From the Wonca President
:
Are the World’s Family Doctors Prepared
2
for an Avian Influenza Pandemic?
From the CEO’s Desk
:
Celebrating Our Wonca Website’s First
3
Anniversary
From the Editor
:
Recording Important Dates for Wonca and
5
our World
FEATURE STORIES
5
•Family Medicine in Bolivia: Thirty Years of Implementation
•Medicina Familiar en Bolivia: 30 Años de su Implementación
•Iberoamerican Conference Calls for Family Doctors to Play Central
Health System Role
Wonca REGIONAL NEWS
9
•Meet Dr Adolfo Rubinstein: Iberoamericana-CIMF Regional President
•First Lady of Timor-Leste Addresses RACGP: Asks for Help for Mothers
and Children
HEALTH AND HEALTH SYSTEM NEWS
12
•Avian Flu Spreads: Countries Prepare for a Pandemic
•Wonca Participates in Millennium Development Goals Workshop
MEMBER AND ORGANIZATIONAL NEWS
15
•Leela De A Karunaratne: Wonca Global Family Doctor for November
2005
•Pakistan Family Doctors Offer Support and Thanks Following
Earthquake
RESOURCES FOR THE FAMILY DOCTOR
17
•Useful Websites on the Avian Influenza Virus
•Global Fellows Positions Available
WONCA CONFERENCES 2005-2011 AT A GLANCE
19
GLOBAL MEETINGS FOR THE FAMILY DOCTOR
20
VOLUME 31
NUMBER 6
DECEMBER 2005
CONTENTS
Wonca website:
http://www.GlobalFamilyDoctor.com
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 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
Editor, Wonca News and Editorial Office
Marc L Rivo, MD
4566 Prairie Avenue
Miami Beach, Florida 33140, USA
Tel: 305 671 7327
Fax: 305 674 8839
Email: marcrivo@aol.com
WONCA GLOBAL SPONSORS
FROM THE WONCA PRESIDENT:
ARE THE WORLD’S FAMILY DOCTORS
PREPARED FOR AN AVIAN INFLUENZA
PANDEMIC?
“Is the world adequately prepared? No. Despite an
advanced warning that has lasted almost two years, the
world is ill-prepared to defend itself during a pandemic.
Most developing countries will have no access to
vaccines and antiviral drugs throughout the duration of
a pandemic.”
WHO. 3 November 2005 (http://www.who.int/csr/
disease/avian_influenza/avian_faqs/en/index.html)
When I have raised the possible impending Avian
influenza pandemic, many practitioners have dismissed
the possibility, with statements such as, “It will never
happen – look what happened when there was panic
about SARS”. But, are the circumstances the same? The
low transmissibility of the SARS virus, combined with
the fact that victims didn’t reach peak infectiousness
until they were already showing clinical symptoms,
made it feasible to control the epidemic using public
health measures. In contrast, the Avian flu viral subtype
H5N1 spreads before symptoms are evident. In
addition, this bird virus is now more lethal to
experimentally infected mice and ferrets and is able to
survive longer in the environment. It has also expanded
its host range, with domestic ducks becoming recent
silent hosts to the virus. Finally, the mutated form of
the virus transmittable from human to human may be
more virulent.
The WHO says in the best-case, conservative
scenario, two to seven million people will die in the
pandemic and tens of millions will need medical
attention. The organisation warns that the global spread
of a pandemic can’t be stopped – but preparing
properly will reduce its impact. It has stated that the
virus may possibly reach all continents in less than
three months! The major impact of the pandemic will
most likely be in the developing world!
The H5N1 virus is particularly worrisome for several
reasons. It mutates rapidly and now has a history of
being able to acquire genes from viruses infecting other
animal species. Laboratory studies have demonstrated
that isolates from the virus have a high pathogenicity
and cause severe diseases in humans and birds. Those
that survive infection excrete virus for at least 10 days
making it easier to spread the virus to poultry and
WONCA
News
FROM THE WONCA PRESIDENT
2
migratory birds. The mutation to a human form is more
likely if humans or pigs are infected with human and
avian strains at the same time, since genetic material is
able to be exchanged in a ‘reassortment’ event, giving
birth to a human form of the virus. By the end of
November 132 confirmed cases of Avian Influenza A/
(H5N1) were reported to WHO of whom 68 (51%) had
died. WHO has declared that the 3
rd
phase of pandemic
alert out of an series of six increasingly severe levels
has already been reached. Officials in Thailand and
Indonesia suspected early in December that the avian
virus may have mutated into a human-to-human form. If
so, then we may be close to entering the 4
th
and more
significant human-to-human spread of the pandemic.
