew
Jesse M. Ehrenfeld
39
and drug discovery. The discussion
covered digital twins, predictive
analytics, and workflow automation,
along with an honest look at existing
gaps and the need for stronger
validation and more representative
datasets.
Webinar 4: Best Practices in
Medical AI Development
The fourth session brought in Dr.
Nathalie Bloch (ARC Innovation
Center, Sheba Medical Center),
who spoke candidly about AI tool
development for clinicians in the
workplace [5]. As her experience spans
both clinical practice and innovation,
she stressed that real clinical problems
(not technology) should lead the
conversation. She shared that AI
solutions work best when clinicians
are involved from the beginning,
helping to shape the problem statement
and the workflow integration. She
underscored the importance of testing
tools in real clinical environments
before large-scale deployment, as
promising systems may fail simply
because they do not align with
healthcare delivery. The discussion
incorporated lessons from real-
world solutions and highlighted the
importance of designing AI tools that
respect clinical time, cognitive load, and
the realities of frontline practice.
Webinar 5: AI for Health Equity:
Bridging the Global Divide
The final session featured Professor
Mary-Anne Hartley (Laboratory
for Intelligent Global Health &
Humanitarian Response Technologies,
LIGHT) who transitioned the dialogue
from individual clinics to the global
landscape, focusing on how AI may
reduce existing healthcare disparities
[6]. She introduced Meditron (https://
jointhemoove.org/meditron), an open-
source medical language model built for
low-resource settings from MOOVE
(https://jointhemoove.org/), a global
platform for validating AI models in
different environments. The discussion
offered insight on data s overeignty,
model ownership, and the need for
lightweight tools that can operate
with limited hardware. Dr. Philip
closed the webinar series by reiterating
the importance of ensuring that AI
serves all health systems, not just
the most advanced health systems.
Looking Ahead
Led by the WMA’s Medical
Technologies Working Group, this
webinar series represents an early step
that supports the WMA’s efforts to
help physicians navigate AI with clarity
and confidence. By bringing together
clinicians, legal experts, technologists,
and global health leaders, this series
created an important space for the
honest discussion about the capabilities
of AI technology in shaping medical
practice. However, questions remain
on how to guide its use to strengthen
clinical judgment, protect patient safety,
and support fair and equitable health
systems. Hence, the WMA’s Medical
Technologies Working Group will
continue to build on the conversations
that emerged across the five sessions,
which can help physicians worldwide
engage with AI thoughtfully,
confidently, and with their patients’ best
interests.
References
1. World Medical Association.
WMA AI webinar series:
summary notes [Internet]. 2025
[cited 2025 Dec 8]. Available
from: https://www.wma.net/wp-con-
tent/uploads/2025/12/AI-Webinars-
1-5-Dated.pdf
2. World Medical Association.
WMA AI webinar #1:
introduction to AI in medicine
[Internet]. 2025 [cited 2025 Dec 1].
Available from: https://youtu.be/Xrs-
I0bT-io8
3. World Medical Association.
WMA AI webinar #2: ethics,
legal, and regulatory aspects of
AI in healthcare [Internet]. 2025
[cited 2025 Dec 1]. Available from:

4. World Medical Association.
WMA AI webinar #3: current
and future applications of AI in
medicine [Internet]. 2025
[cited 2025 Dec 1]. Available
from: https://youtu.be/_znrRUu-
jlMM
5. World Medical Association.
WMA AI webinar #4: best
practices in medical AI
development [Internet]. 2025
[cited 2025 Dec 1]. Available from:

6. World Medical Association. WMA
AI webinar #5: AI for health equity:
bridging the global divide [Internet].
2025 [cited 2025 Dec 1]. Available
from: https://youtu.be/6JfhigYBc9o
Authors
Jacob Mathew, MD, EMDM
Research Assistant,
Health and Explainable Lab,
University of Pittsburgh
Pittsburgh, Pennsylvania, United States
jacob.mathew@pitt.edu
Jesse M. Ehrenfeld,
MD, MPH, FASA, FAMIA, FCPP
Senior Associate Dean and
Executive Director,
Advancing a Healthier
Wisconsin Endowment
Professor, Anesthesiology,
Medical College of Wisconsin
Milwaukee, Wisconsin, United States
jehrenfeld@mcw.edu
Building AI Literacy for Physicians
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40
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AI Empowering Quality Primary Healthcare in China
Global health systems today face
converging pressures, including
demographic ageing, growing burden
of non-communicable diseases, and
persistent disparities in the distribution
of medical resources. Primary Health
Care (PHC)-anchored in community-
based, preventive, and continuous
care-has become the cornerstone for
achieving universal health coverage.
To enhance the performance of PHC,
innovative technologies such as artificial
intelligence (AI) have emerged as critical
instruments in addressing these global
health challenges.
In this context, many countries have
initiated pilot programs to integrate
AI with PHC, but they have found
emerging operational, systemic, and
structural challenges.In Sweden,
a qualitative study of healthcare
professionals found that although
an AI-based triage application was
introduced in PHC, it has not yet been
fully embedded into routine workflows
due to insufficient organisational
support and misalignment with
established work practices [1]. In
the United Kingdom, one workshop
conducted with 16 general practitioners
concluded that they perceived AI’s
potential for aiding diagnosis and
risk assessment, but shared concerns
about its accountability issues and the
potential to increase administrative
workloads [2]. In Sub-Saharan Africa,
a comprehensive review of AI in
healthcare identified multiple
applications in diagnostics, remote
monitoring, and maternal-child
health, but identified challenges
in infrastructure, data ecosystems,
governance, and system readiness [3].
Therefore, international organisations
such as the World Health Organization
(WHO) and the World Medical
Association (WMA) are emphasising
the importance of ethical AI integration
in healthcare to ensure its effective
and responsible use in healthcare.
The WHO’s Ethics and Governance of
Artificial Intelligence for Health calls
for the ethical use of AI to strengthen
the global drive toward health for all
[4]. The WMA Statement on Artificial
and Augmented Intelligence in Healthcare
also stresses that AI must empower
physicians, serve patients, and advance
fairness, rather than serve as a substitute
for human judgement [5].
In response to global calls for ethical and
effective use of AI in healthcare, China
has been a pioneer in implementing
community-led PHC models at all
stages of socioeconomic development
[6]. The health system incorporates
a three-level health service network,
“barefoot doctors” in rural communities,
cooperative medical insurance, and
integration of traditional Chinese and
Western medicine. With Healthy China
2030 Plan and ongoing health systems
reform, China has further integrated
AI into its healthcare system, extending
from community clinics to tertiary
hospitals [7]. These developments are
simultaneously a domestic response to
governance modernisation and an active
contribution to international cooperation
within the global medical community.
Five Dimensions of AI Empowerment
in Quality PHC
China’s experience reveals a coherent
five-dimensional framework for AI
empowerment in quality PHC: PHC
doctors’ capacity, accessibility, efficiency,
integration of preventive and clinical
services, and cross-sector collaboration
(Figure 1). Together, these dimensions
illustrate how technology, when ethically
governed, can reinforce human
professionalism and advance universal
health coverage.
Enhancing Physician Competence. AI
strengthens the cognitive and diagnostic
capabilities of PHC physicians through
decision-support systems, knowledge
retrieval, and predictive analytics. For
example, studies on diabetic retinopathy
screening and conversational AI models
in community clinics have shown
measurable gains in diagnostic precision
and patient communication [8].
Similarly, field experiments conducted
in PHC settings for chest diseases have
demonstrated that machine-learning
assistance improved diagnostic accuracy
from 72% to 96% [9]. Research has
revealed that large-language models
outperform average medical trainees
in theoretical assessments, while
experienced clinicians remain superior
in empathy and contextual judgement
[10]. This evidence underscores that
AI functions as an augmentative, rather
Artificial Intelligence Empowering
Quality Primary Healthcare in China
Hui Yin
Weili Zhao
41
BACK TO CONTENTS
than substitutive, tool: physicians remain
the ultimate decision-makers, while
technology acts as a dynamic cognitive
partner. It aligns with the WMA’s
ethical principle that AI should enhance,
not replace, professional judgement [5].
Expanding Service Accessibility and
Advancing Universal Health Coverage.
By leveraging telemedicine, mobile
diagnostics, and cloud-based platforms,
AI helps bridge the urban-rural divide
in access to care. For example, the
Lin’an District in Hangzhou supports
its Smart Mobile Hospital, which
has integrated mobile clinics, remote
imaging, and digital pharmacies powered
by AI, expanding coverage to more than
500,000 residents across 165 previously
unserved villages [11]. The initiative has
demonstrated how initial investments
in digital tools can evolve into stable,
community-centred systems that support
long-term service provision [12]. Digital
connectivity and smart devices can also
improve rural residents’ access to timely
and continuous care [13]. Hence, AI can
effectively contribute to technological
efficiency and promote health equity, as
envisioned by the Sustainable
Development Goal 3 (Goal 3.8:
universal health coverage).
Improving Service Efficiency and
Reducing Doctors’ Administrative Burdens.
AI enhances operational performance
by optimising workflows and resource
allocation for PHC doctors. For
example, Xiji County in Ningxia used a
cloud-based system and 5G connectivity
to link county–township–village
health facilities, which increased PHC
service efficiency by over 40%, showing
how digitalisation can substantially
streamline rural healthcare delivery [14].
AI enhances information integration,
aiding doctors in standardising clinical
tasks and reporting, and supporting
evidence-based resource planning.
This reduces doctors’ cognitive stress,
allowing them to spend more time
communicating with patients and
making informed decisions.
Integrating Preventive and Clinical
Care. AI facilitates the integration
of prevention, diagnosis, treatment,
and follow-up services – bridging the
traditional divide between clinical
medicine and public health. As an
example, in the Lin’an District, the
Tianmu Health Sharing Platform
has unified hospitals, community
centres, and village clinics through a
single cloud-based network, forming
a closed loop linking clinical and
preventive services [11]. Smart devices
and interconnected data systems have
been shown to strengthen rural health
networks’ responsiveness and resilience
[13]. Doctors can view complete
patient records, receive algorithm-
generated risk alerts, and coordinate
cross-facility follow-up care. AI helps
doctors anticipate risks, intervene earlier,
and maintain continuous relationships
with patients across the full spectrum of
health needs.
Synergizing Health and Social Services.
PHC doctors often encounter patients
whose health problems are intertwined
with social factors such as ageing,
poverty, disability or limited access
to public services. AI enables more
effective cross-sector collaboration
by linking medical data with social
welfare, long-term care, and community
service systems. In China, integrated
digital health platforms connect
medical, civil affairs, social security,
and education databases, providing
elderly and chronically ill patients with
unified health records, welfare benefits,
and care plans [11]. Through such
systems, AI amplifies doctors’
ability to act as health coordinators,
helping them identify vulnerable
patients, organise interdisciplinary
support, and provide continuous
monitoring across sectors, which aligns
AI Empowering Quality Primary Healthcare in China
Figure 1. Five dimensions of AI empowerment in quality Primary Health Care (PHC). Credits: H. Yin and W. Zhao
42
BACK TO CONTENTS
with global trends toward whole-of-
society health promotion.
Enabling Conditions and Ethical
Mechanisms
AI can only empower quality PHC
when it is supported by sound
governance, trustworthy data practices,
professional training, and ethical
safeguards. China’s experience shows
that the successful adoption and use of
AI depends not merely on technological
capability, but similarly on institutional
design and professional responsibility.
Governance and Institutional Norms.
AI in healthcare operates within an
emerging governance framework that
blends legal, ethical, and professional
accountability. Several prominent
frameworks have been developed to
guide the responsible deployment of
AI in healthcare. First, the EU AI
Act provides a risk-tiered approach,
classifying most AI applications in
healthcare as high-risk systems [15].
Second, the AI Risk Management
Framework, by the U.S. National
Institute of Standards and Technology,
offers a structured approach to mapping,
measuring, managing, and governing
AI risks [16]. Third, the Guidance on
Promoting and Regulating the Application
Development of Artificial Intelligence
+ Healthcare, by the National Health
Commission of China, sets clear goals
for the integration of AI in healthcare
by 2027 and 2030, by outlining
measures to ensure the safe and ethical
use of AI in healthcare. It calls for
the development of standards and
guidelines to govern the use of AI in
clinical settings as well as regulatory
frameworks for AI applications, data
security protocols, and privacy protection
measures [17].
Data Infrastructure and the Dual
Imperative of Trust and Security. Reliable,
ethically sourced data underpin every
successful AI adoption in healthcare.
Cross- provincial or municipal
interoperability and local protection
measures can enable scientific
collaboration and safeguard privacy and
consent. Privacy-preserving technologies
(such as differential privacy) have been
piloted to enable AI to analyse patient
data trends without exposing individual
records, thereby reducing the risk of
data leakage [18]. Also, the Blockchain
Service Network can be authenticated
and encrypt patients’ healthcare data,
allowing secure sharing and circulation
of medical data between healthcare
institutions with patient authorisation
[19]. Doctors can use this technology to
gain a comprehensive understanding of
patients’ physical and mental health to
aid in their care management.
Strengthening the Medical Workforce for
the AI Era. Physicians’ responsibilities in
the digital age encompass four domains:
clinical judgement, ethical stewardship,
data oversight, and health advocacy.
The World Federation for Medical
Education (WFME) accreditation
frameworks have increasingly
encouraged medical schools to embed
digital health, data governance, and
AI-related competencies in curricula,
and similarly, recent international
consensus statements identify that AI
literacy, ethics, and data governance as
mandatory learning outcomes for future
physicians [20]. In China, medical
education reform has advanced toward
interdisciplinary medical engineering
integration, where universities and
teaching hospitals have been integrating
AI into curriculum modules on clinical
reasoning, ethics, interpretation of digital
tools, and interdisciplinary collaboration.
Integrating medical with engineering
education allows trainee doctors to
use AI critically, rather than follow
it passively, and AI-assisted training
can improve residents’ ability to frame
differential diagnoses [21,22].
Ethical Foundations and the Principle
of Interpretive Responsibility. The ethical
challenge of AI lies in maintaining
transparency, explainability, and
accountability, as tools used by doctors
must provide clear rationale for their
outputs, enabling physicians to judge
whether recommendations align with
clinical evidence and patient needs. In
Singapore, AI for clinical use is classified
as a regulated medical device, subject to
strict documentation, validation, and
human-in-the-loop governance [23].
China’s draft Artificial Intelligence Science
and Technology Ethics Management
Service Measures (Trial) explicitly
covers high-risk uses (such as medical
AI) and introduces enhanced ethical
management requirements for such
applications [24]. Pilot programmes
in Zhejiang and Beijing now review
AI projects for safety, efficacy, fairness,
and interpretability. This transition
from technological regulation to ethical
co-governance signals a deeper moral
maturity within the global medical
profession.
Looking Ahead
AI will continue to reshape how PHC
doctors diagnose, counsel, and care for
patients. Its long-term value will depend
on whether future developments deepen
doctors’ clinical authority, strengthen
trust, and advance fairness.
Redefining the Medical Profession of
PHC Doctors. The professional identity
of physicians now includes ethical
stewardship of digital tools, advocacy
for patients’ rights, and leadership in
interpreting complex data. This shift
will encourage doctors to see themselves
as informed interpreters, responsible
decision-makers, and ethical guardians,
rather than passive users of technology.
When AI handles repetitive analytical
tasks, physicians can redirect their time
toward empathy, communication, and
contextual reasoning [8]. Future research
should therefore explore how AI
influences medical ethics, patient trust,
and accountability.
AI Empowering Quality Primary Healthcare in China
43
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Transformation of PHC into a
Community-based Integrated and
Quality Care. By enabling a shift from
reactive treatment to proactive health
promotion, AI can advance PHC by
focusing on the guiding principles
of human-centredness, fairness,
cooperation, transparency, and learning.
Where cost and workflow efficiency
are prioritised in the Global North,
equitable distribution of AI innovation
remains the central focus in the Global
South. Future practice should focus on
building systems where AI amplifies the
preventive and integrative roles of PHC
doctors.
Ensuring that AI Promotes Equity.
The success of AI in empowering
doctors depends on its ability to
promote fairness, dignity, and people-
centred care. The promise of AI can
be achieved only if its deployment
mitigates, rather than deepens, existing
inequities. Therefore, future scholarship
and policy must evaluate whether AI
closes or widens gaps between rural and
urban physicians, whether it supports
vulnerable populations (e.g. older adults,
disabilities, underserved), and whether
doctors feel enhanced (not constrained)
in their professional roles.
Conclusion
The increasing prevalence of AI in
healthcare has given rise to a range of
pressing legal, regulatory, and ethical
challenges, including the determination
of liability in AI-assisted misdiagnosis,
the lack of transparency in AI
algorithms, and the protection of patient
rights. China’s five-dimensional model
and experiences provide insights and
potential solutions to these governance
and ethical challenges. Looking ahead,
the integration of AI with PHC will
continue to drive the exploration of
innovative approaches in clarifying
accountability mechanisms, promoting
medical model transition, and
establishing interdisciplinary ethical
governance bodies.
References
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JM, Petersson L, Svedberg P, 
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healthcare-sub-saharan-africa.pdf
4. World Health Organization.
Ethics and governance of
artificial intelligence for health. Ge-
neva: WHO; 2021. Available from:
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item/9789240029200
5. World Medical Association.
WMA Statement on Artificial
and Augmented Intelligence in
Medical Care [Internet]. 2025
[cited 2025 Nov 10]. Availa-
ble from: https://www.wma.
net/policies-post/wma-state-
ment-on-artificial-and-augment-
ed-intelligence-in-medical-care/
6. Peking University Health Sci-
ence Center. The Beijing Initiative
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Chinese. Available from: https://
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w/2023/00aec7cfb8d042de-
82f0eec4e5ab030f.htm
7. National Health Commission of
China. Outline of the Healthy Chi-
na 2030 Plan [Internet]. 2016 [cit-
ed 2025 Nov 18]. Avai­
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cn/national-legislation/outline-
healthy-china-2030-plan
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care with generative AI. Nat Med.
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12. Hadley TD, Pettit RW,
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HM. Artificial intelligence
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2020;9(1):121-7.
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13. Chen Y, Ye Q. The impact of
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15. European Commission. Proposal
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Nov 25]. Available from: https://
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cn/sic/608/612/0929/20250929101
002234695258_pc.html
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Nguyen D, Carter E, Lee M.
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com/wx/detail.do?id=817847
23. Singapore Ministry of Health.
Artificial intelligence in
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[cited 2025 Nov 30]. Available from:
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nese. Available from: https://
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2793
Authors
Hui Yin, MD, MSc, PhD
Health Science Center,
Peking University
Beijing, China
yinhui@pku.edu.cn
Weili Zhao, MSc
Chinese Medical Association
Beijing, China
weilizhao@cma.org.cn
AI Empowering Quality Primary Healthcare in China
BACK TO CONTENTS
45
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Interview with the Family Medicine Expert
Dr. Richard Fitton joins the interview
with Dr. Helena Chapman, the
WMJ Editor in Chief. As a family
physician in the United Kingdom, he is
passionate about ensuring that patients
have access to their medical records,
receive safe medical care with minimal
errors or omissions in patient records,
and are enabled with the means
of patient agency. Notably, he has
almost four decades of experience in
clinical care and patient education
and provision of the knowledge, skills,
and attitudes required by patients for
full participation in their healthcare
decisions.
