From the Wonca President:
2
From the CEO’s Desk
:
3
From the Editor
:
7
FEATURE STORIES
7
Wonca REGIONAL NEWS
13
HEALTH AND HEALTH SYSTEM NEWS
15
MEMBER AND ORGANIZATIONAL NEWS
17
RESOURCES FOR THE FAMILY DOCTOR
19
WONCA CONFERENCES 2005-2010 AT A GLANCE
20
GLOBAL MEETINGS FOR THE FAMILY DOCTOR
21
VOLUME 30
NUMBER 6
DECEMBER 2004
CONTENTS
Wonca President
Prof Bruce Sparks, South Africa
2 Cruden Bay Road
Greenside
Johannesburg 2193
South Africa
Tel: 27 11 646 2140
Fax: 27 11 717 2558
Email: brucespa@global.co.za
Wonca Chief Executive Officer
Dr Alfred W T Loh
Wonca Administrative Manager
Ms Yvonne Chung
World Organization of Family Doctors
College of Medicine Building
16 College Road # 01-02
Singapore 169854
Tel: 65 6224 2886
Fax: 65 6324 2029
Email: admin@wonca.com.sg
Wonca News Editor
Marc L Rivo, MD
Wonca President-Elect
Prof Chris van Weel, Netherlands
Wonca Immediate Past President
Dr Michael Boland, Ireland
Honorary Treasurer
Richard Roberts, MD, USA
Wonca Regional Presidents
Dr Abra T Fransch, Africa
Warren A Heffron, MD, Americas
A/Prof Goh Lee Gan, Asia Pacific
Prof Igor Svab, Europe
Dr Shatendra K Gupta, Middle East
South Asia
Dr Adolfo Rubinstein,
Iberoamericana-CIMF
Wonca Executive Members at Large
Dr Javier Dominguez del Olmo, Mexico
Prof Michael Kidd, Australia
Richard Roberts, MD, USA
Chair, Bylaws and Regulations
Dan Ostergaard, MD, USA
Chair, Publications & Communications
Dr Geoffrey D Martin, Australia
Wonca News Editorial Office
Marc L Rivo, MD
4566 Prairie Avenue
Miami Beach Florida 33140 USA
Tel: 305 671 7327
Fax: 305 671 4770
Email: marcrivo@aol.com
Wonca website:
http://www.GlobalFamilyDoctor.com
FROM THE WONCA PRESIDENT:
WORLD FAMILY DOCTORS: CARING FOR
PEOPLE
There is a tide in the affairs of men,
Which, taken at the flood, leads on to fortune;
Omitted, all the voyage of their life
Is bound in shallows and in miseries.
On such a full sea are we now afloat,
And we must take the current when it serves,
Or lose our ventures.
William Shakespeare (Julius Caesar) 1564-1616
Orlando has come and gone and Wonca continues to
grow and expand its activities. The representatives of
the first seventeen member organisations who founded
Wonca in 1972 could hardly have imagined that within
32 years the body would have swelled to 100
organisations in 83 countries. These countries
collectively constitute 80.5% of the World’s population.
The seeds had been sown in 1964 at the first
international congress hosted in Montreal by the then
College of General Practice of Canada. The previous
triennium edition of Wonca News chronicled the recent
activities of the organisations and in the present
edition, the office holders of the growing number of
committees, working parties and special interest groups
are itemised.
I wish to pay a special tribute to Michael Boland for
his leadership and vision during the last triennium. The
achievements during his ‘reign’ are difficult to emulate. A
tribute too, to our CEO, Alfred Loh, for his administrative
tenacity and governance, and who with Yvonne Chung
have guided our organisation during this period. I hope
and trust that with the giants in family medicine on my
executive committee, we will continue to grow and
develop. Of immediate concern is expansion of our
membership into Africa, the Middle East and Small
Island Developing States (SIDS) globally. While
representing only 20% of the globe’s population the
remaining 113 countries yet to join Wonca, include some
of the poorer nations, with the poorest health care for
their populations. Wonca’s activities in these countries
will require considerable support and cross-
subsidisation by our more affluent member
organisations.
While it will be ‘business as usual’ for the existing
activities of Wonca, the health priorities outlined in the
WONCA
News
FROM THE WONCA PRESIDENT
2
UN Millennium Goals, in the UNICEF/WHO strategy for
Integrated Management of Childhood Illness (IMCI), and
by the global concern for poverty, malnutrition and
violence, will set the agenda for some newer priorities
for Wonca particularly in developing countries. These
include interventions, which family practitioners should
and can address in their practices and clinics such as
attention to underweight children under five, increasing
measles immunisation rates in under 1-year-olds;
numerous HIV/AIDS initiatives for adults and children;
encouraging direct observed treatment for tuberculosis;
and lobbying for access to affordable drugs on a
sustainable basis. The IMCI programme aims to reduce
the annual 10.5 million deaths in children under five and
promote improved growth and development in this age
group. The recently published 2005 UNICEF report “The
State of the World’s Children: Childhood under threat”
emphasises the burden of suffering of children. It states
that more than half the world’s children are suffering
extreme deprivations from poverty, war and HIV/AIDS,
conditions that are effectively denying children a
childhood and holding back the development of
nations. What should Wonca members be doing to
assist?
Sub-Saharan Africa accounts for 75% of worldwide
peoples living with HIV/AIDS and for most of the related
9589 deaths globally per day. A major priority of Wonca
will be to support and train primary care doctors in the
region to manage patients and their families and to
meet the health care needs of the escalating HIV/AIDS
orphan problem. Pre-emptive involvement in the Indian
Sub-continent is also required to address the rising
prevalence in that region.
Family doctors are also ideally placed to address the
international initiatives for the prevention and
management of chronic and non-communicable
conditions, such as hypertension, diabetes, obesity,
alcohol abuse, chronic respiratory diseases and smoking
related disorders. Since almost every patient with
chronic disease has a primary care practitioner, (doctor,
nurse or village health worker), I hope Wonca will be
able to develop and enhance collaborative strategies
with WHO, other international professional bodies,
health foundations and funders, patient advocacy
groups and others to lessen the burden of these
conditions and their devastating complications.
Adolescent health too is an area of increasing concern
and need.
A fortuitous window of opportunity has been created
by the decision of Council meeting in Orlando to
establish the category of Institutional Membership which
WONCA
News
FROM THE WONCA PRESIDENT / FROM THE CEO’S DESK
3
will include Departments of Family
Medicine and family practice training
sites. Such collaborative member-
ship would not only encourage
academic exchange between Wonca
regions but also facilitate
international networks for primary
care research, educational
programmes, and guideline and
protocol development. These
activities, together with joint
projects between Wonca’s various
working parties, committees and
SIGs could herald a new era in
Wonca’s global activities. I am
also encouraged by our recent
discussions on mutual activities
and interests with WHO and other
organisations in collaborative status
with Wonca.
To paraphrase Brutus’s words
prior to confronting the gathering
troops of Mark Anthony and
Octavius at Philippi, we are indeed
floating on a sea full of
opportunities and must use the
prevailing current of global
challenges to fulfil the destiny of
our founders and indubitably be an
organisation of family doctors truly
‘caring for the peoples of the World.’
I am humbled and honoured by
the trust that all in Wonca have
placed in me and I will do all that I
can to discharge my duties in
fulfilment of that trust.
Professor Bruce Sparks
President
World Organization of Family
Doctors
FROM THE CEO’S DESK:
THE ORLANDO WONCA WORLD COUNCIL
The recent Wonca World Council was held over two and a half days at
the Rosen Plaza Hotel in Orlando, Florida, USA. It started on Sunday, 10
th
October 2004 with the outgoing Wonca World President, Dr Michael Boland
as Chair. Before the start of the Council Meeting proper, Dr Dan Ostergaard,
Chair of the Host Organizing Committee (HOC) for the Wonca Conference
2004 welcomed all present and introduced Dr Michael Fleming, President of
the AAFP, who also welcomed the Council delegates to Orlando and to the
17
th
Wonca World Conference that was to take place on 13-17 October 2004.
Before the names of the individual country representatives were read
out, a special announcement was made to acknowledge the Member
Organizations from Wonca’s newest and 6
th
region, Wonca Iberoamericana-
CIMF. The 11 country members were invited to take their respective seats at
the Council table. This was met by enthusiastic and welcoming applause by
all at the World Council. This formal recognition of the 6
th
Region was
indeed a very historic moment for The World Organisation of Family Doctors
(Wonca)
Over the two and a half days of World Council deliberations, numerous
issues of importance were discussed. It would not be possible for me in the
limited space of the CEO’s Column to provide readers with all that was
discussed.
I will highlight only the issues that are of interest and directly impacts
on the member.
Conference Levy & the Bid Process for Wonca Conferences
The World Council discussed extensively the issues of the bid process for
Wonca World and Regional Conferences and also the Conference levies.
Wonca Executive presented to Council draft guidelines on how to overcome
the disadvantages of the present system.
The CEO explained the rationale behind the draft guidelines. He said that
the method of determining the Wonca levies for Regional and World
Conferences had been dependent on competitive bids submitted by
interested Member Organizations (MOs) at the Regional and World Councils.