If the world’s nations are ill-prepared, are our global
family doctors any better prepared to meet a possible
pandemic – one which most scientists say is inevitable
rather than a probability. Given the predicted numbers
of infected persons and deaths, the health facilities will
not be able to cope. The major load will fall on primary
care services including family doctors. But in
discussions with practitioners in various Wonca regions,
few knew:
•the first and subsequent symptoms of avian flu, the
complications, clinical syndromes and modes of
death?
•who is most vulnerable? (so far those affected by the
bird flu have been the young and healthy, not the
usual at risk groups)
•how to prevent or lesson the flu, treat patients and
prevent the spread of the virus? (A most important
preventive measure is the use of face masks – since
it is droplet carried and not airborne - ordinary
masks will suffice).
•that antiviral medications oseltamivir (Tamiflu) or
zanamivir (Relenza) which may lessen or prevent
morbidity, must be given within 48 hours of onset of
symptoms, and that indicators suggest that H5N1
may be developing resistance to Tamiflu.
•that vaccines or medications for developing countries
may be unlikely given that stockpiling and advanced
orders in the US and Europe are expected to
consume the available market.
•that a vaccine may not be available, in any event,
until several months after the onset of the pandemic
•that the virus is spread before symptoms occur – a
risk contributing to the international spread by
travellers in the pandemic.
•that death rates among HIV / AIDS patients are
expected to be lower since these patients may not
be able to mount the immune response required to
produce Adult Respiratory Distress Syndrome, or
ARDS,
the major cause of death in patients so far,
WONCA
News
FROM THE WONCA PRESIDENT / FROM THE CEO’S DESK
3
FROM THE CEO’S DESK:
CELEBRATING OUR WONCA WEBSITE’S FIRST
ANNIVERSARY
This January 2006 marks the first anniversary of our new Wonca Website
under the exclusive financial and operational management of Wonca. It is
therefore appropriate that we take stock of what has been achieved during
this past year.
The three year agreement between Wonca and medi+World International
on the management of the Wonca Website www.GlobalFamilyDoctor.com
(GFD in short) ended in May 2004 with the somewhat bleak prospect then
of the website continuing given inadequate funding. At their meeting in
St Augustine, Florida in November 2004, the Wonca World Executive
decided, after much discussion, that the website continue under direct
Wonca management and funding. This led to two months of flurried
activities during which the management of the website was transferred from
medi+World International to Wonca. At the same time, with the approval of
the Orlando Wonca Council, the Wonca Secretariat set about seeking
collaboration and sponsorship from the pharmaceutical industries to
support GFD.
By January 2005, Wonca had assumed full control of its website and had
installed its own server housed within Dolphin IT in Melbourne, Australia. A
new company, Paradigm Multimedia in Melbourne, was appointed to
manage the site with the new Webmaster, Mr Alex Westcott, replacing Prof
•that health workers and
morticians are expected to be
particularly vulnerable, and that
they and the military, police, and
politicians have been classified
as the first to receive vaccine
and preventive drugs, to prevent
disruption of essential services.
Civil unrest and riots may be
more likely to occur where
health care professionals and
health systems are ill-prepared
or unable to cope with the rate
of infections, admissions to
hospitals and deaths in the first
wave of the pandemic. A second
wave is usual within a year.
Whether or not the predictions
of a pandemic of this magnitude are
realized, an urgent need exists to
upgrade the preparedness of the
world’s family doctors. Member
on developments related to this
potentially devastating pandemic.
I hope, in the words of the Bard,
that this is ‘Much ado about
nothing’ and that, gladly and with
thanks, I will have to eat my words.
On the other hand, if the Avian flu
pandemic is to become as
significant as some predict, then I
hope we family doctors will not miss
the opportunity to make a
significant difference in the lives of
our patients and their communities.
Bruce Sparks, M.D.
President
World Organization of Family
Doctors
Wes Fabb who was then appointed
as GFD Medical Editor. Sub-
sequently, a new Homepage for GFD
was introduced with top and side
menus instituted for better site
navigation.
