For anyone looking back at the history of Wonca, it will be obvious that the years of 2002 - 2004 have been a watershed Triennium for the Organisation. So much has happened and has been achieved that it will be impossible for me to give an exhaustive and comprehensive account. I will try in this column to give only the key achievements and events that have been of particular significance to Wonca and that will likely affect the Organisation in the immediate and long term.

The Wonca Secretariat

This beginning of this triennium witnessed the transfer of the Wonca Secretariat from Melbourne, Australia, which had been the 'home' of Wonca for over two decades, to its new home in Singapore. With this relocation came the change also in the Chief Executice Officer (CEO) and the Administrative Staff. The handing over of the hardware and software of the office administration and the duties of the CEO went very smoothly, helped by the fact that the two CEOs has had a very cordial working relationship in years past within Wonca.

Dr Alfred Loh, Wonca CEO (2nd from left), accompanied by Dr Michael Boland (center); Wonca President, Professor Cheong Pak Yean, President, College of Family Physicians, Singapore (1st right) and Yvonne Chung, Wonca Administrative Manager (1st left), welcomes Mr. Chan Soo Sen, Senior Parlimentary Secretary (2nd right), Prime Minister's Office and Ministry of Health Singapore, to the new Wonca Secretariat in Singapore

From Left to right: Professor Cheong Pak Yean, President, College of Family Physicians, Singapore; Mr Chan Soo Sen, Senior Parliamentary Secretary, Prime Minister's Office and Ministry of Health Singapore; Dr. Michael Boland, Wonca President; Dr Alfred Loh, Wonca CEO; and Ms Yvonne Chung, Wonca Administrative Manager, at the opening of the new Wonca Secretariat in Singapore

There was a steep learning curve for the new officers of the Organisation during the first six months but the day to day management went smoothly. The relocation also provided Wonca the opportunity to register itself as a company limited by guarantee. This was necessary as Wonca had to be a legal entity to sign agreements and claim ownership of intellectual property of any kind. Wonca International Inc was hence incorporated. This important step was made after various options were considered. An Honorary Legal Advisor was also appointed to assist the CEO in Wonca's legal issues. The final step in this legal restructuring of Wonca was the establishment of the Wonca Trust which will have as its trustees, the Members of the Wonca Executive. To commemorate all these changes, the new logo of Wonca was introduced to the world and Member Organisations at the start of the triennium.

The Wonca Executive

In anticipation of an increase in organizational activities and to improve on the working efficiency of the Executive Committee for the triennium, the Wonca President decided that the Executive would meet six-monthly as a full committee. This was a first in the history of Wonca Executive and the subsequent developments and achievements of the triennium have shown this to be a right decision.

Another innovative move by Executive was the inclusion of the Editor of Wonca News as a non-voting Ex-Officio of Executive Meetings. This allowed for better coverage of issues of importance to the Organization in Wonca News. This in turn helped to keep Wonca Direct Members and Member Organisations better informed through the newsletter.

The invitation to the newly appointed Chair of the Bylaws & Regulations Committee to sit as a non-voting Ex-Officio of the Executive was also instrumental in ensuring that the review of Wonca's Bylaws & Regulations recommended to Council were pertinent and workable.

Finally, the triennium saw the further expansion of the Executive Committee by the addition of the representative from Wonca's sixth and newest region - the Iberoamericana-CIMF Region. This meant that Wonca is now represented in all the continents of the Globe

The Wonca Website ( www.globalfamilydoctor.com )

The start of the triennium saw the launch of Wonca's active global website. This was done in conjunction with medi+World International Inc, a media company selected after due process by the earlier Executive Committee of Wonca.

The appointment of the immediate past CEO of Wonca, Prof Wes Fabb, as the Webmaster ensured that the spirit, philosophy, mission and objective of Wonca as an Non-Governmental Organisation was not lost in its website. In just three short years, the website has become widely known, used and appreciated by Wonca members and others globally with over 40,000 visits every month to the website involving over 180,000 pages of the web contents. Of special value and interest to members is the Journal Watch Section of the site which features the latest in relevant FM/GP articles from various reputable medical journals worldwide summarized and presented in a very readable form. Journal Watch articles are also bulk e-mailed thrice a week directly to over 3500 recipients globally as Journal Alerts.

The website also provides valuable hyperlinks to the websites of the larger Member Organisations of Wonca and also gives updated information on future Wonca Conferences, publications, committees, working parties, and special interest groups. With the phenomenal growth and potential of this website, Wonca hopes to interest sponsors keen to work with the Organisation to further the continuing medical education and professional training of family doctors globally, and especially in the developing countries where such facilities or programmes may not be so readily available.

