WONCA Annual Report 2020 - 2021

2020 2021

ANNUAL REPORT

© Olga Zarytska

2020-2021 AT A GLANCE EXECUTIVE COMMITTEE PRESIDENT Dr Donald Li

PRESIDENT-ELECT Dr Anna Stavdal

PAST CEO Dr Garth Manning

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CEO

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WONCA MEMBERSHIP

39

WONCA REGIONAL REPORTS

69

WONCA WORKING PARTY REPORTS

Dr Harris Lygidakis

WHO LIAISON Dr Viviana Martinez-Bianchi

WONCA STATUTORY COMMITTEES Bylaws Committee Finance

Full members Associate Members Organizations in Collaborative Relations Academic Membership

Africa Region Asia Pacific Region East Mediterranean Region Europe Region Iberoamericana - CIMF Region North America Region South Asia Region

Education e-Health Environment Mental Health Quality and Safety in Family Medicine Research Rural Practice International Classification

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113

130 148 154

WONCA SPECIAL INTEREST GROUP REPORTS Adolescent and Young Adult Care Ageing and Health Cancer and Palliative Care Complexities in Health Conflict and Catastrophe Medicine Emergency Medicine Emerging Practice Models for Family Medicine Family Violence Genetics LGBTQ Health Migrant Care, Int Health, and Travel Medicine Non-Communicable Diseases Quaternary Prevention and Over-medicalization Worker’s Health

YOUNG DOCTORS' MOVEMENTS YDM Representative AfriWON Al Razi Polaris The Rajakumar Movement The Spice Route Vasco de Gama Waynakay

WORLD FAMILY DOCTOR DAY 2021 WONCA ACCREDITATION & CERTIFICATION AUDIT REPORT OF TRUST

CONTENTS

ABOUT WONCA

TABLE OF

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ABOUT WONCA

ANNUAL REPORT | 2020-2021

A B O U T W O N C A MISSION The Mission of WONCA is to improve the quality of life of the peoples of the world through defining and promoting its values, including respect for universal human rights and including gender equity, and by fostering high standards of care in general practice/family medicine by: Promoting personal, comprehensive and continuing care for the individual and the family in the context of the community and society.

ABOUT

WONCA

Promoting equity through the equitable treatment, inclusion and meaningful advancement of all groups of people, particularly women and girls, in the context of all health care and other societal initiatives.

OUR Encouraging and supporting the development of academic organizations of general practitioners/family physicians; Providing a forum for exchange of knowledge and information between Member Organizations and between general practitioners/family physicians.

Representing the policies and the educational, research and service provision activities of general practitioners/family physicians to other world organizations and forums concerned with health and medical care.

HISTORY

The World Organization of Family Doctors (WONCA) is a not-for-profit organization and was founded in 1972 by member organizations in 18 countries.

WONCA now has 118 Member Organizations in 131 countries and territories with membership of about 500,000 family doctors and more than 90 per cent of the world’s population.

This includes eight organizations in collaborative relations with WONCA. There are some 21 members in the Academic membership category, which consists of Academic Departments of Family Medicine.

Over 800 individual general practitioners and family physicians have chose to join WONCA in their own right.

Membership of WONCA. WONCA represents and acts as an advocate for its constituent members at an international level where it interacts with world bodies such as the World Health Organization, with whom it has official relations as a nongovernmental organization and is engaged in a number of collaborative projects. The WONCA World Secretariat has transferred from Bangkok, Thailand to Brussels, Belgium in November 2020.

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2020 - 2021

ANNUAL REPORT | 2020-2021

WONCA AT A GLANCE

WO N C A M E M B E R O R G A N I Z A T I O N S WO R L D WI D E

15 MEMBER ORGANIZATIONS

50 MEMBER ORGANIZATIONS

EAST MEDITERRANEAN

EUROPE 7 MEMBER ORGANIZATIONS

8 MEMBER ORGANIZATIONS

NORTH AMERICA

SOUTH ASIA

AFRICA 13 MEMBER ORGANIZATIONS

IBEROAMERICA

ASIA PACIFIC

17 MEMBER ORGANIZATIONS

16 OCTOBER 2020 17TH WORLD RURAL HEALTH CONFERENCE DHAKA 2020

24 MEMBER ORGANIZATIONS

16 – 19 DECEMBER 2020 WONCA EUROPE CONFERENCE

DEC

MAR

OCT

KEY DATES JULY 2020 - JUNE 2021

1 MARCH 2021 WONCA MEMBERSHIP PORTAL LAUNCHED

JAN

MAY

1 JANUARY 2021: WONCA WORLD SECRETARIAT MOVE TO BRUSSELS

11 – 16 MAY 2021 EXTRAORDINARY GENERAL MEETING

18 – 26 JANUARY 2021 WHO EXECUTIVE BOARD MEETING

24 – 26 MAY 2021 WORLD HEALTH ASSEMBLY

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2020 - 2021

WONCA AT A GLANCE

WO N C A D I R E C T M E M B E R S & L I F E D I R E C T M E M B E R S WO R L D WI D E

45 DIRECT MEMBERS 36 LIFE DIRECT MEMBERS

72 DIRECT MEMBERS 46 LIFE DIRECT MEMBERS

316 DIRECT MEMBERS 31 LIFE DIRECT MEMBERS

ANNUAL REPORT | 2020-2021

EUROPE

EAST MEDITERRANEAN

125 DIRECT MEMBERS 37 LIFE DIRECT MEMBERS

NORTH AMERICA

SOUTH ASIA

AFRICA IBEROAMERICA 59 DIRECT MEMBERS 7 LIFE DIRECT MEMBERS

WONCA CHANNELS

30 DIRECT MEMBERS 21 LIFE DIRECT MEMBERS

ASIA PACIFIC 337 DIRECT MEMBERS 92 LIFE DIRECT MEMBERS

9,155 LIKES

30,518 NEWSLETTER SUBSRIBERS

4,271 FOLLOWERS

WEBSITE 259,352 VIEWS

521 FOLLOWERS 4

EXECUTIVE COMMITTEE

EXECUTIVE COMMITTEE

ANNUAL REPORT | 2020-2021

DR DONALD LI WONCA President

DR ANNA STAVDAL WONCA President - Elect

PROF VAL WASS Member-at-Large & Honorary Treasurer

DR VIVIANA MARTINEZBIANCHI Member-at-Large & WHO Liaison

DR PRATYUSH KUMAR Member-at-Large

PROF SHABIR MOOSA President Africa Region

PROF MENG-CHIH LEE President Asia Pacific Region

PROF TAGHREED MOHAMED FARAHA President East Mediterranean Region

PROF SHLOMO VINKER President Europe Region

DR JACQUELINE PONZO President Iberoamericana Region – CIMF

PROF MARVIN REID President North America Region

DR RAMAN KUMAR President South Asia Region

DR ANA NUNES BARATA Young Doctor Representative

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W O N C A

PRESIDENT

As I write this report, my last as President of WONCA, I realise that another year is behind us—a year like no other. The entire world has been put to the test like never before in our lifetimes. Faced with a global threat and many unknowns, the world spent the past year and a half fighting the virus and working to protect the health of people everywhere. Family doctors, patients, and communities came together as one against this global fight. The work undertaken by family doctors and primary care teams globally provides the most efficient and effective health care for patients.

All of us have had to adapt both personally and professionally during the pandemic. For some, there has been a welcome acceleration of the use of technologies. For others, an unwelcome loss of familiar and effective ways of consulting with our patients. All our activities were changed from physical attendance to online meetings and the 23rd World Conference and Council was rightly postponed to 2021 as a virtual Council and Conference, the first in the history of WONCA.

Due to our inability to meet in person as a Council, we sought legal and technical advice and arranged a virtual Extraordinary General Meeting (EGM) of Council in May 2021, to address the challenge of voting in person, as previously required by our bylaws. I am delighted to report that, despite unusual circumstances and the challenges being faced by many of our members, more than the required quorum logged onto the EGM platform to vote on the issue of allowing votes to be held without the need to be together in person. Developing innovative ways to connect and continue to work together are important steps in our recovery from such a shocking experience as the pandemic.

During this year, we created a global movement for World Family Doctor Day on 19 May 2021, with the theme ‘Building the future with family doctors’. It was a wonderful opportunity to come together virtually as family doctors around the world and consolidate our call for global commitment to the delivery of the comprehensive patient-centred health care to each and every person we serve. A magnificent buzz took over social media channels, webinars, and events, with many colleagues joining hands for a better future with family doctors through this movement.

Thank you to every colleague, their families and loved ones and their friends for showing their support.

I am proud to have taken part in a number of different projects that WONCA has worked on and further developed during this year. Primarily, the continued progress of the WONCA Accreditation which has been robustly tested, refined, and implemented focusing on both practice and programme accreditation. I have been invited to speak at numerous conferences, sessions, and meetings, albeit virtually, it was a delight to see so much interaction continue despite all the challenges.

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P R E S I D E N T

I delivered talks to the Royal Australian College of GPs; a semFYC conference in Spain; the Hong Kong Academy of Medicine; and to the Masters in Family Medicine Programme at Edinburgh University. I also delivered opening addresses, virtually, to the Chinese Medical Doctors Association, The Chinese Medical Association and the CrossStraits Medical Exchange Association.

One of the things that has amazed me over the last year is the enthusiasm by our regions, our Working Parties, our Special Interest Groups and our Member Organizations and the work they continue to do despite the challenges of the pandemic.

Regional Conferences continued to be held. Many of them were well-attended, interactive, with prerecorded and live streams running simultaneously. Timing, of course, was a challenge, when participants are living and working in multiple time zones. But the thread is the same: Family doctors across the world are keen and enthusiastic about building and sharing knowledge; about meeting and refreshing relationships with their global colleagues and friends, albeit virtually.

Our Working Parties and Special Interest Groups are the ground-breaking leaders within WONCA. The Working Party on eHealth has developed a dedicated assessment framework to evaluate digital health solutions from a family medicine perspective. The Working Party on Research had expertly addressed a wide range of issues of importance to the growth and development of family medicine globally. The range of topics covered by these groups is extensive and there is always room for people who are ready to offer their time and energy and expertise. I will leave each of them to speak for their achievements further in this report.

ANNUAL REPORT | 2020-2021

Over the years, our involvement with WHO has grown. We routinely field a senior WONCA team at annual World Health Assemblies; our Working Parties and Special Interest Groups are involved with WHO at global and regional levels; WONCA responds to multiple requests for input to WHO papers and events on a frequent basis. We appreciate that being asked for comments and inputs by WHO reflects the growing recognition within WHO of the need for comprehensive, qualified and accessible primary care delivery, to achieve the global goal of Universal Health Coverage.

2020 marked the end of an era with the retirement of WONCA’s long-time CEO: Garth Manning. I want to express my sincerest gratitude to Garth for his excellent work and commitment for the success of WONCA. I know how much time, energy, and determination Garth has put into making WONCA what it is today. 2021 welcomed Harris Lygidakis who continued this important work, and picked up the baton in November from Garth with the establishment of the new Secretariat in Brussels, Belgium.

And finally… a thank you! WONCA is an organization of organizations. Our strengths stem from our members, those national colleges and academies which support the 500,000+ individual family doctors and GPs globally. We do not take that support for granted. So, thank you to every organization, person, loved one, family, and friend who has committed themselves to the work of WONCA and have been keen to help and support in different ways through these tough times.

DR DONALD LI WONCA President

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ANNUAL REPORT | 2020-2021

PRESIDENTELECT A different year! The pandemic changed the conditions for WONCA’s work, virtual communication became the working mode for the executive, and the only way to maintain contact with members and different parts of the organization as well as with external stakeholders. The pandemic has shown us the added value of physical meetings.

Consequences of the postponement of the World Council last year and the planning of this year’s forthcoming virtual Council meeting has required a lot of attention. A big thank you to our president, the CEO and the secretariat staff for their leadership and team work. The pandemic has highlighted the important role of strong primary care and Family Medicine in preparedness and handling of health crisis, and the focus on advocacy on national, regional and global level has been strengthened over the last year.

The P-E is chair of the committee, who is handling this year’s nominations for Fellowship and Life Direct Membership when this report is written.

Equity in nominations is a challenge, related to geography and gender. Revision of policies and criteria for WONCA awards is on the agenda and is a work in progress.

The P-E is also a member of the newly established accreditation committee. Through bimonthly meetings a framework for accreditation is under development, an important activity for WONCA. I took part in a virtual practice accreditation together with Garth Manning in February, and will conduct the physical visit when travel conditions permit it. A similar accreditation is planned for September.

WONCA WEBINARS In autumn 2020, the second round of webinars was organised, experienced as an important arena for contact between WONCA members and leadership, not least in times of pandemic.

Developing this arena is a priority in the time to come.

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AWARDS & NOMINATIONS COMMITTEE

ACCREDITATION COMMITTEE & ACCREDITATION

P R E S I D E N T

Regular contact several times a week between the president(P), president elect (P-E) and the CEO has been a prerequisite to deal with governance issues and the many legal and administrative issues related to the transition of the secretariat.

It was good to take part in the selection process of secretariat staff; and I had the pleasure of visiting the secretariat in Brussels in early July. Good to meet our highly skilled officers in person!

W O N C A

P R E S I D E N T - E L E C T

REGIONAL, NATIONAL & WP MEETINGS It has been great to virtually meet members at several meetings and conferences during the last year, through live and video greetings and presentations at meetings organised by working parties (Rural and Planetary health), Young Doctor Movements (Rajakumar and Vasco da Gama).

It was also a pleasure to speak at the 25th anniversary of the academic department of Family Medicine in Ljubljana.

In virtual times, it is even more important to make sure that the WONCA World leadership takes part at national and regional meetings, in order to nourish the relationship between different parts of our organization, maintain our global network and build an international identity for Family Medicine.

EXTERNAL MEETINGS & WEBINARS

WOMEN IN GLOBAL HEALTH (WGH) The relationship between WGH and WONCA is growing stronger. I have had the pleasure of speaking at two conferences/meetings organised by the European chapter and I attended a webinar organised by the African chapter of WGH. WGH has launched the Gender Equal Health and Care Workforce Initiative this year, and the WP on Women in Family medicine is invited to explore how WONCA can actively engage.

WGH has launched the Gender Equal Health and Care Workforce Initiative this year, and the WP on Women in Family medicine is invited to explore how WONCA can actively engage.

OECD I am still a member of the advisory board for the PaRIS survey; the meetings have naturally taken place online.

To achieve a valid outcome of the survey, it is important that WONCA members urge their national authorities and colleagues to take part when the survey is launched later this year.

For more information, see link: https://www.oecd.org/health/paris/ WHO As usual, both president and president elect have taken part in liaising meetings alongside the WHO liaison, including the NSA meetings held in May in preparation for the virtual WHA. WHO is reorganising their interface with NSAs, and WONCA should reconsider our part accordingly.

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The pandemic has made it clear that good cooperation in health care is vital for health outcomes. In order to understand the different roles health professionals play, we must be in dialogue. It has been interesting to take part in webinars and meetings with other stakeholders at meetings with World Heart Federation and Global Coalition for Circulatory Health, European Forum for Primary Care Aprifel and the multistakeholder Primary Care Conference in Ljubljana in November.

I have also been invited to speak on Family Medicine in arenas of other stakeholders in my own region for policy makers and media. The main focus is as always to raise awareness of primary care and Family Medicine in a global perspective.

P R E S I D E N T

Attendance at regional conferences has been another arena for virtual contact, and has provided valuable input. I have presented at several national meetings in the European region, and have presented at the two European conferences, which have been held over the last year.

ANNUAL REPORT | 2020-2021

W O N C A

ANNUAL REPORT | 2020-2021

P R E S I D E N T - E L E C T

PARTNERSHIP FOR MOTHER, NEWBORN, CHILD HEALTH (PMNCH) In May this year, we signed up for membership with this partnership, an independent multiprofessional partnership embedded in WHO HQ. Read more about the partnership here.

I also attended the annual membership meeting in June.

WHO EUROPE PAN EUROPEAN COMMISSION

CORE VALUES I have been the chair of the WONCA Europe Core Values Task Force over the last couple of years.