What are four ethical considerations
that continue to challenge physicians
with incorporating patient access
to their records into digital health
to enhance clinical care and shared
decision making? How can they work
together to address these challenges?
Firstly, clarifying the processes of
confidentiality: Personal health data
is confidential to the doctor and
patient, but confidentiality should not
preclude patients from seeing their own
data. Patients should be able to view
their personal data, albeit with a few
exceptions. Secondly, providing sufficient
information to patients to explain their
personal health data that physicians share
with them: Informed patients are better
prepared to give consent to proposed
care and health interventions, when
they are provided information that is
tailored to their level of literacy and
linked to their patient accessed records.
Thirdly, deciding whether to allow patients
to see their personal health data during
or before their medical appointment:
Physicians have traditionally shared
“bad news” to patients, which requires
empathy, and compassion in the delivery.
However, one multi-site research
study of more than 8,000 surveyed
patients in the United States found
that most patients preferred receiving
their medical results immediately, and
before physicians’ formal reviews or
consultations [1]. Fourthly, finding a
way for physicians to make their findings
and notes available to physicians in other
hospitals: Physicians treat patients with
complex medical histories from other
hospitals, specialties or countries with
difficulty when they have no access to
the previous medical records. Physicians
will minimise this difficulty when
they allow their patients to share their
personal health data wherever, whenever,
and with whoever, they wish.
When physicians prepare their clinical
notes, they should routinely include a
recommendation that allows patient
access to their digital records, especially
in long-term health plans [2,3].
Physicians’ continuing professional
development should cover the etiquette
of writing notes that can be shared
with patients and how to work with
patient data in the digital world.
Can you describe two lessons learned
during the COVID-19 pandemic
that prompted the need to improve
healthcare practice, safety, and patient
agency?
The COVID-19 pandemic challenged
health systems to respond in the fastest
possible time to a previously unknown,
often fatal, contagious disease. As
service providers and governments
learned lessons in disease surveillance,
care management, and response
measures, two specific lessons have
helped improve patient education and
agency in clinical practice.
Firstly, the National Health Service
(NHS) promoted the NHS App
widely in response to the COVID-19
crisis. The NHS App was used to
communicate with patients who
were in quarantine and unable to visit
health facilities (https://digital.nhs.uk/
services/nhs-app). Patients learned to
use the NHS App to manage medical
appointments and vaccinations, order
repeat prescriptions, and to present their
medical histories to health professionals.
They obtained health information,
chose how the NHS uses their data,
received instant health advice, and
requested medical assistance. Notably,
over one million individuals had signed
up for the NHS App by December
2019, and a total of 33.6 million
individuals by November 2023 [4].
Secondly, the NHS learned to engage
with the public and patients using
these digital channels. Patients learned
to read and use their health records
for work, travel, and to plan their
health. They learned to grant the
NHS permission to contact them for
vaccinations, and to trust the NHS
App with their personal health data for
research, planning, and audit purposes.
The government issued the Regulation
3(4) of the Health Service (Control of
Patient Information) Regulations 2002
during the COVID-19 pandemic
in 2020, requiring the sharing of
confidential patient information
among health organisations (and other
appropriate bodies) to protect public
health and provide healthcare services
Interview with the Family Medicine Expert in
Patient Access to Records and Patient Safety
Richard Fitton
46
BACK TO CONTENTS
during the outbreak monitoring and
response.
How can physicians lead efforts to
facilitate patient access to their records
to effectively ensure patients’ rights
in clinical practice, while striving
to safeguard autonomy in decision-
making processes?
Clinical tutors can provide physicians-
in-training with the knowledge,
skills, and attitudes, to share digital
health records with patients [3,4].
Physicians can advise and encourage
patients to access their digital health
records during consultations. They can
collaborate with information technology
suppliers to develop and enhance
patient portals. However, the question
remains: Can physicians who support
patient access effectively ensure patients’
rights in clinical practice while striving to
safeguard autonomy in decision making
processes?
Data access, physician-patient rapport,
autonomy, and shared decision-making
align directly with the World Health
Organization (WHO) Patient Safety
Charter, which describes 10 patient
rights. 1) right to timely, effective
and appropriate care; 2) right to safe
health care processes and practices;
3) right to qualified and competent
health workers; 4) right to safe medical
products and their safe and rational
use; 5) right to safe and secure health
care facilities; 6) right to dignity,
respect, non-discrimination, privacy and
confidentiality; 7) right to information,
education and supported decision
making; 8) right to access to medical
records; 9) right to be heard and fair
resolution; and 10) right to patient
and family engagement [5]. Notably,
nine rights (all except 5) are linked to
patient access to records, whereas three
rights (rights 1, 7, and 8) support
autonomy in decision-making processes.
Patient access to records is a strong
supporter of patient respect and dignity,
leading to patients who feel more
respected and dignified in clinical
encounters.
How do you anticipate that the
widespread use of health apps and
patient access to their records will
impact patient data, agency, safety,
and privacy?
Over the next decade, patient data
will become ubiquitous to patients.
Health apps will complement and
supplement healthcare structures
and processes, and communities and
villages with limited access to health
professionals will be able to access
their digital data and health services
through these health apps. The promise
of secure national health apps will
reduce the risk of data privacy breeches
currently observed with less secure apps
and websites. Furthermore, patients’
trust in data sharing will improve as
they access their records, understand
how their data are viewed by health
professionals, and inspect their records
for errors or omissions.
With technological advancements and
globalisation, how do you envision
the future of clinical practice, patient
agency, patient safety, patient access to
their records, and the need to protect
data and privacy?
Global digital health languages, such as
SNOMED CT (https://www.snomed.
org/), will unify global health records.
SNOMED CT has standardised the
digital elements of traditional medicine
and has ongoing work to incorporate
the International Classification of
Diseases (11th revision) (https://
icd.who.int/en/). Patient access to
records will be central to health system
development, and a global health data
governance framework, such as the UN
Global Data Compact, will facilitate
cross border care, international data
sharing, migration, and domestic and
international travel [6].
What innovative tools help physicians
to learn more about patient access to
digital records and increased patient
agency?
Patients’ personal stories are very
effective for teaching physicians and
administrators to share records with
patients. Stories can highlight a
holistic framework of patients’ healthcare
experience, demonstrate the benefits
of patient access to health records, and
outline the cultural changes of patient
access to records [7]. Personalised
testimonies offer additional insight
on how to adapt medical education
and training programs – including
the “humanistic touch” – to improve
patients’ expectations, and autonomy,
in care and decision-making, as well as
strengthening global healthcare service
delivery [8-11].
References
1. Steitz BD, Turer RW, Lin CT,
MacDonald S, Salmi L, Wright
A, et al. Perspectives of pa-
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to test results through an online
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2. Pontefract SK, Wilson K. Us-
ing electronic patient records:
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3. Eng K, Johnston K, Cerda I, Kada-
kia K, Mosier-Mills A, Vanka
A. A patient-centered documen-
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Interview with the Family Medicine Expert
47
BACK TO CONTENTS
4. NHS England. NHS App reach-
es record users on fifth anniver-
sary [Internet]. 2023 [cited 2025
May 1]. Available from: https://
www.england.nhs.uk/2023/12/
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ers-on-fifth-anniversary/
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neva: WHO; 2024. Available from:
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item/9789240093249
6. United Nations. Global digital
compact [Internet]. n.d. [cited 2025
Nov 8]. Available from: https://
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nologies/global-digital-compact
7. Quah ELY, Chua KZY, Lin CKR,
Vijayan AV, Abdul Hamid NAB,
Owyong JLJ, et al. The role of pa-
tients’ stories in medicine: a system-
atic scoping review. BMC Palliat
Care. 2023;22(1):199.
8. Patient Voices. The patient voices
digital stories [Internet]. n.d. [cit-
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9. Crowton O. Implementing per-
son centred approaches. BMJ.
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10. Fisher B, Bhavnani V, Winfield M.
How patients use access to their full
health records: a qualitative study of
patients in general practice. J R Soc
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11. Powell J, Fitton C, Fitton R. Shar-
ing electronic health records: the
patient view. Informatics in primary
care. 2006;14:55-7
Richard Fitton, MBBS,
MRCGP, DCH, DRCOG
Family physician (retired)
Manchester, England
richardpeterfitton7@gmail.com
Interview with the Family Medicine Expert
48
Health Privacy Law
In terms of scale, scope, and pace of
change, health information – and the
frameworks governing its protection –
are daunting subjects to confront. As
everyone knows, health information
collected from and about us (which
may be broadly defined to include our
genetic relatives) is used to diagnose
and treat us. The provenance and
curation of this information, however,
can be mystifying. The information
may come from our own medical files,
but it may also come indirectly from
the data of hundreds of thousands, if
not millions, of other people based on
clinical audits, observational research,
clinical trials, and data linkage studies.
In England, for example, the National
Health Service (NHS) holds medical
records of more than 65 million people
‒ practically the entire population in
the nation ‒ dating back for decades
[1]. It is uniquely valuable in holding
cradle-to-grave information on a
national population, and a much-
desired “treasure trove” that tech and
pharma companies, unfriendly
foreign governments, and others would
love to access.
But that desired enhanced access
is, thankfully, protected around the
globe, albeit to varying degrees,
by various normative frameworks,
including laws. Medical confidentiality
is an ancient ethical, professional,
and legal obligation that health
professionals and researchers alike
owe to their patients and participants,
respectfully. To focus on ethical codes,
the Hippocratic Oath advises doctors
that whatever they “may see or hear in
the course of the treatment or even outside
of the treatment in regard to the life
of [patients], which on no account one
must spread abroad”, they will keep to
themselves, “holding such things shameful
to be spoken about” [2]. The Declaration
of Geneva obliges doctors to “respect the
secrets that are confided in [them], even
after the patient has died” [3]. Finally,
the medical research-orientated
Declaration of Helsinki demands that
researchers take “every precaution […] to
protect the privacy of research participants
and the confidentiality of their personal
information” [4].
If we also look to specific texts from
the professional regulators around the
globe, as well as national, regional, and
international laws, there is in fact a
panoply of precepts and rules governing
what health professionals may do with
the things they see, are told, write
down, and share with others. If a
health professional breaches a patient’s
confidentiality, we can be relatively
confident that there will be, at least
in principle, some form of sanction,
be it from the professional’s employer,
a regulator, or a court of law. And
yet, sometimes health professionals,
employers, and governments alike fall
short in respecting the reasonable
expectations of patients and participants
regarding the protection of their
health information. Box 1 presents
details about the “health privacy
law,” an emerging cognate area of
law comprising three distinct legal
frameworks.
Box 1. A Primer on Health
Privacy Law [5]
Health privacy law is an
emerging cognate area of law
comprising three major legal
frameworks: confidentiality
law, privacy law, data
protection law, and laws
governing access to health
records. Depending on the
jurisdiction in question, these
legal frameworks may be
conjoined or separate, and in
some rarer instances, non-existent
(e.g. some jurisdictions still have
not passed data protection laws
that address health information).
It is the corpus of laws and
legal norms that govern 1) the
collection, storage, and use of
information relating to a person’s
or group of persons’ physical or
mental health, including the
provision of health care services,
which reveal information about
one or more persons’ health
status, and 2) the spatial and
decisional aspects concerning one
or more persons’ health, such as
reproductive choices and end-of-
life decision-making.
Confidentiality law is the
legal framework that protects
information disclosed by one
party to another. In the health
context, classically this would be
medical information confided by
a patient to one’s doctor. Unlike
privacy law and data protection
law, it is primarily concerned
with rules around protecting and
sanctioning wrongful disclosure
of health information rather than
rules governing its collection.
Health Privacy Law: Getting the Balance of Interests Right
Edward S. Dove
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49
Privacy law, in its broadest
understanding, is the corpus of
laws and legal norms that govern
the collection, storage, and use
of personal information, as well
as the dimensions of private life
of individuals (what might be
termed our ‘intimate lives’) and,
more provocatively, groups and
communities.
Data protection law is primarily
shaped by statute. It largely
comprises a set of legal rules
that aims to protect the rights,
freedoms, and interests of
individuals whose personal data
are collected, stored, processed,
disseminated, or deleted. Its
principal purpose is to facilitate
flows of personal data across
organisations and countries,
while at the same time ensuring
fairness in the processing of
data and, to some extent,
fairness in the outcomes of such
processing.
In May 2023, it was reported that
a “stalker” doctor at Addenbrooke’s
Hospital in Cambridge, England,
accessed and shared highly sensitive
information about a woman who
had started dating her ex-boyfriend,
despite not being involved in her
care. The doctor first accessed the
hospital’s medical records system and
subsequently another records system
that contained detailed notes of
intimate conversations (e.g. her former
partner’s new girlfriend with her
general practitioner about a family
tragedy, her child’s health). The hospital
initially denied that staff could access
patients’ records through the hospital’s
medical records system, but in a
subsequent meeting with the victim, the
deputy medical director acknowledged
that her full general practitioner’s
records were available for staff to
access [6]. Many other examples
abound, such as concerns about the
NHS sharing patients’ details with the
United Kingdom (UK)’s Home Office
(interior ministry) so it could trace
people breaking immigration rules, and
access to the UK Biobank data from a
so-called “race science” research group
[7,8].
Coupled with these unfortunately not-
so-infrequent instances of putative
health privacy violations is a growing
sense of disempowerment and
bewilderment. This scenario is caused
in part by increasingly sophisticated and
intrusive technical devices, technological
developments, and volume of data
linkage activity alongside massive
mixed datasets of personal and non-
personal data. The vast and growing
array of policies, frameworks, laws, and
legal agreements that characterise data
privacy also influences any confusion or
negative sentiment toward the ability
of state and non-state actors alike to
protect and promote our health privacy.
Indeed, the scale of collection, use,
and sharing of all sorts of information
concerning each individual seems to be
growing exponentially. Data may come
from the smartphone apps that can
track movement and hence trace the
spread of infectious diseases (e.g.
coronavirus disease 2019, COVID-19)
or document vaccination status. It may
come from our visits to the therapist’s
office for a routine appointment or
the hospital for a programmed surgical
procedure or outpatient treatment.
Data may come from simply relaxing
in our apartments, taking the tram,
train or bus to work, speaking to Alexa,
prompting artificial intelligence
(AI) chatbots such as ChatGPT or
DeepSeek with health-related queries,
and going on Bluesky, X, Instagram
or TikTok to post a text or “passively”
scroll through reels. Few doubt
that there is a daunting amount of
information about our lives that is
hoovered up by algorithm-powered
machines, digital devices, and digital
systems, which is then assembled,
stored, and manipulated into various
datasets, and used in ways by
governments, companies, researchers
(and sometimes hackers) often
beyond our understanding and
awareness.
Cutting across this desire for solid
protection in the face of mystifying
and exponential growth in health
information collection and use is the
powerful pull of economic growth
and societal wellbeing-and as part,
medical progress to enable healthy,
happy lives. The collection and use of
health information (e.g. assemblage into
datasets, curation, and making available
to others for different purposes)
depends on its relatively unencumbered
free flow, both within and across
national borders. Health privacy law,
however, may present barriers, such as
strict rules preventing the sharing of
vital information across international
borders, for scientific research and other
bona fide purposes.
The question remains: How do
we achieve the balance between
1) assuring patients and participants
that their health information is
vigorously protected, and sanctions
will be applied to professionals and
other parties (including governments)
who violate that trust; and 2) enabling
health information to be used for the
individual and public good?
In a recently edited book [9] and
forthcoming book entitled Health
Privacy Law [5], the author charts
how the relatively simple days of easy-
to-understand laws protecting medical
secrets passed from patient to doctor
have transitioned to an incredibly
complex interplay of legal frameworks
that govern the collection, use, and
disclosure of health information
concerning individuals and groups (as
patients, consumers or research
participants). For example, the
European Union has complicated
Health Privacy Law
BACK TO CONTENTS
50
interactions between a serious of
substantive laws, including the General
Data Protection Regulation, the
Data Governance Act, the Artificial
Intelligence Act, and the European
Health Data Space Regulation [10-
13]. Aspects of health information
impact the immediate individual (to
whom the information relates) and may
implicate other individuals, which raises
under-addressed questions about group
(or even familial) rights and interests.
In both of these recent works, the
author explains how achieving the
balance involves the careful drafting,
interpretation, monitoring, and
enforcement of legislative instruments,
coupled with clear case law and policy
documents, and easy-to-understand
guidance for health professionals and
patients. These efforts can help drive
global harmonisation and consensus,
and prudently shape what may be
done lawfully with information
concerning our health. Of course,
laws and regulations only represent
part of the journey to building a
culture of sustained protection and
promotion of health privacy. Apart from
compliance with laws and regulations,
health professionals must continue to
act virtuously, working with health
organisations to develop and practice a
culture that supports privacy-promoting
compliance systems. Likewise,
regulators, including health professional
regulators, must possess and hone
sufficient skills to evaluate and ensure
health privacy is respected; regulators
must also have the courage and political
support to hold professionals and
organisations accountable when privacy
violations occur [14].
Health privacy and its regulation is
unquestionably a dynamic, multifaceted
field that engenders deep questions
about power, control, reasonable
expectations, and accountability. The
author encourages readers to critically
consider the ways in which the ethical,
legal, and professional regulatory
frameworks in their home jurisdiction
regulate flows of health information,
whether these frameworks are fit-for-
purpose, and whether regulators are
robust enough in their monitoring
and enforcement. In other words,
readers should ask: Are these
frameworks attuned sufficiently to the
evolving paradigm of large-scale, global,
and digital data-driven healthcare and
biomedical research? Do they strike
an appropriate, proportionate balance
between protecting morally and
legally relevant interests in our health
information, and the interests of society
in promoting safe, efficient, and effective
data flows? Is there a relative balance of
power between relevant stakeholders, or
do the frameworks inadequately protect
individuals (and groups) from privacy
intrusions by powerful actors (e.g.
private companies like Big Tech, well-
funded scientists, intrusive government
bodies)? Should regulators do more, are
they properly resourced to do more, and
is the political will there?
Fundamentally, as we reflect on the
answers to these questions, we should
consider how health privacy law can
help protect and promote human
values, serving the interests of society
and furthering our ability to lead
healthy, flourishing lives. It is my
sincere and admittedly self-interested
hope that readers find health privacy
law as a matter of profound interest
and importance for their practice and
for sustaining trust with patients and
research participants. The forthcoming
book, Health Privacy Law, provides
insight into how we can all do better to
protect and promote our health privacy
in our daily practice.
Special note: This opinion piece is
adapted and excerpted from the author’s
forthcoming book [5], with permission
to reprint kindly granted by Edward
Elgar Publishing.
References
1. Kollewe J. NHS data is worth
billions – but who should have
access to it? [Internet]. The Guard-
ian. 2019 [cited 2025 Aug 20].
Available from: https://www.the-
guardian.com/society/2019/jun/10/
nhs-data-google-alphabet-tech-
drug-firms.
2. Edelstein L. The Hippocrat-
ic Oath: text, translation, and
interpretation. Baltimore: Johns
Hopkins Press; 1943. Available
from: https://archive.org/details/
hippocraticoatht0000edel/page/n3/
mode/2up
3. World Medical Association.
Declaration of Geneva [Internet].