Stable funding was secured by
having five pharmaceutical
multinationals as Wonca Global
Sponsors. With the website’s
infrastructure properly constituted,
GFD has in the period of this one
year grown from strength to
strength. The website has now
become the ‘image of Wonca ’ to
the outside world. During the year,
significant enhancements and
progress have been made.
We have experienced continued
growth and popularity of ‘Journal
Alerts’. Today, more than 4600
recipients receive on their
computers, three days a week, the
latest in medical journal articles of
relevance to FPs/GPs. Over one
hundred medical journals are
scanned every week by the Medical
Editor and two Assistant Medical
organisations of Wonca and
departments of family medicine are
best poised to initiate awareness
and information programmes for
family doctors and other health
professional and community leaders
in their countries and regions. Such
programmes should be organised in
conjunction with others in primary
health care, particularly nurses and
community workers. Family doctors
should be encouraged to update
and familiarise themselves with
national strategies if they exist, and
improve their ability to deal with the
massive loads of patients who could
seek their care and require accurate
and helpful information.
I have attached a list of useful
websites in the Resources for Family
Doctors section of Wonca News for
those who wish to keep up to date
pg_0004
WONCA
News
FROM THE CEO’S DESK
Editors to keep this service going.
The two Assistant Editors appointed
during the course of the year are
Drs Stephen Wilkinson of Australia
and Jim Vause of New Zealand. More
than 5,000 Journal Watch items
posted during the past week, month
and twelve months are now
accessible via the Homepage via a
new clinical database. A new search
facility on GFD allows our readers to
identify Journal Watch items and
Clinical Reviews by keyword titles.
Journal Alert is also now translated
into Spanish for the benefit of our
colleagues in Iberoamericana-CIMF.
Many other popular GFD clinical
features have been enhanced.
POEMS (Patient-Oriented Evidence
that Matters) and eMedicine cases
are regularly posted of the website.
POEMS have also been translated
into Portuguese. Disease and Travel
Alerts are updated daily. Wonca
Regional and World Conferences are
promoted on the Homepage.
Bimonthly issues of Wonca News
are also available on the GFD
website and may be downloaded as
PDF files. Prior issues of Wonca
News are archived and accessible on
GFD beginning with the October,
2001 issue which followed the 16
th
Wonca World Conference in Durban,
South Africa.
An Educational Resource Centre
was introduced to the website in
mid-2005 and is intended to be an
enlarging repository of online
education such as CEMedicus and
Arbor Clinical Nutrition Updates for
the world’s GPs/FPs. CEMedicus is a
repository of case-based clinical
problems for health professionals,
prepared by experts in the wide
variety of fields covered. It has a
rich collection of clinical problems,
many of relevance and interest to
family doctors. Arbor Clinical
Nutrition Updates is a service on
nutrition topics distributed
4
worldwide to over 100,000 health professionals. This is a useful service
that analyses, in a way not dissimilar to Journal Watch, articles in the
literature on clinical nutrition. Articles on a topic are gathered from several
sources and clustered in each issue. The analysis is thorough, scientific, and
a helpful commentary is often provided. Recent publications on Chronic
Obstructive Pulmonary Disease like the IPAG Handbook and the Time to Live
Report have also recently been added to the website.
Most recently, the Wonca Global Resource Directory was introduced to
the website in mid-August 2005. The objective of the Resource Directory is
to make available, on the Wonca website, information about developments
in family medicine around the world, and particularly in countries where
development is still in its infancy. It is also planned to create a database
within the Directory where people and institutions can enter details of
overseas development projects to which they are contributing. This will
enable those interested in international collaboration to ascertain ‘who’s
doing what and where’, thereby increasing collaboration and minimizing
overlap and duplication. It is anticipated that this database will soon build
into a valuable resource for those already involved in, or wishing to
participate in, international collaborative endeavours.
Currently, family medicine related articles are posted on Mongolia,
Russia, Uganda, Lebanon and India.
These are but some of the progress made and new features added to
the Wonca Website during the past year. Statistics gathered from the
website over a nine month period in 2005 testify to the increasing
popularity and value of the website to FPs/GPs globally. For the nine months
of 2005, statistics for the website have revealed over 1,615,243 pages
visited. There were 498,334 unique visits to the website with over 3,873,107
hits for the same period.