Over the years, these bids have become more aggressive as there had been
some financially highly profitable conferences in the past. This had caused
some MOs to put up offers of high levies as one of the incentives for
Councils to select them as hosts.
There were several disadvantages in this approach, which required
Wonca to re-look at how to improve the procedure. The disadvantages were:
1. The increase in the quantum of levy offered, caused the registration
WONCA
News
FROM THE CEO’S DESK
4
fee of the conference to correspondingly increase
and that cost was passed onto the delegates.
2.The higher registration fee could cause difficulty
to some potential attendees from the poorer
member countries and discouraged other
potential delegates from attending, hence
keeping attendances at such conferences down.
3.MOs successful in such bids (with high levies
offered) may find themselves having difficulties
meeting their commitment to Wonca and the
Region, when the registration numbers did not
meet up to expectations. This led to unpleasant
and prolonged negotiations between the HOC
and Wonca to find a fair and equitable solution
to the problem situation. It also meant that the
risk taking involved in the hosting of the
conference was passed from the host Member
Organization to Wonca, which was never the
intention when the conferences were offered to
the MOs to host.
4.A lower than expected attendance, as a
consequence of the higher registration fee, could
result in financial difficulties for the HOC and its
MO. This was one outcome Wonca should try to
avoid if at all possible for its MOs.
Following considerable debate and discussions,
World Council adopted the following proposals :
1.That the use of levies as part of the bid
process
in securing the hosting of World Conferences by
interested MOs be abandoned.
2. That a Member Organization wishing to host a
Wonca World Conference be advised of the levy
to be paid to Wonca World. The amount of the
levy would to be decided on each occasion by
Wonca World Executive. As a guide, a levy of
US$60.oo was recommended.
3. That the agreement to host a Wonca World
Conference between the Host Organising
Committee (and its parent organization) and
Wonca be in the form of a legal contract
specifying the respective duties and obligations
of the HOC and Wonca World.
4. That the concept of ‘Designated Regional
Conference’ be dropped and that all Regional
Conferences using the Wonca name and Regional
logo will be requested to include a levy for
Wonca World. The Wonca World Executive in
consultation with the Regional Presidents of the
respective Regions would decide the amount of
the levy.
As a general guide, a levy of US$30 could be
considered.
Council also voted unanimously in favour of the
proposal to have a contractual agreement between
Wonca World and the Host Organization of the Wonca
Conference.
Revision in the Fee Structure for Wonca Direct
Members.
At its past meetings, Executive had discussed the
issue of the financial dues of Wonca Direct Members
(DM) and felt that it was time that some changes be
introduced. It became clear with recent cost analysis
that Wonca World was incurring substantial financial
loss in processing the DMs following the earlier decision
some years ago to divide the DM dues between Wonca
World and the Regions. In brief, it was costing Wonca
almost US$45 to process and service a Direct Member
per year, which, ironically, meant that the more Direct
Members Wonca had, the more Wonca was losing
financially. In those Regions where part of the DM dues
were apportioned to the Region, Wonca World was in
fact subsidising substantially the Direct Member whilst
the Region received the full apportioned dues.
Executive felt that this current arrangement was not
tenable in the long term and requested World Council to
review the situation with some recommendations it had
proposed.
After much clarification and discussion, World
Council adopted the following:
1.In principle agreement to an increase in the Direct
Membership Dues, except for developing
countries, which would remain unchanged for the
3 year category at US$100.
2.Using the “Wonca World” category of membership
as a working basis, Council recommended that
the proposed new dues of US$75 for a 1-year
membership, and US$165 for 3-years membership
be the upper limit of the fee increase. The other
dues structures where applicable for the Regions
would have to be re-worked and fine tuned with
the respective Regions.
WONCA
News
FROM THE CEO’S DESK
5
3.To keep the dues increase to a minimum, Wonca
should consider a one-time non-refundable
joining fee of an agreed US$ amount.
World Council requested that the changes in the
financial dues structure be effective as from 1
st
January
2005. The CEO was to draw up the new format and
obtain the agreement of all Regional Presidents before
implementing the new structure.
Incorporation of Wonca and Wonca Trust
As this was the first Wonca World Council to be held
since the move of the Wonca World Secretariat from
Melbourne, Australia to Singapore, Executive felt that it
was necessary that World Council be fully briefed on the
processes involved in the incorporation of Wonca as a
legal entity.
The CEO explained in detail to Council the legal
status of Wonca and why the establishment of the
respective companies, World Organization of Family
Doctors Limited (Wonca Ltd)”, and Wonca International
Incorporated (Wonca Inc) and the Wonca Trust, was
necessary in the interest of the Wonca.
He reported that in the first 27 years of its 31 years
existence, Wonca had not been registered as a legal
entity due to its unique nature and the jurisdictions
within which it had been operating, and into which
Wonca did not neatly fit. For all intent and purposes,
Wonca was an unincorporated ‘club’ of international
members that had been operating on trust and
goodwill, bound contractually by its Bylaws. As Wonca
had no express domicile, (ie. it was not registered
anywhere), it could be problematic in future if any legal
issues arose.
As Wonca evolved into an organization with
increasing intellectual properties (eg, ICPC, Guidebook),
this made Wonca (the non-legal entity) vulnerable.
Therefore, with the advice of Wonca’s Honorary Legal
advisor, Executive had embarked upon the best course
of action in the interest of the Organization, that would
give Wonca legal standing.
(In my earlier CEO’s Column I had written quite
substantially on the two legal entities formed for Wonca,
namely World Organisation of Family Doctors Ltd (Wonca
Ltd) and Wonca International Incorperated (Wonca Inc). I
shall not repeat the details in this Column).
The CEO reported to Council that the Directors of
Wonca International Inc were the President of Wonca,
the President Elect of Wonca, and the CEO of Wonca.
These three persons were also the three shareholders,
which meant that each person owned 33% of Wonca’s
assets and this would form part of their estate at death.
This was found to be again an untenable situation
for the Organisation. Therefore, in consultation with
Wonca’s Honorary Legal Advisor, it was advised that the
Wonca Trust be established.
Wonca Trust
The CEO went on to explain to Council the nature of
a Trust. He said that a Trust is a special type of legal
entity arising from a relationship between the Settlor,
the Trustee and the Beneficiary. By setting up the Wonca
Trust, Wonca’s assets, formerly in the name of the three
shareholders, would now be transferred to that Trust
which is owned by Wonca, the Organization. The
Executive Committee would be the Trustee of the Wonca
Trust.
The CEO told Council that he felt that the whole
incorporation process of Wonca had been a worthwhile
and necessary exercise in the prudent management of
the Organization as Wonca is now a legal entity.
The Council commended the CEO on facilitating the
incorporation of Wonca and agreed that the Wonca Trust
be set up.
Wonca accepts its 100
th
Member Organisation
In his report to World Council, Professor Warren
Heffron commented that 2002 - 2004 had been an
exciting triennium with the largest ever number of
organizations admitted into Wonca Membership.
Since the last Council Meeting in May 2001 in South
Africa, 27 new organizations have become Member
Organizations (this included 4 OCRs), and one
Organization, Centro Studi e Ricerche in Medicina
Generale (CSeRMEG), Italy, was upgraded from Associate
Member to Full Member.
He added that at the time of preparing his report,
Wonca had 97 Member Organizations in 79 countries;
(this included 9 OCRs). With the resolution passed at
the Executive Meeting in St Augustine to accept the
resignation of the IMA College of General Practitioners,
India, this brought the number to 96 Organizations in
Wonca.
Prof Heffron then proceeded to announce the names
of the four new Member Organisations whose
applications were approved at the recent Wonca
Executive held in St Augustine. These were (in
alphabetical order) :
The Costa Rican Association of Specialist in Family
and Community Medicine
The Dominican Society of Family Medicine
The Latvia Association of Rural Family Doctors and
The Paraguayan Society of Family Medicine
This makes the Paraguayan Society of Family
Medicine, the 100
th
Member Organisation of Wonca. This
announcement was met with significant applause and
expressions of congratulations to the Organisation.
Prof Heffron was thanked for a task well carried out.
Wonca Academic Membership
At the 2001 Wonca World Council at Alpine Heath,
South Africa, the proposal for an academic membership
category for Wonca was made to Council. This proposal
was accepted by Council and the Wonca Executive was
tasked to report back at the next World Council on the
specific recommendations.
Prof Sparks, who was the Chair of the Ad-hoc
Committee to look into the proposal, reported to the
Orlando World Council that the Wonca Academic
Memberships details had been thoroughly discussed at
Executive and the technical specifics had been included
in the Bylaws and Regulations (Sept 2003) Document.
The Academic Department category of membership
would become effective once the Wonca Bylaws and
Regulations (Sept 2003) were ratified at the next Council
Meeting in July 2007, in Singapore.
He gave the details as follows :
Fee and conditions
1.The membership would be to the Departments of
FM/GP as a whole unit.
2.The individuals of the Department would not be
considered
as
Direct Members.
3.The Academic Department Membership dues would
be US$100 per annum, renewable on an annual
basis. This dues was calculated to cover the base
cost of US$45 of processing membership, plus the
cost of producing the various publications given to
members.