The website has so far achieved limited success in securing some sponsorship from the pharmaceutical industry. It will be an important avenue of co-operation between Wonca and the pharmaceutical agencies in the move to upgrade healthcare and healthcare providers globally.

Wonca Committees, Working Parties, Task Forces, Special Interest Groups

These Wonca sub-agencies were all very active during the triennium and some achieved significant progress in their agenda and objectives.

The WICC continues to have its International Classification of Primary Care (ICPC-2) translated into different languages. To date, over thirty translations of ICPC-2 have been completed with more underway. Of even greater significance, the WHO recognized ICPC-2 as a member of the WHO Family of Classifications. This recognition has led to ICPC-2 being adopted by national governments as they seek to capture data in the primary healthcare context. The issuance of national licenses will in future be a useful revenue of income for Wonca and the WICC. The task ahead is now to have ICPC-2 harmonised with the other WHO-FIC member classifications.

This Working Party continues to lead the global agenda on rural healthcare and related issues. The Wonca World Conferences on Rural Health has grown in size and attendance over the years with the two biggest ones held in Melbourne ( 5th World Rural Conference- 2002 ) and in Santiago De Compostella ( 6th World Rural Conference - 2003 ). Out of these conferences, emerged: (a) The Melbourne Manifesto - A code of Practice for the International Recruitment of Healthcare Professional, (b) The Wonca Policy on Female Family Physicians in Rural Practice and (c) The Wonca Policy on Quality and Effectiveness of Rural Health Care. Efforts are being made now to have these policies adopted by WHO.

The triennium also saw the launch of Wonca's Global Initiatives in these two areas of health. The Special Task Force on Tobacco Cessation has been active throughout the triennium and will be presenting a special session on its findings at the Orlando World Conference. Wonca's call for greater governmental and community involvement in preventing the spread of HIV infections and the care for HIV-AIDS patients have been made on many occasions in different forums globally over the triennium.

In March 2003, the "First Wonca Invitational Conference on Improving Healthcare Globally - The Necessity of Family Medicine/ General Practice Research", was held at Queens University, Kingston, Ontario, Canada. During the Conference, seventy-four experts from thirty-six countries were involved. The conference reviewed the many challenges and opportunities in the development of family/general practice research and found a considerable number of models of success. The Conference noted that is was essential that research be directed at the health problems with the highest impact on patients' health and wellness. This would vary between communities and emphasizes the importance of sentinel systems to monitor morbidity in the community.

Perhaps the most phenomenal change in Wonca during the triennium has been its physical growth in terms of global reach and influence. At the start of the triennium ( June 2001 ), Wonca had 65 Member Organisations with 5 Members in Collaborative Relations. Towards the end of the same triennium ( as at end June 2004 ) there were 88 Member Organisations and 9 Members in Collaborative Relations. There was hence an increase of 23 Member Organisations and 4 Members in Collaborative Relations during the triennium. This rate of physical growth of the Organisation has never occurred before in the 30 years of its history. The new Member Organisations added to the 'Wonca Family' have also given rise to the formation of the Sixth Region of Wonca - The Iberoamericana-CIMF Region with 12 Member Organisations.

What is also important is that the groundwork has been laid during the triennium for the possible formation of two other new Regions of Wonca - a Central Asia and a Middle-East Region. Contacts have been made with family doctors' organizations in these areas that are in the process of formally applying for Wonca membership. These organisations have also expressed the desire to establish their own Regions within the 'Wonca Family' when sufficient numbers of member organizations are present in the grouping. The other significant aspect of this organisational growth is the fact that almost all of the new organizations joining Wonca in the triennium have been from developing and newly independent nations. These are nations where the concept and relevance of General Practice/Family Medicine in the formulation of healthcare policies are more likely to be appreciated and implemented.

The triennium will end at the forthcoming 17th Wonca World Conference in Orlando. It is not surprising that this final event itself will be special in many ways. Besides being the biggest Wonca World Conference ever with more than 12,000 participants (including delegates from the AAFP Congress), the Orlando Conference will also be known for the largest numbers of scientific paper submissions and abstracts selected. The sheer size of the scientific programme, the magnitude of the trade exhibition and the opportunities for continuing medical education and professional development has no precedence. To match all these is the generosity of the Host Organising Committee in instituting the Conference Bursary Programme in which over 90 recipients from over 40 countries will receive financial assistance to come to Orlando for the Conference.

The above issues are only some of the achievements of Wonca in the past three years. In many ways it has been a productive and eventful triennium which will pave the way for the further growth and maturity of the Organisation in the years ahead.

Dr Alfred Loh
Chief Executive Officer
World Organization of Family Doctors