For a very young website, www.GlobalFamilyDoctor.com has done quite
well. Our challenge for the years ahead is to keep improving on the many
aspects of the site and become increasingly relevant to the needs of all
family doctors around the world. We hope all family doctors will come to
see the Wonca Website as the richest source of information of value to
them.
Dr Alfred Loh
Chief Executive Officer
World Organization of Family Doctors
WONCA
News
FROM THE EDITOR / FEATURE STORIES
5
FROM THE EDITOR:
RECORDING IMPORTANT DATES FOR WONCA AND OUR
WORLD
It seems appropriate that this last issue of the 31
st
year of Wonca News
would capture many important milestones in both our global organization
and in the world at large.
This issue features a story on 30 years of family medicine development
in Bolivia. The article, published in full in Spanish and summarized in
English, exemplifies the proud and rich family medicine tradition in Wonca’s
Iberoamericana-CIMF Region. Today, the central role of family doctors in
health systems throughout the Iberoamerican Region is recognized in an
article describing the recent, historic Iberoamerican Conference on Family
Medicine in Chile. In addition, the President of Wonca’s newest region, Dr
Adolfo Rubinstein, is profiled. Although celebrating only its 2
nd
birthday as
Wonca’s 6
th
region, this young region with its distinguished history has
already made its mark on Wonca.
This issue also marks the recent global pandemics and disasters that we
have or will face, including reminders of our successful containment of the
SARS outbreak, the struggle to rebuild from the devastating earthquake in
Pakistan and the emerging Avian Flu pandemic. In his President’s Column,
Professor Bruce Sparks draws important attention to this important time in
our history as he urges vigilance and readiness to contain the Avian Flu
pandemic. Wonca and its member Organizations and family doctors
continue to contribute to global efforts to improve health, as described in
the article on the Millennium Development Goals.
Today, Wonca’s website (
www
.G
lobalF
amilyD
octor
.com) plays a vital role
making a rich array of vital information and resources available to the family
doctor. In his CEO’s Column, Dr Alfred Loh celebrates GFD’s 1
st
year of
operation and describes its online resources accessible to family doctors
throughout the world.
Please send me your stories of the important health issues of our time
and of our global organization so that we both share and record the
important dates in the history of Wonca and our world.
Marc L. Rivo, M.D, M.P.H.
Editor, Wonca News
marcrivo@aol.com
4566 Prairie Avenue
Miami Beach, FL 33140 USA
1-305-674-8839 (fax)
FEATURE STORIES
FAMILY MEDICINE IN
BOLIVIA: THIRTY YEARS
OF IMPLEMENTATION
Family Medicine in Bolivia was
initiated in 1975 based upon
recommendations of the Committee
to Implement Reforms of the Social
Security Administration, a new
health care model to meet people’s
health needs. On December 24,
1975, legislation was signed with 11
articles referencing family medicine
as a means to address the health
system crises and its fragmentation,
inefficiency and deficiencies. In this
manner, Bolivia became one of the
pioneers in South America to
support a family medicine model of
personal and integrated health care.
During 1976 and 1978 the basic
requirements and courses of the
new model were established. In
1979, a three year program follow-
ing the new model was established
under the medical residency in La
Paz with a hospitalist focus. In
1984, the hospitalist program was
modified and administrative and
psychology programs were
established. In 1986, they
established a family medicine
residency in Cochabamba. In 1991,
the Medical Collage of Bolivia
established in the Statutes and
Regulations that a Family Medicine
Specialty should require a minimum
of three years of training and that
family medicine residencies are
three year programs. In 1999, an
important year for Family Medicine,
the Public Health System began
family medicine residencies in three
capital cities, although with only 2
positions per city. Today, nine family
medicine programs exist that
graduate 20 residents per year.
According to a 2002 study, family
physicians represent around 5.5% of
WONCA
News
FEATURE STORIES
6
the total physicians in the county.
No agreement exists as to how
many patients should each family
doctor be expected to treat, with
estimates ranging from 2,500 to
10,000 per family doctor. While it is
good that the Public Health System
is built on family medicine,
inadequate space and support for
the specialty is a limiting factor.