Benefits of Academic Membership
1.Wonca Directory (one copy)
2.Wonca News (six issues annually)
3.Web-based services
(eg. research database, networking opportunities,
educational networks, professional exchanges).
Following some discussions and clarifications given
by Prof Sparks, Council accepted the recommendation of
the Executive that the Academic Membership Category
be set up.
Bid for the 19
th
Wonca World Conference in 2010
Three Member Organisations made bids to host the
19
th
Wonca World Conference to be held in 2010. These
were :
The Greek Association of General Practitioners
The Mexican College of Family Medicine
The Chinese Taipei Association of Family Medicine
Each bidding Organisation was given a 20 minute
time slot to make a presentation to Council at the end
of the first day of the Council Meeting.
The voting by Council for the Host for the 19
th
Wonca
World Conference was held on the morning of the final
day of Council Meeting on 12 October 2004.
The Mexican College of Family Medicine was voted
by Council to be the Host for the 19
th
Wonca World
Conference in 2010 and the venue will be at the Cancun
Congress Centre in Mexico.
Several other important issues were discussed by the
World Council. They will be the subject of some of the
CEO’s Columns in future issues of Wonca News in the
coming year.
Dr Alfred Loh
CEO
December 2004
WONCA
News
FROM THE CEO’S DESK
6
FEATURE STORIES
FAMILY DOCTORS FROM
96 COUNTRIES GATHER
FOR 17
TH
WONCA WORLD
CONFERENCE
Some 7,000 family doctors, the
largest world’s gathering of family
physicians and general practitioners
in more than a decade congregated
in Orlando, Florida from October 13
to 17, 2004 for the 17
th
Wonca World
Conference and the 2004 Scientific
Assembly of the American Academy
of Family Physicians. Wonca
participants totaled more than 2500,
including 1,813 physicians, 183
health care professionals and 672
accompanying persons. In addition,
Wonca participants mingled with
more than 5,000 other physicians
and thousands of exhibitors
attending the AAFP Scientific
Assembly. In all, the Wonca World
and AAFP meetings drew 20,773
physicians, health care
professionals, exhibitors and others
to Orlando from 96 countries across
the globe.
Wonca participants and guests
were treated to a joint Wonca 2004
and AAFP Assembly opening
ceremony that shared the rich
diversity and exuberance of the
world and its family doctors through
a slide presentation, songs and
dance. Opening greetings were
given by AAFP dignitaries and by
Wonca President Michael Boland
and Wonca Executive member Dan
Ostergaard, who also served as
Chair of the AAFP’s Host Organizing
Committee (HOC).
FROM THE EDITOR:
THE WONCA ‘FAMILY REUNION’ IN ORLANDO
Beginning in 1972 and every three years hence, family doctors from
around the world have come together for the Wonca World Council Meeting
and the World Conference of Family Doctors. This issue of Wonca News
highlights the 17
th
such Wonca ‘family reunion’ that took place in Orlando,
Florida, USA this past October.
Since the 16
th
Wonca global meetings in Alpine Health and Durban, South
Africa, in May 2001, both Wonca and the world at-large have undergone
significant changes and taken seemingly divergent paths. During the past
triennium, the world has seen the appearance of terrorism, civil conflict and
global pandemics, such as SARS, which suggests a path that appears less
harmonious and hopeful. Yet, this issue of Wonca News demonstrates that
the World Organization of Family Doctors has taken quite a different journey,
growing exponentially in size, diversity, richness, compatibility and
understanding. Indeed, the stories and photos demonstrate how far Wonca
has traveled during the last triennium in establishing one global family.
This issue of Wonca News also paints a challenging but hopeful picture
of the road that lies ahead in the upcoming triennium. . In his first
President’s Column, Professor Bruce Sparks describes the roadmap that will
guide this triennium’s journey. In his CEO’s column, Dr Alfred Loh
summarizes the key Executive Committee decisions that will have a bearing
on the mode and manner of Wonca’s journey. In addition, several articles
describe the influence of Wonca’s family doctors in meeting people’s health
needs in the European Union and around the world. The message of the
WHO Assistant Director-General, Dr Tim Evans, describes important
opportunities that Wonca may have in developing a global workforce of
family doctors.
As we embark on this new triennium, your reports and photos of your
journey are most welcome in future issues of Wonca News. I look forward
to reading your stories, and sharing them with our Wonca family.
Marc L. Rivo, MD, MPH
Editor, Wonca News
marcrivo@aol.com
4566 Prairie Avenue
Miami Beach, FL 33140 USA
1-305-674-8839 (fax)
WONCA
News
FROM THE EDITOR / FEATURE STORIES
7
DNA, convinced the audience that
genomic information will become
increasingly important to the care of
patients and that family physicians
can and should play a key role in
applying genomics in primary care.
Other keynote speakers also
raised the important role of family
doctors in addressing the world’s
health challenges. Doctor Godrey
Sikipa, a public health specialist
from Zimbabwe and member of the
United Nations Joint Program on
HIV/AIDS, shared that 90% of the
630,000 childhood cases of
maternally transmitted HIV are from
sub-Saharan Africa. Managing AIDS
effectively requires the doctor to
involve a patient’s family, hence
making it the province of family
physicians, said Sikipa. He noted
that 35 countries are facing
physician shortages, and he urged
family physicians to consider
rotations into the areas of need.
Keynote speaker Barbara
Starfield, M.D., M.P.H., presented
evidence that the best care is
primary care. The Professor of
Health Policy and Management at
the Johns Hopkins University School
of Public Health in the USA cited
numerous measures, such as infant
mortality and life expectancy
demonstrated that primary care-
oriented health systems are
associated with healthier
populations that live longer. Citing
international studies, Dr Starfield
said primary care “is more effective,
efficient and more equitable” than
specialty care and that increasing
the number of primary care
physicians is positively associated
with improved health outcomes.
The Scientific Program
Committee and its Chair, Dr Robert
Taylor, provided a dynamic and rich
educational array of plenary
speakers, workshops, and other
interactive venues. A total of 1,246
abstracts from 78 countries were
WONCA
News
FEATURE STORIES
8
accepted for the 17th World
Conference of Family Doctors. Eight
abstracts were submitted and
presented in Spanish. The Wonca
program book contained 1,224
abstracts from the meeting. The
abstracts included 574 oral
presentations, 483 posters, 106
workshops and 61 symposia.
Wonca delegates on their way to the
Scientific Assembly
Wonca delegates from Spain discuss a poster
board presentation
The Wonca participants from all
over the globe took full advantage
of Orlando’s warm and sunny days
and their spectacular, one-of-a-kind
theme parks. The Wonca Council
was treated to a special dinner at
the Epcot Center followed by a
water show and fireworks extra-
vaganza. The Wonca and AAFP
Assembly registrants were given two
free evening passes to a member-
only evening at Orlando’s Universal
Studios theme parks.
For those who attended, Orlando
provided a warm and hospitable
forum to make new friends and
renew old friendships, to share and
learn, and to advance the cause of
family medicine and people’s health
needs around the globe. All things
considered, the 17
th
Wonca World
Conference in Orlando was a
Wonca President Michael Boland at the
Opening Ceremony
Dr Dan Ostergaard, Chair of the Wonca 2004
Host Organizing Committee receiving a gift of
thanks from Dr Pratap Prasad (left) from
Nepal and Wonca MESAR President Shatendra
Gupta (right)
Gracious thanks in the form of
warm applause was given to
Dr Ostergaard and the AAFP’s HOC
for its special Wonca bursary
program. Generous donors
contributed $100,000 (US) through
the AAFP Foundation for a Wonca
bursary program which provided
registration, travel and accom-
modations to 90 family doctors from
39 countries would otherwise been
unable to attend. “Colleagues from
around the world, despite many
challenges, you are here,” said
Doctor Ostergaard. “Now more than
ever, there is a need for inter-
national cooperation toward the
betterment of our specialty and our
patients’ health — international
cooperation that transcends national
political issues.”
Francis Collins, M.D., Ph.D.,
Director of the US National Human
Genome Research Institute, gave the
opening ceremony’s keynote.
Collins, the researcher who led the
Human Genome Project which
mapped and sequenced human
wonderful example of what is
possible when family doctors from
around the globe unite in a spirit of
friendship, understanding and a
common purpose.
Wonca World Council Elects
Leadership, Sets Direction for
the Triennium
The opening moments of the
2004 Wonca World Council meeting
in Orlando set an enthusiastic and
optimistic tone for the meeting and
the upcoming triennium. The World
Council opened to a standing
ovation as the 17 member
organizations comprising Wonca’s 6
th
and newest region, Iberoamericana-
CIMF were officially seated for the
first time. At the conclusion of the
Wonca member organization roll
call, 30 new member organizations
were welcomed for the first time
from Eastern Europe and Central
Asia, the Arab region and Africa, as
well as from Central and South
America.
From left to right, Wonca CEO Alfred Loh,
Wonca Past President Michael Boland and
Wonca President Bruce Sparks
Wonca Administrative Manager, Yvonne Chung
(Singapore), Dr Sylvester Osinowo (Nigeria)
and Dr Maria Teresa Velasco (Mexico) show
the beautiful and varied dress of the Wonca
member organizations
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9
Professor Chris van Weel, right, of The
Netherlands, celebrates his election as Wonca
President-Elect with fellow Dutch GP
colleagues, Dr. Arno Timmermans, center, and
Dr Fons Sipps during the Wonca Council
meeting.