The result will be presented for approval by the regional Council at the first opportunity.

Here are a few links to recent publications on the topic: https://www.tandfonline.com/doi/pdf/10.1080/02 813432.2020.1842676?needAccess=true http://journal.frontiersin.org/article/10.3389/fme d.2021.613977/

P R E S I D E N T

A considerable amount of time and energy has been spent on this project.

As the only practicing health care worker, and one of few of the 17 commissioners with a health background, it has been a challenge to make the case for primary care and Family Medicine. The report is being finalised as we speak.

A learning from the commission work is that a success factor for WONCA’s future advocacy is that we focus on understanding the complexity of health systems and our role in the system. We also need to develop dialogue skills in encounters with financial authorities, globally, regionally and on the national level.

DR ANNA STAVDAL WONCA President Elect

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ANNUAL REPORT | 2020-2021

W O N C A

P A S T C E O2

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May I begin this short report by thanking the CEO, Dr Harris Lygidakis, and CAO, Andrea Zard, for the opportunity to contribute a few words to the WONCA Annual Report 2020-21.

At the completion of my time as CEO at the end of December 2020, my final report on my 8½ years in the role was published in the WONCA News. It provides a summary of my time in office and I have no wish to repeat it here, but it can be accessed at: At the completion of my time as CEO at the end of December 2020, my final report on my 8½ years in the role was published in the WONCA News. It provides a summary of my time in office and I have no wish to repeat it here, but it can be accessed here.

As I indicated in that report, the transition to a new CEO and new Secretariat was not at all as we would have wished it to be, but Harris and I worked hard, through many Zoom sessions, to cover the numerous aspects which WONCA’s CEO deals with on a daily basis. In fact, most of 2020 had been far from normal – for obvious reasons – and we had had to adapt fairly quickly to more virtual meetings and encounters; though this was perhaps less of a transition for a Secretariat with a remote Executive than it might have been for other organizations. Even now, the forthcoming WONCA Council and Conference will be virtual, and we can only look forward with impatience for live events to be able to resume. Roll on WONCA Europe in London in June 2022 and WONCA World in Sydney in October 2023. I will be at both – and look forward immensely to meeting up with so many old friends. Among our many achievements in 2020 we did manage to arrange a series of WONCA webinars, ably assisted by many of our Working Parties and Special Interest Groups and I thank them all for their enthusiasm and participation.

I once again pay tribute to two invaluable colleagues throughout my time as CEO. Dr Nongluck Suwisith was a true friend and partner to me throughout, and WONCA owes her massive recognition for all that she did for the organization as CAO. Enormous appreciation also to Dr Karen Flegg who was another great friend, workmate and supporter as WONCA Editor.

Harris, Andrea and Maria have hit the ground running and are to be congratulated on their hard work and successes so far. They will move the organization forward in all sorts of new directions and I look on in admiration at what they have already achieved.

DR GARTH MANNING WONCA Past CEO

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ANNUAL REPORT | 2020-2021

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C E O 2 0 2 1

The past year has been a time of great challenge, yet also rich with inspiration. For this, we need look no further than the family doctors – members of our WONCA family – who have worked tirelessly on the front line along with other primary healthcare professionals. Not only have they offered treatment and support to patients with Covid-19, but they have also continued caring for the rest of their patients and the public; from those with non-communicable diseases to those suffering from the repercussions of the measures related to the pandemic.

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C E O

As an organization, WONCA has been committed to supporting this incredible dedication and work, while also facing a big transition of its own; the change of the Secretariat. We are delighted to share the details of this successful handover, as well as a summary of the other key efforts of the year, including the introduction of our new membership portal, and our annual events and conferences.

LEADERSHIP TRANSITION For several months we have been working to set up the new Secretariat office in Brussels, which has taken over from the Bangkok Secretariat. Our sincere appreciation goes out to Dr Garth Manning (former CEO) and his team – Dr Nongluck Suwisith, Ms Anuta Mustafa, and Ms Ya Min Cho – for their support and guidance in the transition, as well as for their years of service to our organization. They are succeeded by Andrea Zard, Chief Administrative Officer; Maria Dolores Zavala, Communications & Public Relations Officer; Marie Mahieux, Accounts Manager; and Danae Grunau, Membership Manager. Alongside welcoming in the new team, we have also reviewed our processes according to relevant data protection regulations, updated our privacy policy, and introduced a Data Protection Officer.

THE NEW MEMBERSHIP PORTAL We have introduced a new Membership Portal which enables each Member Organization to keep its account and contacts up to date. Key communications related to administration, membership fees and the Council are now shared through this Portal. It is, however, intended to offer much more than just administrative functions. We have been working to introduce ‘communities’ and provide a modern space for discussion and interaction for our Working Parties and Special Interest Groups.

“BUILDING THE FUTURE” The theme of this year’s World Family Doctor Day was “Building the Future with Family Doctors”.

We developed communication material for the event, including a media kit, which could be tailored and used by national organizations wishing to develop their own campaigns. A collection demonstrating the fantastic activities of our global community is shared here in this report.

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ANNUAL REPORT | 2020-2021

CONFERENCES AND MEETINGS

FINANCIAL STATEMENTS

As a result of the exceptional global context this year, in May we organised an Extraordinary General Meeting of the Council to alter our Bylaws and allow us to hold meetings of the Council by electronic means. Although we certainly all feel the desire to meet in person and sit together in the same room — escaping from the seemingly endless Zoom calls and webinars — we wish to congratulate our community for their perseverance in organising virtual events and continuing to share knowledge during these most challenging circumstances.

Finally, at the end of this report, you will find attached the audited financial statements for WONCA’s financial year ending in December 2020.

DR HARRIS LYGIDAKIS WONCA CEO

The WONCA World Conference and Meeting of the Council have also transformed into virtual events.

It is very unfortunate that our global community will not be able to meet in person in Abu Dhabi this November. We acknowledge the efforts of our colleagues at the Emirates Family Medicine Society, and the East Mediterranean Region, and share their disappointment. At the same time, we know that the there is a growing need to share knowledge and experiences, especially those regarding the effect of the pandemic on family medicine, the patients, and health systems. It is our hope that the virtual World Conference will serve this purpose.

In addition to the World Conference, several other events took place remotely. Two WONCA Europe Conferences and the WONCA Iberoamerica Congress were successfully organised virtually, as well as the meeting of the WONCA Working Party on Rural Practice. Furthermore, the first Planetary Health Conference was launched by the Working Party on Environment with the support of the Iberoamerica Region, showing the criticality of the impact of climate change. It is extraordinary that WONCA is broadly supporting the discussion about environment and showing leadership in advocating for changes. When we view this along with the resilience and adaptability of our community over the past year, we have a lot to celebrate and be optimistic about.

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ANNUAL REPORT | 2020-2021

W O N C A

WHO LIAISON

The years 2020 and 2021 highlighted the importance of global connections, global participation, and global understanding. The concept of the need for being here on this planet, together, as family, resonates now more than ever. The COVID-19 pandemic has highlighted social, racial, economical, and geographical inequities, bringing them to the forefront of global public health concerns. Severe inequities in access to personal protective equipment (PPE) with shortages of PPE endangering health workers worldwide, inequitable access to care and treatment for COVID-19, and inequitable global and regional distributions of vaccines for COVID-19 has made the fight against SARS-CoV-2 and its variants more difficult.

Frameworks to tackle the pandemic have often ignored the importance of primary healthcare, and the role that family doctors play, and can play during pandemic times. WONCA has been present at many conversations, highlighting the importance of the work family doctors can do to mitigate, prevent, and improve pandemic outcomes.

Here are some of the highlights of this past year: On September 17, 2020, WHO launched a global campaign for World Patient Safety Day, emphasising that there is not patient safety without health worker safety. This day was established by the 72nd World Health Assembly in May 2019, following the adoption of resolution WHA 72.6 on ‘Global action on patient safety’.

WONCA was closely involved in formulating the Global Patient Safety Action Plan 2020–2030 through the excellent and continuous work of members of the WONCA Working Party on Quality and Safety, Drs María Pilar Astier and Rosario Perez.

and care workers stating, ‘Health and care workers have been on the frontlines of the pandemic, but are often under-protected and over-exposed.

Protecting the people who protect us is the right and smart thing to do. Now it is time to show our love and appreciation for health workers by making sure workers are vaccinated’.

In January 2021, WHO issued a call to action to vaccine equity, started a #VaccinEquity social media campaign and urged the signing of the Vaccine Equity Declaration.

February 2021, WHO launched the Year of Health and Care Workers 2021.

The 148th session of the Executive Board of the World Health Organization took place virtually in January 2021. I worked together with chairs of the Working Party on Quality & Safety, the Special Interest Group on Emergency Medicine and the Working Party on Mental Health, to draft the statements made at the Executive Board meeting.

Dr Harris Lygidakis, WONCA CEO, and I spoke on behalf of our organization.

As part of Pillar 1 of the agenda related to the benefits of Universal Health Coverage, WONCA in collaboration with the Working Party on Quality & Safety, launched a statement to welcome the Global Patient Safety Action Plan: ‘WONCA encourages governments to invest in strong and safe primary care, in support of the health workforce and in health information systems, as the best efficient initiatives to achieve safe universal health coverage. Our vision is that the provision of quality healthcare in a safe environment should be universally available to all peoples.’

In November 2020, WHO informed that 2021 would be designated the Year of Health and Care Workers (YHCW). During the announcement, WHO Director-General Tedros Adhanom Ghebreyesus urged countries to increase investments in health 14

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Our WONCA statement on Mental Health Preparedness and Response for the COVID-19 Pandemic, prepared together with Prof Chris Dowrick, Chair of the Working Party on mental health, highlighted that: ‘Family doctors will continue to have a central role to play in delivering and coordinating primary mental health care, and in advocating for increased integration between specialist and community-based services. It will also be important to ensure that family doctors, like all other frontline workers, have the support they need to manage their own health and wellbeing during these difficult times. Missing from the WHO report is any reference to long-COVID, a combination of physical and psychological symptoms affecting perhaps 10% of COVID patients: this is a problem for which family doctors are well-placed to offer support and guidance. In addition, it is important to note that safe environment should be universally available to all peoples, and all members of the healthcare team.’

Our WONCA Statement on the COVID-19 Response, prepared together with Dr Victor Ng convenor of the WP on EM highlighted that: ‘Family doctors and their PHC teams are central to health emergency risk management, preparedness, and communication locally and nationally. We urge member states to involve family doctors in each community’s planning of the pandemic response, and in the design of primary health care strategies to approach the present and future crisis and pandemics. To achieve a high-quality emergency response, PHC needs to be appropriately funded with an investment in human resources for health, with training, and improved working conditions, including provision of Personal Protective Equipment for all members of the PHC team.

ANNUAL REPORT | 2020-2021

The PHC workforce should be in numbers sufficient to meet each country’s needs and with educational and skill training to provide the complexity of care required in emergencies often managed by PHC teams. WONCA is committed to the emergency response, in collaboration with WHO, WHO regions through WONCA regional organizations, and with member states through national associations of family doctors. Global and member state collaboration with experts in Family Medicine will enhance the preparedness of PHC during the pandemic and future emergencies.’

Lastly, the WONCA Statement Determinants of Health highlighted:

on

Social

‘Family doctors have a leadership role in identifying and addressing issues that affect patients beyond the clinical setting. They often incorporate assessment tools for SDOH into patient care. Screening allows a proactive approach to address vulnerabilities and barriers, trigger interventions, and implement timely referral and follow-up, helping patients access services within their communities and connecting them to needed services such as food, housing, and transportation. We urge member states to enhance the possibility of a SDOH approach through 1. Electronic connectivity and 2. the support of interdisciplinary primary health care teams working with the community, and 3. wrapping quarantine and isolation support services such as paid leave, rent and utilities support, transportation to health services-or home health, and food security around those diagnosed with COVID 19 who need these important services.’

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ANNUAL REPORT | 2020-2021

WONCA at the 148th session of the Executive Board of the WHO.

THE 74TH WORLD HEALTH ASSEMBLY The 74th World Health Assembly (WHA74) was held virtually, May 24-31, 2021. The theme: ‘Ending this pandemic, preventing the next: building together a healthier, safer and fairer world’.

In his address, Dr Tedros highlighted the suffering experienced by health and care workers during the pandemic: ‘For almost 18 months, health and care workers all over the world have stood in the breach between life and death. They have saved countless lives, and fought for others who despite their best efforts, slipped away. Many have themselves become infected, and while reporting is scant, we estimate that at least 115,000 health and care workers have paid the ultimate price in the service of others. Health and care workers do heroic things, but they are not superheroes. They are humans like the rest of us. They sweat and swear; they laugh and cry; they fear and hope. Many feel frustrated, helpless and unprotected, with a lack of access to personal protective equipment and vaccines, and the tools to save lives.

In this International Year of the Health and Care Worker, we have all been reminded that these are incredible people doing incredible jobs under incredible circumstances. We owe them so much, and yet globally health and care workers often lack the protection, the equipment, the training, the decent pay, the safe working conditions and the respect they deserve…. If we have any hope of achieving a healthier, safer, fairer future, every Member State must protect and invest in its health and care workforce as a matter of urgency.’

He highlighted the deep inequities in vaccine distribution around the world, calling on Member States ‘to support a massive push to vaccinate at least 10 percent of the population of every country by September, and a ‘drive to December’ to achieve our goal of vaccinating at least 30 percent by the end of the year’. He called on vaccine manufacturers ‘to give COVAX first right of refusal on new volume of vaccines, or to commit 50% of their volumes to COVAX this year.

And we need every country that receives vaccines to use them as quickly as possible.

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No dose can lay idle, or worse, be thrown away.

Country-level preparations to reach their populations must move as fast as vaccines’.

The Constituency Statement on Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, asked to:

Non-state actors were invited to attend the virtual assembly and to submit statements related to the agenda of the WHA to the website of the World Health Assembly. WONCA participated with two constituency statements, and four individual statements. I participated in all the discussions pertaining to the items voted on by the member organizations. WONCA statements were drafted with the support of: Prof Felicity Goodyear-Smith (Working Party on Research); Prof Maria-Pilar Astier-Peña (Working Party on Quality & Safety); and Dr Hagit Dascal-Weichhendler, Asst Prof Nena Kopčavar Guček, and Raquel Gomez-Bravo (Special Interest Group on Family Violence), President Donald Li, President -elect Anna Stavdal, and WONCA CEO Harris Lygidakis.

‘Ensure ownership and utilization of findings by end-users by promoting embedding research as an integrated and systematic part of decisionmaking and implementation, which enables a country’s policy-makers, researchers, and communities to work together to collaborate on research projects, ensuing the principles of codesign and co-production. Waive author publication fees for peer-reviewed publications, if the lead author is from an LMIC, so the research is freely available to those to whom the research pertains. Promote ring-fenced health research funding for primary care research in LMIC to ensure that community-based participatory primary care research does not compete with lab-based medical research for funding. Promote dedicated funded time for local primary care clinicians and teachers, and practice-based research networks. Finally, embrace innovative methods in research methodology teaching for young researchers in LMICs.’

As WONCA WHO liaison, I read a Constituency Statement on Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property signed by The International Diabetes Federation (IDF), the International Federation of Surgical Colleges (IFSC), and the World Organisation of Family Doctors (WONCA).

The Constituency Call on WHA For Better CoOrdination For Action On COVID-19, joined by the World Federation of Public Health Associations, International Federation on Ageing, International Hospital Federation, International Physicians for the Prevention of Nuclear War, World Organization of Family Doctors, World Federation of Occupational Therapists, and International League of Dermatological Societies, called on ‘WHO and its member states to take action to: ensure that treatments and vaccines are available to everyone everywhere; transform COVAX into a COVID-19 Solidarity Pooling Platform; increase preparedness, and establish a clear partnership between the politicians and the health, social, and trade unions’ professionals to build public trust and engagement’.

The ‘Statement on Global Action on Patient Safety’ asserted that: ‘Family doctors have reinforced their role as community health referents in the pandemic.

They are trusted voices in the acceptance of vaccines. Investing in primary health care, and family doctor led primary health care teams, is one of the most cost-effective practice governments should put in place to face future global health risks.’