1940 [amended 2017; cited 2025
Aug 20]. Available from: https://
www.wma.net/policies-post/
wma-declaration-of-geneva/
4. World Medical Association.
Declaration of Helsinki [Inter-
net]. 1964 [amended 2024; cited
2025 Aug 20]. Available from:
https://www.wma.net/policies-post/
wma-declaration-of-helsinki/
5. Dove ES. Health privacy
law. Cheltenham: Edward Elgar;
2026.
6. Campbell D. Warnings over
NHS data privacy after “stalk-
er” doctor shares woman’s records
[Internet]. The Guardian. 2023 [cit-
ed 2025 Aug 20]. Available from:
https://www.theguardian.com/
society/2023/may/14/nhs-eng-
land-data-privacy-confidentiali-
ty-records-addenbrookes-hospital
7. Quinn B. Migrants to get Home
Office reference number on NHS
England records [Internet]. The
Guardian. 2023 [cited 2025 Aug
20]. Available from: https://www.
Health Privacy Law
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51
theguardian.com/society/2023/
aug/29/migrants-home-office-ref-
erence-number-nhs-england-re-
cords
8. Burgis T, Devlin H, Pegg D,
Wilson J. ‘Race science’ group say
they accessed sensitive UK health
data [Internet]. The Guardian.
2024 [cited 2025 Aug 20].
Available from: https://www.the-
guardian.com/world/2024/oct/17/
race-science-group-say-they-ac-
cessed-sensitive-uk-health-data
9. Dove ES, ed. Confidentiality,
privacy, and data protection in
biomedicine: international
concepts and issues. Abingdon:
Routledge; 2025.
10. European Parliament. Regulation
(EU) 2016/679 of the Europe-
an Parliament and of the Council
of 27 April 2016 on the
protection of natural persons
with regard to the processing of
personal data and on the free
movement of such data, and
repealing Directive 95/46/
EC (General Data Protection
Regulation) [Internet]. 2016
[cited 2025 Aug 20]. Available
from: https://eur-lex.europa.eu/eli/
reg/2016/679/oj/eng
11. European Parliament. Regula-
tion (EU) 2022/868 of the Eu-
ropean Parliament and of the
Council of 30 May 2022 on Euro-
pean data governance and amending
Regulation (EU) 2018/1724
(Data Governance Act).
[Internet]. 2022 [cited 2025 Aug
20]. Available from: https://eur-lex.
europa.eu/eli/reg/2022/868/oj/eng
12. European Parliament. Regu-
lation (EU) 2024/1689 of the
European Parliament and of the
Council of 13 June 2024 lay-
ing down harmonised rules on
artificial intelligence and
amending Regulations (EC) No
300/2008, (EU) No 167/2013, (EU)
No 168/2013, (EU) 2018/858, (EU)
2018/1139 and (EU) 2019/2144
and Directives 2014/90/EU, (EU)
2016/797 and (EU) 2020/1828 [In-
ternet]. 2024 [cited 2025 Aug 20].
Available from: https://eur-lex.eu-
ropa.eu/eli/reg/2024/1689/oj/eng
13. European Parliament. Regula-
tion (EU) 2025/327 of the Eu-
ropean Parliament and of the
Council of 11 February 2025 on the
European Health Data Space
and amending Directive 2011/24/
EU and Regulation (EU)
2024/2847 [Internet]. 2025
[cited 2025 Aug 20]. Available
from: https://eur-lex.europa.eu/eli/
reg/2025/327/oj/eng
14. Black J. Paradoxes and failures:
‘new governance’ techniques and
the financial crisis. Mod Law
Rev. 2012;75(6):1037-63.
Edward S. Dove, PhD
School of Law and Criminology,
Maynooth University
Maynooth, County Kildare, Ireland
edward.dove@mu.ie
Health Privacy Law
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52
WMA and WVA Commitment to One Health
On 18 July 2025, the World Medical
Association (WMA) and the World
Veterinary Association (WVA)
formalised the new memorandum of
understanding (MOU) at the WVA
General Assembly in Washington,
DC [1]. Dr. John de Jong (WVA
President) and Dr. Jack Resneck, Jr.
(WMA Chair of Council) signed this
agreement to reinforce their respective
organisations’ shared commitment to
One Health (Photo 1). This current
MOU builds on the previous MOU,
which was signed by Dr. Faouzi
Kechrid (WVA President) and Dr.
Cecil Wilson (WMA President) at
the WMA General Assembly, held in
Bangkok, Thailand, in October 2012
[2].
This agreement is intended to create
increased collaboration to provide for a
stronger future for human, animal, and
environmental health. These three areas
are inextricably intertwined and co-
dependent for sustainable life on Earth.
Since 2012, the idea of One Health
has received significant recognition
in global health, which offers a
timely reason to elevate the friendly
cooperation between both organisations.
In October 2024, during the WMA
General Assembly in Helsinki, Finland,
Dr. de Jong met with the WMA
leadership to foster professional
networks and propose potential
collaborations that integrate scientific
expertise between WMA and WVA
members. These multidisciplinary
collaborations are essential, considering
the vast amount of zoonotic and
emerging diseases globally such as avian
influenza, arboviruses, and parasitic
diseases (e.g. Lyme disease). Specifically,
he suggested writing and signing a new
refreshed and more impactful MOU
that would address the pathogens that
affect both humans and animals. As
the WMA leadership enthusiastically
agreed, the drafting of the new MOU
was prepared between January and June
2025, and both organisations signed the
revised MOU in July 2025.
This agreement renews the pledge to
focus on global development objectives
aligned with the One Health concept,
as a unified approach to human and
veterinary medicine. Together, the
WMA and the WVA can work to
educate governments, regulatory bodies,
and the public about the many diseases
that affect various species, helping
to minimise or even eradicate them
in order to create a healthier world.
Proactive advocacy efforts coordinated
by both organisations hold the potential
to increase global attention on these
issues.
This document also further highlights
five priority areas where both
organisations can share valuable
clinical and community expertise
and enhance professional networks.
First, the agreement aims to support
joint educational efforts that expand
engagement between human medical
and veterinary medical schools. Second,
it helps expand efforts to enhance
cross-species disease surveillance and
control related to zoonotic disease
transmission, which aligns with
ongoing collaborations with the World
Health Organization (WHO) and
the World Organisation for Animal
Health (WOAH). Third, the document
proposes to strengthen initiatives
to promote the responsible use and
prescribing practices of antimicrobials,
which will combat the global risk and
spread of antimicrobial resistance.
Fourth, it intends to boost the critical
partnerships between human and
veterinary medical professionals in
academic, clinical care, public health,
and biomedical research. Finally,
it helps explore collaborative
initiatives that advance the
interconnectedness of human and
animal health disciplines with
common activities (such as fellowship
opportunities), including those
established in previous agreements.
Over the past decade, the WMA
and WVA have organised inaugural
One Health events for the global
community. First, using the “Drivers
towards One Health: Strengthening
Collaboration between Physicians and
Veterinarians” theme, leaders organised
the Global Conference on One Health
in Madrid, Spain, on 21-22 May
2012. Second, applying the “Moving
Forward from One Health Concept
to One Health Approach” theme,
leaders collaborated with the Japanese
Medical and Veterinary Associations
WMA and WVA Reinforce Shared Commitment to One Health
John de Jong
Jack Resneck, Jr.
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53
BACK TO CONTENTS
WMA and WVA Commitment to One Health
to coordinate the Global Conference
on One Health in Kitakyushu City,
Japan, on 10-11 November 2016. These
events created a collective platform to
acknowledge the valuable expertise of
human and animal health professions,
underscore the need for cross-sector
partnerships, enhance awareness of
essential leadership, communication,
and facilitation skills, and ultimately
foster greater unity and rapport within
professional networks. As emerging and
reemerging global health risks transcend
geographic borders and species, both
organisations deem the continuation
of joint One Health events as vital
to engaging and empowering health
leaders in scientific discussions that
lead to concrete community and policy
action.
References
1. World Medical Association and
World Veterinary Association.
Memorandum of understanding
between the World Veteri-
nary Association and the World
Medical Association: pream-
ble. 2025 [cited 2025 Oct 23].
Available from: https://www.w
m a . n e t / w p – c o n t e n t / u p –
loads/2025/07/MoU_WVA_
signed-2025.pdf
2. World Medical Association.
One Health Initiative: WMA
and WVA [Internet]. 2012
[cited 2025 Oct 25]. Available
from: https://www.wma.net/blog
-post/one-health-initiative-wma-
and-wva/
Authors
John de Jong, DVM
President, World Veterinary Association
Boston, Massachusetts, United States
drjdejong@comcast.net
Jack Resneck, Jr., MD
Chair of Council, World
Medical Association
San Francisco,
California, United States
jack.resneck@ucsf.edu
Photo 1. The agreement, signed by WMA Chair of Council Jack Resneck, Jr. (left) and WVA President Dr. John de Jong
(right), reinforces the WMA’s and WVA’s shared commitment to One Health. Credits: WMA/WVA
54
Interview with the President of CONFEMEL
Dr. Jorge Coronel joins the interview
with Dr. Helena Chapman, the WMJ
Editor in Chief. As a physician specialist
in intensive therapy, he is the current
President (2025-2027) of the Medical
Confederation of Latin America
and the Caribbean (Confederación
Médica Latinoamericana y del Caribe,
CONFEMEL), as well as the current
Vice President (2025-2026) and
Immediate Past President (2015-2024)
of the Medical Confederación of the
Republic of Argentina (Médica de la
Republica de Argentina, COMRA).
He has actively contributed to national
and regional initiatives, including
serving as the former President of
COMRA’s Drug Commission, endorsed
by the Argentina Ministry of Health,
Pan American Health Organization,
and World Health Organization, which
was responsible for the implementation
of health policies on the rational use of
medicines by health professionals. Also,
as consultant with the Health Sector
of the Inter-American Development
Bank, he led the preparation of the
Strategic Development Plan for the
Province of Salta in Argentina.
Can you share a brief history
about CONFEMEL and describe
the fundamental pillars of the
organisation?
Between 1946 and 1973, the Pan
American Medical Confederation
represented the regional organisation
that linked the national medical
associations within the Americas
region. During the 1970s, several
countries experienced political turmoil
(including coups d’état), which limited
regular coordination of national and
regional meetings. However, medical
organisations continued to actively
operate and coordinate key activities
in their respective countries until the
late 1990s. At this point, medical
organisations agreed that a regional
organisation was essential to unite
countries and focus on how physicians
can deliver quality healthcare services
to the public. This movement led to
the establishment of CONFEMEL
in Santa Cruz de la Sierra, Bolivia, in
1997. Today, CONFEMEL is an
organisation representing more than
two million physicians from medical
institutions from the Latin American and
Caribbean countries, Spain and Portugal,
and external regions (e.g. France, Israel,
Italy).
As CONFEMEL represents its member
medical institutions at all levels, its
organisational pillars are founded on the
principles of universal, comprehensive,
and equally accessible healthcare.
CONFEMEL aims to uphold the
dignity of the medical profession by
promoting ethical and professional
standards, creating and fostering
initiatives that strengthen physicians’
education and training, and defending
physicians’ working rights and
conditions. CONFEMEL actively
collaborates with universities and other
institutions, states, and governments to
accelerate the scientific, technological
and social development of medicine as
well as ensure physicians’ well-being
and safe workplace environment.
How has your medical training and
professional experiences as former
president and current vice president of
COMRA helped prepare you for your
new role as president of CONFEMEL?
I began my career as a primary care
physician in an indigenous community
in northern Argentina, which allowed
me to learn about social medicine and
community health. Later, I specialised in
intensive care, and then received training
in health systems management and
health economics. Before my recent
COMRA leadership role as President
(2015-2024), I had previously served
as the Secretary of Scientific and
University Affairs (2000-2009)
and Union (Gremial) Secretary
(2009-2015), where I acquired
valuable experience in institutional
management that represented the
interests of the Argentinian medical
community. During my tenure as
COMRA President (2023-2024), I led
the Association in defending medical
work and to represent its voice in
international forums, where I understood
the importance of collaborative work,
the exchange of experiences, and debate
based on ethical and philosophical
values.
Also, I have regularly attended
CONFEMEL conferences, where I
contributed to panel discussions for
the collective exchange with regional
members on scientific topics, including
pharmaceutical policies, biomedical
research, and physicians’ working
conditions. This scientific dialogue
has allowed me to acquire a deeper
understanding of the real-time needs,
priorities, and challenges faced by
physicians in the Americas region.
Through my COMRA leadership,
we have continued to support
CONFEMEL’s efforts and strengthen
cooperation between national medical
associations (like COMRA) and
CONFEMEL. I am honoured to serve
Interview with the President of CONFEMEL
Jorge Coronel
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55
Interview with the President of CONFEMEL
BACK TO CONTENTS
as the CONFEMEL President, where
I continue to support CONFEMEL’s
mission and promote organisational
growth, established goals, and expansion
to local, regional, and international
levels.
What are two challenges related to
defending medical practice in Latin
America and the Caribbean? Regarding
the challenges, what are two actions or
interventions that CONFEMEL is
proposing for the next two years?
First, professional standards in
medicine have been difficult to
standardise and validate across Latin
America and the Caribbean institutions,
especially in low-resource settings.
Many physicians experience significant
barriers in their daily workplace, such
as job insecurity, unstable working
conditions, workplace violence, excessive
workloads, and limited infrastructure
and supplies, which deteriorates the
quality of professional practice and
undermines the dignity of physicians.
CONFEMEL has articulated their
quality care must be delivered with
decent working conditions, and that
defending physicians is key to protecting
patients and the healthcare system.
Second, maintaining continued medical
education, while preserving the human
dimension of medical practice, has been
difficult in the face of rapid scientific
and technological advancements (e.g.
artificial intelligence). Recertification
and periodic professional accreditation
are key tools to confirm competence and
ethical behaviors, leading to diagnostic
precision and patient safety. Since
CONFEMEL has highlighted that
technology cannot replace physicians’
compassion, empathy, and ethical
judgment, it is essential to promote
comprehensive medical education that
combines scientific excellence with
humanistic values.
To address these two challenges,
CONFEMEL has outlined two
priority actions for the next decade.
First, CONFEMEL aims to promote
public policies and regulatory
frameworks that guarantee decent and
safe working conditions for physicians.
By working with governments and
national medical organisations, they
can develop timely strategies to ensure
job security, prevent workplace violence
in health institutions, and strengthen
legal and institutional protections
of healthcare professionals. Second,
CONFEMEL intends to strengthen
continuing medical education and
professional accreditation by working
on harmonising recertification
processes, promoting lifelong medical
education, and incorporating evidence-
based content on ethics, public health,
and environmental sustainability.
As a result, CONFEMEL can lead
efforts to prepare physicians to manage
emerging and reemerging global health
challenges and how to effectively use
new technologies (like artificial
intelligence and digital platforms) for
quality healthcare service delivery to
patients.
How can physicians lead efforts to
effectively use artificial intelligence in
the clinical workplace?
As artificial intelligence represents
a significant tool that can help
physicians improve clinical and
administrative processes in health
systems, the effective incorporation of
these novel technologies will require
ethical medical leadership and technical
expertise. CONFEMEL members
believe that physicians must lead this
transformational process from two
perspectives. First, physicians should
actively participate in the design,
evaluation, and application of these
technologies to ensure that their
operational use is based on clinical
(not commercial) criteria. Second, they
must ensure that artificial intelligence
does not hinder the physician–patient
relationship as the heart of medical
practice. We understand that training
new generations of physicians to acquire
digital skills and reinforce critical and
ethical analyses can help leverage these
technological advantages without
losing the humanistic touch in clinical
care. Artificial intelligence can expand
physicians’ clinical capabilities, but it
can never replace their judgment,
empathy or moral commitment to
patient-centred care.
How can physicians contribute to
applying the One Health concept to
clinical and community practice?
Physicians have a fundamental role
in operationalising the One Health
concept in clinical and community
practice. We must broaden the
perspective of medical practice,
by recognising how economic,
environmental, and social determinants
influence well-being and illness. In
our daily practice, we can promote
sustainable health behaviors, participate
in vaccination campaigns, and organise
educational seminars on emerging
diseases risks (including zoonoses).
Physicians can also collaborate with
other professionals (e.g. veterinarians,
ecologists, laboratory specialists) to
educate local communities about the
importance of environmental stewardship,
responsible resource management, and
the prevention of emerging diseases
linked to climate change.
CONFEMEL members understand
the direct links among human,
animal, and environmental health,
and by applying the One Health
concept in our practice, we can
move toward a more preventive
and collaborative healthcare model.
Together, we can promote sustainable
health habits and environmental
practices, contribute to research that
examines emerging disease risks (like
deforestation or extreme heat), and
56
develop relevant policies and guidelines
to protect human, animal, and
environmental health. As physicians,
our medical expertise will help guide
the formation of a comprehensive and
sustainable health model to safeguard
health and well-being for future
generations.
Jorge Coronel, MD
Medical specialist in Intensive Therapy
President,
Confederación Médica
Latinoamericana y del Caribe
(CONFEMEL)
Vice President,
Confederación Médica de la
República Argentina (COMRA)
Salta, Argentina
jorgecoronel08@gmail.com
Interview with the President of CONFEMEL
BACK TO CONTENTS
57
BACK TO CONTENTS
Global Solidarity in Climate Health and Resilience
In an era defined by accelerating climate
change and its cascading effects on
human health, physicians and national
medical associations stand at a defining
crossroad. The climate crisis is not an
abstract environmental issue – it is a
lived public health emergency that tests
the resilience of our health systems, the
principles of our profession, and the
unity of our global community. Within
this shifting landscape, the Trinidad
and Tobago Medical Association
(T&TMA) has positioned itself as a
steward of planetary health, an advocate
for resilient health systems, and a
partner in global solidarity.
From Observation to Action
The 21st century demands a broader
understanding of medicine – one in
which those who care for patients
also engage with the policies that
shape their health and the systems
that sustain their care. Rising
temperatures, extreme weather events,
and emerging vector-borne diseases are
no longer theoretical concerns; they
shape the daily realities of healthcare
delivery, particularly within small island
developing states (SIDS) [1]. SIDS in
the Caribbean face heightened health
risks from climate change, as their
populations are simultaneously exposed
to multiple climate-driven hazards
while being constrained by limited
adaptive capacity and a smaller regional
evidence base [2].
Physicians on the frontlines witness
these impacts firsthand- disrupted
care, health facility vulnerabilities, and
increasing burdens on already stretched
systems. Recognising this convergence,
the T&TMA has advanced a structured
policy framework that positions climate
resilience as both a health priority and
a professional duty. This initiative – one
of the first of its kind by a national
medical association in Trinidad and
Tobago – seeks to embed climate-health
action into the ethical and operational
fabric of medical professionalism.
A Framework for National and
Professional Collaboration
The T&TMA’s climate-health policy
framework, adopted as a formal
institutional position, establishes the
following central priorities: building
climate resilience in health facilities,
equipping physicians with knowledge
and tools to address climate-
sensitive health risks, and promoting
sustainability in healthcare delivery
[3]. This development is intended to
encourage broad-based engagement
among national stakeholders – bridging
the health, environment, and policy
sectors – to address the challenges of
climate change and health collectively at
the local level. It reflects a commitment,
not only to professional leadership but
also to partnership: strengthening the
country’s capacity to adapt and ensuring
that healthcare remains responsive and
resilient amid environmental change.