Wonca President Bruce Sparks with Council
Members of his Africa Region (from left to
right), Sylvester Osinowo (Nigeria), Shadrick
Mazaza (South Africa), Mercy Abiorh-Odjidja
(Ghana), EM Obazee (Nigeria), and Benedict
Opkala (Nigeria)
Doctor Michael Boland from
Ireland, Wonca’s President for the
2001 to 2004 triennium welcomed
the Council members and noted the
dramatic growth of the Wonca family
as its membership reached the
magic number of 100 member
organizations for the first time in its
history. Doctor Alfred Loh, Wonca
CEO, described the transition to and
significant development of the
Singapore Secretariat since its
opening in 2002. During the next
four days, the Wonca Council,
Regions, Working Parties, Task
Forces and Special Interest Groups
reviewed the accomplishments of
the past triennium (see August –
October 2004 Triennium Issue for
details), discussed key policy,
operational and financial issues and
set the course for the new
triennium.
Executive Committee for 2004
to 2007 Triennium
Elections during the World
Council Meeting determined the
global leadership of the World
Organization of Family Doctors for
the 2004 to 2007 triennium. The
Wonca Presidents’ Addresses and
Awards Ceremony served as the
official transition of leadership from
the 2001-2004 to 2004-2007
triennium. After his parting address,
outgoing Wonca President Michael
Boland turned over the office to the
incoming President Bruce Sparks,
who shared his vision, goals and
priorities for the upcoming
triennium. The ceremony ended with
the naming of the first winner of the
Wonca International Award for
Excellence in Health Care (see article
below) as well as the awards for
“Fellowship of Wonca” and
“Honorary Life Membership”.
The 2004 to 2007 Wonca
Executive Committee is comprised of
the following members:
President:
Professor Bruce Sparks, South Africa
Immediate Past President:
Dr Michael Boland, Ireland
President-elect:
Professor Chris van Weel,
The Netherlands
Regional President, Africa
Dr Abra Fransch, Zimbabwe
Regional President, Americas
Professor Warren Heffron, USA
Regional President, Asia-Pacific
A/Professor Goh Lee Gan, Singapore
Regional President, Europe
Professor Igor Svab, Slovenia
Regional President,
Iberoamericana-CIMF
Dr Adolfo Rubinstein, Argentina
WONCA
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1.Nominating and Awards Committee
Chair:Professor Chris van Weel
The Netherlands
Members:Dr Ada Videlei
Venezuela
Dr Nurul Islam
Bangladesh
Dr Bong Yul Huh
Korea
Professor Warren Heffron
USA
2. Finance Committee
Chair:Professor Richard Roberts
USA
Members:Dr Arno Timmermans
The Netherlands
Professor Hava Tabenkin
Israel
Dr Daniel Thuraiappah
Malaysia
3. Membership Committee
Chair:Professor Warren Heffron
USA
Members:Dr Liliana Arias Castillo
Colombia
Dr Matie Obazee
Nigeria
Dr Maarten Klomp
The Netherlands
Dr Sugito Wonodirekso
Indonesia
Dr Pratap N Prasad
Nepal
4. Bylaws and Regulations Committee
Chair:Dr Dan Ostergaard
USA
Members:Dr Geoff D Martin
Australia
Dr Tony Dedeu
Spain
5. Publications and Communications Committee
Chair:Dr Geoff D Martin
Australia
Members:Dr Michael Boland
Ireland
Dr Zorayda Leopando
Philippines
Dr Kumara Mendis
Sri Lanka
Dr Ilse Hellemann
Austria
Dr Carl Steylaerts
Belgium
Dr Gustavo Gusso
Brazil
Dr Marc Rivo (Wonca News Editor)USA
Prof Wes Fabb (GFD Webmaster)Australia
6.Wonca International Classification Committee
Chair:Professor Niels Bentzen
Norway
7. Working Party on Quality in Family Medicine
Chair:Dr Javier Dominguez del OlmoMexico
8. Wonca Working Party on Rural Practice
Chair:Dr James Rourke
Canada
9. Wonca Working Party on Informatics
Chair:Professor Michael Kidd
Australia
10. Wonca Working Party on Women and Family Medicine
Chair:Dr Cheryl Levitt
Canada
11. Wonca Working Party on Research
Chair:Professor Chris van Weel
The Netherlands
Regional President,
Middle East-South Asia
Professor Shatendra Gupta, Nepal
Member-at-Large and Honorary
Treasurer
Professor Richard Roberts, USA
Member-at-Large
Dr Javier Dominguez del Omo,
Mexico
Professor Michael Kidd, Australia
Chair, Bylaws and Regulations
Dr Dan Ostergaard, USA
Chair, Publications and
Communications
Dr Geoffrey D Martin, Australia
Editor, Wonca News (ex officio)
Dr Marc Rivo, USA
Outgoing Wonca President Michael Boland
and 2004-2007 Executive Committee at the
Wonca Presidents’ Address and Awards
Ceremony
Incoming Wonca President Bruce Sparks
receiving the President’s Medal of Office from
outgoing Wonca President Michael Boland
Wonca Committees, Working Parties, Task
Forces and SIGs
During the Wonca World Council
meeting in Orlando, Florida, the
following Chairs and members of
Wonca’s Working Parties, Task Forces
and Special Interest Groups were
elected.
12. Task Force on Tobacco Cessation
Chair:Professor Rick Botelho
USA
13. Wonca Special Interest Group on the Environment
Convenor:Dr Alan Abelsohn
Canada
14. Wonca Special Interest Group on Health Behaviour Change
Convenor:Professor Rick Botelho
USA
15. Wonca Special Interest Group on Ethical Issues
Convenor:Professor Manfred Maier
Austria
16. Wonca Special Interest Group on Psychiatry and Neurology
Convenor:Dr Gabriel Ivbijaro
United Kingdom
17. Wonca Special Interest Group on Travel Medicine
Convenor:Dr Garth Brink
South Africa
18.Wonca Special Interest Group on Men’s Health
Convenor: To be selected
Wonca President Bruce Sparks with honorary Wonca Fellows, Dr Giorgio Visentin, Professor
Roger Strasser and Professor Vince Hunt (from left to right)
Wonca President Bruce
Sparks with Wonca
Honorary Life Members,
Dr Eric McNair (left) and
Dr Michael Boland (right)
Fellowship and Honorary
Membership of Wonca
The Wonca Council gave the
Fellowship of Wonca, its most
prestigious award for service to
Wonca and its mission, to the
following members:
1.Professor Charles Bridges-Webb,
Australia
2.Professor Richard Grol,
The Netherlands
3.Professor Vince Hunt, USA
4.Professor Roger Strasser, Canada
5.Dr Giorgio Visentin, Italy
The Wonca Council also awarded
Honorary Life Membership to the
following members:
1.Dr Michael Boland, Ireland
2.Dr Eric McNair, Zimbabwe
Wonca Celebrates Turning 100
in Orlando!
When the Wonca World Council
previously met in Alpine Heath,
South Africa in 2001 before the 17
th
World Conference for Family Doctors,
the Council represented 71 member
organizations from 57 different
countries. Who at that time would
have believed that Wonca was
about to undergo a historic and
unprecedented growth in member-
ship during the 2001 to 2004
Triennium? Yet, it happened and the
unimaginable occurred. When the
Wonca World Council convened in
Orlando, Florida in October, 2004,
the Council members were greeted
by a dramatic announcement by
Wonca President, Dr Michael Boland
of Ireland, that the organization had
turned 100 …. as in 100 member
organizations!
In three short years, Wonca had
admitted 30 new member organi-
zations, an increase of more than
WONCA
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11
12
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FEATURE STORIES
40% over the triennium. Many of
the seeds for membership growth
were planted and sowed by the past
Wonca Executive leadership, such as
Wonca President Bob Higgins (1998-
2001) and Americas Regional
President Reg Perkin (1993-2001).
Today, Wonca’s 100 member
organizations are from 83 countries
around the globe representing more
than 80% of the world’s population.
As President Boland observed at the
World Council, “Today, Wonca has
become truly a global organization”.
The Paraguayan Society of Family
Medicine (Sociedad Paraguaya de
Medicina Familiar) has the historical
distinction of being the 100
th
member organization of Wonca.
Paraguay was accepted as a Full
Member organization during a
Wonca Executive meeting in
St. Augustine, Florida on Tuesday,
October 5, 2004. Professor Warren
Heffron, President of the Americas
Region and the extremely busy and
productive Chair of the Membership
Committee, recommended their
application for acceptance. That
same day, the Wonca Executive
accepted the applications of three
other member organizations:
•Latvia Association of Rural Family
Doctors, as Associate Member,
pending receipt and approval of
final application materials;
•Costa Rican Association of
Specialists in Family and
Community Medicine (Asociacion
Costarricense de Especialistas en
Medicina Familiar -
Communitaria) as Full Member;
•Dominican Society of Family
Medicine (Sociedad Dominicana
de Medicina Familiar -
SODOMEFA) as Full Member.
