From the Wonca President: 'Reaching the final'

This final issue of Wonca News for this triennium provides us with an opportunity to reflect on the progress made since our last World Council meeting in Alpine Heath, South Africa more than three years ago. Hopefully it will help us to prepare for our forthcoming World Council in Orlando, Florida in October. At that meeting we will be setting our priorities for the next triennium under the leadership of Bruce Sparks.

This is therefore my last opportunity as President to record my gratitude to the large number of people in all parts of the world who have worked so tirelessly to build our organisation during my term of office. To single out individuals would be unfair and to report in detail on every initiative would take too long. Let me attempt therefore to describe the major areas of progress.

The establishment of the new Wonca Secretariat in Singapore has been an outstanding success. The secretariat previously run in Australia by Wes and Marian Fabb had set a high standard and the complexities of transferring from one national, legal, and financial system to another were considerable. The support of the Singapore College was very helpful. We have demonstrated that the Secretariat can be moved - but not easily. For the future it is probably best that the location of the Secretariat remain unchanged for at least three terms.

During these last three years I have been invited to many conferences and meetings. I have delivered more keynote lectures than I care to remember. It has been a great privilege and I am grateful to have been chosen.

Wonca's Membership Growth

The global mission of Wonca challenges us to develop a worldwide membership. Thus in the last three years we have increased the number of organisations, countries, and regions included in membership to a point where we are truly global. I congratulate the Membership Committee for the efficiency with which they facilitated this expansion.

Following years of patient negotiation with Central and South American colleagues, and an outstanding meeting organised by Spanish colleagues in Seville which I attended, we will formally welcome to Orlando a new 'Region Iberoamericana - CIMF' with some 14 new members.

Last year inspiring and enthusiastic leadership from colleagues in Beirut, Lebanon brought together representatives from more than ten Arab countries who agreed to work towards the formation of an Arab Region. Later I had a chance to visit Libya and was encouraged by the level of interest in the proposed region amongst the Mediterranean countries of North Africa.

Dr Michael Boland, Wonca President, 2002-2004

Just a few months ago a conference hosted by colleagues in Nairobi, Kenya brought together individuals and organisations active in East Africa. This Sub-Regional approach to the enormous challenges of the African region is an important strategic development which could be usefully applied in other large regions, particularly where travel is difficult and expensive.

Much important ground work has been done and contacts made in the central Asian Republics and Mongolia. Meanwhile the eastern border of the European Region continues to expand. Here also, at least in the short-term, sub-regions may offer the best solution.

The Wonca web: www.globalfamilydoctor.com

The last Council Meeting in South Africa endorsed the Executive decision to launch a new Wonca Website in collaboration with Medi + World with Wes Fabb as webmaster. In addition to the basic organisational information about Wonca, the site offered a wide range of new educational products and clinical information. Of these the 'Journal Alerts' and its associated features proved to be the most popular, generating most of the 1.8 million hits in a 6 month period. This unique, innovative and popular service, devised and delivered by Wes Fabb as Webmaster, will be the centrepiece of the website going forward.

However maintaining the service depends on the continuous use of a rare combination of skills - scanning large numbers of journals for new information relevant to family practice, summarising key points and presenting it in a highly accessible web format. This work must be realistically remunerated. Given the state of Wonca finances external sources of funding must be found to enable the service to continue. To date this has proved to be very difficult but I remain hopeful that suitable sponsors may be found.

Wonca's Working Groups and Global Issues

The triennium has been an active time for standing committees and working parties. The Research committee convened a memorable global family medicine research conference in Canada. Progress was also recorded in the indexation of Family Medicine Journals following our direct approaches to the Library of Medicine.

The Classification committee received long awaited recognition for ICPC2e when WHO confirmed its inclusion in their family of Official Classifications. I believe this will have major implications for the choice of ICPC as the national classification system of choice for family practice worldwide.

The Rural Practice Working Party is one of Wonca's most active groups and I was privileged to attend several of their conferences. One held in Australia considered the future agenda for collaboration with WHO; another, held in Santiago de Compostella, Spain, laid the foundation for a future resolution of the World Health Assembly in support of rural people and practice. Both meetings included a heady mix of concern for people, a rigorous approach to science, and above all an active passion for justice and fairness.

The Quality Assurance Working Party has undertaken a strategic review of its activities. They have agreed to adopt a project approach in selected regions focussed on specific themes and countries, with active local involvement. They plan to offer technical assistance from initial design to dissemination.

Other Wonca interest groups and working parties have addressed a wide variety of concerns from The Environment to Ethics, from Psychiatry & Neurology to Care of the Elderly to Women & Family Medicine.

Our collaboration with WHO has changed as WHO has changed. The retirement of Dr. Charles Boelen and major internal restructuring led us to look beyond 'Human Resources for Health' to other areas such as Non-Communicable Disease and Tobacco Control. Under the leadership of the new Director General, Dr. Lee we look forward to closer collaboration.

As a world organisation rooted in practice and the pursuit of excellence through training education research and quality, Wonca must continue to develop its regional and global structures to reflect these goals. Major non-communicable disease is one of the most important areas of practice. Family practice needs to contribute to the content of international best practice guidelines and specifically to the strategies for their implementation.

We had hoped to find the funding to undertake these initiatives ourselves. Failing that, we have sought to collaborate with other groups. For example we now have in place a working partnership with 'GOLD' (the international chronic obstructive airways disease guideline group) and their primary care interest group, IPCRG. Similar initiatives in non communicable disease areas such as cardiovascular disease, and diabetes are under discussion. Other existing Wonca Working Parties and Special Interest Groups devoted to Quality, Informatics and Research can contribute positively to these developments.

Reform of our byelaws has continued. The committee has worked hard on a set of changes which will make our procedures more flexible and more responsive to our needs.

As Wonca becomes truly global the challenge of funding our activities becomes ever more pressing. All our new members will contribute financially to Wonca. However their needs will greatly exceed their ability to contribute. Traditional sources of funding - member organisation dues, conference levies, and direct member dues - will not be sufficient. Conferences in particular have suffered from a global downturn in international travel and rising costs.

We must therefore urgently seek new sources of funds. We must also review the level of member dues and invite richer nations to consider voluntary additional specific project funding in a spirit of solidarity with colleagues in developing countries.

Wonca will need to look beyond it's own resources. We should prepare suitable projects that 'fit' not only our priorities but the philanthropic agendas of international charitable foundations and major donors including the international pharmaceutical industry.

In Durban we identified two 'advocacy issues' for the triennium - the first was HIV/AIDS and more specifically the availability of treatment in countries most affected at a price which they could afford. The second was about Tobacco Prevention and Cessation. I have spoken about these issues at every available opportunity and I am aware of many initiatives taken by our member organisations. The WHO Framework Convention on Tobacco Control continues to progress. I have attended and spoken at several global conferences on Tobacco or Health. I will recommend to Council that Wonca continues to identify global non-political advocacy issues.

Finally readers of Wonca News will undoubtedly agree that the editor and staff have greatly enhanced this publication making it more interesting and relevant. I have been convinced that Wonca needs to have a regular internal publication. Congratulations to all concerned.

I am satisfied that Wonca has completed another significant chapter in its development as a global organisation. I congratulate the many unnamed individuals who have made it happen. I will enjoy watching its further progress from the sideline.

Our AAFP colleagues have gone to great lengths to make the Orlando World Conference an experience to remember. Their attention to detail and their determination to host a conference which will appeal to everybody has been extraordinary. I look forward to meeting you there.

Michael Boland
President
World Organization of Family Doctors