A Voice in Global Dialogue
The T&TMA’s leadership extends
beyond the national sphere, with
significant contributions to the collective
discussion at the 76th General Assembly
of the World Medical Association
(WMA) in Porto, Portugal. Through
the “Global Solidarity in Climate
Health and Resilience” presentation,
the T&TMA shared its experiences
and perspectives, understanding that
the lessons drawn from small and
vulnerable states may hold value for
others across the world (Photo 1). The
T&TMA underscored the need for
deeper collaboration among national
medical associations, particularly those
representing small islands and other
climate-vulnerable settings. Equally, the
Association expressed its openness to
learning from the diverse approaches
pioneered by colleagues within the
WMA community. This exchange of
experiences and strategies exemplifies
the essence of professional solidarity –
rooted in shared purpose and mutual
respect. The T&TMA reaffirmed its
readiness to share findings, collaborate
internationally, and contribute to the
collective development of guidance for
climate-resilient and sustainable
healthcare systems.
Trinidad and Tobago Medical Association’s Global Solidarity
in Climate Health and Resilience: A Small Island Perspective
Saksham Mehra
Photo 1. Dr. Saksham Mehra delivered the T&TMA’s
presentation at the 76th WMA General Assembly in Porto,
Portugal, in October 2025. Credit: WMA
58
BACK TO CONTENTS
A Call for Solidarity and
Leadership
No island stands alone. The future
of global health security depends on
cooperation that transcends borders
and hierarchies [4]. The T&TMA
envisions a collaborative approach in
which national medical associations
share insights toward climate-smart,
adaptive health systems. Through its
participation in global forums, the
Association continues to advocate
for inclusion, partnership, and shared
learning – ensuring that small nations
have a voice in shaping global resilience
strategies (Photo 2).
In 2023, a landmark regional
collaboration was established to
strengthen the Caribbean health sector’s
unified response to the escalating
challenges of climate change. This
alliance, comprising national medical
associations from Trinidad and Tobago,
Jamaica, Barbados, St. Lucia, Suriname,
and other Caribbean nations,
in addition to EarthMedic and
EarthNurse Foundation for Planetary
Health, led to the formation of the
Caribbean Health Alliance for Climate
Action (CARHACA). [5]. Through
a collective statement, the region
articulated a shared commitment
to addressing climate change as
an urgent public health priority,
underscoring the critical importance
of coordinated regional action to
mitigate its health impacts and enhance
the resilience and sustainability of
Caribbean health systems.
As the world edges deeper into the
age of climate disruption, the
physician’s role must evolve. Leadership
in this context builds upon clinical
expertise – extending it through
foresight, collaboration, and an
enduring ethical commitment to the
future of care. Rather than prescribing
a single path, the T&TMA hopes to
contribute to a collective professional
movement – where medical associations
worldwide, guided by shared values,
work together to advance sustainable,
evidence-informed health systems.
The T&TMA embraces this
responsibility with humility and
purpose. It stands as both participant
and partner in a broader movement–
uniting professional leadership, public
purpose, and planetary stewardship.
The journey toward climate-resilient
healthcare is not merely about
adaptation; it is about moral clarity
and collective will. In this shared
endeavour, physicians are not passive
witnesses to climate chan­
ge – they
are architects of health-secure futures,
building systems that protect both
people and the planet.
References
1. World Health Organization.
Climate change and health in
small island developing states
– a WHO Special Initiative.
Geneva: WHO; 2018. Available
from: https://www.who.int/publica-
tions/i/item/9789290618669
2. Rise N, Oura C, Drewry J.
Climate change and health in the
Caribbean: a review highlighting
research gaps and priorities. J Clim
Change Health. 2022;8:100126.
3. Trinidad and Tobago Medi-
cal Association. Policy document
on climate change and health.
Port of Spain: T&TMA; 2025.
Available from: https://tntmedi-
cal.com/policy-document-on-cli-
mate-change-health/
4. Gordon-Strachan GM, Parker SY,
Harewood HC, Méndez-Lázaro
PA, Saketa ST, Parchment KF,
et al. The 2024 Small Island
Developing States report of the Lan-
cet Countdown on health and cli-
mate change. Lancet Glob Health.
2025;13(1):e146-66.
5. Trinidad and Tobago Medical As-
sociation. CARibbean Health Al-
liance for Climate Action (CAR
HACA) Statement [Internet].
2023 [cited 2025 Nov 1]. Available
from: https://tntmedical.com/carib-
bean-health-alliance-for-climate-ac-
tion-carhaca-statement/
Saksham Mehra, BMSc
(Dist.), MBBS (Dist.)
External Affairs Chair, Trinidad and
Tobago Medical Association (T&TMA)
Trinidad and Tobago, West Indies
mehrasaksham1@gmail.com
Global Solidarity in Climate Health and Resilience
Photo 2. Group photo of T&TMA members in Claxton Bay, Trinidad and Tobago, in January 2025. Credit: T&TMA
59
Life-Course Vaccination
Vaccination has long been recognised
as one of the most successful and cost-
effective public health interventions
in human history. This preventive
medicine approach has eradicated
smallpox, nearly eliminated polio,
and significantly reduced the burden
of infectious diseases worldwide [1].
Yet despite this progress, inequities
in access, insufficient investment,
and under-recognition of the importance
of immunization across the life course
continue to hinder the realisation of its
full potential [2]. On 4-5 November
2024, a coalition of international health
and community-based non-government
organisations (NGOs) gathered in
Geneva, Switzerland, to reaffirm a
shared commitment: to strengthen
advocacy for life-course vaccination.
The resulting call to action, endorsed by
leading global associations representing
physicians, nurses, pharmacists, social
workers, ageing networks, students, and
patient advocates, urges policymakers
and health systems to view vaccination
not merely as a childhood intervention,
but rather as a lifelong necessity that
safeguards individuals, health systems,
and societies [3].
This article will explore the rationale,
scientific evidence, and pathways for
implementing life-course vaccination
strategies in global health systems. It
will emphasise the vital role of health
and social care professionals as both
beneficiaries and advocates and situate
vaccination within the broader fight
against inequity and non-communicable
diseases. Finally, it will outline concrete
actions for governments, international
organisations, and communities to
advocate for making vaccination
accessible to everyone, at every stage of
life.
Vaccination Beyond Childhood:
Why the Life-Course Approach
Matters
Historically, immunization has
been framed largely as a paediatric
intervention. Childhood vaccination
programs have been remarkably
effective, achieving high coverage rates
for diseases such as measles, diphtheria,
and pertussis. However, focusing
exclusively on children fails to recognise
the complex epidemiology of infectious
diseases and the vulnerabilities
that arise at every stage of life. For
example, adolescents and young adults
require protection against human
papillomavirus (HPV), meningococcal
disease, and hepatitis B, which carry
long-term health risks if left unchecked
[4]. Adults benefit from vaccines
against influenza, pneumococcal disease,
coronavirus disease (COVID-19), and
pertussis boosters, which can reduce
absenteeism, maintain workforce
productivity, prevent transmission to
vulnerable groups, and protect during
pregnancy [5]. Older adults, particularly
those with frailty or chronic conditions,
face a heightened risk of severe
outcomes from influenza, pneumonia,
shingles, and respiratory syncytial
virus (RSV); vaccination at this stage
helps maintain independence, reduce
healthcare utilisation, and extend
healthy life expectancy [6-8]. Since
a life-course approach recognises
that immunity wanes, exposures
change, and comorbidities accumulate,
vaccination must therefore be
continuous, adaptive, and equitable to
ensure protection for all [9].
The Burden of Vaccine-Preventable
Diseases in Adults
Global data highlight a pressing need
to expand immunization beyond
children. Influenza alone causes up to
650,000 respiratory deaths annually,
Life-Course Vaccination: A Global Call to Action
for Equity, Resilience, and Strong Health Systems
Michael Moore Bettina Borisch Julia Tainijoki-Seyer
Marta Lomazzi
BACK TO CONTENTS
60
with disproportionate impacts on
older adults, pregnant women, and
people living with chronic conditions
[10]. Pneumococcal disease contributes
significantly to morbidity and mortality
in adults over age 65, while pertussis
outbreaks continue to threaten both
adults and infants [11,12]. Moreover, the
COVID-19 pandemic underscored the
vulnerability of health and social care
professionals, where frontline workers
were exposed daily to pathogens, not
only risking their own health but also
becoming potential vectors of disease
transmission. Hence, vaccination has a
dual importance: safeguarding essential
workers and protecting the patients and
communities they serve [13].
Infectious Diseases and the
Cascade of Non-Communicable
Diseases
Immunization is not only critical for
preventing communicable diseases, but
also plays a major role in preventing
or limiting the progression of non-
communicable diseases (NCDs).
Infections can trigger or worsen chronic
conditions, creating a cycle of health
decline. For instance, influenza
and pneumonia increase the risk
of cardiovascular events, including
myocardial infarction and stroke [14].
Chronic respiratory diseases, such as
chronic obstructive pulmonary disease,
are exacerbated by recurrent infections,
often resulting in hospitalisations [15].
Also, HPV infections are directly
linked to cancers, including cervical,
oropharyngeal, and anal cancers
[16]. Finally, new vaccines are being
researched and developed to target
other chronic conditions, including
hypertension, diabetes, and obesity
[17]. Protecting populations against
infectious diseases is dually a matter of
acute prevention and a vital strategy for
reducing the global burden of NCDs.
Equity as a Central Principle
Access to vaccines remains profoundly
inequitable. The World Health
Organization reports that millions
of adults worldwide lack access to
basic immunizations. Low- and
middle-income countries (LMICs)
face particular challenges, including
limited supply chains, under-resourced
health systems, and competing health
priorities. Within high-income
countries, marginalised groups – such as
migrants, ethnic minorities, and persons
in precarious employment – also face
barriers in accessing vaccination [18].
Equity must be at the heart of any life-
course immunization agenda, including
ensuring that health and social care
professionals in all contexts can access
recommended vaccines, recognising
their right to protection and their role
as trusted advocates for immunization.
Health and Social Care Professionals:
Protectors and Advocates
Health and social care professionals
occupy a unique position at the
intersection of personal vulnerability
and community responsibility, and
evidence consistently shows that their
attitudes toward vaccines strongly
influence patient uptake. Empowering
these professionals to advocate for
immunization requires ensuring they are
fully protected through comprehensive
vaccine access, providing training and
resources to communicate effectively
with hesitant populations, and
embedding vaccination into occupational
health programs. Prioritizing the health
workforce in this way safeguards their
own health, strengthens the resilience
of health systems, and fosters greater
confidence in the communities they
serve [19].
The Ten Action Points
The Call to Action outlines ten
concrete steps for advancing life-course
vaccination, providing a clear roadmap
for operationalizing immunization in
diverse contexts [3]:
1. Ensuring full access to
recommended vaccines to protect
health and social care professionals:
Mandatory occupational health
programs, workplace vaccination
campaigns, and subsidised or free
access to vaccines can safeguard
the workforce and reduce risks of
disease transmission to patients and
the wider community.
2. Guaranteeing equitable access
to vaccines throughout all stages
of life: Governments and health
systems can implement policies
that remove financial, geographic,
and social barriers, such as offering
vaccines at community
clinics, mobile health units, at
pharmacies, and through school
– and workplace-based programs.
Ensuring affordability, particularly
in LMICs, is essential for reducing
disparities and achieving broad
coverage.
3. Mobilising the health workforce
for vaccine delivery: Health
systems can provide healthcare
professionals with up-to-date
guidance, communication training,
and resources for addressing
vaccine hesitancy, and logistical
support, such as cold-chain
infrastructure and mobile
vaccination units.
4. Establishing comprehensive adult
vaccination schedules for life-course
protection: National immunization
programs can define standardised
schedules and integrate
immunizations relevant to adult
populations into routine primary
care visits, including influenza,
pneumococcal disease, HPV, and
COVID-19 boosters.
5. Developing interoperable
immunization registries: Digital
platforms that link primary care,
pharmacies, hospitals, and public
health authorities can identify gaps,
support timely reminders, enable
Life-Course Vaccination
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61
real-time monitoring of vaccine
uptake and coverage, and facilitate
targeted interventions.
6. Integrating vaccination into multi-
sectoral health priorities and
strategies: Collaboration between
ministries of health, education,
labor, and social protection can
position vaccines as essential
tools for its broader public health
value, including healthy ageing,
maternal and child health, non-
communicable disease prevention,
and workforce productivity.
7. Expanding and simplifying
vaccination pathways: Strategies,
such as walk-in clinics, community
pharmacies, outreach campaigns,
and telehealth scheduling, can
make vaccines more accessible,
particularly for professionals
working in underserved areas.
8. Raising awareness and building
vaccine confidence: Increasing
health literacy and awareness
requires culturally sensitive
communication, educational
campaigns, and leveraging
trusted community leaders.
Tailored messaging that addresses
misinformation and emphasises the
benefits of vaccination across the
life course can strengthen public
trust.
9. Embedding community engagement
into vaccine development and
delivery: Participatory approaches,
including focus groups, community
advisory boards, and co-design
of vaccination campaigns, can
be responsive to local needs and
priorities and ultimately enhance
uptake and relevance.
10. Leveraging youth and ageing
organizations to champion
vaccination: Engaging student
networks, professional associations,
and senior advocacy groups
can amplify advocacy, mentor
future health leaders, and create
community-based champions who
promote immunization at every
stage of life. It can build capacity
and influence across generations.
The Time for Integrated Action is
Now
Vaccination saves lives, reduces
inequities, strengthens health systems,
and contributes to social and economic
resilience. Life-course vaccination is
not optional, but rather a necessity.
Investment, integration, and innovation,
guided by equity and solidarity, are
essential to build resilient health
systems, ensure universal access to
vaccination, and protect people’s health
across all stages of life. Implementing
the ten action points outlined in the
Call to Action will ensure protection
at all stages of life and contribute
decisively to global health resilience,
starting with health and social care
professionals.
References
1. Haelle T. The staggering suc-
cess of vaccines. Nature. 2024;
634(8035):S34-9.
2. World Health Organization.
Immunization agenda 2030.
Geneva: WHO; 2021. Available
from: https://cdn.who.int/media/
docs/default-source/immunization/
strategy/ia2030/ia2030-draft-4-
wha_b8850379-1fce-4847-bfd1-
5d2c9d9e32f8.pdf
3. World Federeation of Public
Health Associations. Life course
immunization: why lifelong
vaccination is essential for public
health [Internet]. 2025 [cited 2025
Oct 8]. Available from: https://
www.wfpha.org/life-course-immu-
nization/
4. World Health Organization.
Global report on agisim.
Geneva: WHO; 2021. Available
from: https://iris.who.int/server/
api/core/bitstreams/71ad96a0-
d29a-4457-9d54-52029c24c76c/
content
5. Boccalini S, Ragusa R, Panatto D,
Calabrò GE, Cortesi PA, Gior-
gianni G, et al. Health technolo-
gy assessment of vaccines in Italy:
history and review of applications.
Vaccines (Basel). 2024;12(10):1090.
6. Ferdinands JM, Blanton
LH, Alyanak E, Chung JR,
Trujillo L, Taliano J, et al.
Protection against influenza
hospitalizations from enhanced in-
fluenza vaccines among older adults:
a systematic review and network
meta-analysis. J Am Geriatr Soc.
2024;72(12): 3875-89.
7. Wildenbeest JG, Lowe DM,
Standing JF, Butler CC.
Respiratory syncytial virus
infections in adults: a narrative
review. Lancet Respir Med.
2024;12(10):822-36.
8. Centers for Disease Control and
Prevention. About TeenVax view
[Internet]. 2024 [cited 2025 Oct 8].
Available from: https://www.cdc.
gov/teenvaxview/index.html
9. World Health Organization.
Vaccinating at every age is key
to unlocking the full potential
of immunization [Internet]. 2025
[cited 2025 Oct 8]. Available
from: https://www.who.int/news/
item/05-06-2025-vaccinating-at-
every-age-is-key-to-unlocking-the-
full-potential-of-immunization
10. World Health Organization.
Influenza (seasonal) [Internet].
Life-Course Vaccination
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62
2025 [cited 2025 Oct 8].
Available from: https://www.who.
int/health-topics/influenza-seasonal
11. Kobayashi M, Leidner AJ,
Gierke R, Farrar JL, Morgan
RL, Campos-Outcalt D, et al.
Use of 21-valent pneumococ-
cal conjugate vaccine among U.S.
adults: recommendations of the
Advisory Committee on
Immunization Practices — United
States, 2024. MMWR Morb Mor-
tal Wkly Rep. 2024;73(36):793-8.
12. Von König W, Halperin S,
Riffelmann M, Guiso N.
Pertussis of adults and infants.
The Lancet Infect Dis.
2001;2(12):744-50.
13. Kroflin K, Gonzalez Utrilla
M, Moore M, Lomazzi M.
Protecting the Healthcare
Workers in low- and lower-
middle-income countries through
vaccination: barriers, leverages,
and next steps. Glob Health
Action. 2023;16(1):2239031.
14. Warren-Gash C, Blackburn R,
Whitaker H, McMenamin J,
Hayward AC. Laboratory-
confirmed respiratory infections
as triggers for acute myocardial
infarction and stroke: a self-
controlled case series analysis
of national linked datasets
from Scotland. Eur Respir J.
2018;51(3):1701794.
15. Tesfaigzi Y, Meek P, Lareau S.
Exacerbations of chronic
obstructive pulmonary disease and
chronic mucus hypersecretion. Clin
Appl Immunol Rev. 2006;6(1):21-
36.
16. World Health Organization.
Human papillomavirus and
cancer [Internet]. 2024 [cited
2025 Oct 8]. Available from:
https://www.who.int/news-room/
fact-sheets/detail/human-papillo-
ma-virus-and-cancer
17. Nakamaru R, Nakagami H,
Rakugi H, Morishita R. Future di-
rections of therapeutic vaccines for
chronic diseases. Circulation. 2020;
84(11):1895-1902.
18. Centers for Disease Control and
Prevention. Ensuring vaccine
access for all people [Internet].
2024 [cited 2025 Oct 8].
Available from: https://www.cdc.
gov/vaccines/basics/vaccine-equity.
html
19. Utrilla MG, Tan SY, Moore
M, Lomazzi M. Exploring the
complexities of vaccine
sentiment among healthcare
and public health professionals:
essential strategies for
encouraging vaccine uptake.
Front Public Health.
2025;13:1537255.