The Statement on Global Plan of Action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence:

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‘WONCA recognises the importance of family doctors as first point of contact for victims, as well as providers of continued multigenerational care having a crucial role in facilitating disclosure of family violence. Family doctors are trusted leaders in their communities and committed to patients and families, as well as leaders of primary health care teams. They must be aware of the magnitude and impact of family and gender violence on patient's health and the health care system. (…) As it has been pointed out in the WHO report, the COVID-19 pandemic and measures to combat it have increased the magnitude of family/gender violence. WONCA, and especially the SIG on Family Violence, propose to engage more actively with WHO, member states, WONCA Member Organizations, and other interested partners in the development of materials, policies, webinars and training of members of the PHC workforce to recognise and address all forms of family and gender violence, as well as promote research on these topics. A coordinated and continuous effort is needed to increase training for all members of the healthcare team, to improve identification, support and referral of victims of family violence…’

The WONCA statement on the Health Workforce recommended: ‘1. A global commitment to appropriate, longterm and sustainable funding for PHC; 2.

Funding for the education, training, and employment of appropriate numbers of family doctors and other members of the primary healthcare team, in order to meet each community’s needs, so that every country is ready to provide the universal health coverage needed in pandemic and non-pandemic times; 3.

Breaking silos and providing innovation in data and technology with data integration, allowing much improved health information exchange between hospitals, PHC, labs, practices, and health departments; 4. Support for research at the PHC level; 5. The inclusion of PHC in Humanitarian Aid and Global Health planning and budgeting.’

ANNUAL REPORT | 2020-2021

A fourth WONCA statement, ‘the Response by World Organization of Family Doctors to the WHA74 Agenda Item 13.2 (Political declaration of the third high-level meeting of the General Assembly on the prevention and control of noncommunicable diseases)’ was unfortunately not read at the assembly: ‘Primary care teams which include family doctors, are essential in the delivery of good quality, cost-effective, comprehensive, coordinated, continuous, person-centred primary care in high-, middle-, and low-income countries alike. An effective approach to improving the quality of care for people with NCDs is through improved primary care delivery.

WONCA recommends increasing funding at every country and region to further strengthen primary care service delivery in order to meet the growing burden of NCDs, and investing in, and supporting the recruitment, education and adequate training of a primary care workforce.’

A full report is available at WONCA at 74th World Health Assembly, WONCA and WHO News WHO TELECONFERENCES Several working teleconferences were held during this past year. Participants have included for WHO: Ed Kelley, Shannon Barkley, John Fogarty, WHO Division of UHC and Life Course, Yuki Suma Department of Ageing and Life Course, Bente Mikkelsen, NCD director, Neelam Dhingra-Kumar, Coordinator, Patient Safety and Risk Management, James Campbell, Health Workforce and others For WONCA: Donald Li, Anna Stavdal, Shabir Moosa, Viviana Martinez-Bianchi, Harris Lygidakis. Dimity Pond, Prof Maria-Pilar AstierPeña.

Several members of working parties and interest groups already are directly connected with departments and teams at WHO and its regional offices. One important plan will be to do a mapping of such efforts to highlight areas of collaboration, assets, and gaps.

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COLLABORATION PLAN BETWEEN WHO & WONCA FOR THE PERIOD 2022–2024 Official relations between WONCA and WHO are governed by the ‘Framework of Engagement with non-State actors’. The basis of official relations is a plan for collaboration between WHO and WONCA as non-State actor with agreed objectives and outlining activities renovated every three years and structured in accordance with the General Programme of Work and Programme budget and consistent with the Framework.

The plan for collaboration contains activities that have been jointly planned with and tailored for WHO, and directly contribute to WHO's programmes. The proposal for the period for 2022–2024 was drafted by Non-State actor focal points: Viviana Martinez-Bianchi, MD WONCAWHO Liaison and Harris Lygidakis, MD and CEO WONCA together with WHO Designated Technical Officer (DTO): Shannon Barkley outlies several areas of collaboration. These areas follow through on prior work and have been designed with the guidance of prior and current activities of WP and SIGs. WHO STRATEGIC PRIORITY(IES) I) ONE BILLION MORE PEOPLE BENEFITING FROM UNIVERSAL HEALTH COVERAGE WHO OUTCOME(S) OUTCOME 1.1 – IMPROVED ACCESS TO QUALITY ESSENTIAL HEALTH SERVICES 1. Strengthening of Primary Health Care WONCA will contribute to the development of stronger PHC by providing technical assistance on the development and accreditation of Family Medicine training programs and multidisciplinary primary care teams. Examples include the development of AfroPHC together with the WHO Africa region. This can be expanded on an ad-hoc basis as requested by Ministries of Health or WHO Country Offices.

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2. Global Patient Safety Action Plan WONCA will continue to contribute to the Global Patient Safety Action Plan through consultations, the promotion of the plan, and celebration of the yearly World Patient Safety Day. An example is the great work already in place in collaboration with the WONCA Working Party on Quality & Safety.

3. Active contribution to implementation of the operational framework for primary health care Support WHO in the implementation of the operational framework for PHC by providing technical input to and review of numerous implementation tools including policy briefs, case study compendium, WHO Academy course on PHC, PHC monitoring and measurement guidance, the PHC global report, and implementation solutions.

Potential contributions to a universal knowledge platform on PHC. 4. Improving PHC in rural areas WONCA will work with WHO on technical papers, documents and webinars related to the development of a rural heath workforce, including rural health policies, resources needed, and training. An example is the work of the WONCA Working Party On Rural Practice, on the webinar series on Rural Health Equity, and the lessons in rural proofing of health policies, strategies, plans, and programmes.

5. Support WHO mental health initiatives, in particular implementing the WHO mhGAP at primary health care and community level WONCA, through the Working Party on Mental Health works closely with WHO and tailors its mental health activities, including their consultancy services specifically to support the WHO mhGAP programme.

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WONCA will support WHO in assisting Member States to design programmes to enable health ministries to develop teams and indicators to implement mhGAP at primary care and community levels, development of primary mental health care services, integration of mental health and primary care professionals. Education and training: creation, delivery, and evaluation of primary mental health care education and training programmes; focus on how to screen, diagnose and manage common mental health problems in primary care and community settings, adapted to meet the needs of specific national cultural contexts. Research: advice on identification of primary mental health care research priorities and funding opportunities, collaboration on implementation and evaluation of research project. Provide technical input to WHO on integrating mental health into primary health care. WONCA will provide, based on experiences to date, feedback and inputs on future WHO training programmes planned on mental health, in particular for addressing the management of mental health in the primary health care, consistent with patient and professional values, promoting concept of mental health and well-being. With reference to evidence-based health care, WONCA will support WHO to promote and develop mental health research activities in primary care and the primary care interface, and contribute to the research base. WONCA will collaborate to promote and develop patient information about mental health issues as well as develop and promote appropriate literature for primary care professionals using a variety of resources, and address the issue of stigma associated with mental health difficulties.

6. Active contribution to the implementation ICPC3 WONCA is working with WHO on the development and implementation of primary care relevant classification systems, in particular alignment of ICPC3 with ICD11. Joint work to ensure conceptual consistency between ICPC and the other members of the family of classifications,

ANNUAL REPORT | 2020-2021

in particular ICD-11 and ICHI. This work has been long standing and led by the WONCA International Classification Committee (WICC).

7. Contribute a primary care and family practice perspective to WHO policy in relation to family violence and violence against women Provide technical input on primary care and family practice perspective to WHO for technical documents on family violence and violence against women, disseminate WHO policies, and document WONCA constituencies, in particular its members who are family doctors, as agreed by with WHO. Develop materials, webinars, research, and training of members of the healthcare team to recognise and address all forms of family and gender violence. This area will be led by the WONCA Special Interest Group on Family Violence, as suggested during the WHA74.

II) STRATEGIC PRIORITY 2: ONE BILLION MORE PEOPLE BETTER PROTECTED FROM HEALTH EMERGENCIES WHO OUTCOME(S) OUTCOME 2.1 – COUNTRIES PREPARED FOR HEALTH EMERGENCIES OUTCOME 2.2 – EPIDEMICS AND PANDEMICS PREVENTED OUTCOME 2.3 – HEALTH EMERGENCIES RAPIDLY DETECTED AND RESPONDED TO 1 . Emergency Preparedness Family doctors and their PHC teams are central to health emergency risk management, preparedness, and communication locally and nationally.

WONCA is committed to the emergency response, in collaboration with WHO, with WHO regions through WONCA regional organizations, and with member states through national associations of family doctors.

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This includes training of family doctors, webinars, and information sharing to involve family doctors in each community’s planning of the pandemic response, including vaccine access and distribution, and in the design of primary health care strategies to approach the present and future crisis and pandemics. WONCA develops webinars, as well as other educational material on COVID-19.

III) STRATEGIC PRIORITY 3: ONE BILLION MORE PEOPLE ENJOYING BETTER HEALTH AND WELL-BEING OUTCOME 3.1 – DETERMINANTS OF HEALTH ADDRESSED OUTCOME 3.2 – RISK FACTORS REDUCED THROUGH MULTISECTORAL ACTION OUTCOME 3.3 – HEALTHY SETTINGS AND HEALTH IN ALL POLICIES PROMOTED 1. Global Strategy for Women’s, Children’s and Adolescents’ Health WONCA will work with WHO to actively contribute to the implementation of the Global Strategy for Women’s, Children’s and Adolescents’ Health WONCA Special Interest Group on Adolescent and Young Adult (AYA) Care, and WONCA Working PARTY on Women in Family Medicine (WWPWFM) will share expertise, develop webinars, training, and documents/ WONCA will contribute to the work of WHO to strengthen primary care and family practice capacity to deliver adolescentresponsive care. WONCA is participating in STAGE on women and children nutrition.

2. Contributions to the work of WHO GCM/NCDs as a GCM participant

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WONCA will offer consultations, work on material and webinars to address the care of NCDs from a PHC perspective. Material will be disseminated at world and regional conferences and by member organizations.

3. Contribute to the implementation of the Global Strategy and Action Plan on Ageing and Health and the Integrated Care for Older People Support the implementation of the ageing strategy through provision of technical assistance; engage key researchers in the ICOPE implementation; continuing to provide a primary care and family practice perspective to the field of healthy ageing; provide opportunities for training, including technical expertise in the development of programs; leverage the network of researchers for data collection and translational research; contribute to advocacy, disseminating policies and practice through WONCA’s channels, including regional and world scientific meetings THE WEBINAR SERIES ON RURAL HEALTH EQUITY I would like to recognise the Rural Working Party of WONCA for organising together with WHO and other external partners, a series of webinars on Rural health equity.

WHO Academy is rapidly upscaling training via a number of digital, easily accessible learning applications. Please help WHO design and prioritise content and delivery methodologies that support and enable health workers worldwide to boost their knowledge and skills related to the COVID-19 outbreak. Sign onto the WHO academy to learn more.

WONCA will work with WHO in the development of the implementation roadmap for 2023–2030 to support the prevention and control of NCDs, and support countries to decide on priority activities and pathways that accelerate progress towards achieving SDGs.

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PARTNERSHIPS DERIVING FROM WHO COLLABORATION Civil Society Engagement Mechanism for UHC2030 (CSEM) The International Health Partnership for UHC2030 (UHC2030) is the global movement to strengthen health systems for Universal Health Coverage (UHC), as part of the Sustainable Development Goals (SDGs). It is a multi-stakeholder platform that promotes collaborative work at global and country levels on Health Systems Strengthening (HSS), advocates for increased political commitment to UHC, and facilitates accountability and knowledge sharing. We became an official partner in October 2019 during the UN High Level Meeting. https://csemonline.net/

ANNUAL REPORT | 2020-2021

It has been a privilege and an honour to serve in the role of WONCA-WHO liaison from 2016 to 2021. I am thankful for the opportunity and for the guidance I received from WONCA executive leadership, prior WONCA presidents, and WONCAWHO liaisons, and from current leaders of working parties and interest groups. I dedicated many hours to the role of representing Family Medicine and WONCA’s interests, while never losing sight of the importance of the people and communities we care for.

DR VIVIANA MARTINEZ-BIANCHI Member-at-Large & WHO Liaison

I would like to encourage member organizations, and WONCA members to review the website, and see how you can participate to improve UHC. The Coalition for Circulatory Health The Global Coalition for Circulatory Health (GCCH) provided a global perspective on the circulatory risk factors and outcomes associated with COVID19 and covered ways of supporting the health care workforce. A Global Summit on Circulatory Health is scheduled for November 22–23, 2021.

WONCA President elect, Anna Stavdal represented Family Medicine interests during a Heart Talks webinar, in October 2020, titled: ‘What will the post-COVID workforce look like and how will it be trained? Turning an access to care crisis into integrated care delivery systems’.

LINKS of importance to WONCA WHO Website on PHC: Primary health care (who.int) Global Action Plan for Healthy Lives and Wellbeing for All

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STATUTORY COMMITTEES

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WONCA

STATUTORY COMMITTEES

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BYLAWS

C O M M I T T E E

The committee comprises: Professor Shabir Moosa (South Africa) Professor Rich Roberts (USA) Dr Karen Flegg (Australia) Dr Ana Nunes Barata (Portugal) Dr Doral Bernal (Colombia) This year (and term) has been a very busy one for this committee, especially considering COVID-19 and the challenges it posed to the usual organisation of WONCA activites.

A range of changes needed were identified from early 2019, discussed over 2019/2020 in the committee and formally presented to the WONCA Executive Committee at the biannual extended meeting held virtually on 14-15 May 2020.

Most proposals were accepted and some deferred. The WONCA Africa Regional Bylaws were accepted with minor changes.

A Bylaw issues identified in May 2020 that became acutely necessary to deal with was amending the Bylaws to allow a virtual Council Meeting in November 2021. Work on related Bylaw changes resulted in an asynchronous Extraordinary General Meeting between 11th and 16th May 2021 prefaced by two consultative workshops.

The amendments were passed by the necessary quorum with 12 Officers of the Organization and 88 Council Members representing 94 Member Organizations. A total of 95 Council Members (Officers of the Organization and Council Members representing Member Organizations) cast 140 valid votes: 87 Council Members, representing 130 votes, voted in favour of the adoption of the resolution; 8 Council Members, representing 10 votes, voted against the adoption of the resolution. The resolution was adopted by a super-majority of more than two-thirds (2/3) of the votes cast.

WONCA Past Presidents Professor Amanda Howe, Professor Michael Kidd, Professor Richard Roberts, and Professor Chris van Weel verified and supported the results as accurate and as meeting the criteria for quora and a decision.

The latest Bylaws (with amendments from the Extraordinary General Meeting at the end of May 2021) with change related to online meetings can be accessed at the WONCA website.

considering the move of the Secretariat to Luxembourg in January 2021 and banking implications. The Articles of Association for the registration in British Virgin Islands was finalised by the Executive Committee as an operational decision as empowered by the Bylaws. There was considerable consultation with the Committee, consultants and the Executive Committee. After much hard work the Articles of Association were aligned to Bylaws and finalised with only a few amendments needed to the Bylaws. The Executive is still deliberating on how to be transparent to Council on the Articles of Association in the face of urgency to register WONCA in Switzerland.

The Committee has deliberated on the Bylaws amendments proposed and required. It has been acutely aware of the challenges of a long list of changes and the virtual nature of the next Council meeting.

These proposals for further amendments to the Bylaws are group as follows:

Much of the committees focus shifted since May to the Articles of Association that were necessary for the legal registration of WONCA as an Association Switzerland,

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Articles of Association related: names and definitions; meetings; and dissolution, YDM issues Conference issues Awards Regional Dispute Resolution Deletions Short amendments/clean up In addition to these amendments the Committee has recommended to the Executive Committee that several issues warranting Bylaw amendment be workshopped with Member Organisations and related stakeholders going forward.

These are the definition of family medicine, the definition of family doctors, the vision of WONCA, the mission of WONCA, the values of WONCA, the voting structure, change of name of Young Doctor Movements to New Doctor Movements, and the creation of a regular strategic plan as an organisational policy.