During this meeting, the Wonca
Executive Committee regretfully
accepted the resignation of the IMA
College of General Practitioners of
India (however, India is still
represented by the Indian Academy
of General Practice, a full member).
As a result, Wonca completed the triennium with exactly 100 member
organizations.
In addition to its 100
th
member organization, Wonca also added an entire
new region, Wonca Iberoamericana-CIMF to represent Latin America, the
Spanish-speaking Caribbean and the Iberian Peninsula countries of Spain
and Portugal.
Although Wonca’s newest region, Iberoamericana-CIMF’s member
organizations are quite well developed, organized and effective. As a
testimony to the new region’s readiness to contribute meaningfully to the
World Organization of Family Doctors, the Wonca Council selected
Iberoamericana-CIMF’s bid to host in 2010 the 19
th
Wonca World Conference
of Family Doctors in Cancun, Mexico.
Regional President Adolfo Rubinstein (3
rd
from left) and Member-at-Large
Javier Dominguez (4
th
from right) with members of their Iberoamericana-CIMF region
Warren Heffron (right), President of the
Americas Region and Chair of the
Membership Committee, enjoys a light
moment with Philip Evans (left), past
President of the Europe Region
Such growth presents a challenge for an organization with a mission to
improve the standing of primary care worldwide - even in developing
countries with limited resources, President Boland said. “With this global
reach comes global responsibility,” he said. “Some of our new members
have limited resources.” “Our challenge is,” he explained, “how do we
increase resources to improve the position of family medicine in countries
joining us – especially developing countries?” Despite this challenge, much
enthusiasm exists for Wonca continued global expansion in the upcoming
triennium.
WONCA REGIONAL NEWS
PRIMARY CARE
ADVOCATES SHAPING THE
EUROPEAN UNION
The European Union has
increased during 2004 from 15 to 24
member countries. Traditionally
health has not been an EU interest
or responsibility. Individual countries
have retained control over their
health systems. Given the
challenges facing countries in
relation to adequate and
appropriate health care provision,
the Dutch government, currently
holding the EU Presidency held a
conference at the Hague from
September 7-9, 2004, to consider
the future of health care in the EU.
The Dutch College of General
Practitioners and other interested
parties in the Netherlands ensured
that Primary Care was one of the
major topics to be considered at the
EU conference. Wonca Europe
participated in the conference and
made major contribution.
The working group dealing with
primary care issues commented on
the EU’s interest and gradual
involvement in health care. As
politicians and health care planners
to ensure that all patients receive
optimum care, they noted the
following key challenges:
•Meeting patients’ needs. How
to ensure involvement and
empowerment, equity and
solidarity, access to care and
high quality services?
•Addressing the growing
number of elderly. How to
effectively address the
increases in both chronic
diseases and co-morbidity?
•Attaining the goals of quality
and affordability. How does
society and government meet
the requirement of clinically
effective and cost effective
health care?
•Encouraging flexibility. How
do can health systems
respond rapidly to specific
scientific, medical and social
developments?
•PHC be provided on a
multidisciplinary basis with
effective support from
health care management. In
addition, close and col-
laborative links need to be
maintained with secondary
care services as well as public
health services.
Concern was expressed regarding
the possible development of market
based models of health care
systems within the EU. Any market
mechanism should able to support
and improve health care in relation
to ageing populations, chronic
illness and vulnerable groups and
underpin the commitment to
comprehensive care, equity and
community solidarity. It was noted
that the EU Social Protection
Committee is required to set up the
open method of coordination on
health care and long term care, and
develop common targets for
member states to achieve.
They present the following
specific points related to PHC:
•Evidence indicates that health
systems with a high PHC
orientation are more clinically
and cost effective.
•PHC is an investment in the
local community providing
economic develop, social
cohesion and cooperation, in
addition to health benefits.
•PHC should be an essential
factor in the empowerment of
patients.
•PHC targets and indicators
should be incorporated so
that member states can be
WONCA
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REGIONAL NEWS
compared on the basis of
PHC orientation.
The report on European Primary
Health Care (PHC) to this conference
provided clear evidence that PHC,
with its essential values,
characteristics and proven effective-
ness should form the basis and a
significant part of health care
provision to meet the above needs.
The group proposed an EU Primary
Health Care Forum to help translate
the evidence of PHC’s effectiveness
into coherent policy.
The European Commission was
represented at the meeting. It was
noteworthy that during the
comments from the Commission at
the end of the conference the only
specific area of care to be high-
lighted by the Commission for new
attention was Primary Health Care.
Wonca Europe will be following
developments in relation to this EU
initiative.
Dr Philip Evans
Immediate Past President
Wonca Europe Region
Register Now for the May 2005
Asia-Pacific Regional Conference In
Japan
The Organizing Committee and
the Japanese Academy of Primary
Care Physicians are both pleased
and honored to be hosting the
World Organization of Family
Doctors Wonca Asia Pacific Regional
Conference 2005 from May 27 to 31,
2005, in Kyoto, Japan. The theme of
the conference will be “General
Practice /Family Practice— As a
Global Standard.”
In the 21st century, the number
of qualified family physicians and
general practitioners capable of
diagnosing illness synthetically has
increased worldwide. This
13
Tsukasa Tsuda, M.D., Ph.D.
Chairperson
Host Organizing Committee
Makoto Komatsu, M.D.
Honorary Chairperson
Host Organizing
Committee
development has increased the
need for the adoption of global
standards for family physicians and
general practitioners. Consequently,
the scientific program of the
conference will deal with education
and training, research, quality
assurance, and more efficient use of
funds in order to meet this require-
ment according to the principles of
primary care — specifically, “com-
prehensiveness”, “communication”
and “coordination.”
By engaging in discussions and
exchanges of information at the
conference, participants will be able
to acquire the latest information and
knowledge as well as new skills. As
a result, they will be able to
contribute significantly to solutions
to various medical issues in their
home countries. This will clearly
promote health and social welfare
not only in the Asia Pacific Region,
but worldwide.
The conference site will be the
Kyoto International Conference Hall,
one of Japan’s most reputable
conference centers. Host to
numerous scientific meetings
throughout its history, the hall is
situated on an attractive site
convenient to the center of Kyoto.
May is a particularly pleasant time
of year in Kyoto, as the city is
suffused with emerging greenery
during the spring season. Kyoto is
also renowned for its illustrious
history. From 794 to 1868, the city
reigned as Japan’s capital and home
to the Imperial Court. The city
embodies a wealth of traditional art,
architecture and crafts that have
been carefully preserved in more
than 1,600 Buddhist temples and
270 Shinto shrines. Participants will
be able to take advantage of
Kyoto’s many cultural properties in
addition to enjoying the stimulating
scientific program.
To learn more about the Asia
Pacific Regional Conference and to
register online, please visit our web
site at http://www.wonca2005.jp/.
Additional contact information is
available in this issue under “Global
Meetings for the Family Doctor”.
We pledge to do our utmost,
together with the members of the
Japanese Academy of Primary Care
Physicians, to ensure the conference
is fruitful and productive for all. We
look forward to welcoming you to
Kyoto in May 2005.
The Greek Island of Kos to Host
September 2005 Europe Regional
Conference
It is an honour and a privilege to
invite you to the 11th Conference of
the European Society of General
Practice/Family Medicine-WONCA
Region Europe, which will be held in
Greece from the 3rd to the 7th of
September 2005.
The overall theme of the
Conference has been determined to
be “From Hippocrates to the Human
Genome: The Past, Present and
Future of General Practice/Family
Medicine.”
It is time to re-examine the
Hippocratic principles, taking into
consideration the large and recent
scientific breakthroughs and to test,
in terms of time endurance, our
classical values in order to reassure
them. As far as Greece is concerned,
the country that has invented Family
Medicine in the past, it will have the
chance to reinvent it once more in
the Conference, as well as to reform
any basic principles while
monitoring the evolution of General
Practice along with its challenges.
We believe that the concept of
Family Medicine is a classical one.
Nevertheless, we strongly feel that it
is our duty to argue on our belief
and to prove that our specialty is
the actual core of Medicine itself; to
such an extend this is, that the later
cannot evolve as a science and a
function in the absence of the
former.
Bodossakis Merkouris
HOC Chairman
The Conference will be organized
in the island Kos, the birthplace of
Hippocrates. Kos is a place where
antiquity and modern civilisation
find themselves in unison. The
island of Kos is situated in the
southeastern region of the Aegean
Sea and is the third largest
(295 sq. m.) of the Dodecanese
Islands. Kos is an island of
magnificent beauty also described
as the jewel of the Greek Islands.
Besides its breath taking golden
sandy beaches, Kos is also full of
ancient monuments, remnants from
its glorious past. Kos is the site of
the famous Hippocrates’ Plane tree,
where the father of modern
Medicine used to teach and practice
medicine. This is considered to be
the oldest tree in Europe. It is also
home to the Asclepion of Kos, a
temple dedicated to the Asclepios,
the god protector of health in
ancient Greece. The island’s mild
climate, among the finest in the
Mediterranean, is the primary reason
for the island’s abundant green and
other physical charms. No wonder
that people call it “the garden of the
Aegean”.
To learn more about the 2005
Europen Regional Conference and to
register online, please visit our web
site at
http://
www
.woncaeur
ope2005.or
g/.