Authors
Michael Moore, AM, PhD
Past President (2016-2018) &
Chair of the International Immunization
Policy Taskforce, World Federation
of Public Health Associations
Geneva, Switzerland
mimomph@gmail.com
Bettina Borisch, MD, MPH, FRCPath
Chief Executive Director,
World Federation of Public
Health Associations
Geneva, Switzerland
bettina.borisch@unige.ch
Julia Tainijoki-Seyer,
MD, MSc (MIHMEP)
Senior Advocacy and Medical Advisor,
World Medical Association
Geneva, Switzerland
julia.seyer@wma.net
Marta Lomazzi, PhD, PD
Chief Operating Officer, World Federation
of Public Health Associations
Geneva, Switzerland
marta.lomazzi@wfpha.org
Life-Course Vaccination
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63
BACK TO CONTENTS
Health Checkup System in Japan
Today, Japan represents a model where
economic growth since World War II
has resulted in high average and healthy
life expectancy rates. Specifically, the
average life expectancy at birth is
estimated at 84.5 years (87.2 years
in female, 81.7 years in males), as
compared to 77.4 years in the Western
Pacific and 71.4 years worldwide
[1]. Also, the average healthy life
expectancy at birth (e.g. years lived in
“full health”) was approximately 73.4
years (74.8 years in females, 71.9 years
in males), as compared to 68.2 years
in the Western Pacific and 61.9 years
worldwide [1].
The Japanese health system supports an
estimated 124 million residents, with
universal healthcare with its lifelong
health checkup system and emphasises
disease prevention and primary
healthcare. This health checkup system,
which was established after World War
II, has undoubtedly contributed to
promoting health in Japan however, has
faced challenges due to the declining
birthrate, aging population, and ongoing
digital transformation of healthcare.
In this article, the author will discuss
the structure of Japan’s health checkup
system, specifically focusing on four
phases – infant and child, school-
aged children, working adults, and
elderly – and share general views on its
challenges.
Components of the Health
Checkup System
Japan’s health checkups system is
entirely conducted by physicians and
is stratified by age group according
to the type and competent authority.
For example, health checkups are
implemented by the Children and
Families Agency and the Ministry of
Education, Culture, Sports, Science and
Technology (MEXT) in infants and
children (0 to 6 years) and school-aged
children (6 to 18 years), and by the
Ministry of Health, Labour and
Welfare (MHLW) in adults and the
elderly. The MHLW launched the
National Health Promotion Movement
in 2000 – recognised as Health Japan
21 – as the national policy of reducing
risk of non-communicable diseases and
promoting the healthy life expectancy
beyond the 72-75 age range [2]. The
third term (2024-2035), will build
upon successes of the first term (2000-
2012) and second term (2013-2023),
including the further enhancement of
health screening programs across the
country.
Infant and Child Health Checkup
(0 – 6 years)
By law, municipalities are required
to provide infant health checkups
for children aged 18 months and 3
years, and the participation rate is
over 90%. From FY 2023, health
checkups for infants of 1 month, 3
months, and 9 months, as well as
children of 5 years of age have been
implemented under the subsidy program
of the Children and Families Agency.
Results are kept by each municipality
and recorded in the mothers’ paper-
based maternal and child health
handbooks. A digital version of the
maternal and child health handbook
is currently being introduced, allowing
mothers to manage checkup results via
digital devices (e.g. smartphones).
In addition to the infant health
checkups, regular health checkups
from infants to children of 6 years are
provided annually at kindergartens and
biannually at nurseries and certified
daycare centers. The enrollment rate
of children is approximately 90%, and
the health checkup participation rate
is approximately 100%. Checkup data
are managed separately by each facility,
and results are provided to parents with
recommendations to undergo further
medical tests as necessary.
School Health Checkup
Under the jurisdiction of MEXT,
the school health checkup is defined
as “screening for diseases to detect any
problems that may affect a child’s school
life,” and “identifying health issues at
school and utilising such information for
health education.” Stipulated by the
School Health and Safety Act, school
health checkups, which are conducted
from April to June each year, cover
primary, junior high, and high school
grades [3]. The checkup results (11
checkup items) are managed separately
by each school, and results are provided
to parents with recommendations.
Schools utilise these results to provide
health education on lifestyle-related
diseases in children. Additionally, health
education at school includes topics
such as cancer, smoking cessation,
and preconception care, which are
implemented on a voluntary basis.
Notably, one major issue concerning
the school health checkup system is the
lack of effective collaboration between
MEXT and MHLW to integrate health
checkup data after adolescents graduate
from high school.
Review of the Health Checkup System in Japan
Koji Watanabe
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Health Checkup System in Japan
Health Checkup System from Working
Adults to Elderly
Health checkups for working
adults include workplace checkups
implemented by employers and
regional checkups implemented by
municipalities. Workplace health
checkups include the regular health
checkup with the physical examination
and blood tests (e.g. hepatic function,
lipid levels, cardiac function tests), and
specific health checkups by business
type, such as radiation exposure tests (if
handling radiation) or organic solvent
exposure tests (if in the printing
industry). Regional health checkups
include screenings for cancer (e.g.
gastric, lung, colon, breast, cervical)
and other diseases (e.g. hepatitis virus,
osteoporosis, periodontal disease).
Specific Health Checkup and Health
Guidance
Since 2008, the Specific Health
Checkup and Health Guidance
program has been implemented to
prevent lifestyle-related diseases
with a focus on visceral fat obesity
in individuals aged 40 years and
older. This program is mandatory for
those individuals covered by the
National Health Insurance and the
employee health insurance. Individuals
who meet certain criteria based on the
health checkups are selected, and an
estimated 25% of checkup participants
currently fall into this group and receive
health guidance. For participants with
a particularly high risk, motivational
or more proactive health guidance
and consultations are provided
depending on the degree of risk
(Figure 1). To maintain the evidence-
based guidelines, the Specific Health
Checkup and Health Guidance
program is reviewed every five years at
MHLW review meetings, with medical
expertise provided by the Japan Medical
Association (JMA).
Encountered Challenges in the Health
Checkup System
While this health checkup system may
have contributed to Japan’s high average
and healthy life expectancy today, it
does not include a unified standard for
health checkup results. Since checkup
results of infants and children (0 to 6
years) and school-aged children (6 to
18 years) are managed by the MEXT,
data cannot be combined with health
checkup data from adults and the
elderly, which are managed by the
MHLW. Hence, the implementation
of health information management and
health education is limited across the
lifespan.
To address this challenge, the health
system is identifying opportunities to
incorporate novel digital technologies
in health service delivery, especially for
the management of health checkup
information throughout the lifespan.
First, the MHLW is developing the
Nationwide Healthcare Information
Platform, to serve as a foundation for
the collection, external provision and
reception, storage, and sharing of health
information. Second, a Public Medical
Hub (PMH) serves as a foundation
for managing local health checkup
information in a municipal-level
database, allowing each individual to
access their own health information via
the government-managed Mynaportal
[4]. Finally, basic guidelines for
Personal Health Records (PHRs) have
been established to enable individuals to
securely review and manage their health
records [5].
Conclusion
In response to these government-
led initiatives, the JMA has actively
consulted with the relevant ministries,
agencies, and other organisations to
establish a robust foundation for health
checkup information in the nation.
Moving forward, the JMA aims to
develop and sustain the foundation
of a universal health checkup system,
whereby each citizen can centrally
manage their lifelong health checkup
data and use information to maintain
and improve their physical and mental
health and well-being.
References
1. World Health Organization. Health
data overview for Japan [Internet].
2025 [cited 2025 Oct 25]. Available
from: https://data.who.int/coun-
tries/392
2. Nomura S, Sakamoto H, Ghaznavi
C, Inoue M. Toward a third term of
Health Japan 21 – implications from
theriseinnon-communicabledisease
Figure 1. The Specific Health Checkup and Health Guidance program is administered by health insurance providers. The
insurers encourage members to participate in this program, expecting that this will reduce the number of patients who re-
quire medical care for lifestyle-related diseases (like diabetes), and thereby helping to control future healthcare expenditures.
Credit: K. Watanabe
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burden and highly preventable risk
factors. Lancet Reg Health West
Pac. 2022;21:100377.
3. Government of Japan. School
Health and Safety Act (Act
No. 56 of 1958) [Internet]. 1958
[updated 2015; cited 2025 Oct 25].
Available from: https://www.jap-
aneselawtranslation.go.jp/en/laws/
view/4851/en
4. Digital Agency, Government
of Japan. Public Medical
Hub (PMH): information
coordination system connecting
local governments and medical
institutions [Internet]. 2025 [cit-
ed 2025 Nov 10]. Available from:
https://www.digital.go.jp/en/poli-
cies/health/public-medical-hub
5. Ministry of Health, Labour and
Welfare, Government of Japan.
Data-based health management
initiatives roadmap [Internet].
2021 [cited 2025 Nov 10]. Availa-
ble from: https://www.mhlw.go.jp/
english/policy/health-medical/data-
based-health/dl/211124-01.pdf
Koji Watanabe, MD
Executive Board Member
Japan Medical Association
Tokyo, Japan
Health Checkup System in Japan
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A Junior Doctor’s Guide to Everyday Leadership
For many junior doctors, the view on
leadership is seen as a distant concept
or formal, hierarchical title-something
reserved for department heads, hospital
directors or those professionals with
decades of experience. It is erroneously
perceived as a final destination (a
position you get) rather than a daily
practice (something you do). From the
moment they first lead a ward round,
manage an emergency scenario or guide
a medical student in a clinical task,
junior doctors are already in leadership
roles as frontline decision-makers. The
gap, therefore, is that traditional medical
education excels at teaching clinical
skills, but often fails to provide a
framework for the influence, vision, and
action required of these daily leadership
responsibilities. Junior doctors are often
thrust into these roles without the tools,
confidence or supportive definition of
what leadership at their level looks like.
The Medical Education Working
Group, a key component of the World
Medical Association (WMA)’s Junior
Doctors Network (JDN), has identified
this critical gap. They recognised that
junior doctors were struggling with a
definition of leadership that was
intimidating and inaccessible, causing
them to overlook the leadership
opportunities and responsibilities
that they already held. This observation
prompted the organisation of the
“Leading from the Frontline: A Junior
Doctor’s Guide to Everyday
Leadership” webinar in October
2025. This title has a two-fold
meaning: “Leading from the Frontline”
shifts the focus away from the executive
suite and onto the ward, and “Everyday
Leadership” reframes the idea of
leadership from a final destination to a
daily practice.
This webinar, moderated by Dr.
Merlinda Shazellenne (WMA JDN
Medical Education Director and
Medical Education Working Group
Chair), featured two global medicine
leaders: Dr. Jacqueline Kitulu (WMA
President) and Dr. Ashok Philip
(WMA Immediate Past President). The
discussion dismantled old hierarchies
and offered a new, accessible framework
for leadership. Their collective message
highlighted that leadership is about
influence, vision, and action, starting
in the hospital ward on day one. The
shared insights provided a practical
guide based on five key pillars:
redefining leadership, fostering effective
communication, engaging in advocacy,
building a legacy through mentorship,
and navigating resilience to prevent
burnout.
Redefining Leadership: Influence
Without a Title
As Dr. Kitulu shared her personal
journey to medicine, she emphasised
the simple “stumble” early in her career
as she wandered into a meeting of the
Kenyan Medical Women’s Association.
She recognised senior doctors who
had served as lecturers, and she
enthusiastically signed up to volunteer.
She recalled, “I just jumped into
volunteering as Assistant Treasurer. There
I am, a young doctor, unfamiliar with the
organisation, and now I will serve as the
Assistant Treasurer for a big organisation”.
This single act of volunteering – of
simply observing and filling this
organisational need – motivated her to
apply for and be elected as Chair of
the Association just three months later.
She encouraged junior doctors to be
proactive and find relevant leadership
opportunities to join, contribute
expertise, learn from colleagues, and
make a positive difference in the
community.
During his medical education, Dr.
Philip said that bullying was common,
and junior doctors were frequently
scolded or had physical clinical notes
tossed at them. His leadership moment
presented itself when he gained
seniority in the workplace. He said,
Leading from the Frontline:
A Junior Doctor’s Guide to Everyday Leadership
Merlinda Shazellenne Venkatesh Karthikeyan Marie-Claire Wangari
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“I realised that you can protect them by
standing between them and the bully”.
For Dr. Philip, his leadership began as
an act of passion for his patients and
fellowship with his colleagues.
To combat junior doctors’ fears
of leadership, Dr. Philip stated
unequivocally that as a doctor in
the ward, they are already a leader of
the healthcare team of interns, nurses,
physiotherapist, and other health
professionals. Likewise, Dr. Kitulu
advised junior doctors to reframe
leadership to making a change where
you are, and become “changemakers”
not “keyboard warriors” – a term she
uses for those in Kenya who complain
on X (formerly Twitter) but never
act. She encouraged junior doctors
to identify the challenge and develop
a novel solution, noting that “they
can just start somewhere where they can
make a change”. The fulfillment, she
argued, comes from the change and
impact, not the formal leadership title.
Effective Communication: The
Conductor’s Baton
If leadership is action, then effective
communication is the tool that makes
it possible. As the core function
of any doctor remains in leading
interprofessional teams with mutual
respect, communication skills, and
diplomacy, the concept of a team
should be visualised as a collaborative
ensemble rather than a pyramid
shape. Since “hierarchical leadership”
and “inter-cadre wars” are potential
challenges, Dr. Kitulu encouraged junior
doctors to view the health system as an
orchestra. “You cannot have an orchestra
of one instrument, as you need flutes,
clarinets, and violins. The health system
works in a similar manner, as you work
with many health professionals, such as
nurses, pharmacists, and nutritionists, who
complete their specific role to complete the
system”.
Echoing these sentiments, Dr.
Philip highlighted that collaborative
communication extends to training
and the need for engagement (not by
confrontation) when dealing with
other professionals (e.g. pharmacists).
He shared how he changed his
communication approach in teaching,
by shifting from a more direct or
confrontational style to a Socratic
method of asking questions, trusting
that junior doctors already knew
the answers. This technique enabled
confidence (rather than fear), which
ultimately improved team dynamics and
patient outcomes.
Advocacy: From Patient to Peer
Junior doctors are uniquely positioned
to advocate for their working
conditions and their patients. This
new framework for leadership –
acting as a changemaker and a
respectful collaborator – is the
foundation for advocacy to protect
patients, improve systems, and support
colleagues. Dr. Philip shared his
personal story of “standing between
them and the bully” when advocating
for safe working conditions and culture.
Similarly, Dr. Kitulu stressed that rather
than simply accepting a flawed system,
junior doctors are changemakers who
can identify the problem, develop
timely solutions, and create positive
change.
Mentorship and Legacy: The
Cross-Directional Path
Leadership is a journey of continuous
learning, making mentorship a critical
component in medical education and
training. Dr. Philip urged junior doctors
to not be intimidated by senior-level
leadership and the classic internship
mantra (“see one, do one, teach one”),
but instead focus on finding a mentor
and becoming a mentor. Expanding
upon this insight, Dr. Kitulu described
mentorship as a cross-directional
process, where senior-level leadership
can learn vital new skills from their
junior colleagues, ultimately breaking
down traditional hierarchies. She
underscored the core professional duty
of finding a mentor and serving as a
mentor, noting that legacies are built by
passing on knowledge, skill, and
confidence, not by individual
achievement.
Resilience and Burnout: The
Armor of Passion
In a demanding career, junior doctors
can be challenged to maintain the
passion to lead, advocate, and mentor
without succumbing to burnout. Dr.
Philip said firmly that passion is the
most critical layer of armor to protect
against burnout in the workplace.
He lamented the trend of students
being forced by their families to study
medicine, only to find that they cannot
manage the relentless demands of the
job. Complementary to passion, Dr.
Kitulu emphasised the importance of
“work-life integration” (not balance)
and established priorities. As a personal
example, during her tenure as president
of the Kenya Medical Association, her
frequent travel plans meant that she
would be accompanied by her husband
and sons. She illustrated how
professional and personal lives can
coexist, rather than compete, and
stressed that building personal resilience
through active self-care (e.g. walking
groups) can inspire our purpose to
make an impact in the world.
A Call to Action: Your Leadership
Starts Now
The webinar concluded with a
powerful, unified call to action.
Dr. Philip affirmed the value that
junior doctors bring to the workplace
by stating, “Stick with the junior
doctors, and you are already leaders”.
Similarly, Dr. Kitulu shared inspiring
words that encapsulated the webinar:
A Junior Doctor’s Guide to Everyday Leadership
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“You are not leaders of tomorrow; you
are leaders of today. It starts right
now. Step into those spaces, volunteer
in spaces that allow you to grow.
Find a mentor, and mentor someone.
Be the changemaker”. These personal
journeys underscore that true medical
leadership is a present action, daily
choice, and responsibility that belongs
to every doctor on the frontline.
Authors
Merlinda Shazellenne,
MBBS, OHD, FCMA
Past Medical Education Director and Chair
of Medical Education Working Group,
WMA Junior Doctors
Network (2023-2025)
Seremban, Malaysia
dr.merlinda@gmail.com
Venkatesh Karthikeyan, MD
Publications Director,
WMA Junior Doctors Network
Patna, India
4852012@gmail.com
Marie-Claire Wangari, MBChB
Independent Global Health Consultant
Past Chair,
WMA Junior Doctors Network
Nairobi, Kenya
mcwangari.wm@gmail.com
A Junior Doctor’s Guide to Everyday Leadership
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According to the World Health
Organization (WHO), an estimated
1.3 billion people (16% of global
population) have experienced living
with a significant disability [1]. The
global disability burden continues
to rise, especially with an ageing
population and increasing prevalence
of non-communicable diseases.
Disability is defined across three
dimensions: impairment (e.g. physical
or mental functional limitations),
activity limitation (e.g. reduced vision,
hearing or mobility), and participation
restrictions (e.g. challenges in work,
social, leisure, health services) [2]. It
can occur at any point in the lifespan,
and may result from a range of factors,
including genetics, in utero exposures
(e.g. infections), developmental
abnormalities, and injury.
Persons with disabilities frequently
face social and systemic barriers
across their communities and health
systems, suggesting that their
environment can directly influence
their lived experiences and extent of
disability [3]. Frequent barriers include
attitudinal (e.g. discrimination, stigma,
stereotyping), communication (e.g.
inability to understand verbal or written
messaging), physical (e.g. structural
impediments that block mobility),
policy (e.g. insufficient enforcement
of current laws and regulations,
lack of workplace accommodations),
programmatic (e.g. insufficient time
or scheduling), social (challenges in
seeking employment, completing
academic programs or experiencing
violence), and transportation (e.g.
limited access, inconvenient schedules
or distances) [3]. Specifically, this
hardship can be further exacerbated
by rising healthcare costs, limited or
lack of coordinated health services
(e.g. rehabilitation, assistive technology,
telemedicine), and inadequate training
of health professionals to manage
disability care [4]. Addressing these
barriers will require sustainable political
commitment to adopt disability-
inclusive policies and frameworks
that promote equitable access to
essential healthcare services and ensure
appropriate funding mechanisms and
community-based resources, helping
persons with disabilities achieve their
highest attainable standard of health
[4].
Notably, three landmark World Health
Assembly (WHA) frameworks, which
relate to health equity for persons with
disabilities, have been adopted and
incorporated into global health
systems. First, the Resolution
WHA 54.21 (International Classification
of Functioning, Disability and Health,
ICF) was approved in 2001, which
aligned international standards for
defining and measuring health and
disability [5]. Second, the Resolution
A/RES/61/106 (Convention on the
Rights of Persons with Disabilities),
adopted in 2006, mandates that
Member States safeguard equal
WMA Members Promote Disability-Inclusive Care
for Global Health Systems
Disability-Inclusive Care for Global Health Systems
Credit:
Drazen
Zigic
/
shutterstock.com
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access, quality, and standards of
healthcare services and protections
for persons living with disabilities
[6]. Third, Resolution WHA 74.8
(The highest attainable standard of
health for persons with disabilities)
in 2022, to guarantee that persons
with disabilities receive effective
health services, equal protection
during emergencies, and equal
access to health interventions [7].
