World Medical Association Questions

In light of the Canadian Medical Association’s (CMA) withdrawal from the World Medical Association (WMA), we have been asking questions about the BMA’s involvement. Our questions are detailed below, and we are now awaiting a response in the form of a report to Council. We will update the site as we have answers, and continue to press the issues we have concerns about.

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Background

The World Medical Association was established in 1947 in the wake of war crimes by doctors in Hitler’s Germany, two years after the BMA proposed the idea. It hosts biannual international meetings, lobbies significantly at UN bodies, and has a controversial history as a major contributor to issues of medical ethics.

We have a large input into the WMA, for example the BMA policy on the TTIP trade deal became the policy of the WMA, BMA work on ethical procurement is now WMA policy.

The current WMA president, Dr. Leonid Eidelman, clearly plagiarised his inaugural speech from a prior Canadian president’s speech and other sources, resulting in the CMA resignation from the WMA. The explanation, which blames speech writers, and apology of Eidelman, did not satisfy the CMA, who expected further action, perhaps including resignations and policy change. “Eidelman apologized to the WMA council and assembly, saying that he had originally written the speech in Hebrew and was unaware of any plagiarism during the translation into English. But Damji said that explanation was not convincing and did not include an apology to the CMA or Simpson, nor an acknowledgement that as president he is the arbiter of ethics for the WMA.” 

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Representatives:

The BMA is currently represented on the WMA Council by Mark Porter, who hasn’t been a Chief Officer for well over a year, and Andrew Dearden, BMA Treasurer and WMA Treasurer, who is shortly resigning his BMA post. It appears that our representatives to international medical associations, of which the WMA is just one, report to our international committee. However, the process for appointment and accountability of the representatives is unclear to us.

We are told that BMA sends Chief Officers to WMA. The 2017 WMA Council guide states that members of council are chosen by the National Medical Association (NMA) elected to occupy a particular seat.

“Members of the Council are individuals chosen by the National Medical Association (NMA) elected to occupy a particular seat. The NMA may choose to change or substitute its individual representative at its own discretion, informing the Secretary General as soon as it wishes to make a change. It is generally expected that the Council member will represent the views of his or her NMA or the region they have been elected from rather than his or her personal views, however this is a matter to be decided between the NMA and its chosen representative”

We believe that representatives do not have to be Chief Officers, but that if BMA appointments are on that basis explanation is required for deviation from policy, and accountability must be ensured. Mark Porter’s term will end in April 2019, and we should consider our processes before this date.

What was our position on the CMA resignation?

Cost to BMA:

What is the WMA membership fee paid by the BMA? Are there any other costs as a result of our membership?

What are the expenses incurred by the BMA for BMA representatives to go to WMA Council, events and conferences? Where members of the BMA hold office in the WMA (the Council or an officer role), which organisation meets the costs?

We are told that the WMA conferences have registration fees which cover travel between locations, some meals and the costs of the conference.  Representatives from BMA who are WMA Council members have travel and accommodation covered by the WMA, but the BMA pays under our usual policies for other representatives and BMA staff.

Value:

The BMA has significant influence on the WMA which produces international policy. However, it is important that we, as reps accountable to the membership, ensure this is worth the cost. From some information, provided below, you might get the impression that the WMA is a corrupt and ineffective organisation. We are very concerned our members money is being used in this way & would like reassurances.

The reputation & ethical principles of the WMA are important to consider when considering the value of our relationship. The plagiarism incident and the lack of action in the aftermath is one issue. However, it is not the first. In 2017 the BMA requested a suspension the 2016-2018 president of the WMA pending a resolution of corruption charges which were not known to Council. This was rejected & Dr Desai remained in post. His case was never heard as the government denied ‘sanction to proceed’…On this we agree with Dr David Berger: “The WMA council’s rejection of the BMA’s proposal to suspend Desai pending an investigation into his appointment shows that the organisation is not serious about ensuring the probity of its own senior officers. The WMA claims to set the global standard in medical ethics, but it is ignoring the justifiable concerns of those who believe that it is wrong to appoint a president who is disbarred from practising medicine and who has criminal charges against him for corruption. Any fair minded person can see that this casts the credibility of the WMA as the world’s peak medical body into serious doubt.”

Other issues are more longstanding, such as the concerns highlighted in this 1994 BMJ articleIt highlights membership & votes effectively being up for sale to the highest bidder, a wasteful ‘ceremonial circus’ of meetings and complete inability to communicate with the average doctor.

The WMA lists it’s important corporate partners as Bayer AG, Eli Lilly and Company, GlaxoSmithKline and Pfizer, Inc. These companies appear to sponsor projects but it unclear what they get in return. 

Advocacy for physicians’ and patients’ rights” is listed as a service of the WMA. However, we believe the average UK doctor is unaware the WMA exists. What is the WMA doing for the rights of doctors? Has this been hindered by “the registration of the WMA in New York, where it is subject to antitrust laws”? This article states it has raised problems in formulating some declarations, notably one on medical manpower.

We note with interest from the same article that the BMA has left the WMA on more than one occasion. Notably, in 1984 it “supported a breakaway group made up of the medical associations of Denmark, Finland, Iceland, Ireland, the Netherlands, New Zealand, Norway, and Sweden, joined later by Canada and Jamaica. The group met annually and flirted with the idea of establishing a rival international body before opting to campaign for four key changesfirstly, that member associations of the WMA should be truly representative of the medical profession in their country; secondly, that member associations should be politically independent of their own governmentthirdly, that the WMA should adopt a more democratic voting system; and, fourthly, that any barrier to the association adopting and publishing its statements should be removed.

We would like to see that these have been met, and that no further concerns have been raised.

 

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