In 1977, 44 family physicians
meeting at the Polyclinic “Piloto” of
Miraflores in La Paz founded the
Bolivian Society of Family Medicine.
From its creation, they have focused
on the education of family doctors,
on creating an academic society, a
biennial Congress and have been
active members of the new Wonca
Iberoamericana-CIMF region. They
currently have 6 regional family
medicine societies located in La Paz,
Cochabamba, Santa Cruz, Oruro,
Potos’ and Chuquisaca.
Thirty years since the establish-
ment of Family Medicine in Bolivia,
our specialty has had to overcome
many crises that have confronted
the specialty, above all the lack of
interest and support of the govern-
ment and the preoccupation with
hospital based care. However,
progress has taken place in the
following areas:
•More asistance to primary care
which takes care of 80-90% of
people’s health problems at an
affordable cost to the patient.
•A growth in the number of
family doctors and improve-
ments in the training curriculum.
•Participation in regional and
global conferences and events
of Wonca and its family doctors
•The growth of a scientific
society of family doctors.
Despite our successes over the
past 30 years, we still have many
needs to address to enhance the
quality of the profession, including:
•Development of a standard
residency curriculum for the
profession.
•A recertification process to
assess the competence of family
doctors.
•The inclusion of family medicine
as a required undergraduate
medical education course.
•The broad recognition of family
medicine as the entry point
into and ambulatory care model
for the health system.
•The formation of family
medicine departments in all
universities.
•Support for and training of new
family medicine leaders.
•Enhancements in medical
consultation standards and
measurement systems to
improve access, visit time and
quality of family medicine care.
•More government funding and
scholarships.
(Editor’s Note: The English
translation above summarizes the
following article on Family Medicine
in Bolivia submitted by Dr Miguel A.
Su‡rez Cuba)
Medicina Familiar en
Bolivia: 30 Años de su
Implementación
La medicina familiar en Bolivia
se implanta como respuesta a las
recomendaciones del Comité de
Implementación de Reformas de la
Caja Nacional de Seguridad Social
(CNSS), el mismo sugiere al
Gobierno Boliviano, la
implementación del Sistema de
Medicina Familiar como un nuevo
modelo de atención para satisfacer
las necesidades de los pacientes, el
Gobierno mediante Decreto Ley del
24 de diciembre de 1975 en su
capitulo III, en 11 artículos hace
referencia a la medicina familiar y la
reconoce como la especialidad
capaz de satisfacer las necesidades
de la crisis asistencial de ese
momento; surge esta motivación
como una necesidad de cambio
generado por la fragmentación, la
ineficiencia y la cobertura deficiente
de la atención de salud.
Es así como la Caja Nacional de
Seguridad Social se constituye en la
pionera en Sudamérica en adoptar
un nuevo modelo basado en la
atención integral de las personas.
Dr. Miguel A. Suárez Cuba
Medico de familia
Vicepresidente Sociedad Boliviana de
Medicina Familiar Filial La Paz
Formación de recursos humanos:
Inicialmente se forman bajo la
modalidad de cursos intensivos de
9 y 12 meses durante los años 1976
a 1978, con la finalidad de cubrir a
la brevedad posible los
requerimientos del nuevo sistema.
En enero de 1979 se instituye la
formación de los recursos humanos
bajo el sistema de residencia
médica, con sede en la ciudad de
La Paz, regulada por el
Departamento de Enseñanza e
Investigación de la CNSS, con una
duración de 3 años, bajo un perfil
netamente asistencialista, porque se
lo realiza con enfoque hospitalario.
En 1984 se reformula el tiempo de
formación a 2 años, se modifica el
perfil de formación, un año de
formación hospitalaria, otro en el
área técnico-administrativa y
psicosocial. Por 1986 se crea la
residencia en medicina familiar en
Cochabamba, donde la Universidad
Mayor de San Simón (UMSS) y el
Consejo Nacional de Residencia
Médica (organismo que cuenta con
representantes del Ministerio de
Salud, Caja Nacional de Seguridad
Social y Facultad de medicina),
7
WONCA
News
FEATURE STORIES
juegan un papel importante en la formación de
recursos humanos a través de un convenio
interinstitucional.