Some changes that appear contentious will hopefully be addressed in these consultations. The debates and proposed changes have been kept as organisational record.

ANNUAL REPORT | 2020-2021

Organizational Policies have also been reviewed to be in alignment with the Bylaws and for good governance of WONCA as a global organisation.

Changes to Organisational Policies will be a multi-year process after the above Bylaw amendments have been addressed.

I would like to acknowledge the Secretariat, Bylaws Committee and Executive Committee for their excellent work.

PROF SHABIR MOOSA Chair Bylaws and Regulations Committee

All regional Bylaws have been collated. However, there is no record of them being ratified by Council as expected. Whilst the variability presents challenges to global integrity of WONCA it is accepted that WONCA Bylaws will be used to arbitrate in any dispute.

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FINANCE

C O M M I T T E E

As anticipated 2020 was another challenging year requiring flexible and regular adjustments to address the uncertainties and difficulties Covid-19 has introduced. We have at the same time been (i) transferring to a new secretariat (ii) introducing new payment and accounting systems, and (iii) establishing the WONCA Association in Switzerland. We remain in a strong position financially but, as with so many other organisations, we face a time of financial constraint where prudent budgeting is essential The Financial statement for 1st January 202031st December 2020 presented here gives full details of income and expenditure for this period.

My report will summarise how we balanced the budget for 2020, the challenges we face in 2021 and how we are responding. I thank Garth Manning and Harris Lygidakis (past and present CEOs), the Thai and Brussels secretariats and the Regional Treasurers on the finance committee for their expertise and support.

Overall position: The end of year 2020 audit showed an overall loss of $70,000. We had hoped to breakeven but some payments for accreditation were delayed as a result of work holdbacks caused by Covid restrictions and travel limitations. The accreditations did subsequently take place in 2021 and will be reflected in the 2021 budget. Our total assets in December 2020 were $806,589 compared to $103,939 in 2019. Currently the June 2021 balance sheet, shows assets of $929,365, of which $717,048 are deposited in the bank account.

Overall, when presented with the 2020 outcomes, the Finance Committee agreed that WONCA had a stable financial position considering the global crisis. They felt it was a significant achievement given the extenuating circumstances to present a relatively small loss.

2020 Income: As the report confirms we faced a 100% loss in conference levy income due to postponement of the 2020 WONCA World Council and other regional events. Fortunately, membership subscriptions held steady.

Consultancy accreditation processes moved to a virtual platform and were maintained apart from a relatively small shortfall due to delayed visits.

Overall, the shortfall on income was $649956 compared to $767781 in 2019.

2020 Expenditure: The loss of conference income was balanced by a marked reduction in travel expenditure. WONCA Executive replaced the usual twice yearly face to face meetings with virtual events, WHO meetings were virtual and Executive member travel allowances were underspent. The transition budget, set aside in anticipation of the transfer to a new site, supported increased secretarial expenses. Throughout the year we were able to make predictions and small adjustments to keep the budget in balance and reduce the shortfalls. If the consultancy payments had not been delayed, we had hoped for a balanced budget.

PARTNERSHIPS DERIVING FROM WHO COLLABORATION The transfer to a new secretariat in Brussels, moving to new accountancy and audit management and closing and opening new accounts has proved bureaucratically time consuming and, at times, frustrating. This has led to some delay in setting up the monthly budgeting reports and invoicing member organisations. By April we were fully up and running.

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C O M M I T T E E

Moving the WONCA organisation to Switzerland from the British Virgin Islands is in process with some additional legal costs which can be covered in the budget. Long term this is an important move. Switzerland offers a stable and transparent legal environment for international associations and favourable tax treatment for non-profits (no corporate taxation, VAT exemption). A Swiss nonprofit Association will facilitate bank transactions and allow us to open a merchant account. By receiving a proper non-profit registration, it will be easier to apply for grants.

Facilitating Membership Organisation Payment: Until this is achieved and the bank account transferred, for unavoidable technicalities, direct payment via Merchant accounts, e.g. PayPal, cannot be offered. This with the lack of face to face meetings for direct cash payment impacts on some small member organisations for whom bank transfer charges can be prohibitive. We are aware of these issues and aim to resolve them as soon as possible.

Moving to a virtual 2021 World Council. We were hoping for a face to face meeting with a return to more predictable conference levies. Our anticipated 2021 conference levies were reduced from £175,000 to $20,000. However, the loss from this income can be set against reduced travel and accommodation expenditure for WONCA Executive and the secretariat. It was easier to budget once the decision was made.

Consultancy income: Accreditation consultancies continue on virtual platforms with successful outcomes in China , Arizona and Bahrain for both postgraduate training and practice accreditation. This is proving an important initiative supported by the WONCA Education and Quality and Safety Working Parties. We hope it will expand in future.

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In conclusion: As we plan for 2022 and 2023 it seems inevitable these challenges will continue to some extent. We will never return to the same modus operandi. Virtual rather than face to face meetings impact significantly on conference income and personal networking but save on travel costs. We can anticipate some increased use of virtual platforms impacting on conference levies. An increased focus on income generation through consultancies, sponsorship, and grants is essential if we are to rebuild a surplus to support member organisations and offer discretionary funding opportunities to working parties and special interest groups.

FINANCE COMMITTEE Prof Val Wass (Chair), UK Dr Francine Lemire, Canada Prof Job Metsemakers, Netherlands Regional Treasurers: Dr Elizabeth Reji (Africa), South Africa Dr Md Husni Jamal (Asia Pacific), Malaysia Dr Oraib Alsmadi (East Mediterranean Treasurer 2018–2021), Jordan Dr Josep Vilaseca (Europe), Spain Dr Marina Almenas (Iberoamericana), Puerto Rico Dr M A Quayum (South Asia), Bangladesh

PROF VAL WASS Chair of the Finance Committee and Honorary Treasurer

Discretionary Funding: Unfortunately, as there was no surplus in the budget, no awards have been made this year or planned for 2021. A sad reflection on the cautionary approach we have had to adopt.

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MEMBERSHIP

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WONCA

MEMBERSHIP

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WONCA MEMBERSHIP

FULL MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

Afghanistan

Afghanistan Association

Algeria

Société Algérienne Générale

Argentina

ACRONYM

YEAR

Medicine

AFMA

2015

Médécine

SAMG

2015

Argentine Federation of Family and General Medicine

FAMFyG

2002

Armenia

Armenian Physicians

AAFP

2007

Australia

The Royal Australian General Practitioners

RACGP

1973

Austria

Austrian Society of General Practice

ÖGAM

1996

Bahrain

Bahrain Family Physicians Association

BFPA

2004

Bangladesh

Bangladesh Practitioners

College

General

BCGP

1987

Bangladesh

Bangladesh Physicians

Academy

Family

BAFP

2004

Belgium

Belgian Society Practitioners

General

BSGP

1998

Bolivia

Bolivian Society of Family Medicine

SOBOMEFA

2002

Bosnia & Herzegovina

Association of Family Physicians of Republic of Srpska

Bosnia & Herzegovina

Association of Family Physicians of the Federation of Bosnia and Herzegovina

Botswana

Botswana Physicians

Brazil

Brazilian Society of Community Medicine

Bulgaria

Bulgarian General Practice Society for Research and Education

Cameroon

Medcamer Family Medicine

Canada

The College of Family Physicians of Canada

Family

de

Association

of

College

of

of

for

Association

Family

of

of

2011

AFPFBIH

2019

Family

Family

and

2011

SBMFC

BGPSRE

MFM CFPC

2002

2016

2020 1973

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WONCA MEMBERSHIP

FULL MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

Chile

Scientific Society of Family General Medicine of Chile

China

ACRONYM

YEAR

SOCHIMEF

2002

Chinese Medical Doctor Association General Practitioners Sub-Association

CMDA-GP

2018

China

Chinese Society of General Practice

CSGP

1995

China

General Practice Branch of Cross-Strait Medicine Exchange Association

SEMA-GP

2016

Colombia

Colombian Society of Family Medicine

SOCMEF

2002

Costa Rica

Costa Rican Association of Specialists in Family and Community Medicine

Croatia

Croatian Coordination

Croatia

Croatian Medicine

Cuba

and

2004

KOHOM

2010

CAFM

1997

Cuban Society of Family Medicine

SOCUMEFA

2006

Czech Republic

Czech Society of General Practice CLS JEP

CSGP

1993

Denmark

Danish College Practitioners

DSAM

1976

Dominican Republic

Dominican Republic Society of Family Medicine

SODOMEFA

2004

Ecuador

Ecuador Society of Family Medicine

SEMF

2002

Egypt

Egyptian Family Medicine Association

EFMA

2007

El Salvador

Salvadorean Association

AMEFAES

2005

Estonia

Estonian Family Doctors Society

ESFD

1996

Fiji

Fiji College of General Practitioners

FCGP

1993

Finland

Finnish Practice

FAGP

1984

France

French College of General Practice

LECMG

2014

Family

Physicians

Association

of

of

Family

Association

Family

General

Physicians

for

General

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ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

FULL MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

ACRONYM

YEAR

Georgia

Georgia Family Medicine Association

GFMA

2004

Germany

German College of General Practitioners and Family Physicians

DEGAM

1982

Ghana

Society of Family Physicians of Ghana

SOFPOG

2017

Ghana

West Africa College of Physicians, Faculty of Family Medicine - Ghana Chapter

WACPGCFM

1999

Greece

Greek Association Practitioners

ELEGEIA

1988

Greece

Greek College of General Practitioners

GCGP

2019

Greece

Hippocrates, Association of General Practice

HAGP/FMG

2020

Hong Kong

The Hong Kong College of Family Physicians

HKCFP

1978

Hungary

Hungarian Research Organization of Family Physicians

CSAKOSZ

2010

Iceland

The Icelandic Practitioners

ICFP

1980

India

Indian Medical Association College of General Practitioners

IMACGP

2011

India

Academy of Family Physicians of India

AFPI

2011

Indonesia

Indonesian Society of Teachers in Family Medicine

KIKLPI

2017

Indonesia

The Indonesian Association of Family Physicians

IAFP

1982

Iran

Iranian Society of General Practitioner

ISGP

2016

Iraq

Iraqi Family Physicians Society

IFPS

2005

Ireland

Irish College of General Practitioners

ICGP

1985

Israel

Israel Association of Family Physicians

IAFP

1973

Italy

Interdisciplinary Scientific Association of both Family and Community Medicine

AsSIMeFaC

2004

College

of

of

General

General

31

ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

FULL MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

ACRONYM

YEAR

Italy

Centro Studi e Recerche in Medicina Generale

CSeRMEG

1991

Jamaica

The Caribbean Physicians

CCFP

1992

Japan

Japan Primary Care Association

JPCA

1985

Jordan

Jordan Society of Family Medicine

JSFM

2004

Kazakhstan

Kazakhstan Physicians

KAFP

2003

Kenya

Kenya Association of Family Physician

KAFP

2004

Korea

Korean Academy of Family Medicine

KAFM

1983

Kosovo

Association of Family Physicians of Kosovo

AFPK

2019

Kuwait

Kuwait Association of Family Physician and General Practitioners

KAFPGC

2015

Kyrgyzstan

Family Group Practice and Nurses Association of Kyrgyzstan

FPGA

2003

Lebanon

Lebanese Society of Family Medicine

LSFM

2003

Lesotho

Lesotho Medical Association

Liberia

Society of Family Physicians of Liberia

SOFPOL

2020

Lithuania

The College of Family Physicians of Lithuania

LSGK

1997

Luxembourg

Société Scientifique Luxembourgoise de Médecine Générale

SSLMG

2005

Macau

Associacao dos Medicos de Clinica Geral de Macau

AMCGM

1992

North Macedonia

Association of General Practitioners of Macedonia

AGPM

2012

Malaysia

Academy Malaysia

of

AFPM

1975

Malaysia

The Malaysian Family Specialists' Association

Medicine

FMSA

2019

of

College

Association

Family

of

of

Family

Family

2007

Physicians

32

ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

FULL MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

ACRONYM

YEAR

Malta

Malta College of Family Doctors

MCFD

1989

Mexico

Mexican College of Family Medicine

COMMEFAC

2002

Mongolia

Mongolian Association Medicine Specialists

MAFMS

1998

Morocco

National Collective General Practitioners

MG MAROC

2015

Myanmar

Myanmar Medical Association, General Practitioners' Society

GPSM

2005

Nepal

General Practitioners' Association of Nepal

GPAN

1997

Netherlands

Dutch College of General Practitioners

NHG

1973

New Zealand

The Royal New Zealand College of General Practitioners

RNZCGP

1973

Nicaragua

Asociación Nicaraguense de Medicina Familiar

ANIMEF

2006

Nigeria

Faculty of Family Medicine, National Postgraduate Medical College of Nigeria

FGMPNPMCN

1998

Nigeria

Association of General and Private Medical Practitioners of Nigeria

AGPMPN

1980

Norway

Norwegian College of General Practice

NFA

1976

Oman

Oman Family Medicine Society

FAMCO

2007

Pakistan

Pakistan Society of Family Physicians, Lahore

PSFP

1996

Pakistan

College of Family Medicine Pakistan

CFMP

1973

Palestine

Palestinian Medicine

Panama

Asociación Panamena de Medicina Familiar

APMF

2002

Paraguay

Paraguayan Medicine

SPMF

2004

of

and

Association

Society

of

Family

Moroccan

Community

of

of

2019

Family

Family

33

ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

FULL MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

Peru

Peruvian Society of Community Medicine

Philippines

Philippine Physicians

Poland

ACRONYM

YEAR

SOPEMFYC

2002

PAFP

1973

The College of Family Physicians in Poland

KLRwP

1996

Portugal

Portuguese Association of General Practice and Family Medicine

APMCG

1985

Romania

Romanian National Society of Family Medicine

SNMF

1998

Russia

All Russian Fund - Association of General Practitioners of Russian Federation

Saudi Arabia

Saudi Society of Community Medicine

Serbia

Family

Academy

of

and

Family

2007

SSFCM

1994

Section of General Practice of Serbian Medical Society

SMAS

2006

Singapore

College of Family Physicians Singapore

CFPS

1973

Slovak Republic

Slovak Society of General Practice

SkS GP

1993

Slovenia

The Slovenian Medical Association / Slovenian Association of Family Physicians

SFMS

1993

South Africa

South African Academy of Family Physicians

SAAFP

1981

Spain

Spanish Society of Community Medicine

SEMFYC

1988

Sri Lanka

College of General Practitioners of Sri Lanka

CGPSL

1978

Sweden

Swedish College of General Practice

SFAM

1977

Swiss Society Medicine

SGAIM/SSMIG

1995

Switzerland

The Syrian Association

SFMA

2010

Syria

of

Family

Family

General

Family

and

and

Internal

Medicine

34

ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

FULL MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

ACRONYM

Taiwan

Chinese Taipei Association of Family Medicine

Tajikistan

Public Organization Association of Family Workers of Tajikistan

Thailand

The General Practitioners/Family Physicians Association of Thailand

GPFPAT

1985

Turkey

Turkish Association Physicians

TAHUD

2003

United Arab Emirates

Emirates Family Medicine Society

Uganda

Association of Family Physicians of Uganda

AFPU

2010

United Kingdom

Royal College of General Practitioners

RCGP

1973

Ukraine

Ukrainian Medicine

UFMA

1999

Uruguay

Uruguayan Society of Family Medicine

SUMEFAC

2002

United States

Society of Teachers of Family Medicine

STFM

1981

United States

American Physicians

AAFP

1973

Venezuela

Venezuelan Society of Family Medicine

SOVEMEF

2002

Vietnam

Vietnam Association Physicians

VAFP

2005

Zimbabwe

The College of Primary Care Physicians of Zimbabwe

CPCPZ

1976

Association

Academy

CTAFM

YEAR

2018

National Medicine

of

of

of

of

Family

Family

Family

Family

1988

2006

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ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

ASSOCIATE MEMBER ORGANIZATIONS COUNTRY

FULL MEMBER ORGANIZATIONS

ACRONYM

YEAR

Australia

Australian College Remote Medicine

Canada

The Section of Teachers and Section of Researchers

China

Cross-Straits Medicine Exchange Association Committee of International and Medicine