Similarly, the WHO published
the WHO Global Disability Action
Plan 2014-2021 in 2014, setting a
comprehensive framework for national
policies and plans that remove structural
barriers and strengthen disability care
(including rehabilitation and assistive
tools) [8]. Next, the WHO Global
Report on Health Equity for
Persons with Disabilities was published in
2022, offering evidence-based findings
on the burden of disability, capturing
national examples of health inequities,
and providing recommendations to drive
national action [9]. This global report
led to the subsequent launch
of the WHO Health Equity for Persons
with Disabilities: Guide for Action
in 2024, as practical guidance for
ministries of health and stakeholders
to implement these evidence-based
findings across health systems and “leave
no one behind” [10]. Finally, the WHO
Disability Health Equity Initiative was
publicised in 2025, as an approach to
promote health equity for persons living
with disabilities based on four priorities:
1) building leadership with persons
with disabilities and stakeholders; 2)
prioritising disability-inclusive health
as a political priority; 3) developing a
disability-inclusive health sector; and
4) establishing key indicators, evidence,
and monitoring [11].
The International Day of Persons
with Disabilities, implemented by
the United Nations (UN) General
Assembly in 1992, is observed annually
on 3 December [12]. The “Fostering
disability-inclusive societies for advancing
social progress” theme aligns with
two recent global events – Global
Disability Summit 2025 in April
2025, and Second World Summit for
Social Development in November
2025 – where global leaders discussed
and confirmed their commitment to
promoting an inclusive and equitable
world. With one in six persons living
with a disability worldwide,
understanding the interconnectedness
of the UN Sustainable Development
Goals (SDGs) associated with
disability-inclusive care, services, and
quality of life – like SDG4 (quality
education), SDG8 (decent work and
economic growth), SDG10 (reduced
inequalities), and SDG11 (sustainable
cities and communities) – serves as a
call to action for all nations to assess
health system leadership and
governance, strengthen health
surveillance systems, support
timely research initiatives, and
implement novel initiatives that
meet the diverse needs and provide
social protection for all persons with
disabilities.
In this article, physicians from 15
countries – Canada, Ethiopia, Hong
Kong, India, Italy, Ivory Coast, Kenya,
Latvia, Malaysia, Myanmar, Philippines,
Portugal, South Africa, Tunisia, and
United Kingdom – described statistics
of the national disability burden, existing
challenges to support disability-inclusive
care, national policies that protect
dignity and health and employment
rights and health professions’ training
programs. They shared community-
based initiatives that support efforts to
promote inclusivity and reduce stigma
and discrimination related to persons
living with disabilities in their countries.
Canada
Canada’s population is aging, where an
estimated 27% of the adult population
in Canada is living with a disability,
and this number is expected to increase.
Currently, one in five Canadians
does not have access to a family
doctor, and people with disabilities
face larger barriers to care than the
general population, demonstrating a
monumental healthcare access problem
for Canadians living with disabilities.
Over the past decade, significant strides
have been made in Canada to improve
accessibility for people with disabilities,
including clear accessibility requirements
in building codes, workplace
accommodation legislation, and funding
support for accessibility aids.
However, an unrecognised policy
approach is the support for health
professionals who themselves have
disabilities. According to the 2021
Canadian Medical Association National
Physician Health Survey, data show
that 23% of Canadian physicians report
living with a disability, impairment
or long-term condition. As Canada
is currently experiencing a severe
physician shortage, ensuring that
physicians with disabilities can thrive
in the workplace has a two-fold benefit
for patients with disabilities. By creating
supportive workplace policies, physicians
with disabilities are able to increase
their contributions to the workforce
and directly have a positive
impact on the physician shortage.
Equally important, data show that
patients tend to have better outcomes
when the physician workforce better
represents the population it serves.
Programs, policies and initiatives
to advance disability inclusion in
medicine are growing in number
across Canada. The Ottawa Hospital
(TOH) implemented the first hospital
position statement on the inclusion
of physicians with disabilities in
2021, followed by the Department
of Medicine accessibility and
accommodations policy for
physicians with disabilities in 2022
[13,14]. Today, other healthcare
institutions are taking similar
steps, including Montreal’s Jewish
General Hospital position statement
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and the TOH Department of
Emergency Medicine accommodations
policy. Drawing from the TOH policy
lead, the Ontario Medical Association
implemented an educational resource,
which outlines legal protections for
physicians with disabilities and the
process for requesting workplace
accommodations [15].
Defined institutional standards,
leadership roles, and strategic planning
are growing to improve accessibility
in medical education and practice.
First, the Association of Faculties of
Medicine of Canada (AFMC) adopted
functional Core Competencies, a
significant step toward inclusion and
support for learners with disabilities
in Canadian medical education
and has created a “Physicians with
Disabilities” network to lead f
urther efforts in inclusion in medical
training [16]. Second, Toronto
Metropolitan University created
dedicated leadership positions with a
disability health lead and special advisor
to the dean, and McMaster University
opened the position of Postgraduate
Medical Education (PGME)
accessibility advisor with disability to
provide support and coaching. Finally,
national health leaders are implementing
further progress across Canada by
advancing accessibility within the
development of the Canadian National
Health Worker Well-Being Plan.
Improving disability inclusion in
medicine is important not only
to improve equity, but also to preserve
the medical workforce in a health
human resource crisis in Canada. All
medical organisations should find
opportunities to advance accessibility
within strategic planning, leadership,
initiatives, and resources for physicians
and learners across Canada [17].
Medical associations can play an
important role by advancing awareness
of and advocating for the protection
of physicians’ employment rights.
Likewise, hospitals can implement
accommodation policies informed
by best practices. Medical education
institutions can update their admissions,
accommodation, and accessibility
processes, while supporting informed
voices in leadership and practices for
learners with disabilities. The
movement to improve accessibility in
medicine in Canada is accelerating,
and organisations and institutions
should act now to position themselves
as leaders, rather than sitting on the
sidelines of progress.
Ethiopia
Ethiopia has the second-largest
population in Africa and carries
a high burden of disability.
According to a national survey
conducted in 2024, the number of
persons over 2 years of age living with
severe and some disabilities was 6
million (5.8% of the population) and
20.6 million (19.7% of the population)
individuals, respectively [18]. The most
common disabilities were mobility
difficulties for children 2 to 4 years of
age, anxiety and depression for children
5 to 17 years of age, and mobility,
visual and memory difficulties for
adults. The survey further indicated
that persons with disabilities in
Ethiopia experienced significantly
reduced access to basic services like
healthcare and education, as well as
limited employment opportunities and
restricted participation in society [18].
As steps to address this national
burden, Ethiopia ratified the UN
Convention on the Rights of
Persons with Disabilities in 2010
[6]. Ethiopia’s constitution, laws, and
policies also aim to guarantee equality,
non-discrimination, and reasonable
accommodation as well as education
and employment opportunities
for persons with disabilities. First,
Proclamation No. 568/2008 prohibits all
forms of discrimination in employment
based on disability, unless the nature
of the work dictates otherwise,
and requires employers to provide
appropriate working and training
conditions for the workforce [19].
Second, the Ministry of Labour
and Social Affairs launched the National
Plan of Action on Disability (2012–2021)
in 2012, which aimed at creating an
inclusive society through education,
health services and employment
opportunities [20].
The Ethiopian Medical Association
continues to advocate for promoting
inclusive medical care, education, and
research across the nation. As one
example, after learning about a medical
school that suspended two individuals
(medical student and resident) because
of their disability in April 2022,
members engaged with the university,
Ministry of Health, Ethiopian Human
Rights Commission, and Ethiopian
Federation of Associations of Persons
with Disabilities. Subsequently, the
Ethiopian Medical Association released
a statement calling for the reversal
of the decision and robust academic
support measures for both students
to succeed in their training programs
[21]. As the Association recommended
that healthcare professions be fully
inclusive of persons with disabilities,
the call to action was two-fold. First,
it established an ad hoc committee
as well as developed a concept note
outlining mechanisms for providing
reasonable accommodation for
persons with disabilities in healthcare
professions, while ensuring standards
for safe and effective practice. Second,
it reaffirmed its readiness to work with
medical schools, Ministry of Education,
and Ministry of Health to update
admission criteria for medical and
residency training programs and create
a disability-inclusive healthcare system.
As we observe the International Day of
Persons with Disabilities, the Ethiopian
Medical Association reaffirms its
readiness to foster disability-inclusive
society.
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Hong Kong
As a result of rapid socioeconomic
development and medical innovation,
Hong Kong now leads the world in
life expectancy at birth. Nonetheless,
an increased life expectancy does not
necessarily correspond to a healthier
society, and the WHO and public
health experts are increasingly
emphasising health expectancy. Since
2000, disability has emerged as a
significant public health challenge in
Hong Kong, where the Hong Kong
government’s Census and Statistics
Department has regularly conducted
thematic surveys on the disability
burden. The latest report revealed a
7.1% overall disability prevalence in
2020, as well as an increased proportion
of individuals with physical disabilities
(38.4% in 2013 to 55.3% in 2020),
primarily attributed to the ageing
population [22]. Public health
researchers from the Chinese University
of Hong Kong published findings that
demonstrated that the disability-free life
expectancy at 65 years of age increased
more slowly by 1.8 years (from 14.6
to 16.3) in men and by 0.1 year (from
16.4 to 16.5) in women between 2007
and 2020, when compared with the
increase of life expectancy by 3.7 years
(from 18.3 to 22.0) in men and by 2.1
years (from 22.7 to 24.8) in women,
highlighting an expansion of disability
burden among the elderly with male-
female health-survival paradox [23].
Comprehensive policy approaches
to promoting healthy ageing for all
and addressing underlying social
determinants of health with an equity
focus are urgently needed to address
the substantial caregiving demand and
significant cost on health and social
care costs for the future secondary to
the rapidly ageing population with
rising dependency ratio [23].
Over the past two decades, the Hong
Kong government and the organisations
under the Joint Council for People with
Disabilities (https://www.jointcouncil.
org.hk/en/) have made tremendous
efforts to promote the rights and
freedoms of persons with disabilities.
At the government level, recognising
the increasing number of elderly
persons with disabilities and risk of
caregiver stress or burnout, it recently
unveiled relevant strategies in its 2025
Policy Address. The primary initiatives
include increasing the provision of
day rehabilitation training for elderly
persons with disabilities to alleviate
caregiver burden, launching the cross-
departmental Carer Support Data
Platform to enable timely recognition
and support for high-risk caregivers
(e.g. when caregivers are admitted for
hospital care), and installing intelligent
accident-detection systems for high-
risk households [24]. At the community
level, increased awareness of the
extended needs of ageing persons with
disabilities has led to the launch of the
five-year Jockey Club End-of-Life
Community Care Project’s “Unison
Project,” inaugurated in June 2025, to
provide personalised palliative and end-
of-life care specifically for persons with
disabilities and caregiver support [25].
Driven by the “Safeguarding the Health
of the People” mission statement,
the Hong Kong Medical Association
(HKMA) launched the Community
Service Committee (CSC) in 2014,
and has established various Community
Elderly Health Management
Programmes since 2016. Currently, the
CSC is running several community
projects to support the elderly
and caregivers in districts with
the highest proportion of residents over
65 years of age, namely Siu Sai Wan,
Chai Wan, and Kwai Chung districts.
With over 5,000 service hours per
year, our Volunteer Outreach Team for
the Elderly received the “Outstanding
Volunteer Group” award at the Hong
Kong Volunteer Award 2023. Recently,
a new “Boardgame Training for Elderly
with Dementia,” curated by physicians
and experienced community volunteers
as a 2023 pilot programme and 2024
in-home training programme,
demonstrated significant improvement
in participants’ performance in overall
contribution, emotion, and
communication. The programme
now collaborates with several elderly
community centres (as non-government
organisations) in providing “Training
for Carers” and “Train the Trainer”
programmes, and the HKMA is
developing “Boardgame Training
Tools” to ensure future successful
implementation with community
providers [26]. In observance of
the International Day of Persons
with Disabilities, the HKMA urges
communities and governments around
the world to collaborate with physicians
in delivering evidence-based innovative
solutions to address the numerous
challenges faced by persons with
disabilities in today’s advancing society.
India
Persons with disabilities represent
a significant health and social priority
in India, with profound implications for
physicians and the healthcare system.
According to recent epidemiological
data, almost 1% of the Indian
population lives with a disability, and
5.1% of households include at least one
person with a disability, a proportion
that represents a numerically substantial
and vulnerable group in a country
of 1.4 billion [27]. Over the past two
decades, the burden of disability has
intensified with India’s demographic
transition, including reported locomotor
(44.7%) and mental disabilities (20.1%),
which place considerable demands
on the healthcare workforce [27].
Furthermore, the economic burden is
staggering, where estimates show that
India loses Rs. 4.5 lakh crore (equivalent
of US $54.88 billion) annually due to
the exclusion of persons with disabilities
from productive participation in society
[28]. For Indian physicians, this reality
underscores the need to move beyond
fragmented care approaches toward
integrated, equitable, and inclusive
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healthcare delivery that recognises
disability not merely as a medical
challenge, but rather as a fundamental
human rights imperative.​
India has established a robust legislative
and programmatic framework to
advance disability inclusion and
healthcare access. First, the Rights of
Persons with Disabilities Act of 2016,
enacted to give effect to the UN
Convention on the Rights of Persons
with Disabilities, guarantees equal
rights, non-discrimination, protection
from abuse, accessibility, and full
participation in community life
[29]. Second, several transformative
initiatives demonstrate physicians’
and government commitment to
disability-inclusive healthcare. The
Accessible India Campaign (Sugamya
Bharat Abhiyan), launched in 2015,
aims to ensure universal accessibility
across built infrastructure, transport
systems and the information and
communication technology ecosystem
[30]. The Niramaya Health Insurance
Scheme (https://nationaltrust.nic.
in/niramaya/), adopted in 2008,
provides affordable coverage up to Rs.
1 lakh (equivalent of US $1,129) for
individuals with disability, with no
pre-insurance medical examination
requirements. These multisectoral
initiatives – spanning legislative
protections, infrastructure accessibility,
and financial protection mechanisms
– collectively demonstrate India’s
commitment to creating an inclusive
healthcare ecosystem where persons
with disabilities can access equitable and
dignified care. Beyond these flagship
programs, other policies addressing
workplace accommodation and assistive
technology provision further reinforce
this commitment, positioning disability-
inclusive healthcare as a cornerstone of
India’s broader public health agenda.
As physicians and healthcare leaders
in India, our collective call to action
must transcend conventional medical
management to embrace disability as an
equity and social justice imperative.
Firstly, they must strengthen disability
care related competencies through
continued professional education.
Health professions educators bear the
responsibility for cultivating inclusivity
by supporting persons with disabilities
in entering and progressing through
medical training. Secondly, they must
engage persons with disabilities as
partners (versus passive recipients) in
health program design, implementation,
and evaluation. Finally, they must
ensure that disability screening, early
intervention, and rehabilitation services
are integrated into routine healthcare
delivery. India’s vision of inclusive
development and sustainable health for
all (Sabka Saath, Sabka Vikas) cannot
be realised without physicians stepping
forward as advocates in fighting
barriers and ensuring that persons with
disabilities receive dignified, equitable,
and quality healthcare.
Italy
The International Day of Persons with
Disabilities, celebrated on 3 December,
represents a symbolically significant
occasion and practical opportunity for
Italian health professionals. This day
calls upon physicians and institutions
to promote inclusive policies, continuity
of care, and healthcare pathways
that remove the physical, cultural,
and social barriers that hinder the
full participation of persons with
disabilities in society. According
to PASSI d’Argento, the National
Health Institute’s (Istituto Superiore di
Sanità) surveillance system focusing on
the elder population, three of 10 Italian
adults over 65 years of age have partially
or completely lost their autonomy,
where 14% live with disabilities, and
16% are classified as frail [31]. After 85
years of age, these proportions rise to
40% and 30%, respectively. With care
responsibilities falling almost entirely on
families (providing 95% of the support),
while only a minority receive public
assistance, this burden on the National
Health Service (Servizio Sanitario
Nazionale, SSN) and family caregivers
highlights the need for integrated social
and healthcare models and continuous
rehabilitative pathways. Economic and
territorial inequalities remain profound,
where disability risk is tripled
by poverty and quadrupled by low
educational attainment, and the
proportion of older adults living with
disabilities in southern Italy is markedly
higher than in northern Italy.
Against this backdrop, Italy has
strengthened its legislative framework
by updating Law 104/1992 through
structural reforms. First, the Legislative
Decree No. 62 of 2024 introduced a
basic disability evaluation system,
managed by the National Social
Security Institute (INPS) and the
Individual Life Project (pilot initiative
across nine provinces during 2025)
[32,33]. Supportive measures have
included the establishment of a
National Supervisory Authority,
the updating of Essential Levels of
Care (Livelli Essenziali di Assistenza,
LEA) and prosthetic nomenclature, and
the launch of the Disability Portal that
consolidates diagnostic recognition and
administrative procedures. Furthermore,
several public and Third Sector
initiatives contribute substantially to the
provision of support services for persons
with disabilities. In Sicily, Sportello D-
established by the National Agency for
the Protection of Disabilities (Agenzia
Nazionale per la Protezione delle
Disabilità, APS) – operates the country’s
only national telephone helpline
dedicated to individuals with disabilities
and their families, offering timely
guidance and assistance in navigating
available resources. Likewise, Lega
del Filo d’Oro, one of Italy’s longest-
standing non-profit organisations, has
for more than six decades played a
pivotal role through its regional centres
in supporting individuals who are deaf,
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blind or affected by multiple sensory
impairments, ensuring continuity
of care and specialised rehabilitative
services.
These initiatives are accompanied
by a growing demand for health
professionals’ training based on the
bio-psycho-social model, reasonable
accommodation, and integration of
social and healthcare pathways. In
2024, as the Integrated Home Care
(Assistenza Domiciliare Integrata,
ADI) services reported that Italian
adults living with disabilities represent
239,000 of 625,000 total households
served, the Alliance against Poverty
report (https://alleanzacontrolapoverta.
it/) noted that information campaigns
and services remain fragmented [34].
Hence, strengthening continuous
care pathways will be imperative,
and physicians can lead efforts
with multidisciplinary teams, social
services, and non-governmental
organisations and serve as facilitators
of the Individual Life Project. Ensuring
equitable access to services (especially
in southern regions in Italy) and
investing in education and training are
vital so that health professionals
can advocate for disability rights and
inclusion. Protecting persons with
disabilities means not only providing
care, but also fostering participation,
upholding dignity, and enabling
joint health decisions. These robust
efforts will transform 3 December
from a formal commemoration day
into a call for collective responsibility
for all communities.