El Colegio Medico de Bolivia en 1991, establece en
sus Estatutos y Reglamentos que la formación de
especialistas deberá tener un mínimo de 3 años; a
partir de este año la formación en residencia son 3
años. El ano1999 marca un hito importante para la
medicina familiar, el Sistema Publico empieza la
formación de Médicos residentes en la especialidad en
3 ciudades capitales, aunque con un número muy
pequeño, dos por ciudad. Actualmente existen nueve
residencias para formación de recursos humanos en
medicina familiar, cuatro corresponden a la Caja
Nacional de Salud, cuatro al Sistema Publico y uno a la
Caja Petrolera de Salud, con un promedio de egresados
de 20 por año a nivel nacional.
A la fecha no existe un censo del número exacto de
médicos familiares formados por residencia y
reconvertidos bajo la modalidad de reconversión por 10
años de ejercicio en el primer nivel de atención. De
momento, no esta completamente normado el numero
de familias adscritas por cada medico familiar, la
asignación es caótica, va desde 2.500 personas en
algunos consultorios, hasta 10.000 en otros con un
promedio de 5.000. Si bien el Sistema Publico esta
formando médicos familiares, lo lamentable es que no
esta creando espacios de trabajo e ítems para la
especialidad, situación que desmotiva a quienes ya se
formaron y los que desearían formarse.
Según un estudio de la OPS del año 2002, al
momento los médicos familiares en Bolivia, representan
alrededor del 5.5% de total de médicos en el país.
Después de la formación de un “pool” de médicos
familiares, se vio la necesidad de que se agrupen para
poder mantenerse por una parte, organizados y por
otra, actualizados a través de eventos académicos que
además les servirían para mantenerse competentes. Es
así que en fecha 3 de agosto de 1977, en instalaciones
de la Policlínica “Piloto” de Miraflores, en la ciudad de
La Paz, con 44 médicos familiares en calidad de
fundadores, se funda la Sociedad Boliviana de Medicina
Familiar.
Desde su creación se ha convertido en la entidad
que más se ha preocupado por la educación continua
de quienes trabajan en el primer nivel de atención
(Medico Familiares, Médicos Generales, enfermeras,
trabajadoras sociales, odontólogos y otros). Se
constituye en el ente académico científico que aglutina
a todos los médicos familiares y a los socios
adherentes, profesionales de la salud afines a la
especialidad del país. Principal impulsor y difusor de la
especialidad al interior de la CNSS y el gremio medico,
destacándose como una de las más activas, organiza
dos tipos de reuniones, un Congreso y Jornadas
nacional. Las jornadas son cada dos años al igual que
los Congresos, en este ultimo se elige la nueva Junta
Directiva que llevara las riendas de la sociedad en los
siguientes dos años; estos eventos están destinados a
la reflexión, sobre temas de interés para el Medico
Familiar, al análisis de programas o acciones comunes a
todos los países miembros de CIMF-WONCA, y la
actualización, e intercambio de información y
experiencias locales e internacionales sobre la marcha
de la medicina familiar y la atención primaria.
Agrupa a 6 sociedades regionales, en orden de
importancia, La Paz, Cochabamba, Santa Cruz, Oruro,
Potosí y Chuquisaca. Participa en la formación de
médicos residentes de la especialidad de medicina
familiar, aunque la mayoría lo los docentes son de
carácter ad honorem, diseña las líneas de base para la
mejora curricular de la especialidad, otorga el certificado
de especialista junto al Colegio Medico de Bolivia. Entre
sus objetivos se planteo la formación de docentes
propios de la especialidad, para cumplirlo el año 2002
se lleva a cabo el diplomado en formación de docentes
para Medicina Familiar y Atención Primaria, de carácter
semipresencial con el apoyo de la facultad de
medicina de la UMSS, y Fundación para la Medicina
Familiar del Hospital Italiano, cuyo plantel de profesores
son los encargados de hacer realidad este proyecto. Se
llegan a formar cerca de 40 docentes bajo esta
modalidad, provenientes de 3 ciudades, La Paz,
Cochabamba y Oruro. Producción científica: La
Sociedad Boliviana de Medicina Familiar publico una
revista científica durante los años de 1990 a 1994,
reedita el 2001 al 2003.
El CIMF se funda en agosto de 1981 con participación
de representantes de Canadá, Estados Unidos, México,
Argentina y Venezuela; Bolivia hace su ingreso en
diciembre de 1989. Mediante el representante de CIMF