Italy

Italian Academy of Family Physicians

AIMEF

1999

Latvia

Rural Family Doctors Association of Latvia

RFDAL

2005

Nigeria

Society of Family Physicians of Nigeria

SOFPON

2007

Philippines

Foundation for Educators, Inc

FFFME, Inc

1995

Romania

The National Centre for Studies in Family Medicine

CNSMF

2006

United States

American Board of Family Medicine

ABFM

1986

United States

Association of Departments of Family Medicine

ADFM

2012

of

Family

Rural

and

Medicine

ACRRM

2000

STSR

2006

2019

36

ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

ORGANIZATIONS IN COLLABORATIVE RELATIONSHIP (OCR) COUNTRY

FULL MEMBER ORGANIZATIONS

ACRONYM

YEAR

Belgium

The Network: TUFH Office

France

International Federation of Medical Students' Associations

IFMSA

2010

Italy

International Society of Doctors for the Environment

ISDE

1989

Kenya

Institute of Family Medicine of Kenya Trust

INFA-MED

2004

Netherlands

International Primary Cardiovascular Society

IPCCS

2017

Switzerland

World Federation of Public Health Associations

WFPHA

2017

Switzerland

World Health Organization

WHO

2017

United Kingdom

European Association Communication in Healthcare

of

EACH

2015

United Kingdom

International Primary Care Respiratory Group Dept. of General Practice and Primary Care

IPCRG

2007

United States

North American Research Group

NAPCRG

1997

Primary

2006

Care

Care

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ANNUAL REPORT | 2020-2021

WONCA MEMBERSHIP

ACADEMIC MEMBER ORGANIZATIONS COUNTRY

ACADEMIC MEMBER ORGANIZATIONS

Australia

University of Western Australia

Australia

The Australian National University

Australia

Monash University

Bangladesh

Bangladesh Institute of Family Medicine & Research

Bhutan

Khesar Gyalpo University of Medical Sciences of Bhutan

Canada

Memorial University Health Science Centre

Canada

University of Toronto

Canada

Queen's University

China

United Family Health Care

China

Ruijin Hospital North Shanghai Jiaotong University School of Medicine

Colombia

Universidad de la Sabana

Colombia

Fundación Universitaria Juan N. Corpas

Cyprus

University of Nicosia Medical School

Egypt

Aswan Family Medicine Residency

Haiti

Queensland University

Indonesia

Faculty of Medicine, Universitas Gadjah Mada

Jamaica

Department of Community Health & Psychiatry

Kuwait

Kuwait Medical Institute for Medical Specialisation

Malawi

University of Malawi

Netherlands

Erasmus Medical Center

Netherlands

Radboud University Nijmegen Medical Center

Netherlands

University Medical Center Utrecht

Norway

University of Bergen

Pakistan

Aga Khan University

Palestine

Annajah University Nablus- West Bank

South Africa

University of Cape Town

Tajikistan

National Republican Training and Clinical Family Medicine Center

Tanzania

Aga Khan University- Eastern Africa

United Kingdom

King's College London

United States

South Side Hospital

United States

Boston University

United States

University of Florida

United States

Florida State University

United States

University of Wisconsin Medical Foundation

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ANNUAL REPORT | 2020-2021

WONCA

REGIONS

© Getty Images

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WONCA

AFRICA

REGION

WONCA AFRICA EXECUTIVES The following were elected to the WONCA Africa Exco in October 2018 (and allocated tasks): 1. President: Prof Shabir Moosa (Coordinating Stakeholder Engagement) 2. President-elect: Dr. Dan Abubakar (Coordinating Membership) 3. Secretary: Dr Joy Mugambi (Coordinating WPs/SIGs) 4. Treasurer: Dr Elizabeth Reji (Womens Party Chair) 5. Additional Member: Dr. Temitope Ilori (Supporting stakeholder engagement) 6. Additional Member: Dr Jane Namatovu (Coordinating Conference) 7. Co-opted Member: Dr Kwame Asisi-Boateng (Afriwon Chair) Bi-monthly EXCO meetings in 2020/2021—held using Zoom and minuted, have been erratic due to COVID—and were held on November 10, 2020, March 9, 2021 and June 15, 2021.

As per allocated tasks there has been some progress: 1. Stakeholder Engagement (Shabir Moosa) a. WONCA Africa Member Organisations (MO) Consultations: WONCA Africa had a wellattended Council Meeting on June 23, 2020 with the full Executive Committee and representatives of Botswana, Cameroon, Nigeria, South Africa, Uganda attending. The meeting had a robust discussion and supported the extension of the term of the WONCA Africa Executive Committee to November 2021. A WONCA Africa Council Meeting planned for 27th May 2021 failed and another is planned for 18th July 2021 to prepare for WONCA Africa Council before the World Council in November 2021.

b. WONCA Africa Bylaws: The draft ‘Bylaws of WONCA Africa’ adopted by the WONCA Africa Council Meeting in October 2018 and supported

by WONCA Exco will be presented to the WONCA Council Meeting in Abu Dhabi 2021 for approval. c. WHO Afro: After Dr Tumusiime resigned in November 2020, he linked us to acting officials who were emailed in May 2021 to support the engagement from February 2020, including engagement with WHO Country Representatives.

There has been no response to date. WHO and WHO AFRO officials have however been involved in many of the AfroPHC workshops. There were six areas of collaboration identified (The full document is available in a post): 1. Building relationships and mutual understanding further; 2. Strengthening the DHS through family physicians; 3. Improving the quality of PHC and DHS; 4. Connecting WHO resources with the training of family physicians; 5. Primary care research; 6. Support for development of AfroPHC There are engagements by WONCA Africa MOs at the country level with WHO Country representatives, coordinated by Innocent Besigye.

This is now being merged into the development of country chapters of AfroPHC. d. AfroPHC: The African Forum for PHC has become a powerful space for frontline primary care team members to advocate for PHC in UHC, with website, google group, monthly webinars and a leadership/management course. The organization has been formalised 20th April 2021 with a diverse executive, with Dr Innocent Besigye as President and Prof S. Moosa as the Executive Coordinator.

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The organization has been formalised 20th April 2021 with a diverse executive, with Dr Innocent Besigye as President and Prof S. Moosa as the Executive Coordinator. Monthly policy workshops are supporting progress on developing a concept note on PHC Teams, including family doctors in Africa that is planned to be submitted to WHO AFRO. There has been extensive networking with other global and Africa-wide PHC organisations under the banner of AfroPHC, including nurse, clinical officer and community health worker organisations. Some specific projects / partnerships are: 1. AMREF: Partnering in the AfroPHC workshop on CHWs 15th June 2021 and the AHAIC Commission on ‘The State of Universal Health Coverage in Africa’.

2. SPARC: This partnership has been strengthened within AfroPHC with a Twitter Chat and a joint workshop planned for July 24, 2021.

3. WCEA: Developing African-appropriate CPD and other educational material in collaboration with RCGP and diaspora from UK. 4. ICN APN Committee: Supported meeting and partnered in mapping way forward for Advance Practice Nurse curriculum framework in Africa.

5. PHCPI: Engaged in Allies for PHC group.

6. TUFH: Partners in African efforts on PHC education, including facilitating a workshop in complexity in PHC August 17, 2021.

7. WONCA: Partnerships with several Working Parties and Special Interest Groups, especially Quality and Safety (Workshop September 21) and Rural (Workshop October 19, 2021)

ANNUAL REPORT | 2020-2021

e. African Journal of Primary Health Care and Family Medicine: AJPHCFM, as the official journal of WONCA Africa is growing well. A report for JanMar 2021 shows ±30000 visitors, most from Africa.

It had 21 acceptances with 13 published.

The board is acutely aware that 87% of articles published are from South Africa although South Africa makes 51% submissions. The journal is extensively indexed.

Its citation-based measurements have shown steady improvements over the years.

African region Publications

African region Publications

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ANNUAL REPORT | 2020-2021

f. Primafamed: Primafamed as the official Academic Organisation of WONCA Africa, has 40 institutions from 25 countries in the network with Prof. Bob Mash as coordinator. Primafamed has been supporting Family Medicine education across Africa, particularly the Train the Trainers programme and collaboration in curriculum development. It also supports research, including collaborations and mentorship (including Afriwon). Both education and research are supported by monthly e-workshops from March 2021. It is also part of the global PHC Research Consortium since 2019. Bob Mash serves as Chairman of the PHC RC Board. Africa is involved in two projects. Primafamed is also part of the International Thematic Network on Climate Change, Migration and Health. It is in partnership with Ghent University and a number of strategic international partners. It is part of the NORHED grant with work in Malawi and Zambia and expected to cover three Primafamed meetings. It has links to WONCA World Working Parties on Research and Education. WONCA Africa and Primafamed participate in each other’s EXCO’s, and usually aligns their annual meetings with WONCA Africa meetings. It is linked to WHO AFRO and AfroPHC as part of WONCA Africa. It has a listserve to communicate with academics across Africa. There is a plan for a two-day virtual conference in October 2021. A French academic from DrC has been coopted to support linkages with Francophone Africa.

b. Potential Members: Ethiopia, Somaliland, Rwanda, Mali, Togo, Namibia, DRC, Benin, Cape Verde.

2. Membership

c. We still have challenges with obtaining a list of African members from chairs of WPs/SIGs. This limits the ability of WONCA Africa to support WPs/SIGs engagement with local MOs/individuals.

a. New Members: 1. Botswana: Botswana Association of Family Physicians.

2. Cameroon: Medcamer 3. Liberia: Liberia Family Physician Association

3. Secretariat (Joy Mugambi) a. The website www.WONCAafrica.org , Facebook page, Twitter and YouTube are actively supported by a virtual assistant. b. All Member Organisations were expected to plan activities for World Family Doctors Day 19th May 2021 and share them on the Facebook page of WONCA. 4. Working Parties / SIGs in Africa (Joy Mugambi) a. Dr Mugambi and Prof Moosa are part of the WPs/SIGs WhatsApp group. b. There are only a few WPs/SIGs in which Africans are known to be participating or leading: 1. Afriwon led by Dr Kwame of Ghana; 2. WP on Women and Family Medicine led by Elizabeth Reji of South Africa; 3. WP on Mental Health led by Dr Ariba of Nigeria; 4. WONCA Rural led by Dr Dan Abubakar of Nigeria / Ian Couper SA; 5. WP on Environment with Dr Henry Lawson of Ghana; 6. SIG on Emergency Medicine Africa region led

by Dr Mugambi Joy;

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5. Afriwon (Chair Kwame Asisi-Boateng) a. There are several theme groups in Afriwon: 1. Dr Bola Fatusin – Education and Training, including MCQs development 2. Dr Ettang Enwongo – Image 3. Dr Pius Ameh – Research, including Afriwon Research Collaboration (ARC) 4. Dr Jessie Mbamba – Exchange b. Afriwon is working on growing membership using a Whatsapp platform with 254 members.

They are having monthly meetings. They are also working on social media.

6. Women (Chair Elizabeth Reji) a. WWPWFM Africa exec members are: 5. Kenya: Dr Joy Mugambi 6. Malawi: Dr Martha Markwero / Dr Jessie Mbamba 7. Nigeria: Dr Olusola Oluwaseun /Dr Moyosore Makinde 8. Sierra Leone: Dr Melvina Thompson/ Dr Oteju Aramide 9. South Africa: Dr Elizabeth Reji 10. Zambia: Dr Mpundu Makasa 11. Uganda: Dr Jane Namatovu / Dr Lilian Mukisa b. WWPWFM Africa has monthly teleconferences with Zoom. c. WWPWFM Africa has a successful listserv of more than 100. d. WWPWFM Africa participated in the global WWPWFM webinar on ‘Women Family Doctor Leaders for COVID-19 Response and Recovery’ with ±100 participants. e. WWPWFM Africa celebrated International Women’s Day on March 8, 2021.

ANNUAL REPORT | 2020-2021

h. COVID-19 has frustrated many planned WWPWFM Africa activities.

7. Finances (Elizabeth Reji) a. WONCA Africa has improved financially. b. The annual allocation of $7000 to the WONCA Africa President has been used substantially to support WONCA Africa activities e.g., network support, Zoom, website, social media, translators, supporting Afriwon etc. This is being accounted for monthly by the WONCA Africa Treasurer and reported to the WONCA Africa EXCO. c. WONCA Africa has $1200 in cash from the WONCA Africa 2019 Conference, but this cash is still with the LOC due to costly bank transfer costs, the closure of the WONCA Africa bank account and the lack of a face-to-face meeting since. d. The resolution to levy African member organisations (MO) $1 per member of MOs has produced results with $2761 collected by WONCA for WONCA Africa. e. WONCA Africa EXCO proposal to WONCA to provide seed-funding for WONCA Africa Conferences was approved and is still to be used by the 2022 LOC. 8. Awards a. Montegut Award: This was not awarded in 2020 and is being advertised for 2021 for the 2021 WONCA Conference. b. WONCA Africa 5-star doctor: Nominations for 2020 and 2021 are still outstanding.

PROF SHABIR MOOSA President Africa Region

f. WWPWFM Africa organised a mentoring and leadership workshop in Malawi on May 15, 2021 and a Primafamed Workshop on MCQs on June 2, 2021. g. WWPWFM Africa organised a Quality and Safety Course in Nigeria June 11, 2021.

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WONCA

ASIA PACIFIC

REGION

ASIA PACIFIC REGION EXECUTIVES President: Prof. Meng-Chih Lee (Taiwan) President-elect: Dr. Husni Jamal Mohammad (Malaysia) Immediate Past President: Prof. Jung-Kwon Lee (Korea) Hon. Secretary: Dr. Brian Chang (Taiwan) Hon. Treasurer: Dr. Husni Jamal Mohammad (Malaysia) Members At Large Dr. Tesshu Kusaba (Japan) Prof. Shan-Zhu Zhu (China) Dr. Aileen Riet Espina (Philippines) Young Doctor Representative: Dr. Erfen Gustiawan Suwangto (Indonesia) OTHER APPOINTMENTS APPROVED BY APR COUNCIL SINCE MAY, 2019 AS FOLLOWS: NAC Chair: Dr.Mohammad Husni Jamal (Malaysia) APR Representative for WONCA Working Party on Research: Prof. Ryuki Kassai(Japan) JOBS DONE IN 2020–2021 1. President-elect Husni performed a very smooth transition process with current President Lee and Hon. Secretary Brian Chang, and shall take the APR office in the coming APR council/world council meeting, probably in a virtual way.

President Lee is so honourable and grateful to be nominated and endorsed as WONCA Fellow, WONCA’s most prestigious award to individuals who have rendered outstanding service to the WONCA organization, by so many APR MOs.

Additionally, this year we have received a donation of USD1000 from ABFP and the other coming support by Montegut Scholarship for application.

3. APR has successfully run the GP Forum on Chronic Diseases with Pfizer as well as the California Academy of Family Physicians in the past two years, and the agreement of collaborative education project for APR practitioners with the Medscape Education has been signed, and effective since 2021.

4. President Lee has honorarily been invited by WONCA Europe to attend 2020 Berlin Virtual WONCA European Conference on APR behalf, and also invited as one of keynote speakers for 2021 Annual Meeting of the Cross-strait Exchange Association of General Practice.

5. APR has launched an official statement on the control of COVID-19 pandemic, which has been adopted by WHO Western Pacific Region Office (WPRO), and published as attached.

6. APR MOs have celebrated 2021 World Family Doctor Day-Building the Future with Family Doctors through different ways, for example online forum on 2021 theme by the Taiwan Association of Family Medicine.

6. APR MOs have celebrated 2021 World Family Doctor Day-Building the Future with Family Doctors through different ways, for example online forum on 2021 theme by the Taiwan Association of Family Medicine.

2. APR enjoys an excellent financial status, about reserved fund of USD 200,000 left for the next term of presidency, compared to only two thirds reserved fund when I took the office in 2016.

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2021 World Family Doctor Day

7. Professor Dr Sheikh Mohd Amin Bin Sheikh Mubarak (Malaysia) is the winner of 2021 APR fiveStar Doctors Award, and will be awarded in person at the coming APR Conference in Myanmar.

