From the President: November 2013

WONCA president with young family doctors at the 50th anniversary conference of the Indian Medical Association College of General Practitioners (IMA CGP)

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Hope, Healing and Healthy Nations through Family Medicine

In October, I represented WONCA at a conference in Hyderabad, in India, to celebrate the 50th anniversary of the establishment of the Indian Medical Association College of General Practitioners (IMA CGP).
The IMA CGP has a special place in the history of WONCA, our World Organization of Family Doctors. WONCA was established, in 1972, by 18 national colleges and academies of family medicine from around the world, and the IMA CGP was one of our 18 founding organisations. In the lead up to the creation of WONCA, these 18 organisations had hosted four world conferences to focus on the development and strengthening of family medicine. The third of these world conferences was hosted in India, by the IMA CGP, in 1968.

The South Asia Region of the world is very important to WONCA. After all, 25% of the world’s population lives here. WONCA now has three member organisations in India: the Indian Medical Association College of General Practitioners, the Federation of Family Physicians' Associations of India, and the Academy of Family Physicians of India. These three organisations work together, alongside the other WONCA member organisations in the nations of South Asia. In the words of Mahatma Gandhi: “Honest differences are often a healthy sign of progress.” Each of our member organisations in the region is different, but respects each other’s differences, builds on each other’s strengths, and unites as advocates for the role that family medicine can play in achieving universal health coverage for every person in this region of the world.

In Hyderabad, I met with many of our colleagues and learned that the Indian Medical Association has one of the largest general practitioner memberships of any professional organisation in the world, with 230,000 doctors as members, of whom 60% are general practitioners. By my calculation, that is around 140,000 general practitioner members of the IMA. The college itself includes over 1000 family physicians, as members who have achieved advanced specialist qualifications in our professional discipline.

I was invited to deliver the IMA CGP Golden Jubilee Dr S Arulrhaj Oration, with the title “Hope, Healing and Healthy Nations through Family Medicine”. This oration commemorated both the 50th anniversary IMA CGP and the many contributions of the Chief Patron of the IMA CGP, Dr S Arulrhaj. Dr Arulrhaj has held many influential leadership roles including President of the Indian Medical Association and President of the Commonwealth Medical Association; roles that underpin a life of leadership and service in medicine.

I had asked Dr Arulrhaj for some messages to share in the oration. He recommended I should stress the need to continue to grow family medicine in India, the need for qualified family doctors to serve the needs of communities, and the need for “the medical students and young doctors of India to enter family medicine by choice, and not by chance”.

India, like many nations, has a focus on strengthening primary care and has recognised that universal coverage with only succeed with strong teams of health practitioners working together with communities to provide high quality primary care and that family doctors are an important part of this solution. Recent commitment by the Indian Government to ensure every medical student has experience in family medicine and to support postgraduate training in family medicine are important reforms which have delivered great improvements in the quality and availability of well trained family doctors in many parts of the world.

One of the leaders in the establishment of WONCA was Dr Prakash Chand (PC) Bhatla, who represented the IMA CGP. In 1976, Dr Bhatla became the first recipient of our most prestigious award, the WONCA Fellowship. At WONCA’s inaugural meeting, in 1972, Dr Bhatla spoke about the need to educate general practitioners in providing preventive and curative treatments, in being health educators and counselors, and in motivating and educating people and communities about health.

One line of Dr Bhatla’s 1972 speech really speaks to me: “Every national health program, including the Family Planning Program, should include the involvement of general practitioners. Education and motivation of the community has to be done on a personal basis. And who is nearer to the community than the family doctor?”

As family doctors we need to be engaged by our governments and international health organisations in the planning and delivery of national health programs. Family doctors are part of their local community, and have the trust of their local community, and can be part of ensuring the successful delivery of health programs, especially to the most vulnerable members of our populations.

I spoke to this theme during a meeting I had in October, with Mark Dybul, the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund has been one of the great global health success stories of the 21st century, tackling some of the most serious infectious diseases in some of the world’s poorest nations. By generating billions of dollars of donor funds, and working with the health systems in each country, prevention and treatment programs have led to millions of lives being saved.

But this is only the beginning. The Global Fund has recognised that, if it is going to be most effective, it needs to work with the health systems in each country, rather than setting up parallel vertical programs that risk weakening the existing health infrastructure. And strong primary care is a core component of ensuring the success and sustainability of programs to tackle serious health risks. The Global Fund is keen to engage with WONCA and our member organisations in the successful implementation of their programs in low and middle income nations.

There is great potential for WONCA and our member organisations in each country to work in partnership with global health organisations, as we do with the World Health Organization, to ensure health care is available to all people in all communities in each nation of the world.

After all, “who is nearer to the community than the family doctor?”

Michael Kidd
WONCA President