14
WONCA
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REGIONAL NEWS
15
WONCA
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REGIONAL NEWS / HEALTH AND HEALTH SYSTEM NEWS
HEALTH AND HEALTH
SYSTEM NEWS
WHO’S ASSISTANT
DIRECTOR GENERAL
CALLS FOR GLOBAL
FORCE OF FAMILY
DOCTORS
Timothy Evans, M.D., Ph.D., the
World Health Organization’s
Assistant Director-General for
Evidence and Information for Policy,
carried an important message to
Wonca’s leadership and its family
doctors during the 17
th
Wonca World
Conference in Orlando. He wants the
organization to create a global
health workforce of family doctors
to join WHO’s campaign to provide
health care and developmental
assistance to the world’s neediest
populations.
Doctor Evans, a Canadian born
physician-health economist and
former Director of Health Equity at
Additional contact information is
available in this issue under “Global
Meetings for the Family Doctor”.
We are waiting to welcome you
to our beautiful country so that we
could offer our hospitality, always
under the gaze of Zeus, protector of
guests according to the ancient
Greek tradition.
Bodossakis-Prodromos R.Merkouris
Chairman, Host Organizing
Committee
Greek Association of General
Practitioners
Among the most important
barriers to achieving the MDGs is a
massive shortage of health workers,
with the challenge of mobilizing a
million health workers by 2010 to
provide needed health services.
“For example”, said Dr Evans, “WHO
data indicate that there are from
nine to 10 health workers for every
1,000 people in the United States
and many European nations.
Globally, the average is 4.2 health
workers for every 1,000 people, but
in sub-Saharan Africa, it is 0.8 per
1,000 people,” he said, “making the
delivery of essential health care
virtually impossible”.
Physicians, especially family
doctors, are needed to help deliver
essential health services.
“In the last 25 years, a sense
has developed that the poor can do
without a doctor,” observed Dr
Evans. “Yet, where there is no
doctor, health outcomes are
increasingly worse and people die.”
Evans challenged Wonca to
promote “family doctors sans
frontieres.” He said these new
global family physicians should be
trained with special curricula that
“focus on populations in the
greatest health need.” Using this
model, Evans said family medicine
might develop an accredited
subspecialty in “global family
practice”. He shared his notion of
an “Africa Health Works” recruiting
brochure for family doctors. The
marketing materials emphasized “an
exciting and challenging work
environment”, to be “a part of a
global workforce”, and “part of a
team delivering essential primary
care”, where “a doctor can save
more lives in a month than a
lifetime”.
In addition to recruiting
physicians for global practice, Evans
said WHO invites Wonca to
nominate a commissioner to be
the Rockefeller Foundation prior to
joining the WHO, was the keynote
speaker at the Wonca plenary
session entitled “Family Doctors in
the 21st Century: Embracing the
Global Health Imperative.” His
delivered a powerful message that
WHO needs to recruit a million more
health care workers – including
family physicians – to meet the
millennium development goals, or
MDGs, established by WHO and the
United Nations Development Fund in
2002. The MDGs, which include
health goals for child mortality,
maternal health, tuberculosis,
malaria and HIV/AIDS address the
fundamental determinants of human
development in all countries (see
article below).
Dr Timothy Evans,
WHO Assistant
Director General
For Evidence and
Information for
Policy
In his plenary, Dr Evans
described significant global
challenges to human development
in the 21
st
century. Health challenges
include enormous inequalities in
health status among countries
beginning in childhood where the
infant mortality rate in sub-Saharan
Africa with more than 175 deaths
per 1,000 live births. A major
challenge to health status
improvement is “an information
paradox”, the lack of meaningful
health information, which the WHO’s
Assistant DG called “the first
injustice”. Fundamentally, Dr Evans
exclaimed, “if you can’t count
people, then people don’t count”.
An Oxford trained economist and
Harvard trained general internist
and former international health
economics professor, Dr Evans is
responsible for helping the WHO
developing an effective health
information infrastructure to
measure the MDGs.
16
WONCA
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HEALTH AND HEALTH SYSTEM NEWS
considered for WHO’s new Commission on Social
Determinants of Health. The commission was created to
address a fundamental problem facing world health:
returning recently treated patients – especially young
children – to the subpar living conditions that caused
their sickness in the first place. “What good does it do
to treat people and then send them back to the
conditions that made them sick?” Dr Evans asked.
In addition to his plenary presentation, Dr Evans met
with the Wonca Executive to discuss elements of a col-
laborative agenda between Wonca and WHO in the
upcoming triennium. Before catching a return flight to
Geneva, Dr Evans joined the Executive Committee on-
stage for the Wonca Presidents’ Address and Awards
Ceremony. In his parting comments, Dr Evans
summarized the many important potential areas for
mutual collaboration between Wonca and the WHO,
including rural and remote health care, health
information data enhancement such as the International
Classification of Primary Care, as well as family medicine
development initiatives in Africa and other medically
underserved areas in the world.
Both the message and WHO’s messenger were
enthusiastically embraced by Wonca’s leadership and its
audience of family doctors from 96 countries around the
globe.
UN Sets Ambitious Millennium Goals for Health,
Education and Development
The Millennium Development Goals commit the
international community to an expanded vision of
development, one that vigorously promotes human
development as the key to sustaining social and
economic progress in all countries, and recognizes the
importance of creating a global partnership for
development. The goals have been commonly accepted
as a framework for measuring development progress.
Many of the targets of the MDGs were first set out by
international conferences and summits held in the
1990s. They were later compiled and became known as
the International Development Goals. (For a review of
progress on the International Development Goals see
www
.paris21.or
g/betterworld.) In September 2000 the
member states of the United Nations unanimously
adopted
the M
illennium D
eclaration. Following con-
sultations among international agencies, including the
World Bank, the IMF, the OECD, and the specialized
agencies of the United Nations, the General Assembly
recognized the Millennium Development Goals in 2002
as part of the global road map for implementing the
Millennium Declaration.
Millenium Development Goals for 2015
The United Nations adopted 8 Millennium
Development Goals and 18 targets to reach by 2015.
Approximately 50 indicators are proposed that would
help the UN and its member nations track progress
towards achieving the goals. The 8 MDGs and 18
targets are as follows:
1.Eradicate extreme poverty and hunger
•Target 1: Halve, between 1990 and 2015, the
proportion of people whose income is less than
$1 a day
•Target 2: Halve, between 1990 and 2015, the
proportion of people who suffer from hunger
2.Achieve universal primary education
•Target 3: Ensure that, by 2015, children
everywhere, boys and girls alike, will be able to
complete a full course of primary schooling
3.Promote gender equality and empower women
•Target 4: Eliminate gender disparity in primary
and secondary education preferably by 2005 and
in all levels of education no later than 2015
4.Reduce child mortality
•Target 5: Reduce by two-thirds, between 1990
and 2015, the under-five mortality rate
5.Improve maternal health
•Target 6: Reduce by three-quarters, between 1990
and 2015, the maternal mortality ratio
6.Combat HIV/AIDS, malaria, and other diseases
•Target 7: Have halted by 2015 and begun to
reverse the spread of HIV/AIDS
•Target 8: Have halted by 2015 and begun to
reverse the incidence of malaria and other major
diseases
7.Ensure environmental sustainability
•Target 9: Integrate the principles of sustainable
development into country policies and program
and reverse the loss of environmental resources
•Target 10: Halve, by 2015, the proportion of
people without sustainable access to safe
drinking water and basic sanitation
•Target 11: Have achieved, by 2020, a significant
improvement in the lives of at least 100 million
slum dwellers
WONCA
News
HEALTH AND HEALTH SYSTEM NEWS / MEMBER AND ORGANIZATIONAL NEWS
MEMBER AND ORGANIZATIONAL NEWS
WONCA’S FIRST INTERNATIONAL EXCELLENCE IN
HEALTH CARE AWARD TO PROFESSOR DE MAESENEER
Professor Jan De Maeseneer was selected to be the first recipient of
Wonca’s International Award for Excellence in Health Care, also called
the’“Five Star Doctor Award”. This distinguished international recognition
was presented by Professor Chris van Weel, Wonca’s President Elect, during
the Presidents’ Award Ceremony on October 15, 2004 at the 18
th
World
Conference of Family Doctors in Orlando, Florida, USA.
In bestowing the award, Professor van Weel stated, “Jan De Maeseneer’s
professional contribution to family medicine has been directed at addressing
the important health problems in our populations, striving for more
effective, more efficient, more timely, safer health care and securing fairness
and equity towards those in greatest need.”
