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03 May 2019

The World Medical Association held its 153rd Council session in the last week of April.

The gathering, attended by AMA President Dr Tony Bartone (who can be found in this accompanying group photograph – hint, he’s on the left), was held in Santiago, Chile.

Following are some of the resolutions to have come out of the WMA Council session.


Do not implement IAAF regulations on classifying women athletes
The World Medical Association has called on physicians around the world to take no part in implementing new eligibility regulations for classifying female athletes.

The regulations from the International Association of Athletics Federations (IAAF) require women athletes with specific differences in sex development to medically reduce their natural blood testosterone level if they wish to continue racing as women in a few restricted events.

The Differences of Sexual Development (DSD) rule, introduced last year, followed the case of South African runner Caster Semenya, the world and Olympic champion, who has had to undergo gender verification testing to confirm her eligibility to compete in the women’s division.

At its Council meeting in Santiago, Chile, the WMA demanded the immediate withdrawal of the regulations. It said they constitute a flagrant discrimination based on the genetic variation of female athletes and are contrary to international medical ethics and human rights standards.

Following an initiative by the South African Medical Association, the WMA fears the regulations would constrain the athletes concerned to take unjustified medication, not based on medical need, in order for them to be allowed to compete, and accordingly require physicians to prescribe such medication.

It is in general considered as unethical for physicians to prescribe treatment for excessive endogenous testosterone if the condition is not recognized as pathological. The WMA calls on physicians to oppose and refuse to perform any test or administer any treatment or medicine which is not in accordance with medical ethics, and which might be harmful to the athlete using it, especially to artificially modifying blood constituents, biochemistry or endogenous testosterone. 

WMA President Dr. Leonid Eidelman said: “We have strong reservations about the ethical validity of these regulations. They are based on weak evidence from a single study, which is currently being widely debated by the scientific community. They are also contrary to a number of key WMA ethical statements and declarations, and as such we are calling for their immediate withdrawal.”

World shortage of health professionals
Governments around the world have been urged by the World Medical Association to address the predicted global shortage of 18 million health professionals by presenting concrete plans for investing in the health workforce.

At its meeting in Santiago, Chile the WMA agreed a proposal for consideration at the High-Level United Nations Assembly meeting in September calling for governments to submit policies and financial commitments to meet the workforce shortage. In addition, the WMA wants to ensure safe and dignified working environments, where staff can thrive without fear of violence or coercion.

The September meeting in New York will be the first one-day UN High-Level Meeting on universal health coverage on the theme of ‘Moving together to build a healthier world‘. A preparatory multi-stakeholder hearing has been held to find a political consensus to draft a declaration at the September meeting setting out government commitments.

The WMA proposal document says that closing the health workforce gap is essential to achieving universal health coverage. 

It reads: “Today, there are 76 countries with less than one physician per thousand people and three billion people without access to a health professional. It is unacceptable that the patient with cancer in Sierra Leone cannot get the care they need because there is no oncologist in the country or that the woman with obstetric fistula has to suffer because there is no gynaecologist.” 

WMA Chair Dr. Frank Montgomery said: “As our evidence to the High Level Meeting of the United Nations makes clear we strongly support the global move towards universal health coverage. This is high quality health care accessible for everyone at the time of need and without any financial barrier. This will not be achievable at once and everywhere, but nothing less should be the aim.

“As doctors, we took an oath to make our patients our first priority, and we believe that everyone should have access to high quality services without fear of financial hardship. 

“Primary health care is a tool to further universal health care and the entry point into the health care system should be primary health care within a physician-led system. However, physicians are engaging alongside other health professionals to help make universal health care a reality for patients. Health care should be delivered in a multi-disciplinary health care team.”


Warning on vaccine hesitancy

The World Medical Association has expressed its alarm about increasing reports of measles outbreaks in many parts of the world.

At its Council meeting in Santiago, Chile, the Association said that misconceptions about vaccinations and reduced vaccination rates posed a significant challenge for health authorities of all nations.

An emergency resolution agreed by the meeting said it was clear that increasing global travel by ‘less than appropriately protected individuals’ as well as misconceptions posed a challenge.

The resolution strongly reaffirms the WMA’s 2012 Statement on the Prioritisation of Immunisation, denouncing unfounded and inaccurate claims about the possible dangers of vaccine administration.

Dr. Frank Montgomery, Chair of the WMA, said: “The growing measles outbreaks are putting both children and adult lives at risk. We echo the warning from the World Health Organisation that ‘vaccine hesitancy’ has become a top global health threat.

“Measles is not a trivial disease and vaccination should be regarded as a public duty and not an individual choice. The risk to herd immunity from vaccine hesitancy based on false data must be confronted.” 

WMA policy clearly states that vaccination and immunisation have been acknowledged as an effective and safe preventive strategy for several communicable diseases. And vaccine development and administration have been the most significant intervention to eradicate infectious diseases and influence global health in modern times. 

The WMA is renewing its call to all its national medical association members to increase awareness of immunisation schedules and for individual physicians to pay special attention to addressing the concerns of vaccine hesitant parents.

Published: 03 May 2019