PROF MENG-CHIH LEE President Asia Pacific Region

R E G I O N

ANNUAL REPORT | 2020-2021

Dr Sheikh Mohd Amin Bin Sheikh Mubarak

THINGS TO BE DONE 1) The 2021 APR council meeting will be held virtually in late October or early November, 2021 before the World Council meeting when the President-elect and new officers will take the office of APR based in Malaysia.

2) Congratulations to Dr Than Tun Aung (Myanmar) and Dr Chrismar L. Mocorro (Philippines) for being selected as the recipients of Professor Meng-Chih Lee's APR Presidential Bursary! Recipients will be awarded USD 1,000 each for their outstanding efforts in promoting Family Medicine both locally and globally, and be honoured at the 2022 Myanmar APR Regional Conference.

Appendix. Wonca APR Statement on control of COVID-19 Statement of Asia Pacific Region of the World Organization of Family Doctors (WONCA APR) on COVID-19 Pandemic -Forging Formal Public-Private Primary Care Partnerships and Enhancing Application of Digital Technology (Taiwan J Fam Med 2021; 31: 1-4) DOI: 10.3966/168232812021033101001

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ANNUAL REPORT | 2020-2021

WONCA

EAST MEDITERRANEAN REGION EAST MEDITERRANEAN REGION EXECUTIVES The following were elected to the WONCA EMR executive in June 2021 and allocated tasks: WONCA EMR President: Professor Taghreed M. Farhat (Egypt) WONCA EMR President-Elect: Professor Abdulaziz Al-Mahrezi (Oman) Immediate Past President: Jinan Usta (Lebanon) Honorary General Secretary: Dr Nagwa Nashat Hegazy (Egypt) Honorary Treasurer: Dr Huda Al Duwaisan (Kuwait) Member at Large: Dr Ashraf A. Qayoum Amir (Saudia Arabia) Member at Large: Dr Fatima Zohra Mchich Alami (Morocco) Member at Large: Dr Mohammed Ali Rabae (Palestine) Member at Large (YDM representative): Dr Anas Almohtaseb (Jordan)

As per allocated tasks there has been some progress: Attending the WONCA Teleconference Meetings.

Executive

Bylaws: Approved the bylaws committee proposal for bylaws amendments regarding virtual meetings and voting. Formulation of the new WONCA EMR Bylaws and Regulations Committee and the final draft ‘Bylaws of WONCA EMR’ will take the normal consequences and will be presented to the WONCA Council Meeting in Abu Dhabi 2021 for approval.

Links with WHO in the region. Activities with WHO: being part of the steering committee for regional professional diploma in Family Medicine to act as a bridging program towards Universal Health Coverage in EMR region. This is in continuation with a previous work. Also attending the following meetings:

There has been a monthly executive meeting, held using Zoom.

WONCA EMR new Executive board

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- First meeting on ‘COVID-19 Online Training for Nurses Working at the Primary Care Settings’ to discuss the draft contents of the five modules on Wednesday Feb 24. We prepared and sent a presentation on the communication of primary health care personnel during COVID-19.

- Second meeting on Thursday March 11, 2021, to discuss the feedback of first module on ‘COVID-19 Online Training for Nurses Working at the Primary Care Settings.

- Third meeting on May 5, 2021, attended the Ceremonial Meeting on Signing a Collaborative Agreement of World Health Organization and Arab Board of Health Specialisations to strengthen Family Medicine/ Practice and health systems to progress towards universal health coverage in the Arab world.

- Fourth meeting on the July 5th, 2021, attended a private health sector marketplace event for engagement with the private health sector in maintaining essential health services.

The Five-Star Doctor 2021. The winner of WONCA EMR Five-Star Doctor of 2021 is Dr Rachid Amiry from Morocco.

R E G I O N

ANNUAL REPORT | 2020-2021

Regional activity: Conducting a Virtual Scientific Gathering to focus on IBD Referral Guide and Hereditary Angioedema entitled ‘PRACTICAL INSIGHTS IBD&HAE’ endorsed by World Organization of Family Doctors East Mediterranean Region, chaired by Dr Oraib AlHamad and the speakers were Dr Zaher Koutoubi Consultant, Gastroenterology & Hepatology and Dr Fares Zaitoun.

Celebrations of World Family Doctors Day 2021. The WHO EMRO Regional Director issued a statement to highlight the importance of implementing family practice in the countries of the region and taking the COVID-19 pandemic as an opportunity to expand and improve health services for the long run. Almost all the member countries of EMR region participated in the celebrations of Family Doctors’ Day. The activities were very varied and are summarised below: 1) Egypt: The Egyptian Family Medicine Association designed a poster for family physicians and primary health care providers, wearing the personal protective equipment while working. The image, based on the pillar of building the future with family doctors and primary care Teams, aimed to thank these professionals for their efforts. Under the pillar of building the future with the family doctor and you!

2) Iraq: Creation of video by the Iraqi Family Medicine association highlighting the role of the family physician and the important role that they play in providing optimal and comprehensive primary health care.

3) Jordan: Jordan society of Family Medicine (JSFM) celebrated WFDD with a presentation by JSFM Deputy President, Dr Oraib Alsmadi, on the role of Family Physicians during the COVID-19 pandemic, and the building capacity of family physicians during the pandemic. Members of Jordan AlRazi YDD movement participated on this virtual discussion.

WONCA EMR Five-Star Doctor of 2021 , Dr Rachid Amiry

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4) Lebanon: Several health awareness activities, with creation of a salute video to all doctors for their generosity and dedication in facing the challenges caused by COVID-19 and the economic crisis that the country is going through.

5) Morocco: Continuing medical education highlights the importance of Family Medicine discipline during Covid.

6) Oman: Creation of a video highlighting family physicians as partners in health doing community outreach and educational activities.

7) Palestine: Poster was developed showing gratitude to every family physician during their dedicated work during the Gaza attacks.

8) Qatar: Publishing messages and orientational videos related to Family Medicine in different social networks and media coverage about the roles and responsibilities of family doctors.

9) The Algerian Society of General Medicine (SAMG) started an awareness campaign to underline the major role of general practitioners and their great contribution in the health system in Algeria.

R E G I O N

ANNUAL REPORT | 2020-2021

MEMBER ORGANIZATION ACTIVITIES: National Collective of General Practitioners of Morocco (MG Maroc) During the lockdown period of the COVID-19 pandemic, the MG Maroc was able to continue providing support and continuing medical education for the medical professionals via different social networks, such as Zoom, WhatsApp, etc. Different webinars were conducted, recorded & streamed on the association YouTube channel. Approximately more the 1000 attended and there were 25,000 views to the below eight webinars.

In connection with the COVID-19 Pandemic.

The practice management of COVID-19 in out-patient care). 1- « La prise en charge pratique de la COVID 19 en ambulatoire » Tow flagship vaccine *The flu Vaccine *The different covid vaccines-« Deux vaccins phares » Is there a post covid? « Y a-t-il un post COVID? »

10) UAE: Emirates Family Medicine Society launched a campaign on different social media platforms to express our gratitude and appreciation to all family doctors towards their vital roles as Front Line Heroes during the Pandemic.

Celebrations of World Family Doctors Day 2021.

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During Ramadan: Five webinars were held namely: Ramadan and the digestive system illnesses« Ramadan et les maladies digestives » «, Sport and Ramadan « Ramadan et sport » , Heart and Ramadan «Cœur et Ramadan », Elderly people and Ramadan «Personnes âgées et Ramadan » and Fasting and health «Le jeun et la santé » .

Lebanese Society of Family Medicine Guide on Response to COVID-19 Pandemic through Municipalities in Lebanon: The Lebanese Society of Family Medicine (LSFM) developed a guide to inform and support municipalities in dealing with COVID-19 pandemic.

Annual Conference: The LSFM organised its Annual Conference entitled ‘Family Medicine in Times of Crisis’. The conference was delivered virtually over two days November 20–21, 2021, with 318 registered participants.

The conference included different sessions that provided an evidence-based update on important and timely topics relevant to family physicians especially during crisis e.g., Family Medicine Across the Lifespan, 2020 and the Global Health Challenges, Palliative Care for the Family Physician: Delivering High-Quality Care to Your Patients, Healthcare, and the Economy, How to Maintain a Good Practice During a Crisis and Exploring New Horizons.

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Emirates Family Medicine Society Activities: Conducting regular virtual meetings; approximately 35 webinars with overall more than 11,000 attendance.

4th Emirates Family Medicine Conference in a Hybrid way with CME up to 40 hrs.

Approximately 60 plenary sessions over 7 days with more than 100 local, regional, and international faculty involved (committees, chairpersons, speakers). Also five colleges from around the world had participated namely: The College of Family Physicians of Canada, The Royal Australian College of General Practitioners (Australia), The American Board of Family Medicine (USA), The Royal College of General Practitioners (UK) & American Faculty starting 2018 American Academy of Family Physicians.

Egyptian Family Medicine Association: Had held a collaboration with the Egyptian Federation of NGOs working on health and will conduct a joint meeting to plan getting private primary health care sectors into accreditation.

EFMA conducted a Zoom meeting to discuss the merits and demerits of COVID-19 vaccination, a fruitful discussion with attendees from Lebanon, Bahrain, Saudi Arabia, Iran and Egypt.

EFMA shared the activities of the dialogue forum with civil society organisations to achieve developmental goals. This forum was organised by the Ministry of Social Affairs and European Union on 27th July.

Lebanese Society of Family Medicine, Annual Conference

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The Algerian Society of General Medicine: The 1st Interactive Générale Médecine (RIAMAG EST) organised by HESPRO in collaboration with the Algerian Society of General Medicine on Friday, June 18, 2021 was held with 12 workshops where various themes were scheduled during that day, allowing each participant to attend three different workshops.

The Algerian Society of General Medicine organised a webinar about the latest developments in the treatment of asthma, and it is presented by doctors from Lebanon and Tunisia.

Egyptian Family Medicine Association:

The Algerian Society of General Medicine:

Iraqi Family Physicians Society

Iraqi Family Physicians Society In collaboration with the Iraqi Family Physicians Society & University of Karbala College of Medicine, an IMA-UK summer scientific meeting on Zoom on July 24th 2021 was held to discuss Iraq’s requirements for Family Medicine as an essential specialty, challenges facing family physicians in Iraq and what is new in COVID vaccines and therapeutics.

PROF. TAGHREED M. FARAHAT President East Mediterranean Region

DR. NAGWA N. HEGAZY Honorary General Secretary

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WONCA

EUROPE

REGION

The activities of WONCA Europe had been heavily influenced by the COVID pandemic. In the first few months of 2020, efforts were mainly focused on postponing events; eventually, we realised that it will take time to get back to face-to-face meetings and conferences.

WONCA Europe conference 2020 was planned to take place in Berlin in June, it had been moved to December and then become virtual.

WONCA Europe conference 2021 was planned to take place in Amsterdam in July, and turned to a virtual conference.

The same happened in our networks and SIGs. In February 2021, Professor Ungan stepped down from his position as WE president. I replaced him as the President and we went for postal voting for the vacant position of President-elect. Professor Frese from Halle, Germany had been elected as our new President-Elect.

After the conclusion of the Amsterdam conference, we started to plan the 2022 London conference hoping that we will be able to conduct it as a face-to-face conference.

SIGS AND NETWORKS WONCA Europe supports the professional development, research, education and quality improvement of general practice/Family Medicine, through our networks and special interest groups.

European Network for Prevention and Health Promotion in Family Medicine and General Practice (EUROPREV) The European Rural and Isolated Practitioners Association (EURIPA) The European Society for Quality and Safety in Family Practice (EQUIP) The Vasco Da Gama Movement (VdgM) Special Interest Groups European Primary Care Cardiovascular Society (EPCCS) General Practice Infectious diseases Network (GRIN) International Primary Care Respiratory Group (IPCRG) Primary Care Allergy Interest Group (EAACI Primary Care) Primary Care Diabetes Europe (PCDE) The European Society for Primary Care Gastroenterology (ESPCG) EURACT In April, EURACT’s Spring Council meeting was organised online. A new fund program for EURACT research was proposed and discussions about the future courses and conference took place. The 3rd Medical Education Conference had been postponed to 2022. Instead, EURACT is organising an online 2-hour symposium in October. The topic will be ‘How to be a good GP/FM teacher in the digital era’.

Networks Networks European Academy of Teachers in General Practice/Family Medicine (EURACT) European General Practice Research Network (EGPRN)

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EURACT published the educational guidelines for Basic Medical Education and Specialty Training. And also launched a case-based CME program for GPs on the management of COVID-19. It is very easy to access and free!

Visit the PinPoint Platform and register yourself at https://mirrorsmed.org. This CME program is developed in collaboration with WONCA Europe and ISSECAM. EGPRN EGPRN continued with its regular work, adjusting to the circumstances. EGPRN organises two virtual scientific meetings: The 90th EGPRN (Virtual) Conference 16th-17th October 2020: Digital medicine and e-health in primary care (216 participants). And the 91st EGPRN (virtual) Conference 30th April-1st May 2021: Closing evidence gaps in GP/FM (144 participants). Hoping to have the next meeting in Halle, Germany on October 2021 in a face-to-face format.

Selected abstracts had been published in the European Journal of General practice (Volume 27, Issue 1, 2021) and in the Eurasian journal of Family Medicine (Supplement 1, 2021) EGPRN offered COVID-19 special grants for two projects: Quality of care and patient safety in general practices in times of a pandemic (Zalika Klemenc Ketiš, EQUIP and the department of Public Health and Primary Care at Ghent University lead by Sara Willems) and the COVID-19 pandemic: Reorganisation of health services and coping of health care workers in primary health care. Conceição Outeirinho with co-researchers.

The web based course achieved 313 participants until now, more than 20 presented their final project and got a graduation certificate.

EGPRN has currently 190 individual members and 37 institutional members. Prevailing type of membership is three years, which gives stability to our work.

EURIPA The 10th Forum was scheduled to take place in Siedlce in eastern Poland in September 2020. The theme was ‘Understanding our patients—working closely together’, the faceto-face conference had been postponed to 2021 and a virtual conference took place.

In September 2020, an e-Forum explored the theme: How Rural and Remote General Practice/Family Medicine is responding to the challenges of the COVID-19 Pandemic—now and for the future. It hosted 98 attendees from 27 different countries.

The Grapevine communicate continues to be published three times a year and is circulated widely.

In the autumn of 2020, EURIPA worked with WONCA Europe to develop a statement on behalf of WONCA Europe to present at the WHO European Region meeting. The statement was titled: ‘Digital Health & Telemedicine in Primary Care addressing also Inequity in Rural Health’. The World Working Party on Rural Practice held a virtual conference and webinar series in 2020.

EQUIP EQuiP had two council meetings that had been held virtually in November 2020 and March 2021. Small groups worked on several topics including: eHealth, Equity, Indicators & Tools and Methods, Patient Safety & Doctor's Health, and Teaching Quality & Safety. The annual conference moved to virtual on March 2021. EQuiP participated in the 1st International Scientific Conference of Primary Care in Slovenia, which was also organised under the patronage of EQuiP.

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The EQuiP Newsletter was produced four times per year in an interactive pdf. Finally, a video on promotion on patient safety was developed by EQuiP. It was entitled ‘Small steps towards patient safety’.

VdGM VdGM has had a very busy year. VdGM responded to the pandemic by creating a space for their members to share information, guidelines and ideas to deal with the challenges of the pandemic. VdGM ran an online council meeting with online elections.

Nick Mamo had been elected as PresidentElect (taking over early as President in January 2021). A new EB had been elected as well.

In December, VdGM held its first virtual preconference organised in Germany, with the first virtual exchange. The VdGM Forum planned to take place in Edinburgh has been postponed to January 2022.

VdGM had two virtual council meetings in February and June 2021, they are looking for options for registering the organization officially. In July, a number of VdGM members managed to meet face-to-face, with others joining online for a hybrid pre-conference in Amsterdam.

New countries are represented now in VdGM after the introduction of representatives from: Armenia, Bosnia-Herzegovina, Hungary, Iceland, Latvia, Estonia and North Macedonia.