Professor Jan De Maeseneer (left),
holding his Wonca International
Award for Excellence in Health
Care, with Wonca President-Elect
Chris van Weel
17
8.Develop a global partnership for
development
•Target 12: Develop further an
open, rule-based, predictable,
nondiscriminatory trading and
financial system (includes a
commitment to good
governance, development,
and poverty reduction—both
nationally and internationally)
•Target 13: Address the special
needs of the least developed
countries (includes tariff-and
quota-free access for exports
enhanced program of debt
relief for HIPC and
cancellation of official
bilateral debt, and more
generous ODA for countries
committed to poverty
reduction)
•Target 14: Address the special
needs of landlocked countries
and small island developing
states
•Target 15: Deal compre-
hensively with the debt
problems of developing
countries through national
and international measures in
order to make debt
sustainable in the long term
•Target 16: In cooperation with
developing countries, develop
and implement strategies for
decent and productive work
for youth
•Target 17: In cooperation with
pharmaceutical companies,
provide access to affordable,
essential drugs in developing
countries
•Target 18: In cooperation with
the private sector, make
available the benefits of new
technologies, especially
information and
communications
Achieving the MDGs by 2015 will
require more focus on development
outcomes and less on inputs, to
effectively measure national
progress towards meeting the
MDGs, and to engage even more closely with our partners in helping
governments improve human development. The goals establish yardsticks
for measuring results, not just for developing countries but for rich countries
that help to fund development programs and for the multilateral institutions
that help countries implement them. The first seven goals are mutually
reinforcing and are directed at reducing poverty in all its forms. The last
goal-global partnership for development - is about the means to achieve the
first seven. Many of the poorest countries will need additional assistance
and must look to the rich countries to provide it. Countries that are poor
and heavily indebted will need further help in reducing their debt burdens.
And all countries will benefit if trade barriers are lowered, allowing a freer
exchange of goods and services.
For the poorest countries many of the goals seem far out of reach. Even
in better-off countries there may be regions or groups that lag behind.
Countries need to set their own strategies and work, together with the
global partners, to ensure that poor people are included in the benefits of
development.
(Editor’s note: Further information on the United Nation’s Millennium
Development Goals and progress to date can be found at
http://www
.un.or
g/millenniumgoals/ )
18
WONCA
News
MEMBER AND ORGANIZATIONAL NEWS
Jan De Maeseneer was born in 1952 in the ancient
Flemish city of Ghent, Belgium, where he subsequently
entered medical school and then practiced as a family
physician. He began one of the first multi-disciplinary
community health centres in the country, ‘de Botermarkt’
in the deprived area of Ledeberg. He started this centre
together with his wife, Anita De Winter, at that time also
a family physician and currently a psychiatrist. This
decision to serve and advocate for underserved
populations has been Jan’s trademark ever since, as he
has passionately moved Belgian health care policy
towards meeting its population’s needs.
Jan De Maeseneer’s on-going commitment to health
care for the people in Ledeberg has also been the basis
for his academic work. In 1978, he started as a part-time
research assistant at the Department of Public Health.
In 1981, he moved to the Department of Family
Medicine, at the University of Ghent. His PhD thesis in
epidemiology was the very first in-depth analysis of
morbidity encountered in Belgian communities and the
effectiveness and efficiency of GPs’ performance caring
these health problems.
In 1991, he was appointed Chair of Family Medicine
at Ghent University. As Chair, he led efforts to restruc-
ture the undergraduate curriculum and imprinted a
community orientation, evidence based focus to both
the research and teaching programmes of the medical
school. A growing stream of international publications
followed from the Community Oriented Primary Care
model applied in ‘de Botermarkt’ in Ledeberg: with its
focus on developing a multi-disciplinary team; pursuing
a community oriented diagnosis; structuring care at the
level of the neighbourhood; addressing health, poverty
and accessibility of health care; tackling epidemics in
the community; and providing inter-cultural care. In this,
a working relation has been established with important
groups in the community (eg, women, elderly) to tailor
care, and also to other professionals. The investment in
health care, as a consequence, did pay dividends as
well in areas like education and safety.
These achievements in itself would qualify, but it is
particularly in the way Jan De Maeseneer did pursue
this, that makes him the true five-star family doctor. He
sought to improve Belgian health care by sharing this
development process with others – acting locally, but
thinking globally. As a consequence, the experiences in
the Ghent medical school and the multidisciplinary team
in Ledeberg are also the basis of collaborations with the
universities of Cochabamba, Bolivia, Cape Town South
Africa, Yaounde, Cameroon, and throughout Europe.
It is the unbeatable combination of the head and the
heart that form this true five-star doctor and make
professor Jan De Maeseneer the first winner of the
International Award for Excellence in Health Care.
(Editor’s note: This article is excerpted from Professor
van Weel’s presentation of the Wonca International
Excellence in Health Care: The 5 Star Doctor Award.
Those interested in contacting Professor Maeseneer are
welcome to email him at’jan.demaeseneer@ugent.be )
Italy Increases Its Presence In Wonca
In Italy there is not one college of GPs. Instead, one
may belong to a number of representative organizations
from different scientific societies. Wonca is increasing in
importance among the Italian general practitioners. In
1992, CSERMEG became an Associated Member of
Wonca (around 70 members). In 1995, ISDE (around 100
members) became an Associate Member. In 1999, AIMEF
became an Associate Member (around 800 members). In
2001, CSERMEG was selected to be the organizer of the
Wonca Europe 2006 Regional Conference and in 2002
became a full member.
Assimefac is the result of the fusion between
Asscumi and Simefac. It is a broad organisation (2500
members). Asscumi was formerly a research group (with
several research project performed together with
Csermeg) with a strict link with the Trade Union Cumi,
Simefac is coming from the University and was dealing
with the epidemiology. Assimefac is interested more on
CME and on research, its link with the University may be
an open door to have an official specialty in Family
Medicine in Italy. As they join together they started to
be interested to the international topics and they asked
to be officially involved in Wonca. In 2004, Assimefac
became a full member. SNAMID is now asking for
membership.
Although the numbers are not exceptional for Italian
general practice (around 30,000 GPs practice in Italy),
an increasing interest is observed. The idea of all GP
organizations coming together for the European Con-
ference is becoming more and more appealing for the
Italian scientific society, and, when CSERMEG asked
them to send an official representative for the scientific
committee of Wonca 2006 they all (ACP, SIMG, SNAMID,
ASSIMEFAC, AIMEF, SIMEF, SIQuAS) accepted.
The Scientific Committee of 2006 Conference now for
the first time represents all Italian General Practitioners.
After some introductory meetings, the Scientific Com-
19
WONCA
News
MEMBER AND ORGANIZATIONAL NEWS / RESOURCES FOR THE FAMILY DOCTOR
mittee has already organized a meeting in Treviso in October 2003 on the European Definition of General
Practice. They are working for a second meeting on the position of Italian General Practice on CME. They are also
collaborating on research and publications.
There is a definite will of bringing Italian General Practice into a European and global community, and to
bring Wonca in Italy. The Florence conference in August 2006 “Towards a Medical Renaissance – Bridging the
gap between Biology and Humanities” is becoming an extraordinary occasion for bringing Italian general
practitioners together.
Giorgio Visentin
Ernesto Mola
visentin@tin.it
ernemol@tin.it
RESOURCES FOR THE FAMILY DOCTOR
RCGP DEFINES FUTURE ROLE OF GPS
The Royal College of General Practitioners (RCGP)
has unveiled its vision for the future of GPs in the
United Kingdom. Founded in 1952, the Royal College of
General Practitioners (RCGP) aims to encourage and
maintain the highest standards of general medical
practice and act as the ‘voice’ of general practitioners
on education, training and standards issues. The
membership includes 21,000 of the 37,000 GPs currently
practising in the UK The publication, The Future of
General Practice, says that while GPs no longer have a
monopoly on the provision of primary care, they still
play a pivotal role within patient care. Nurses and
pharmacists all have a greater role to play in the
modern NHS but GPs must remain at the heart of
patient care.
Effectively a ‘defence of the realm’ document from
GPs, the publication argues that new primary care
frameworks must not remove a patient’s choice to see
their GP.
Prof. David Haslam, Chair of the RCGP, said: “The
challenge for the future is to ensure the development of
GP practices so that the current situation of
overcrowding in outpatients departments and
inappropriate use of secondary care can be minimised.
Complex patient care needs to be accessible and
personalised. GPs are the best people to deliver that
care, now and in the future.”
GP access is of particular importance to older
chronically ill patients who need continuity of care.
Sixty-five per cent of patients aged 65 or over have two
or more chronic conditions and with an ageing
population, the report argues, this figure is likely to
increase dramatically. GPs need to co-ordinate patient
treatment to avoid fragmentation of care that can lead
to compli-cations relating to medication and the
duplication of investigations and referrals. GPs perform
a vital role in community care. 90% of the work of the
NHS takes place with a GP, with a 91% satisfaction
rating.
GPs are now using new technology and their
increased specialist know-ledge to enable better patient
diagnosis and to perform minor operations that
previously were only carried out at outpatients’ clinics at
local hospitals.
WONCA
News
CONFERENCES 2005 – 2010
Information correct as at November 2004.
May be subject to change.
