Valedictory address 63rd World Medical Association General Assembly Bangkok, Thailand, October 2012

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Valedictory address

63rd World Medical Association General Assembly

Bangkok, Thailand, October 2012
I will start by greeting and thanking you all delegates from the medical associations who gave me the privilege and the honor to represent the WMA.
By thanking WMA Officers: the immediate former President, Wonchat Subhachaturas, and all our former Presidents; the Chairman of the Council, my dear friend Mukesh Haikerwal; the Vice-Chairman, Masami Ishi; our treasurer, Frank-Ullrich Montgomery; the Chairmen of our Standing Committees, Thorunn Jambu, Michael Marmot and Leonid Eidelman. All the members of the Council… Our always present Secretary General, bright counselor and friend, Otmar Kloiber. 
The friends we have in the extraordinary and competent WMA staff: Yoonsun “Sunny” Park, Roderic Dennett, Lamine Smaali, Clarisse Delorme, Anne-Marie “Anna” Delage, Julia Seyer, Adolph Hällmayr and Annabel Seebohm; Peteris Apinis and Nigel Duncan. Also a very special warm greeting to Joelle Balfe. Our dear interpreters: thank you so much!
My dear Friends and Colleagues,
I will talk about a long journey, from Montevideo, by the Atlantic Ocean, to Bangkok, by the Pacific…
Since Montevideo (Uruguay), October 2011, I have faced an extensive agenda, which gave me the opportunity to live the reality of medical practice, problems and accomplishments of many of the nowadays more than one hundred National Medical Associations that form our World Medical Association. Just after taking over the Office, our first commitment was to take part in the Social Determinants of Health at the International Conference in Rio de Janeiro (Brazil).
At that time, we talked about the importance of finding a solution for the social inequalities seen in both wealthy and developing countries. Those inequalities are the main factor responsible for the level of health of our populations. They refer to the conditions on how people are born and grow up, to the differences in education, opportunities and working conditions, and to the conditions on how people age. There, we emphasized the importance of the role of Physicians in this field. In addition to assisting people in need, the profession includes interventions in factors that give rise to poor health.
In Chihuahua (Mexico), last November, we offered solidarity to our Mexican colleagues at the Assembly of Mexican Medical College, where the issue was the answer to violence against health professionals related to the drug trafficking war, particularly in the city of Juarez. There, I could see the many aspects of the insecurity lived by doctors in many areas around the world.
Several National Medical Associations from Latin-American Nations met on November 19th in Panama City (Panama). Among the problems that threaten the quality of medical attention and, especially, Medicine, I observed the repeated political interferences in medical organizations, mainly in Bolivia and Venezuela. In Bolivia, the government tried to dismantle the medical profession and to regulate it themselves. They also decided on ethical issues and technical competences that qualify different specialties. The main goal of the Bolivian government is to fully control the profession.
Still in November, in Porto (Portugal), we met Portuguese medical students in order to discuss the European economic crisis viewed from the standpoint of young doctors in a continent that is going through major challenges.
This January and February, in São Paulo (Brazil), at the headquarters of the Medical Association of the State of São Paulo and in Rio de Janeiro (Brazil), we subscribed and announced the worldwide campaign for 2012 – “Global appeal” against the discrimination faced by persons affected by leprosy, a neglected disease that still affects hundreds of thousands of people in different regions of the world.
One year after the earthquake followed by a tsunami and a nuclear accident in Japan, on March 11th, 2012, we were in Tokyo (Japan) to discuss with our colleagues from the Japanese Medical Association about the WMA “Montevideo Declaration”, which deals with the role of the medical associations and the physicians in response to disaster situations. The successful mobilization of Japanese physicians around that key issue gives us a picture of the enormous benefits of readiness in decreasing the impacts of catastrophic events less and less infrequent in people’s lives.
In April this year, in Taipei (Taiwan), at the opening of the 20th International Conference on Health Promoting Hospitals, I addressed the role of hospitals and health services in the promotion of health and in tackling the social determinants of health. During that same event, we actively participated in the meeting “Health without Danger”, which was oriented to the management processes in health institutions and to environment preservation. More and more, the environmental impact of modern hospitals has been capturing the attention of society.