During the WONCA Europe Conference 2021, there were several awards given: Marina Jotic Ivanovic—Fons Sips Outstanding Achievement Award. This is an award given every two years to a VdGM member who has inspired us.

Peter Kurotschka—Junior Researcher Award for a qualitative study on the experience of GPs across Italy during the early stages of the COVID pandemic with

a thematic analysis. Runners-up were Ebrahim Mulla looking at predicting frailty, and Aviel Nagar looking at a UTI diagnostic tool.

IPCRG The IPCRG was very active in response to COVID-19. A new desktop helper on Desktop Helper 11 Remote Respiratory Consultations was created based on the evidence supplemented with experience-led care workshops with patients and primary care clinicians. An evidence-based question and answer service developed for the members on COVID-19 and other respiratory questions.

And finally, a webinar series on COVID-19 and respiratory health, gained participation of 550 individuals in 82 countries.

Over 800 delegates from 63 countries joined the first online world conference May 2021.

249 abstracts accepted, 150 e-posters and three prize-winners from Bangladesh, Sri Lanka and Nepal at our 1st world online conference IPCRG received independent educational grants from several pharmaceutical companies enable them to provide free resources to their global membership.

Conference sponsorship from pharma companies enabled them to keep registration rates very low.

EAACI Primary Care The pandemic year has seen reduced activity and income within the EAACI organization. It has responded by hosting a successful digital conference in 2020 and plans to focus on offering both paid and unpaid access to elearning with a platform it is creating. They are working on an article on anaphylaxis to the EJGP.

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Current activities of the group include the task forces and publications of algorithms in primary care to cover urticaria, asthma, food allergy and anaphylaxis. This work is led by Dermot Ryan. Dr Martha Cabrera has distributed an allergy education questionnaire across Europe with the support of the IPCRG and WONCA and allergy charities. Dr Liz Angier has been involved in the EAACI guidelines in teenagers with asthma and anaphylaxis and EAACI created YouTube videos for this with several publications in allergy journals. A toolkit for good practice is being developed.

A publication on the management of anaphylaxis and prescribing of adrenaline in primary care led by Dr Liz Angier is due in the UK and is submitted to the Clinical Experimental Allergy.

PCDE The association comprises over 2200 multidisciplinary individual European members. PCDE is the official Diabetes Special Interest Group of WONCA-Europe and organises diabetes tracks within the WONCA regional conferences. PCDE has a close working relationship with EUDF, IDF, EASD, WHO, PCDS, REDGDPS and other international and regional leading Diabetes and Primary Care organizations .

Main activities: E-learning/educational projects, an update on the Consensus Statement.

Activities in progress: CME modules, LDC elearning project, EASD e-learning project, Webinars PCDE Talks.

The 16th International PCDE conference had been postponed to 2022 and the preparations started. Examples of 2020 projects: ‘Impact of COVID-19 on chronic diseases and mortality: a systematic review’ and ‘Epidemiology of SARSCoV-2 in persons with diabetes mellitus and obesity in Catalonia’.

ESPCG ESPCG normal activities including live, faceto-face, educational meetings have been postponed and funding streams have also been impacted. Our key partner in much of the important educational activity, United European Gastroenterology (UEG), has suffered in a similar vein, and this has also impacted both revenue the ability to grow the network throughout Europe. Despite all of this, they present an updated ‘State of the Art Gastroenterology’ workshop at WONCA Europe virtual event. Additionally, ESPCG has been playing a key role across the UEG organization from Public Affairs to Research, Science, Education, Guidelines and Best Practice. The recently developed statement on ‘Reducing the Burden of Chronic Digestive Diseases’, endorsed by WONCA Europe, UEG and ESPCG is a clear example of that collaboration. ESPCG is collaborating with UEG in the development of European guidelines on nausea and vomiting and on bloating and abdominal distension. Finally, ESPCG is working in collaboration with the University of Crete to develop new guidelines and e-learning on NAFLD-NASH.

Seven Webinars done and available on PCDE site, and the next series of PCDE Talks starting Sept.

The 16th International PCDE conference had been postponed to 2022 and the preparations started.

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MEMBER ORGANIZATION ACTIVITIES: WONCA Europe has 46 member organizations from 42 countries. There is one country with 3 MOs (Greece), and two countries with 2 MOs (Bosnia and Herzegovina, and Croatia).

According to our bylaws, when there is more than one MO in a country, all MOs should agree on one representative that has the vote of the country. We had postal voting for the position of PE, and unfortunately none of these countries had agreed on one representative. This is an alarming sign that means that we should have to consider very cautiously accepting new members from countries with an MO in WONCA Europe.

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ORGANIZATIONS WITH CLOSE COOPERATION In the last year we continued our fruitful collaboration with EFEC, WHO Europe, UEMO and ECO. We have been involved in creating the 2021 ESC Guidelines on ‘Cardiovascular disease prevention in clinical practice’ with the European Society of Cardiology and the ‘Nonalcoholic fatty liver disease: A patient guideline’ with the EASL (The European Association for the Study of the Liver).

MONTHLY NEWSLETTER We created a monthly newsletter to update our MOs and directly our members. Until now we had 14 editions. We use the newsletter to enhance the communication with our members, especially in times when travel is restricted and conferences and meetings are virtual.

PROF. SHLOMO VINKER President Europe Region

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WONCA

IBEROAMERICANA - CIMF

REGION

WONCA IBEROAMERICANA-CIMF EXECUTIVES

Waynakay: Young doctors movement from Latin America.

Regional President: Jacqueline Ponzo Executive Coordinator: Thomas Meoño Martín Honorary Treasury: Marina Almenas Southern Cone Vice Presidency: Marcela Cuadrado Mesoamerica Vice Presidency: Jose Luis Huerta Andean Countries Vice Presidency: Dora P. Bernal Iberia Vice Presidency: Jorge Brandao, from Feb 2021: Salvador Tranche Representative Waynakay, Young Doctors Movement: Gabriela Di Croce NATIONAL ASSOCIATIONS, ACTIVE CIMF MEMBERS: Federación Argentina de Medicina Familiar y General, Sociedad Boliviana de Medicina Familiar, Sociedade Brasileira de Medicina de Família e Comunidade, Sociedad Colombiana de Medicina Familiar, Asociación Costarricense de Especialistas en Medicina Familiar y Comunitaria, Sociedad Cubana de Medicina Familiar, Sociedad Chilena de Medicina Familiar, Sociedad Ecuatoriana de Medicina Familiar, Sociedad Española de Medicina de Familia y Comunitaria, Federación Mexicana de Medicina Familiar, Sociedad Nicaragüense de Medicina Familiar, Sociedad Panameña de Medicina Familiar, Sociedad Paraguaya de Medicina Familiar, Sociedad Peruana de Medicina Familiar y Comunitaria, Associação Portuguesa de Medicina General e Familiar, Academia de Medicina Familiar de Puerto Rico, Sociedad Dominicana de Medicina Familiar y Comunitaria, Sociedad Uruguaya de Medicina Familiar y Comunitaria.

Special situation: Sociedad Venezolana de Medicina Familiar.

Inactive: Sociedad Salvadoreña de Medicina Familiar.

Regional President, Jacqueline Ponzo

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C I M F

Waynakay: Young doctors movement from Latin America.

In this report, it is not possible to talk about something without talking about COVID-19 pandemic. We live a special time, full of uncertainty, pain, challenges. Part of our mission is to carry on light and hope to patients, colleagues and people in general. It is not easy to maintain the necessary strength, and this is one of the reasons that improve our convictions in the collective organizations, WONCA, WONCA Iberoamericana CIMF, and all of the National Associations of Family Medicine / Family and Community Medicine.

The COVID-19 pandemic continues to affect our region. South America has the highest number of confirmed cases and deaths in the world. If we add Spain and Portugal, this proportion will increase. We know, besides, that the other health problems, inattention to known health problems, and deaths for others causes, increase too. And we know, besides, that all of these problems do not affect everyone equally, but rather the most vulnerable are more affected.

The summary of our report (from our region) in this period is: Hard work; Work with a lack of adequate health conditions; Poorly paid and underrecognized work; Deaths in the exercise of the profession; Social commitment; Continuous professional development; Advocacy for Family Medicine and primary care in pandemic management; Less time for corporate activities; More need for activities and collective organization Pain and contradictions; Learnings; Maximum dedication and strength.

In this context, from WONCA IberoamericanaCIMF, we continue collective and collaborative working. The mains fields of the activities were:

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Build and support our organization: CIMF: Executive Committee of CIMF: one meeting per month; CIMF Working Groups: Two new groups in development: Community Mental Health and Women in Family Medicine. Activities from Spirituality and Health Group, Environmental and Health, and Quaternary Prevention Groups. Meeting with the coordinators of all Working Groups of CIMF on Oct 15.

CIMF, sub-regionals special meetings: Oct 29 Mesoamerican, Nov 5 Southern Cone, Nov 19 Andean Countries, 11 Feb Iberia.

CIMF Extraordinary Board Council: Apr 10 2021.

CIMF Web site, maintenance. Link Events: organization of 7th. Ibero American Congress of Family Medicine and WONCA Planetary Health with de Brazilian Society of Family and Community Medicine and its 16th.

Brazilian Congress, 100% virtual, the next Aug 19-22. Link National Associations CIMF Members have intense activity, especially in the attention to COVID-19 pandemic, academics and advocacy.

WONCA: WONCA Executive Board, one meeting per month, and some special meetings.

Advocacy: Statement in January 2021: Family Medicine / Family and Community Medicine is essential for an adequate response to the pandemic COVID-19. Link Statement to support family doctors in Colombia in May 2021, in defending the right to health and its claims in favour of a better health system. Link Support for family doctors in the pandemic context: Balint Groups, with Waynkay, young doctors movement.

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Collaborative inter-institutional action: Active participation in the development of a virtual course with Nephrologist Latin American Society and Pan American Health Organization: Acute Renal Injury for Primary Care Teams, free online from Dec 2020. Link Contribution to the first course of Planetary Health for family doctors, online, from Brazil (UFRGS, Telesaude), now in progress to English version from Planetary Health Alliance, Harvard University. Link Meeting and beginning the coordination with Latin American Association of Palliative Care, from March 2021. Link Integration to WHO-Civil Society Working Group for Action on Climate Change & Health, with participation of CIMF representation in the plenary and in Education Group, from Feb 2021. Link Jun 17: Meeting with the Instituto Guatemalteco de Seguridad Social, exploring for cooperation.

As President, I have participation in academic activities in different countries of the region (Argentina, Brazil, Colombia, Chile, Ecuador, España, México, Perú, Puerto Rico, República Dominicana and Uruguay), some academic publications, and periodic interviews about pandemic in national and international mass media. Some of these are present in the Annex.

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After long months of social distancing and precautions, we are privileged to be survivors of a pandemic that has taken many lives. We should be proud to be part of family medicine. This professional group has given itself fully in defence of the health of its peoples, and continues to do so.

We also feel the pain of inequity, which makes this region the hardest hit by the pandemic, and keeps many people without access to vaccination. But above all we feel the deep conviction that Family Medicine / Family and Community Medicine is the medicine of the future, and so, we have a very important mission in our hands, with or without gloves, but united.

DR JACQUELINE PONZO President Iberoamericana Region – CIMF

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ANNEX Academic Activities 1. Jun 4: Conference in the International Virtual Symposium of Family Medicine and Primary Care in Europe and America. The Pedagogical and Technological University of Colombia (UPTC) 2. Jun 4: 63 Congress of Academic of Family Medicine of Puerto Rico.

3. Sep 19: Conference in Webinar about Community Mental Health, Peru 4. Sep 26: Conference in Webinar, Federación Argentina de Medicina Familiar y General (FAMFYG).

5. Oct 6: Conference in XV International Congress of Medicine (Family Medicine), Colegio Médico de Trujillo, Perú.

6. Oct 7: Conference in Congress of Family and Community Medicine in República Dominicana.

7. Oct 22: Conference in IX National Congress of Family Medicine. El Bosque University, Colombia.

8. Oct 24: COVID in primary care, by SEMF, Ecuador.

9. Oct 26: WONCA webinar: Mental Health.

10. Oct 31: Bio-ethical and Planetary health. In a course for medical students. UFRGS, Porto Alegre, Brazil.

11. Nov 15: WONCA webinar: Planetary Health.

12. Dec 4: Planetary Health, panelist, in Capixaba Brazilian Congress.

13. Dec 8: Interview with Waynakay. About Family Medicine.

14. Dec 18: Meeting with Waynakay Peru 15. Jan 8: Conference from University of Valparaiso, Chile. Challenges and learning in crisis 16. Mar 25: Main Conference, in the opening ceremony of Residence and Postgraduate Family Medicine Program of UNAM, Mexico.

17. Apr 23: 64o.Congress AMFPR, Puerto Rico: Social Determinants of Health, WONCA panel, shared with Viviana Martínez Bianchi.

18. May 19: World Family Doctor Day. Regional conference, from. Valparaíso, Chile.

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19. May 28: I International Symposium Family Medicine Universidad de la Sabana, Colombia.

20. Jun 8: Community Mental Health Forum, Peru.

Publications Ponzo-Gómez Jacqueline. El rey desnudo.

Emperor's New Clothes. Editorial. Rev Mex Med Fam 2020;7:85-7. Available in: http://www.revmexmedicinafamiliar.org/files /rmmf_20_7_3_085-087.pdf Silva Aycaguer LC, Ponzo Gómez J. Un año de epidemia de COVID-19: Cuba y Uruguay en el contexto latinoamericano. Rev Cubana Hig Epidemiol [Internet]. 2021 [citado 30 Jun 2021].

Disponible en: www.revepidemiologia.sld.cu/index.php/hie/ article/view/1063.

Reprint in English: A Year in the COVID-19 Epidemic: Cuba and Uruguay in the Latin American Context.

Available in: http://mediccreview.org/a-year-covid-19epidemic-cuba-uruguay-context/ International Interviews May 31, Associated press. Desborde de fallecidos por COVID-19 no da tregua en Uruguay.

Available in English in: https://apnews.com/article/uruguaycoronavirus-pandemic-health-lifestyle72d7dbfd9f8b57aa870dc92ef554c743 May 12, Washington post. Uruguay coronavirus: Cases, deaths surge in South American nation.

March 23, Associated press. Coronavirus rompe récord en Uruguay.

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WONCA

NORTH AMERICA

REGION

PROF MARVIN REID President North America Region MEMBER ORGANIZATIONS American Academy of Family Physicians (AAFP-Full Membership) American Board of Family Medicine (ABFMAssociate membership) Caribbean College of Family Physicians (CCFP-Full Membership) College of Family Physicians of Canada (CFPCFull Membership) North American Primary Care Research Group (NAPCRG-Organization in a Collaborative Relationship) Society of Teachers of Family Medicine (STFMFull Membership) Association of Departments of Family Medicine (ADFM-Associate Membership) CFPC Section on Teachers and Section on Researchers (Associate Membership) The WONCA NA Region had a relatively sedate year at the WONCA NA executive level. However WONCA NA is dominated by relatively strong and autonomous family medicine societies from Canada , the United Sates and the Caribbean. The main highlight at the executive level was the drafting of a formal constitutional structure to strengthen organizational structure of WONCA NA. Notwithstanding within the Region, member societies have been active with elections, promoting the discipline of Family Medicine, hosting their annual conferences virtually as well as being engaged in advocacy. Highlights include: Conferences – AAFP Family Medicine eXperience (FMX) 2020 conference, College of Family Physicians of Canada Family Medicine Forum (FMF) 2020 conference, Society of Teachers of Family Medicine Annual Spring conference,

North American Primary Care Research Group conference and the CCFP inaugural distinguished lecture and webinar. Of note, Prof Shabir Moosa, President WONCA-Africa delivered the inaugural CCFP distinguished lecture “Primary Healthcare and how the system addresses health problems, in particular CNCD” on March 14th, 2021.

COVID response – All member societies have been engaged in assisting our members, communities, policy makers and governments in responding to the COVID19 pandemic through a range of activities such as provision of technical advice, providing care, training and education of health team members. To assist the global response the societies have aggregated resource materials inclusive of policy documents, management guidelines, educational materials for professionals and non-professionals and have made these resources freely available to interested parties on their web portals.