Ivory Coast
For doctors in Ivory Coast, the
International Day of Persons with
Disabilities is not only a symbol of
solidarity, but also a call for professional
and civic responsibility. According to
the National Institute of Statistics
(L’Institut National de la Statistique,
INS), the National Survey on the
Situation of Persons with Disabilities
2021 reported that approximately
600,000 Ivorians (2.4% of the
population) live with a disability,
and the most common disabilities
are physical and hearing (deaf-mute)
impairments [35]. Today, national
disparities are driven by health system
challenges (e.g. weak infrastructure,
limited rehabilitation equipment,
insufficient health professionals’ training
in the specific care of people with
disabilities), social stigma, and limited
access to employment and educational
opportunities. The International Labour
Organization reported that only 2%
of people with disabilities have formal
employment in Ivory Coast, compared
to the 20% national average, in 2025
[36]. This reality challenges the medical
community to find opportunities to
strengthen public awareness, promote
clinical compassion, and defend the
right to health for all.
Over the past three decades, the Ivory
Coast has undertaken several concrete
actions to improve the situation of
persons with disabilities. First, Law No.
98-594 (10 November 1998) constitutes
the foundational legal framework
for the protection of civic, social,
and economic rights of persons with
disabilities [37]. Second, the Ministry
of Women, Family, and Children
and the Ministry of Health, Public
Hygiene launched the National Action
Plan 2021–2025 for the promotion and
protection of the rights of persons with
disabilities [38]. Third, the national
community-based rehabilitation
programs, supported by the WHO,
focuses on community participation,
socioeconomic reintegration of persons
with disabilities through primary
health centres, and health professionals’
training in disability care [39]. Fourth,
the Ministry of Employment and
Social Protection regularly conducts
national campaigns (via media and
digital platforms) to share information
about community programs, reserved
employment quotas, and workplace
adjustments. Leaders adopted the
Vocational Guidance and Rehabilitation
Commissions (through two decrees) in
2021, aimed at promoting the social
inclusion of people with disabilities in
public and private sectors.
The international campaign offers
a call for inclusion and equity for
persons with disabilities, where health
professionals can further humanise
medical practice, strengthen the
patient-provider relationship, and
integrate the universal values ​​
of
respect, dignity, and social justice into
every act of care. Specifically, Ivorian
doctors affirm their commitment to
working towards inclusive medicine,
by supporting health professionals’
training on disability care (e.g.
physical, sensory, and cognitive
needs of patients) and empathetic
communication. They can advocate
for strengthened disability governance
within public health policies, improved
intersectoral coordination, and increased
participation of people with disabilities
in decision-making processes that affect
them. Professional associations, like
the Federation of Associations of
People with Disabilities of Ivory Coast
(FAHCI), continue to play a crucial
role in advocating for accessibility,
education, and economic empowerment
of persons with disabilities.
International medical solidarity through
shared practices, research, and advocacy
will energise a regional and global
dynamic that collectively accelerates
progress toward a more inclusive world.
Kenya
According to the Kenya Government’s
2019 Population and Housing Census,
the number of persons living with a
disability was 0.9 million (2.2%
of the population), with significant
geographic disparities between rural
(0.7 million people) and urban (0.2
million people) [40]. The most
common disability affected mobility
(42% of persons with disabilities),
followed by visual (36.4%), cognitive
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(23.2%), hearing (16.7%), self-
care (15.3%), and communication
(12.1%). Recent national analyses have
identified several recurrent gaps, such
as limited availability and geographic
coverage of rehabilitation and assistive-
technology services, deficiencies in
routine surveillances systems to capture
disability data, and shortage of health
professionals trained in disability-
inclusive clinical care and rehabilitation
[41]. These gaps are compounded by
the variable implementation of national
policies at the county level as well as
social (e.g. stigma, affordability)
and physical (e.g. transportation)
barriers to care.
In Kenya, several key initiatives
have provided evidence-based
frameworks for policy reform, service
integration, and societal inclusion
of persons living with disability. To
support these advocacy efforts, the
National Council of Persons with
Disabilities (NCPWD) (https://
ncpwd.go.ke/) has served as a key
voice for ensuring that existing
policy is translated into consistent,
county-level service delivery. First, the
NCPWD Strategic Plan 2023–2027
provides the NCPWD’s direction
in promoting disability inclusion
through research, socio-economic
empowerment, and institutional capacity
and coordination [42]. Second, the
Disability Landscape in Kenya report,
based on findings from a NCPWD
study that was published in 2024,
highlighted insight on policies,
programmes, and emerging challenges
that affect persons with disabilities at
national and county levels in Kenya
[43]. Third, the NCPWD Status
Report on Disability Inclusion report,
published 2024, provided a detailed
account of Kenya’s achievements
in disability inclusion in the public
sector after the implementation of the
Disability Mainstreaming Performance
Indicator in 2022-2023 [41].
Legislative and policy efforts, alongside
community-based rehabilitation
programmes and disability
mainstreaming guidelines, continue
to strengthen the national response.
Notably, the Kenya National Assembly
passed the Persons with Disabilities
Act 2025 in 2025, which aimed to
reorganise the NCPWD’s functional
mandate and leadership structure for
protecting, promoting, and monitoring
the rights of persons with disabilities,
including incentives and reliefs [44].
Also, this policy strengthened Article
54 of the Kenyan Constitution, which
guarantees the rights of people with
disabilities, including the right to
be treated with dignity, access to
education and public places, and the
use of appropriate communication
methods [45]. Notably, these national
policy reforms have been spearheaded
by Senator Crystal Asige, a visually
impaired leader who lost her sight to
glaucoma during childhood [46].
The Kenya Medical Association
reaffirms its role in ensuring that
persons with disabilities are both
recipients of care and empowered
partners in shaping a health system
that truly leaves no one behind.
Clinicians encounter disability across
every specialty – congenital, acquired,
physical, sensory, intellectual, and
psychosocial – and health professionals
must reaffirm their clinical responsibility
for the early identification, reasonable
accommodation in clinical settings,
multidisciplinary rehabilitation, assistive-
technology prescription, and advocacy
for patients’ rights to education, work,
and social participation. For doctors in
Kenya, the International Day of Persons
with Disabilities is a critical reminder
that healthcare must be inclusive,
equitable and responsive to the needs
of persons living with disabilities. The
day underscores that health systems
must integrate disability into public-
health programming, primary care and
emergency planning so that people with
disabilities are not left behind.
Latvia
Commemorated on 3 December, the
International Day of Persons with
Disabilities is an important reminder
for Latvian physicians that the global
burden of disability is a significant
concern for our patients and their
families. According to 2023 Eurostat
data from the European Union (EU)’s
Statistics on Income and Living
Conditions survey, Latvia has the
highest self-reported level of disability
in the EU, where an estimated
40.7% of people older than 16 years
of age self-reported moderate or severe
long-term limitations in performing
their usual activities due to health
problems, compared with an EU
average of 26.8% [47]. According
to the Latvia Ministry of Welfare
and the Central Statistical Bureau,
approximately 213,500 people (11.3%
of the population) had a diagnosed
disability in 2023, and 9,700 children
(28 per 1,000 children) were diagnosed
with disabilities in 2024. Specifically,
114,675 adults (18-64 years) had a
diagnosed disability in 2024, with
functional limitations categorised as
very severe (9,620 people), severe
(45,197 people), and moderate
(59,858 people). Taken together, these
self-reported and administrative
data underline both the scale of
disability in Latvia and the importance
for physicians to understand disability
as a spectrum of lived experience,
from self-perceived limitations to
formally assessed long-term functional
impairments.
Latvia’s progress in disability rights
and healthcare is anchored in a
comprehensive legal framework and
recent social policy reforms. The
Disability Law defines disability as
a long-term or non-transitional very
severe, severe or moderate level of
functional limitation that affects
a person’s mental or physical
abilities, ability to work, self-care
and integration into society, in line with
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the UN Convention on the Rights of
Persons with Disabilities [48]. Under the
Health Care Financing Law and related
regulations, persons with disabilities
are exempt from patient co-payments,
are entitled to social, psychosocial, and
vocational rehabilitation, and provided
an individual rehabilitation plan and
priority access to state-funded healthcare
services [48]. These provisions shape
physicians’ daily practice, encouraging
early identification of foreseeable
disability, multidisciplinary rehabilitation
planning, and closer cooperation with
social services. In parallel, the Social
Protection and Labour Market Policy
Guidelines 2021–2027 and the Social
Services Improvement and Development
Plan 2022–2024 set out a vision for
a modern, accessible social services
system that prioritises deinstitutionali­
sation, independent living, and
community participation for people
with disabilities [49]. Amendments to
the Law on Social Services and Social
Assistance adopted in December 2024,
introduce a mandatory minimum
package of municipal services starting
in 2025 (e.g. home care for people with
severe functional impairments, crisis
centres, group homes for people with
mental health conditions, social care
centres for people and children with
severe functional disorders, shelters)
and between 2026 and 2028 (e.g. day
care, respite services, and specialised
workshops) [50].
As a complement to these structural
reforms, the Latvia Ministry of
Welfare has launched national
awareness initiatives, such as the
“Step into Another’s Shoes” campaign
and the annual “Mismatched Shoes
Day” (https://cilveksnevisdiagnoze.lv/
en/mismatched-shoes-day/). These
events invite schools, workplaces, and
communities to wear mismatched
shoes annually on 26 September, as an
opportunity to coordinate public events,
share stories on social media, and
promote empathy and inclusive
attitudes towards people with functional
impairments and mental health
disorders [4]. These measures create
a more supportive environment for
physicians to discuss disability openly,
reduce stigma, and connect patients
with available community-based
services.
For Latvian physicians, the call to
action on the International Day of
Persons with Disabilities is to make
disability inclusion an integral part
of everyday practice, education, and
advocacy. As systematic clinical
evaluations detect functional difficulties,
health professionals can advocate
for disability as an interaction between
health conditions and environmental
barriers, and adapt personalised
care pathways with reasonable
accommodation. These efforts can
include ensuring barrier-free access to
facilities and diagnostic equipment,
flexible appointment scheduling,
accessible information (e.g. easy-
to-read materials, sign language
interpretation, augmentative and
alternative communication), and home
visits or telemedicine consultations.
Closer cooperation with municipal
social services, personal assistants,
rehabilitation teams, and long-term
care providers will be essential to
align treatment plans with available
community-based support and caregiver
needs. Medical education should
incorporate didactic and practical
content on disability rights and
communication skills, by inviting people
with disabilities and professors who
have directly worked with communities
with disabilities to serve as partners
in training and research. Through
the Latvian Medical Association and
other professional bodies, physicians
can advocate nationally, regionally,
and internationally for adequate
financing of accessible health services,
data systems that capture disability
respectfully, and full implementation
of the UN Convention on the Rights
of Persons with Disabilities across
all sectors. By doing so, we help ensure
that in Latvia and beyond, no one is
left behind in the health system.
Malaysia
In Malaysia, the International
Day of Persons with Disabilities
reminds health professionals that
inclusion must be central to how we
deliver healthcare services. According
to the Malaysia Department of Social
Welfare (Jabatan Kebajikan Masyarakat,
JKM), the Persons with Disabilities
(OKU) registry reported an increased
number of persons with disabilities
from 637,537 individuals in January
2023 to 767,243 individuals in March
2025 [51]. However, community-
level surveys suggest that over 11% of
adults may be living with functional
limitations, as a clear indication of
underrepresentation in official records
[51]. As the burden of disability
increases with age, nearly 1.7 million
older Malaysians (over 65 years of
age) are expected to require disability-
related support, with women
comprising the majority, by 2040 [51].
Despite progress, challenges remain
in ensuring access to quality care,
rehabilitation, education, and
employment across all settings.
Over the past two decades, Malaysia
health leaders have continued to
advocate for and strengthen its
disability care ecosystem. First, the
Government adopted the Persons with
Disabilities Act 2008 (Act 685),
which established the National Council
for Persons with Disabilities, providing
a legal foundation for health and social
protection and rights of persons with
disabilities [52]. Second, the Ministry
of Health has collaborated with
public and private sectors to expand
Community-Based Rehabilitation
programs, now operating in over 550
locations nationwide. For example,
national campaigns on vision screenings
(including screening for diabetic
retinopathy) and cataract surgeries
have led to a decline – from 1.5% in
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2014 to 0.7% in 2023 – in preventable
blindness among older adults [53].
Third, the Social Security Organisation
(SOCSO) runs an exemplary Return to
Work (RTW) programme, supporting
thousands annually by integrating
medical, vocational, and psychosocial
rehabilitation services [54]. Furthermore,
private sector organisations have
stepped up, including FWD Takaful
offering insurance products tailored for
persons with disabilities, and Malaysia
Airports’ Butterfly Effect initiative
supporting inclusive environments for
neurodivergent travellers (e.g. autism).
As physicians, we play a critical role in
dismantling systemic and social barriers
and creating supportive environments
across communities and workplaces.
We must champion disability-inclusive
education and training, integrate
services within primary care, and
leverage technologies that ensure no
one is left behind. The Malaysian
Medical Association is strengthening
disability-inclusive healthcare by
initiating continued medical education
modules on disability care, engaging
in policy advocacy under its National
Health Policy Committee, and
supporting rehabilitation and
reintegration efforts in alignment with
SOCSO’s Return to Work Programme.
Myanmar
The International Day of Persons with
Disabilities has special significance for
Myanmar physicians, particularly those
working on the frontlines, observing
the increased burden of disability
during the military coup. According
to the Myanmar’s Ministry of
Labour, Immigration and Population’s
2019 Inter-censal Survey of the Union
Report, an estimated six million persons
over 5 years of age (12.8% national
prevalence) reported living with a
disability [55]. Although prevalence
rates were similar across residence
types (12.4% among 13.5 million urban
residents and 13.1% among 32.8 million
rural residents), geographic disparities
remain with higher prevalence rates in
Chin (20.6%), Rakhine and Ayeyawady
(17.3%), and Magway (17.0%), when
compared to lower prevalence in Shan
(8.6%) [55]. Also, the International
Campaign to Ban Landmines
announced that Myanmar had the
highest number of casualties from
landmines and explosive ordinances
in 2024, resulting in thousands with
severe injuries (including amputations
and long-term impairments) [56].
This national crisis has revealed
major shortcomings in disability
data, healthcare coverage (including
rehabilitation services and social and
community support), challenges that
are likely to worsen amid the ongoing
military coup, increasing landmine
casualties, and rising healthcare needs
from non-communicable diseases like
diabetes and cardiovascular conditions.
Under the leadership of State
Counsellor Daw Aung San Suu
Kyi, the democratically elected civilian
government actively pursued reforms
to support disability care and inclusion
[57,58]. First, the National League for
Democracy (NLD) government and
stakeholders established the Myanmar
Federation of Persons with Disabilities
(MFPD) in March 2016, which
provided employment and vocational
training for individuals with disabilities.
Second, the Government of Myanmar
adopted the 2015 Law Protecting the
Rights of People with Disabilities in
2017, following its ratification of the
UN Convention on the Rights of
Persons with Disabilities in 2011
[57,58]. This law was complemented
by the launch of the Employing Persons
with Disabilities Handbook in 2018,
and adoption of a national disability
policy in 2019, guaranteeing access
to healthcare, education, employment,
social welfare, and emergency support
for all people with disabilities by
December 2023 [57,59]. Furthermore,
the NLD government actively
participated in the Association of
Southeast Asian Nations (ASEAN)
Enabling Masterplan 2025, which
demonstrated regional commitment to
disability-inclusive development [59].
However, the latest military takeover
has severely disrupted the NLD
government’s progress on these policies
and initiatives. The military operations
have resulted in increased sexual
harassment and assault on women and
children with disabilities, abandonment
of mobility devices and prosthetics
(to avoid air strikes), and restricted
access to critical medical treatment and
prosthetic care (to avoid landmines)
[60,61]. Amnesty International has
documented cases where individuals
with psychosocial and intellectual
impairments are subjected to arbitrary
detention and torture, due to perceived
noncompliance with soldiers’ orders
[61]. These operations directly violate
Article 11 of the Convention on the
Rights of Persons with Disabilities and
the UN Security Council Resolution No.
2475.
Physicians in Myanmar and worldwide
are responsible for raising awareness,
educating the public and decision-
makers alike, and collaborating with
disability groups to improve access to
community-based services and ensure
the rights and dignity for persons living
with disabilities. Myanmar health l
eaders should prioritise funding
local organisations with the expertise
and trust to support medical
treatment, rehabilitation, prosthetics,
and psychosocial services for persons
living with disabilities in the nation.
International organisations, such
as the UN, World Medical Association
(WMA), and Junior Doctors Network
(JDN), can advocate for health
professionals’ training in disability
medicine, mental health, and trauma
rehabilitation, especially in conflict-
affected areas like Myanmar. As they
help restore and improve community-
based services and inclusive education,
they can advocate for greater solidarity
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sustainable action to guarantee that
persons with disabilities are not left
behind.
Philippines
The International Day of Persons with
Disabilities (IDPD), observed annually
on 3 December, resonates deeply in the
Philippines, a country with a strong
cultural emphasis on family and
community support. For the Filipino
medical community, the day is a
potent reminder of the social model
of disability—shifting focus from
individual impairment to the societal
barriers that hinder full participation. It
underscores our ethical and professional
responsibility to dismantle these barriers
within the healthcare system and
beyond. It represents a call for active
engagement in advocacy, policy-making,
and the provision of truly accessible and
inclusive health services, moving beyond
mere curative care to comprehensive
rehabilitation and social integration.
Philippine health leaders have observed
a vast underreporting in official registry
systems, where this disparity points to a
major gap: the invisibility of persons
with disabilities and their exclusion
from essential government benefits
and services. First, the 2016 National
Disability Prevalence Survey found
12% of respondents older than 15
years of age reported severe disability,
whereas the Philippine Statistics
Authority (PSA) concluded that 4.1%
and 22.9% of individuals older than 15
years of age and over 65 years of age,
respectively, reported living with any
functional difficulty [62,63]. Second,
a critical gap in care is the lack of
accessible and affordable rehabilitation
services, as only a small percentage
of health facilities nationwide have
complete rehabilitation services
(physical therapy, occupational therapy,
speech therapy), with the majority
as private ownership and costly [64].
Furthermore, persons with disabilities
face significantly higher rates of
multidimensional poverty compared to
those without disabilities, highlighting
a socio-economic gap that directly
impacts health outcomes and access to
care [62,63].
Over the years, the Philippines
has enacted several landmark
laws advancing disability rights
and inclusion. The Magna Carta
for Persons with Disabilities (Republic
Act No. 7277, as amended) serves as
the cornerstone of this framework,
mandating State support in health,
education, and employment, granting
persons with disabilities a 20%
discount on key goods and services,
VAT exemption, and requiring at
least 1% of positions in public and
private institutions to be reserved for
persons with disabilities [65,66]. The
Universal Health Care Act (Republic Act
No. 11223) and Republic Act No. 10754
expanded these protections by ensuring
mandatory PhilHealth coverage for
all persons with disabilities and directing
the Department of Health to develop
specialised benefit packages, such as the
Z-benefit program for children with
disabilities [64,66,67]. Complementing
these efforts, the Inclusive Education Act
(Republic Act No. 11650) institutionalises
inclusive learning through Inclusive
Learning Resource Centres in every
district and mandates individualised
education plans and workforce training
to support learners with disabilities
[68]. At the local level, Republic Act
No. 10070 requires the establishment of
Persons with Disability Affairs Offices
(PDAOs) in all provinces, cities, and
municipalities to coordinate programs
and services. Collectively, these policies
reflect the Philippines’ continuing
commitment to disability-inclusive
governance, equitable healthcare, and
accessible education.
