From the President: Lessons from Latin America

Photo: Panel of presidents of WONCA’s Iberoamericana Region: (from left to right, Julio Ceitlin, Javier Dominguez del Olmo, Adolfo Rubinstein, Liliana Arias, Maria Inez Padula Anderson)


The Waynakay Movement is the organization for young family doctors in WONCA’s Iberoamericana region (covering the Spanish and Portuguese speaking nations of the Americas, as well as Spain and Portugal). "Waynakay" means "youth" in the Quechua language of the Andes in the western part of South America. WONCA’s Waynakay Movement is led by enthusiastic young family doctors including Andrea de Angulo from Colombia, Rodolfo Deusdará from Brazil and Virginia Cardozo from Uruguay. In March I had the opportunity to meet with many members of the Waynakay Movement at an energy-charged meeting in Montevideo in Uruguay. I learned about some of the challenges facing those training to become family doctors in many countries of the region, and their aspirations for their future careers.

Photo: WONCA president with members of the WONCA Waynakay Movement

I was in Montevideo, with 1600 other family doctors from 26 nations, attending the 4th WONCA Iberoamericana Congress on Family and Community Medicine hosted by the Uruguayan Society of Family Medicine (Sociedad Uruguaya de Medicina Familiar y Comunitaria) and led by the wonderful Jacqueline Ponzo. The theme of the congress was “quality and equity in health care” which is very appropriate given the focus of WONCA’s current global work on strengthening primary care to ensure universal health coverage.

WONCA’s Iberoamericana regional organisation was founded in 1981 by Argentine family medicine pioneer, Julio Ceitlin. The organization brought together societies and colleges of family medicine in the countries of the region and in 1996 was named the Confederacion Iberoamericana de Medicina Familiar (CIMF). In 2004 CIMF joined WONCA and brought the countries of South America and Central America into the WONCA family and made WONCA the truly global organization that it is today.

WONCA’s Iberoamericana Region now includes 20 countries, from Mexico, Cuba, Puerto Rico and Dominican Republic in the north, through Central America and South America, to Uruguay, Argentina and Chile in the south, plus Portugal and Spain, and includes over 600 million people.

One of the highlights of the Montevideo meeting was a panel with several CIMF presidents, including Julio Ceitlin (now 90 years old), Javier Dominguez del Olmo from Mexico (2000-2004), Adolfo Rubinstein from Argentina (2004-2010), Liliana Arias from Colombia (2010-2013) and Maria Inez Padula Anderson from Brazil (2013-2018). These family medicine leaders, past and present, engaged with colleagues in discussing the challenges facing family medicine in many countries and the opportunities to strengthen primary care and ensure universal health coverage for all people of the region.

Photo: Palacio Salvo in Plaza Independencia (Independence Square) located between Ciudad Vieja (Old City) and downtown Montevideo

WONCA is playing our part in supporting quality and equity in global health, and we have set ourselves three main challenges. First, we are committed to better understand the strength of each of our member organisations in each region, and to expand WONCA’s influence by supporting the development of new member organisations in more low- and middle-income nations, including all nations of Central America and South America, to ensure that all people have access to high quality family medicine.

WONCA’s second challenge, recognizing the importance of the next generation of family doctors, is actioned through our commitment to supporting the next generation of family doctors especially through the development of young family doctor movements in all seven regions of the world, and through the appointment of a young family doctor to represent the world’s young family doctors on the WONCA executive.

WONCA’s third challenge is our commitment to strengthen WONCA’s work with the World Health Organization (WHO) at global and regional levels to expand the role of family medicine in strengthening primary health care in all countries and supporting universal health coverage, and to ensure that each country has a well-trained and supported family medicine workforce.

Our work with the World Health Organization becomes stronger and stronger thanks to the leadership of our WONCA liaison person with the WHO, Maria-Luisa Pettigrew. In March the WHO released two interim reports on its new Global Strategy on People-Centred and Integrated Health Services. WONCA is contributing to the development of this strategy and has been leading a consultation process that has involved hundreds of family doctors from around the world.

This new global strategy from the WHO aims to provide a “compelling vision of a future in which all people have access to health services”. The strategy calls for reorienting health care systems to prioritize primary and community care services and includes reference to the important role of family doctors in countries like Brazil. The interim WHO report contains 10 quotes; four from patients and carers, two from health care managers, and four from family doctors. This recognition of the importance of the contributions of family medicine to people-centred and integrated health services is very welcome. Here are some of the extracts:

“I really value the long term relationship I have with many patients. I also know their families and the community well.” Female family doctor from the WHO Western Pacific Region.

“We need more support from the government to adopt more family medicine and to increase the budget for primary health care.” Female family doctor from the WHO Eastern Mediterranean Region.

“What I value the most in my work is good relationships with the people the nurses and I care for. We have a post-conflict multi-ethnic population. Once as bad enemies they now sit in my waiting room together and talk and understand each other.” Male family doctor from the WHO Europe Region.

“Politicians need to understand that primary care is the backbone of any health system and getting it right will lead to cost benefits, healthier populations and public faith in the system.” Male family doctor from the WHO Region of the Americas.

There is hope for global health as the world wakes up to the importance of strengthening primary care and the important role we play as family doctors in ensuring universal health coverage and high quality care.

Family medicine has the power to play a transformative role in the shaping of all societies, as we are seeing in the countries of Central America and South America. I hope you all have the opportunity to see this for yourself as a participant in our 2016 WONCA World Conference in Brazil.

Photo: WONCA president succumbs to peer pressure from a group of young doctors and has his first taste of mate, a traditional South American caffeine-rich infused hot herbal drink, served in a leather-clad gourd and sipped through a metal straw

Michael Kidd
World Organization of Family Doctors (WONCA)

  Prof Kidd’s keynote speech on Quality and Equity and Global Family Medicine: perspectives from Latin America, delivered at the 4th WONCA Iberoamericana Congress on Family and Community Medicine, can be found here.