Charles Boelen: WONCA & Family Docs, best partners for health system revival

A guest feature by Charles Boelen, MD, international consultant in health system and personnel, former coordinator of the WHO (Geneva office) program of human resources for health, president of RIFRESS. boelen.charles@wanadoo.fr

In 1988, as a newly assigned coordinator of the Human Resources for Health program at WHO Headquarters in Geneva, I met the then WONCA President and liaison officer with WHO, Dr M K Rajakumar, from Malaysia. In his frank style, his first words were: “We often meet and talk at WHO but never do things together”! Having already worked for years in different parts of the world, at WHO national and regional office levels, I boomeranged to him: “OK, let’s start doing things”!

Cascading for that first contact several events followed over ensuing years: a later WONCA President, Dr Göran Sjönell, took a decision with Dr Michael Boland (also to become WONCA President), to hold an international WHO-WONCA sponsored conference in London, Ontario, on “Making medical practice and education more relevant to people’s needs : the contribution of the family doctor. It was also agreed to draft a WHO-WONCA collaborative plan of work, one of which was to write the first version of a book, which years later was reedited by Michael Kidd and became a best seller, “The contribution of family medicine to improving health systems : a guide from the World Organization of Family Doctors”. See re-edited "Guidebook" information.

In 1995, a resolution was passed by the World Health Assembly (WHA 48.8) entitled : “Reorientating medical education and medical practice for health for all”, with clear reference of the crucial role of family doctors.

A monograph, “Doctors for health”, enunciated a global strategy to implement the above- mentioned resolution, with due reference to the “Five-star-doctor”, highlighting key aptitudes any physician anywhere should possess. WONCA President, Bob Higgins MD, suggested to use this model for a WONCA award. Since then, WONCA has promoted it worldwide. More on the “Five-star-doctor” award.

The publication in 2000 of WHO strategy “Towards Unity For Health”, fostering a strong partnership among stakeholders in the health system, led WONCA leadership to organise an international expert committee to examine how family medicine could become a ‘cement’ among health actors, for greater unity of purpose.

Throughout the years, WONCA has been on the side of innovation : more recently in 2016, the then President, Amanda Howe , delivered a keynote speech at the world summit on social accountability in health, held in Tunisia, in conjunction with an international NGO, The Network Towards Unity for Health (TUFH).

Today, in the special circumstances of the viral pandemic, there is nothing more important than to strengthen links with faithful friends. The notion of solidarity and “social accountability” is being more widely used.

In 1995, I published with Jeff Heck (an American family doctor), a WHO monograph “Defining and measuring the social accountability of medical schools”. Today, being socially accountable is a requirement for any health actor, and the synergy must be generated among policy making bodies, health organisations, academic institutions, health professionals and civil society for the emergence of a health system that is person-centred, equitable and efficient. It becomes now obvious that it is closely linked to sustainable development goals and the influence of a whole spectrum of health determinants.

Family doctors are not only first line practitioners, they also excel as medical educators, team builders, researchers and health service designers. They have a foot everywhere and are good in understanding the standpoint of others, an ideal recipe to make the unity chemistry work. The family doctor is potentially the best ally in the enterprise of revival of a health system funded on humanist values because he or she is open to adapt their own behaviours to better meet priority health needs of society.

WONCA is well considered by two international organisations dedicated to social accountability in health : TUFH for the anglophones (www.thenetworktufh.org) and RIFRESS (Réseau International Francophone pour la Responsabilité Sociale en Santé) for the francophones (www.rifress.org). They look forward to strengthen their collaboration.