In Ankara and Istanbul (Turkey), also last April, WMA was represented by the President and by the Chairman of the Council for the mediation between physicians and a parliamentary group in that country in regards to a crisis caused by a decree, which brutally restricted the independency and the authority of doctors for professional ethics and technical self-regulation.  The increasing animosity of the Turkish government towards the medical profession created a hostile environment for health professionals, which generated serious situations: Physicians were blamed for the consequences of an erroneous public system, and the dissemination of false information on the lack of doctors has been used as a justification to “import” physicians from neighbouring countries. The climax of the crisis was the murder of a 30-year-old doctor, followed by demonstrations all over the country. In Istanbul, as the president of WMA, I participated in a manifestation with more than 20 thousand doctors, bringing the city of Istanbul into a halt and raising a popular outcry as an extension of that tragedy.
On April 23rd, in London (England), Presidents of WMA and its Council took part in the meeting “Health Care in Danger”, an initiative that gathers organizations such as World and British Medical Associations, International Red Cross / Crescent and Doctors without Borders on the growing wave of violence against health professionals in civil and military conflicts in several regions of the world such as Somalia, Libya, Egypt, Bahrain, Syria, Iraq, Afghanistan, Israel, Mexico, Colombia.  At that time, we presented WMA’s position in the field of ethics and medical neutrality in situations of conflict. Physicians and other medical professionals have been arrested, kidnapped, tortured and murdered in retaliation for assisting people that eventually belonged to an opposing group. Hospitals have been bombed and invaded. Such incidents have interrupted humanitarian actions, causing the withdrawal of voluntary teams to whom security cannot be provided, and leaving a great amount of unassisted people behind.
At the end of April, more precisely from the 24th to the 29th, many of us were together when the Council Meeting of World Medical Association took place in Prague, Czech Republic.  In addition to the issues already mentioned before, another important ones such as the review of the Declaration of Helsinki were addressed.
In Geneva (Switzerland), this last May, at the WHO Assembly, we confirmed our partnership with WHPA and we discussed the economic crisis and health care. We hosted the traditional ”WMA Luncheon”, which had the United States Secretary of Health and Human Services, The Honorable Kathleen Sybelius as a lecturer, and counting on the presence of Health Ministers from many countries.
Last July, I took part in the “Healthcare systems in times of crisis _ Protect the present – Build the Future” Symposium: a debate in Lisbon (Portugal) with Portuguese health authorities and Michael Porter from Harvard Business School about the quality of care and the opportunities rose in times of economical difficulties.
The value of a profession can be measured through the reputation of its members, the quality of the services they provide to their people, and their many contributions to Science, but also through their capacity to organize and support other organizations. I also had the privilege of attending the Assemblies of the German Medical Association, last May, in Nurnberg (Germany), the American Medical Association, last June in Chicago (United States), and, in Bournemouth (England), the British Medical Association Assembly. In each one of those occasions, I could express to them, on behalf of the millions of doctors in the other 100 National Medical Associations which integrate the World Medical Association, our deep gratitude.
In August, CONFEMEL gathered in Lima (Peru). This meeting gave me another opportunity to talk about the many reasons why they should strength the participation of Latin-American countries in the WMA.
In Madrid (Spain), last September, the main subject under discussion was medical attention to immigrants and the different regulations in several European countries.
Finally, last September in the Sea of Galilee, in Tiberias (Israel), with Yoran Blachar and Leonid Eidelman, we discussed the possibilities of new partnerships with UNESCO in an educational program on medical ethics.
Dear Friends and Colleagues,
Before leaving, I would like to share with you a Guarani (South American Indian ethnic group) story:

Nhanderuvuçu, the Great Father, announced that the world would perish because of men’s iniquity, and ordered the sorcerer Guiraypoty to pray.
The Earth was then got out of the ties that hung it in the sky and fire spread out, forcing Guiraypoty and his tribe to flee toward the East.  
They started a very long and hard journey, nowadays known as the Peabiru way, an ancient Indian route that linked the Pacific and the Atlantic Oceans, from Peru to São Paulo.
They finally reached, at heaven’s door, the “yvy marã ei”, which means “land without evilness”, a land with no suffering where people never get sick, old or die.
In 1947, just after the miseries of World War II, the millions of doctors represented herein started a long journey, crossing land and ocean. We have completed our path, our “Peabiru”, always praying for good standards in medical care, standing for human rights in health, and looking for a healthy land of equal opportunities, solidarity and justice.
Dear Cecil Wilson, now it is your turn to lead us and light our way.
I am ready to follow you.
Thank you very much.
José Luiz Gomes do Amaral

President of the World Medical Association (2011-2012)

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