20
WONCA CONFERENCE 2005 – 2010 AT A GLANCE
See Wonca Website www.GlobalFamilyDoctor.com for upates
2005
Region
Venue
Theme
27 – 31 May
Asia Pacific
Kyoto
Family Fractice/ General Practice – As a
Regional ConferenceJAPAN
Global Standard
3 – 7 Sept
European
Kos Island
From Hippocrates to the Human
Regional ConferenceGREECE
Genome: The Past, Present and Future
of General Practice/Family Medicine
2006
27 – 31 Aug
European
Florence
Towards Medical Renaissance:
Regional ConferenceITALY
Between Biology and the Humanities
8 – 15 Sept
7th Rural Health
Seattle
Transforming Rural Practice
Conference
Washington
Through Education
USA
4 – 9 Nov
Asia Pacific
Bangkok
Happy and Healthy Family
Regional ConferenceTHAILAND
2007
24 – 28 July
18th WONCA
SINGAPORE
Human Genomics and its Impact on Family
World Conference
Physicians
17 – 21 Oct
European
Paris
Rethinking Primary Care in the European
Regional
FRANCE
Context: A New Challenge for General
Conference
Practice
2008
Date to be
Asia Pacific
Melbourne
Theme to be confirmed
confirmed
Regional
AUSTRALIA
Conference
2009
5 – 8 Jun
Asia Pacific
Hong Kong
Building Bridges
Regional
Conference
2010
26 – 30 May
19
th
WONCA
Cancun
Millennium Development Goals:
World Conference
MEXICO
The Contribution of Family Medicine
21
WONCA
News
GLOBAL MEETINGS FOR THE FAMILY DOCTOR
GLOBAL MEETINGS FOR THE FAMILY DOCTOR
WONCA WORLD AND REGIONAL CONFERENCE CALENDAR
Asia Pacific Regional Conference, Japan 2005
Host:Japanese Academy of Primary Care Physicians
Theme:Family Practice/General Practice – As a Global
Standard
Date:27 – 31 May, 2005
Venue:Kyoto, Japan
Contact:The Japanese Academy of Primary Care Physicians
Tokyo Medical Association Bldg 302
2-5, Kandasurugadai Chiyoda-ku,
Tokyo 101-0062 Japan
Tel:81 3 5281 9781
Fax:81 3 5281 9780
Email:pc@primary-care.or.jp
Wonca Europe Regional Conference, Kos Island 2005
Host:Greek Association of General Practitioners
Theme:From Hippocrates to the Human Genome:
The Past, Present and Future of General Practice/
Family Medicine
Date:3 – 7 September, 2005
Venue:Island of Kos, Greece
Contact:The Greek Association of GPs (Elegeia)
Mr. Raoul Merkouris
21, N.Kountourioti Str. (5th floor)
54625-Thessaloniki
Greece
Tel:30 2310 550048, +30 2310 539995
Fax:30 2310 539995
Email:elegeia@woncaeurope2005.org
Web:http://www.woncaeurope2005.org
Wonca Europe Regional Conference, Florence 2006
Host:CSERMEG
Theme:Towards Medical Renaissance
Date:27 – 30 August, 2006
Venue:Florence, Italy
Contact:OICsrl
Viale Matteotti 7
50121 Florence, Italy
Tel:+39 0555 0351
Fax:+39 0555 001912
Email:wonca2006@oic.it
Web:http://www.woncaeurope2006.org
Wonca 7
th
Rural Health Conference, Seattle-Anchorage 2006
Host:Wonca Rural Health Working Party
Theme:Transforming Rural Practice Through Education
Date:8 – 15 September, 2006
Venue:Sept 8 – 10 – Wonca Rural Conference
University of Washington campus
Sept 11-13, 34
th
Annual Advances in Family Practice
University of Washington campus
Sept 13 – 15, Post Conference
Talkeetna Alaskan Lodge
Anchorage, Alaska
Contact:OIC
Viale Matteotti 7
50121 Florence, Italy
Tel:+39 0555 0351
Fax:+39 0555 001912
Email:wonca@oic.it
Web:http://www.woncaeurope2006.org
15
th
Wonca Asia Pacific Regional Conference, Bangkok 2006
Host:General Practitioners/Family Physicians Assoc,
Thailand
College of Family Physicians, Singapore
Theme:Happy and Healthy Family
Date:November 5 – -9, 2006
Venue:Sofitel Central Plaza and Bangkok Convention
Centre
Contact:Dr Kachit Choopanya, Chairman,
Host Organizing Committee
10
th
Floor, Royal Golden Jubilee Building
2 Soi Soonvijai
New Petchaburi Road
Bangkok, Thailand 10320
Tel:66(0) 2716 6651
Fax:66(0) 2716 6651
Web:www.thaifammed.org
18
th
Wonca World Conference, Singapore 2007
Host:College of Family Physicians, Singapore
Theme:Human Genomics and its Impact on Family
Physicians
Date:24 – 28 July, 2007
Venue:Singapore International Convention and Exhibition
Centre
Contact:Dr Tan See Leng, Chairman,
Host Organizing Committee
College of Family Physicians, Singapore
College of Medicine Building
16 College Road #10-02
Singapore 169854
Tel:65 223 0606
Fax:65 222 0204
Email:rccfps@pacific.net.sg
Web:www.wonca2007.com
Wonca Europe Regional Conference, Paris, 2007
Host:French National College of Teachers in General
Practice
Theme:Rethinking Primary Care in the European Context
Date:17 – 21 October, 2007
Venue:Palais des Congres
Paris, France
Contact:French National College of Teachers in General
Practice
6 rue des 2 communes
94300 Vincennes
Tel:33-153 669 180
Email:cnge@cnge.fr
Web:www.cnge.fr
22
WONCA
News
GLOBAL MEETINGS FOR THE FAMILY DOCTOR
19
th
Wonca World Conference, Cancun 2010
Host:Mexican College of Family Medicine
Theme:Millennium Develop Goals:
The Contribution of Family Medicine
Date:26 – 30 May, 2010
Venue:Cancun Conventions and Exhibition Center, Cancun
Mexico
Contact:Mexican College of Family Medicine
Anahuac #60
Colonia Roma Sur
06760 Mexico, D.F.
Tel:52-55 5574
Fax:52-55 5387
Email:javierdominguez14@hotmail.com
Web:www.wonca2007.com
MEMBER ORGANIZATION AND RELATED MEETINGS
4th Austrian Winter Conference on General Practice
and Family Medicine, Austria
2005
Date:January 15 – 22, 2005
Venue:Hotel Rote Wand in Lech am Arlberg, Austria
Contact:Vienna Medical Academy, att. Hedwig Schulz, Alser
Strasse 4,
1090 Vienna, Austria
Phone:+43 1 405 13 83-10
Fax:+43 1 405 13 83-23
E-mail:h.schulz@medacad.org
Web:www.oegam.at
The Royal New Zealand College of General Practice
Conference, Christchurch 2005
Theme:New Horizons:Celebrate the Art of General Practice
Date:14 – 16 July 2005
Venue:Christchurch Convention Centre
Contact:www.rnzcgp.org.nz/conferences
14th Nordic Conference of General Practice, Stockholm
2005
Host:Swedish Association of General Practice and
Family Medicine Centre
Theme:General Practice in a Changing World
Date:June 15 – 18, 2005
Venue:Hotel Rote Wand in Lech am Arlberg, Austria
Contact:Anne Thorell
Centre of Family Medicine
Phone:+46 (0)73-682 55 39
Email:Anne.thorell@klinvet.ki.se
Web:www.allmanmedicin.nu/congress/menu.htm
The Royal College of General Practitioners (RCGP)
Spring Symposium, Blackpool 2005
Theme:General Practice for a Cosmopolitan Age
Date:8-10 April 2005
Venue:Bournemouth, United Kingdom
Contact:Alison Sage
Wessex Faculty
Royal College of General Practitioners
Andover War Memorial Hospital
Charlton Road
Andover Hants SP10 3LB
Phone:01264 355005
Fax:01264 355115
Email:spring2004wsx@rcgp.org.uk
Web:www.blackpool2005.com/
The Society of Teachers of Family Medicine (STFM)
38
th
Annual Spring Conference, New Orleans 2005
Date:30 April – 4 May, 2005
Venue:New Orleans Marriot Hotel
Contact:Priscilla Noland
STFM
11400 Tomahawk Creek Parkway
Leawood, KS, 66211-2672, USA
Tel:1 800 274 2237, ext. 5410
Fax:1 816 906 6096
Email:assndfm@stfm.org
Web:http://www.stfm.org
Association of Health Care Professionals (AHCP)
16
th
Conference, London 2005
Theme:Advances in Family Medicine/General Practice
Date:20 – 23 August, 2005
Venue:London, England, UK.
Contact:Secretariat,
AHCP
P. O Box 18265
London EC2A 3TT
England, UK
Tel:44 20 7749 7243
Fax:44 20 7739 8683
Email:info@ahcp.org.uk
American Academy of Family Physicians (AAFP)
Annual Scientific Assembly, San Francisco 2005
Date:28 September – 2 October, 2005
Venue:San Francisco, California
Contact:AAFP
11400 Tomahawk Creek Parkway
Leawood, Kansas 66211-2672, USA
Tel:1 913 906 6000
Fax:1 913 906 6075
Email:international@aafp.org
Web:http://www.aafp.org
13
th
World Conference on Smoking or Health, Washington, DC
2006
Theme:Building Capacity for a Tobacco-Free World
Date:12 – 15 July, 2006
Venue:Renaissance DC Hotel
Washington, D.C., USA
Contact:John Seffrin, PhD
Chief Executive Officer
American Cancer Society
Email:secretariat2006@cancer.org
Web:http://www.2006conferences.org/