Our call to action for Filipino physicians
is a commitment to disability-
competent care and transformative
advocacy. In practice, we must dismantle
physical barriers and negative attitudes
to ensure fully accessible diagnostic and
therapeutic environments, including
effective communication (e.g. Filipino
Sign Language interpreters), while
simultaneously advocating for the
expansion of affordable, decentralised
community-based rehabilitation to
bridge the rural-urban service gap.
Professionally, medical and allied health
institutions must integrate rights-based
disability studies into core curricula and
continuing medical education, with
training on screening tools, legal
mandates (like the 20% discount and
VAT exemption for persons with
disabilities), and invisible disabilities.
Finally, as policy advocates, we must
leverage our influence to ensure the full
implementation and funding of existing
laws (like PhilHealth’s Z-benefit
packages and operationalisation of
local PDAOs) to accurately capture the
needs of persons with disabilities and
ensure their inclusion in the promise of
universal healthcare.
Portugal
The International Day of Persons
with Disabilities allows us to hold up
a mirror to medicine with an essential
question: who is left out when we
design, fund, and deliver healthcare
services? Disability cannot be treated
as an external social issue, as it is a
determinant of risk, outcomes, and care
experience, with clear implications for
triage, diagnosis, therapy, rehabilitation,
health literacy, and governance. In
Portugal, the 2021 Census identified an
estimated 1.1 million persons (10.9% of
the population) living with at least one
significant limitation in the activities
of daily living, where 65.6% of persons
with disabilities are 65 or older, with
a higher prevalence of multimorbidity,
frailty, polypharmacy, and functional
risk [69]. Persons with disabilities face
daily challenges, including buildings
and equipment that lack universal
accessibility, rehabilitation programs
(onset and maintenance) that are
insufficient for complex needs, and
Disability-Inclusive Care for Global Health Systems
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communication modalities without
plain language or alternative formats
(e.g. sign language interpreter).
Since digital systems often do not
comply with accessibility standards,
rehabilitation goals, needs, metric
assessment, and outcomes evaluation,
physicians can lead clinical and
advocacy efforts in each consultation,
discharge, and reassessment.
In recent years, Portugal adopted the
Resolution of the Council of Ministers No.
119/2021, which launched the National
Strategy for the Inclusion of Persons
with Disabilities 2021–2025 (Estratégia
Nacional para a Inclusão das Pessoas
com Deficiência, ENIPD 2021–2025)
in 2021 [70]. The guiding themes
(e.g. education, employment, culture
and sport) translate into operational
requirements for hospitals and primary
care and outpatient community
care, focusing on patient safety (e.g.
architectural and communication
accessibility), care quality (e.g. easy-
to-read materials, informed consent).
These integrated pathways that link
rehabilitation, long-term care, and social
protection are essential elements
of continuity of inclusive disability
care. Second, the Independent Living
Support Model (Modelo de Apoio à
Vida Independente, MAVI), organised
through Independent Living Support
Centres (CAVI), shifts the axis of care
towards autonomy and participation,
where persons with disabilities can
live in the community with daily
support for mobility, self-care, study,
work, and civic involvement [71].
Treatment plans include functional goals
(e.g. walking, communicating, self-care,
work), resulting in optimal rehabilitation
outcomes and reduced hospitalisations.
Third, awareness campaigns have
expanded to combat stigma and
improve literacy in rights and health.
Continuing education programmes for
health professionals emphasise inclusive
communication, functional assessment,
adapted screenings (e.g. mammography,
colonoscopy, oral health), and
prevention of adverse events linked
to inaccessibility. Telehealth tools and
patient portals can extend service
coverage and meet accessibility
requirements, such as adequate contrast,
screen reader compatibility, keyboard
navigation and captioning.
The International Day of Persons with
Disabilities reminds us that equity is a
clinical method, organisational design,
and daily decision-making process,
and health systems must leave no
one behind in access, quality, and
health outcomes. Disability should be
considered a determinant of health,
where clinical practice is connected
with community resources and policy,
reasonable accommodation, and
health professionals who are trained
to offer disability inclusive care. In
Portugal, the combination of public
strategy, operational instruments
(like MAVI and CAVI), awareness
campaigns, and professional training
serve as robust actions to ensure fair
practice. Each physician, service, and
health system should ask what needs
to change tomorrow so that persons
with a disability receive safe, effective,
and respectful care that is shaped
by scientific knowledge and clinical
humility.
South Africa
The International Day of Persons
with Disabilities serves as a reminder
to healthcare practitioners to advance
dignity, equity, and meaningful
participation for more than 3.3 million
South Africans living with disabilities
[72]. Recent national data illustrate that
South Africans have reported broad
disability (any degree of difficulty in at
least one functional domain) (15.7%)
and severe functional limitations
(3.4%), which disproportionately affects
women and older adults, reflecting
both biological vulnerability and social
determinants [72]. Since these
statistics do not include people living
in institutions, where disability is
more common, the true burden is
likely underestimated [72]. Clinicians
continue to witness the consequences
of longstanding structural inequities
within this vulnerable group, including
lower education, reduced access to basic
services, and limited accessibility of
assistive devices (12% of the population)
[72]. These multidimensional challenges
translate to poorer health-seeking
behaviours, poorer health outcomes, and
significantly reduced quality of life.
In response to these ongoing inequities,
South Africa has introduced integrated
policies and system-wide reforms aimed
at strengthening disability inclusion
across health and social sectors. The
Government of South Africa adopted
the White Paper on the Rights of Persons
with Disabilities in 2015, which
reflects the need for sustained political
commitment to coordinated disability
care and accessibility [73,74]. Also,
recent innovations in science and
technology have further expanded
access to communication and assistive
devices through the Department of
Science, Technology, and Innovation
(DSTI). Furthermore, South Africa
has prioritised disability-inclusive
approaches to the growing concern
of gender-based violence (GBV),
where the national GBV accessibility
checklist promotes inclusive
communication, staff sensitisation,
safe infrastructure, and supportive
policies [73]. Together, these
initiatives demonstrate a multisectoral
commitment to advancing rights,
protection, and equitable service access
for persons living with disabilities.
As physicians in South Africa, we
call for collective, multidisciplinary
and multi-sectoral action to advance
disability inclusion as a core component
of health systems strengthening. We
advocate for inclusive policies based
on key global documents, like the
Missing Billion framework (https://
www.themissingbillion.org/) and the
WHO Health Equity for Persons with
Disability-Inclusive Care for Global Health Systems
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Disabilities, and integrated service
delivery with investments in timely
multidisciplinary care (e.g. high-quality
surgical care, rehabilitation, assistive
technologies, palliative care) [10,75].
Health professionals can champion
disability-inclusive policies, improve
equitable access, identify functional
disabilities early, ensure timely referrals,
and support coordinated rehabilitation
and community reintegration.
Partnership with communities,
caregivers, and persons living with
disabilities is key to co-design services
that ensure access, affordability,
acceptability, and dignity [10].
Collectively, our leadership, advocacy
and commitment towards disability-
inclusive care will shape meaningful
health systems reform and advance
health for all.
Tunisia
Tunisia is a country located in the
Maghreb region of North Africa, with
borders to the Mediterranean Sea
(north), Algeria (west and southwest),
and Libya (southeast). According to the
Tunisia National Institute of Statistics
(L’Institut National de la Statistique,
INS)’s 2024 General Population and
Housing Census (RGPH-2024), a
total of 12 million residents (over 5
years of age) are living with a disability,
including 375,600 persons (3.3%) with
a severe disability and 1.3 million
persons (12.2%) with moderate or
minor disabilities with functional
limitations [76]. Although the survey
did not emphasise the cognitive domain,
most disabilities were reported as visual
(7.1%), mobility (6.4%), and hearing
limitations (3.7%), and the prevalence
of functional limitations increases
significantly with age (4.2% for 5-14
years of age and 65.5% for over 80
years of age). Notably, post-traumatic
disability was estimated at 23.6% for
road traffic accidents and 30.9% for
other types of accidents. Data remain
sparse and inconclusive, however, as
the Tunisian Health Examination
Survey (THES-2016) reported a 2.8%
prevalence of a physical or mental
disability in the Tunisian population
(3.3-4.0% in Tunis District), yet the
Ministry of Social Affairs concluded a
14.1% disability prevalence [77,78].
The Government of Tunisia has
demonstrated sustained commitment to
protecting the rights of persons living
with disabilities since 1981, adopting
a general law on the protection and
promotion of the rights of persons
living with disabilities. First, leaders
signed the Convention on the Rights
of Persons with Disabilities, which
was adopted in 2006 (Resolution A/
RES/61/106). Second, the Framework
Law No 2005-83 (2005) establishes
the protection to persons living with
disabilities as a national obligation,
which was later reinforced by Law
41 (2016) that allocated 2% of annual
recruitment to persons with disabilities
in the public sector and set a 2% quota
for employees in all public and private
companies with more than 100
employees. Third, Article 54 of the
Constitution (2022) states: “The State
shall protect persons with disabilities
against all forms of discrimination
and shall take all measures necessary
to guarantee their full integration into
society.” Fourth, the Committee on the
Rights of Persons with Disabilities
evaluated the disaster response plans
and services for persons with disabilities
in 2023, concluding the need to
revise the “disability” definition and
implement a deinstitutionalisation
strategy (transform long-term care and
support comprehensive community-
based services) [79].
Moreover, the Government of Tunisia
has continued to support sports and
education programs for individuals
with special needs, including sustained
investment in Paralympic athletes
(since 1988) [80]. According to the
Ministry of Education, a total of
22,000 children with special needs
were attending public schools for the
2025-2026 academic year, noting that
the increasing number of students
with disability cards (including autism)
over the past few years. Although the
specialised national health surveillance
system can monitor school and
university health in Tunisia, challenges
have arisen highlighting vulnerable
scenarios faced by children and women
who are victims of violence [81-83].
In Tunisia and worldwide, physicians
and other healthcare professionals are
key leaders to advocate for primary,
secondary, and tertiary prevention and
disability inclusion and care across
their health systems. Collective efforts
should focus on reducing stigma and
discrimination related to mental health
disorders and physical disabilities
(like mobility limitations and visual
impairments) across health institutions,
schools, and communities. Together,
they can commemorate International
Day of Persons with Disabilities
as an opportunity to mobilize all
communities, increase awareness
of the health and social challenges
associated with disabilities, and ensure
the protection of rights and dignity
of people living with disabilities.
United Kingdom
The British Medical Association
(BMA) sees International Day
of Persons with Disabilities as an
opportunity to recognise and celebrate
our disabled medical workforce,
highlight how disability-inclusive
care benefits patients, and share how
ableism affects people’s health and
employment. According to the Family
Resources Survey, the estimated number
of disabled persons in the United
Kingdom (UK) was 16.8 million
people (25% of the total population)
in 2023/2024, increased from 12.2
million (19% of the total population)
in 2012/2013 [84]. Furthermore, a 2025
UK-wide BMA survey of 801 disabled
doctors and medical students found
that an estimated 70% believed that
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ableism was a notable challenge in their
place of work or study [85]. The survey
also concluded that additional barriers
include delays in accessing workplace
adjustments (a legal entitlement
in the UK), inadequate routes to
report disability-related bullying and
harassment, poor understanding of
neurodiversity, and deferred specialist
treatment for neurodivergence (such as
attention-deficit/hyperactivity disorder,
ADHD) [86].
In England, data on the experiences
of disabled health professionals are
collated in the annual NHS England
Workforce Disability Equality Standard,
which can help inform lobbying
for policy improvements [87]. As
an organisation, the BMA is also
lobbying the Government to introduce
mandatory disability pay gap reporting
for all organisations with over 250
employees. Members have called for
this policy to be accompanied by a
requirement for employers to publish
gap action plans, as it would likely
increase transparency and galvanise
employers. The BMA recognises that
the economic security of individuals
is fundamental to public health
and is a signatory to the Disability
Employment Charter (https://www.
disabilityem­ploymentcharter.org/),
which mandates the Government to
improve employment opportunities and
experiences for disabled people.
The BMA acknowledges that doctors
worldwide play a crucial role in
reducing health inequalities for disabled
people. They call on all physicians and
medical bodies in the UK to champion
the rights and inclusion of disabled
people. These efforts can include acting
as allies to disabled peers and colleagues,
challenging ableism, providing
adjustments and paid disability leave,
and using evidence-based data to ensure
that local and national policies and
practices are informed by the voices
of disabled people. Furthermore, by
strengthening medical education and
training bodies, doctors can acquire
a robust understanding of how to
meet the individual accessibility and
communication needs of disabled
patients in their care management plans.
Conclusion
“Addressing health inequities for persons
with disabilities benefits everyone. Older
persons, people with noncommunicable
diseases, migrants and refugees, or other
frequently unreached populations, can
benefit from approaches that target the
persistent challenges to disability inclusion
in the health sector.”
– Dr. Bente Mikkelsen, WHO Director
for Noncommunicable Diseases
The commemoration of International
Day of Persons with Disabilities
underscores the need to holistically
understand health and social inequities
experienced by persons with disabilities,
design and enforce policies and
programs that meet their health
and social needs, and advocate for
political commitment for sustainable
health financing. Since disability
may involve an impairment (e.g.
reduced vision, hearing or mobility)
coupled with environmental, social,
structural or individual challenges,
expanding research capacity across
academic, public and private sectors
will be crucial to accelerate evidence-
based findings that can reinforce
more inclusive and equitable policies
and practices [75,88]. Applying
the One Health concept (human-
animal-environment nexus) will offer
a unique perspective on the risks
(e.g. socioeconomic or environmental
condition), lived experiences (e.g.
stigma or economic hardships), and
care management (including the
rehabilitation framework) associated
with disabilities [89]. Specifically, the
4C’s (communication, collaboration,
coordination, capacity building) can
guide community-based collaborations,
build rapport among researchers and
stakeholders, promote targeted health
messaging, and strengthen health
professionals’ training in disability-
related care.
The global medical community holds
a powerful voice to advocate for an
inclusive and equitable society that
“leaves no one behind” and ensures social
support and protection for patients with
disabilities, families, and caregivers. As
clinical and surgical experts in multiple
specialties, WMA members can focus
on promoting disability-inclusive care
and services (including telehealth)
within their health systems, partner
with local organisations to coordinate
health campaigns, design and
incorporate disability-focused content
for health professionals’ education and
training programs, and develop relevant
epidemiological and participatory
research initiatives to understand
individual- and systems-level
factors affecting disability. This
collective article highlights how
physicians can lead policy development,
engage health system leadership and
governance, support health professions’
training, and organise community
educational campaigns across
the Africa, Asia, East Mediterranean,
Europe, North America, and Pacific
regions.
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Authors
Catarina Aguiar Branco, MD
Director, Physical and Rehabilitation
Medicine Department, ULS
Entre Douro e Vouga
President, College of Specialties in
Physical and Rehabilitation Medicine,
Portuguese Medical Association
Member, Executive Committee,
European Society of Physical and
Rehabilitation Medicine
Porto, Portugal
Salvatore Amato, MD
President, Order of Surgeons and
Dentists of Palermo (OMCeO)
Member, National Executive Board &
Delegate for Foreign Affairs, National
Federation of Orders of Surgeons
and Dentists (FNOMCeO)
Palermo, Italy
Gunta Anca, MD
Vice-President, European Disability Forum
Chairperson, SUSTENTO (Latvian
Umbrella Body for Organisations
of People with Disabilities)
Riga, Latvia
Disability-Inclusive Care for Global Health Systems
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87
Filippo Anelli, MD
President, National Federation of Orders
of Surgeons and Dentists (FNOMCeO)
Rome, Italy
Tsedeke Asaminew, MD, MSc
Standing Committee of Medical Education,
Ethiopian Medical Association
Addis Ababa, Ethiopia
Alberto Caldas Afonso, MD
Professor, Department of
Pediatrics, University of Porto
Director, Northern Maternal
and Child Health Center
Porto, Portugal
Maria Minerva Calimag,
MD, MSc, PhD
Departments of Pharmacology and
Clinical Epidemiology, Faculty
of Medicine and Surgery,
University of Santo Tomas
Immediate Past President,
Philippine Medical Association
Manila, Philippines
Helena Chapman, MD, MPH, PhD
Milken Institute School of Public Health,
George Washington University
Washington DC, United States
Maymona Choudry, MD, MPH
School of Medicine, Ateneo de
Zamboanga University,
Zamboanga City, Philippines
Carlos Cortes, MD
Specialist, Clinical Pathology
President, Portuguese Medical Association
Associate Professor, Coimbra Business School
Porto, Portugal
Kate Firth, LLB, BA
Senior Policy Adviser, British
Medical Association
London, United Kingdom
Rym Ghachem Attia, MD
President, Tunisian Medical Association
(Conseil National de l’Ordre des Médecins)
Tunis, Tunisia
Venkatesh Karthikeyan, MD
Senior Resident, Department of
Community and Family Medicine,
All India Institute of Medical Sciences
Patna, India
Simon Kigondu, MD
Obstetrician Gynaecologist
President, Kenya Medical Association
Nairobi, Kenya
Inge Kleinhans-Klopper,
MBChB, MPH, MMed PHM, FCPHM
Public Health Medicine Specialist,
Department of Anaesthesiology, Sefako
Makgatho Health Sciences University
Pretoria, South Africa
Tony Siu Chi Ling, MB BS(HK),
MRCOG, FHKAM(O&G)
Honorary Secretary, The Hong
Kong Medical Association
Hong Kong, China
Siphesihle Mahanjana-Chataika,
MBChB, PGDPH, MMed
PHM, FCPHM
Public Health Medicine Specialist,
Clinton Health Access Initiative
Pretoria, South Africa
Tigist Mekonen, BSc, MPH
Executive Director, Ethiopian
Medical Association
Addis Ababa, Ethiopia
Anderson N’dri, MD
Psychiatry resident, Psychiatric
Hospital of Bingerville
University Felix Houphouët
Boigny of Cocody
Chairperson, JDN Ivory Coast
Abidjan, Republic of Ivory Coast
Mhlengi V. Ncube, MSc, PhD
Head of Health Policy and Research,
South African Medical Association
Pretoria, South Africa
Tegbar Yigzaw Sendekie,
MD, MPH, PhD
Immediate Past President,
Ethiopian Medical Association
Addis Ababa, Ethiopia
Michael Quon, MD, FRCPC
Department of Medicine (General
Internal Medicine), University of
Ottawa, The Ottawa Hospital
Inflammation and Chronic
Disease Program, Ottawa
Hospital Research Institute
Ottawa, Ontario, Canada
Thirunavukarasu Rajoo, MD,
MBA, LIMSEA (Harvard)
President, Malaysian Medical
Association (2025–2026)
Kuala Lumpur, Malaysia
Joss Reimer, MD, MPH, FRCPC
Associate Professor, College of Community
and Global Health, Rady Faculty of
Health Sciences, University of Manitoba,
Past-President, Canadian
Medical Association
Winnipeg, Manitoba &
Ottawa, Ontario, Canada
Wunna Tun, MBBS, MD
Fellow, Medical Education
JDN Secretary
Yangon, Myanmar
Disability-Inclusive Care for Global Health Systems
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