HEALTH EQUITY / ADVOCACY The issue of health equity, racial inequalities, and the underinvestment of governments in primary care is a common thread across the region. Within this context, member societies have promulgated statements condemning discriminatory and racist acts while encouraging the family medicine community to speak out against inequality and systemic racism.

Additionally, a seminal publication “Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care” was published May 4th by the National Academies of Sciences, Engineering, and Medicine (1). This reports while focusing on the situation of the United States of America reinforces the universal concept that primary care is foundational to health care system and critical to achieving health equity.

References.

1. National Academies of Sciences E, Medicine. Implementing HighQuality Primary Care: Rebuilding the Foundation of Health Care.

McCauley L, Phillips RL, Jr., Meisnere M, Robinson SK, editors.

Washington, DC: The National Academies Press; 2021. 448 p.

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WONCA

SOUTH ASIA

REGION

DR. RAMAN KUMAR President South Asia Region

WONCA SAR EXECUTIVES President: Dr. Raman Kumar. Academy of Family Physicians of India (AFPI) Secretary: Dr. Pramendra Prasad Gupta.

General Practice Association of Nepal (GPAN) President Elect: Dr. Tariq Aziz. Pakistan Academy of Family Physicians (PAFP) Immediate Past President: Prof Dr Kanu Bala. Bangladesh Academy of Family Physicians (BAFP)

SAR President, Dr. Raman Kumar.

Executive Members Dr Marie Andrades . College of Family Medicine of Pakistan Dr. Md. Abdul Quayum. Bangladesh Academy of Family Physicians Dr. K. Sri Ranjan. College of General Practitioners of Sri Lanka Prof. N. M. Abdal. Bangladesh College of General Practitioners (BCGP) Chair Spice Route: Dr Sankha Randenikumara.

College of General Practitioners of Sri Lanka.

SAR Executive Members

Past Presidents/VP Dr. Md. Nurul Islam - Bangladesh. Former WONCA MESAR Vice President Dr. S. K. Gupta - Nepal. Former WONCA SAR Vice President Dr. Preethi Wijegoonewardene - Sri Lanka.

Former WONCA SAR President Dr. Pratap Narayan Prasad - Nepal. Former WONCA SAR President Prof Kanu Bala - Bangladesh. Former WONCA SAR President SAR Executive Members

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COVID PANDEMIC SITUATION Like the rest of the world, the SAR region is also challenged with the ongoing COVID pandemic.

There have been various phases of lockdowns and unlock-downs since 2020.

International transportation has been disrupted therefore we didn't have any major face-to-face meetings or conference during the past year. Yet family physicians throughout the region have been at the forefront of providing care and relief. We have lost many of our colleagues and their family members to the COVID pandemic. The second wave of COVID devastatingly hit a few countries of the region, however, the second wave is mostly in decline now. Vaccination drives started in January 2021 in most countries and the coverage is improving. There is talk of an impending third wave.

WONCA SAR EXECUTIVE MEETING VIDEO CONFERENCE 2020 The first WONCA SAR virtual executive meeting took place on June 12, 2020 through video conferencing. The meeting was convened by Dr Premendra Prasad, the regional secretary of the South Asia region (including India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and Maldives.

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Dr Marie Andrades, Member at large; Dr Sankha Randenikumara, Chair Spice Route; Dr Zakiur Rahman, Organising chair WRHC Dhaka 2020. It was an elaborate meeting running for more than two hours in a very cordial environment. All executive members showed commitment to take forward the South Asia Region in the domain of Family Medicine, primary care, rural health— academics, practice and research. Convener: Dr Pramendra Prasad, Secretary WONCA SAR. EXTENSION OF REGIONAL EXECUTIVE TENURE Due to the ongoing COVID crisis, a regional faceto-face council could not be held due to postponement of the Abu Dhabi WONCA World Conference. Following resolution was circulated to all council members and adopted.

WONCA South Asia Region will follow the same process and timeline as World WONCA, with regional officers remaining in position until the full meeting of the World Council in November 2021.

ACADEMIC EVENTS In spite of the COVID-19 pandemic, member organizations of the region continued to organise CME and academic events through digital and video conferencing tools. There is more regional interaction due to the availability of digital platforms and online opportunities. Many collaborative events such as One Mental Health were organised in the region.

WONCA SAR Executive Meeting

Following executive members participated: Dr Raman Kumar, Regional President; Dr Tariq Aziz, President-Elect; Dr Kanu Bala, Immediate Past President; Dr Pramendra Prasad, Regional Secretary; Dr Sri Ranjan, Member at large

Mental Health Day 2020, SAR Academic Events

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ACADEMIC PLAN During the executive meeting, president and secretary presented plans to introduce a formal academic program for the South Asia region on behalf of WONCA SAR. The CPD programs and logistics of award of credit hours were discussed.

Dr Tarik Aziz shared his experience from the academy and how online accreditation is being done. Dr Marie informed about being designated the regional lead for WONCA Working Party on Education and discussed the plans to introduce WONCA accreditation of CPDs. The executive members congratulated Dr Marie for this new role and responsibility. The executive members also requested her to take the responsibility of educational plans for the South Asia region. The Executives thanked Dr Marie Andrades for accepting this responsibility and the program schedule will be circulated and we will be trying for the CPD points for this program. Secretary will share a detailed academic program in due course.

Following plans are underway: South Asia Lecture Series Faculty Development Workshop Primary Care Research Workshops National CMEs and CPD programs Schedule of National Conferences Schedule of WONCA International Conferences Schedule of WONCA Regional Conference MRCGP Int training program Revival of South Asia Primary Care Research Network PROGRESS OF FAMILY MEDICINE DISCIPLINE India Inclusion of Family Medicine as a mandatory discipline through the National Medical Commission Act 2019, a legislation passed in the Indian Parliament.

SAR, World Family Doctor Day 2021

Inclusion of Family Medicine for employment at specialist posts in the public health system of India. Government of Uttar Pradesh—Most populous state/ province in India with a population of 200 million in 2021. Moreover, revision and inclusion of Family Medicine as a human resource in the revised Indian Public Health Standards (IPHS) draft 2021.

Establishment of Specialist Board in Family Medicine under the National Board of Examinations, Ministry of Health and Family Welfare, Government of India 2018.

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Pakistan Academic department of Family Medicine are being established at all medical colleges.

A new diploma in Family Medicine program has been launched in collaboration with WHO. New Family Medicine journal launched at one of the medical colleges.

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JOURNAL Journal of Family Medicine and Primary Care continue to publish during the pandemic.

Eminent academicians of the South Asia region are on the editorial board of the journal. The journal published many pertinent papers and research projects on COVID. The journal also published the South Asia solidarity statement on COVID.

WONCA Rural Conference has strengthened support for Family Medicine and rural practice.

Diploma in Family Medicine program being offered for GPs for a few decades.

Nepal Most medical colleges in Nepal have now established a department of General Practice and Emergency.

The post graduates’ specialist in general practice have been duly integrated into the health system.

Sri Lanka Sri Lanka has made steady progress and the College of GPs is very active in promoting Family Medicine discipline.

Annual academic programs were organised during COVID. Department of Family Medicine exists at various universities.

Bhutan Bhutan has developed a four year GP training program at KGUHS Thimpu and the first batch has qualified.

The curriculum has been recently published in the Journal of Family Medicine and Primary Care.

Government of Bhutan has shown keen interest in supporting General Practice.

SAR, Journal of Family Medicine and Primary Care

WORLD RURAL HEALTH CONFERENCE DHAKA 2020 The organization of the WRHC 2020 Dhaka was delayed but finally organised successfully in a hybrid model, where international participants contributed through an online platform whereas the local delegates participated in person. It is spread over a series of lectures, panel discussions, opening ceremony in October 2020 and closing in February 2021.

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17th World Rural Conference

WORLD FAMILY DOCTORS DAY (WFDD) CELEBRATION A series of online and onsite events were organised to mark the World Family Doctor Day through the South Asia Region. The official website of the Spice Route Movement was also launched on WFDD this year.

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COLLABORATION WITH OTHER WONCA REGIONS 1. The Leadership and Entrepreneurship Group of the Rajakumar Movement, the Young Doctors Movement of the World Organization of Family Doctors in the Asia Pacific Region, held a special session on Sunday, July 26, 2020 at 8pm Jakarta time through Skype with Dr Raman Kumar, current President of WONCA South Asia Region and former Young Doctor Representative on the WONCA World Executive.

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SPICE ROUTE MOVEMENT The Spice Route Movement has bloomed beautifully. A formal council has been formed. A website of the movement was launched on World Family Doctors’ Day. Each of the MOs Spice Route Units are doing excellent academic activities, webinars, workshops and skill development events. The Spice Route Movement has achieved impressive progress since its inception in 2010. It is now indeed a vibrant group of young doctors dedicated to Family Medicine.

2. The Rajakumar Movement Research Group, Philippine Academy of Family Physicians Residents’ Organization, and Myanmar Primary Care Research Unit organised a series of sessions on Basic Research in Primary Care. Dr Raman Kumar President WONCA South Asia was invited to deliver a talk in the inaugural session.

3. WONCA Africa—South Asia Primary Care Dialogue—As regional presidents in WONCA, we thought it would be really great to build collaboration between our regions (South Asia & Africa), starting with a zoom meeting between us, targeted specifically at our member organizations. It was organised on October 22, 2020.

4. WONCA SAR president was invited to speak at the 21st International Eastern Mediterranean Family Medicine Congress EMFMC2022, to be held on 12th – 15th May 2022 in Adana, Turkey.

SAR, World Family Doctor Day 2021

SOCIAL MEDIA & OTHER COMMUNICATIONS IN SOUTH ASIA One of the objectives of the present executive was to bring family physicians and Family Medicine leaders together and develop a closer working relationship. For this the available tools of social media can do wonders. Following activities were noted: 1. WhatsApp groups - FM Leaders South Asia, The Spice Route Movement 2. acebook page 3. Facebook groups 4. Webinars and online panel discussions

SAR collaboration with other WONCA Regions

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WHO REGIONAL COMMITTEE MEETING This year's (73rd) meeting was organised in Bangkok digitally and attended by WONCA SAR president virtually. The Regional Committee for South-East Asia is WHO’s governing body in the region. It is composed of representatives from the region’s 11 Member States, as well as Associate Members. The Regional Committee meets every year to formulate policies, provide oversight for regional programs, hear progress reports, and consider, revise and endorse new initiatives. It adopts resolutions and makes decisions that guide the work of the Regional Office and country offices for the coming year. In WHO SEARO, there are many countries that are not part of WONCA SAR. It is a challenging situation for engagement.

WONCA regions need to work in collaboration.

Human Resource The HLP Meeting reviewed the paper and made the following recommendations for consideration by the 73rd Session of the Regional Committee.

Actions by Member States: (‎1)‎ Use the window of opportunity afforded by the COVID-19 pandemic to increase investment in the health workforce; (‎2)‎ Strengthen HRH governance by strengthening the capacity of HRH units; (‎3)‎ Increase quality of education, job creation for and distribution of nurses and midwives as per country contexts.

Actions by WHO: (‎1)‎ Monitor and report progress on the Decade of Strengthening of HRH through the fourth progress report scheduled for 2022; (‎2)‎ Provide technical support to Member States as appropriate to strengthen HRH to achieve UHC and health security; (‎3)‎ Organise a one-week executive online course on HRH leadership and management.

Priority Issues Policy and technical matters discussed. Decade for health workforce strengthening in SEA Region 2015–2024: Mid-term review of progress, challenges, capacities and opportunities.

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Annual report on monitoring progress on UHC and health-related SDGs. Progress reports on selected Regional Committee resolutions, promoting physical activity in the South-East Asia Region.

South-East Asia Regional Action Plan to implement the Global Strategy to reduce harmful use of alcohol (2014–2025).

Access to medicines.

South-East Asia Regional Health Emergency Fund.

Expanding the scope of the South-East Asia Regional Health Emergency Fund (SEARHEF).

Strengthening emergency medical teams (EMTs) in the South-East Asia Region.

Intensifying activities towards control of dengue and elimination of malaria in the South-East Asia Region.

Measles and rubella elimination by 2023.

Challenges in polio eradication.

Dr Zakiur Rahman from Bangladesh, regional five-star doctor award 2021

SCHOLARSHIPS & AWARDS Jyoti and Ramnik Parekh Award - To Spice Route Delegates for attending Conferences MRCGP Int Scholarships for attending conferences .

WONCA SAR – Dr Zakiur Rahman from Bangladesh has been awarded the regional five-star doctor award this year.

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FAMILY MEDICINE HALL OF FAME (An initiative of WONCA SAR & Journal of Family Medicine and Primary Care - JFMPC) Publication of biographies of Family Medicine Leaders in a special feature—‘Family Medicine Hall of Fame’—to immortalise their personality and work in the international scientific archive.

Secretary Dr Pramendra Prasad Gupta has proposed establishing a recognition of ‘Family Medicine Hall of Fame’, which will be an initiative of WONCA SAR and journal of Family Medicine and primary care (JFMPC). In this program we will be publishing the biographies of Family Medicine Leaders in a Special Feature—‘Family Medicine Hall of Fame’ to immortalise their personality and work in the international scientific archives. The proposal has been accepted by the executive.

Dr Prakash Chandra Bhatla, one of the founding fathers of WONCA and the first recipient of WONCA Fellowship award has been identified to be the first person to be included in the Family Medicine Hall of Fame.

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WONCA WORKING PARTY ON

EDUCATION PROF VAL WASS Chair, WWPE

There are opportunities and threats to every crisis. This year, as the pandemic has continued to challenge, has been no exception and has impacted on our work as follows: OPPORTUNITIES TO SUCCESSFULLY MOVE OUR 2020 OBJECTIVES FORWARD: (1) WWPE executive: The rapid move to virtual technology has enabled a new WWPE regional executive to form and meet monthly by zoom. I am most grateful to them for amazing support. I stand down as Chair in November 2021 and we are in the process of appointing a new chair.

(1) 2021-2022: Appointment of new WWPE chair and review of aims and objectives.

(2) WONCA Executive Accreditation committee: The formation of this committee to include representation from the WWPE and the Quality and Safety Working Party has strengthened the delivery and governance of WONCA consultancies and accreditation processes. We are delighted our standards have proved such a strong foundation for this work.

(2) 2021-2022: Continue to support WONCA accreditation processes updating standards as needed.

WWPE Regional Executive Prof Marie Andrades (Pakistan) South Asia Prof Carmen Elena CabezasEscobar (Ecuador) Iberoamericana-CIMF Dr Nagwa Hegazy Nashat (Egypt) East Mediterranean Dr Victor Ng (Canada) North America Dr Njeri Nyanja (Kenya) Africa

(3) Book commission: A proposal has been accepted by Taylor and Francis for a book; Family Medicine in the Undergraduate curriculum: Preparing medical students to work in evolving health care systems. Commissioning of chapter authors starts in early September.

(3) 2021-2022: Launch at WONCA Europe 2022.

Dr Robin Ramsay (UK) Europe Dr Chandramani Thuraisingham (Malaysia) Asia Pacific

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(4) Finalise WONCA principles and standards for undergraduate training: We planned to agree at WONCA World conference 2020. Now postponed to 2021 at virtual WWPE preconference meeting.

(4) 2020:2021: Finalise UG standards statement November 2021.

2020-2021 OBJECTIVES THREATENED BY COVID: Not meeting at conferences, sharing workshops and exchanging views has inevitably distanced our members to some extent and impacted on some of our objectives: (5) 2020-21: Establish a web depository. Dissemination of free access offers from our affiliated journal Education for Primary Care has improved thanks to the secretariat Communications officer.

Support for access to resources remains the main request from members; old and new.

(5) 2021-2022: Continue to promote education collaboration on scholarship and publication through our affiliation with Education for Primary Care journal. Keep dialogue open to ensure future work on the WONCA website offers this facility.

(6) 2020-21: Work to collaborate with other WONCA networks. Due to budget restrictions, there have been no further discretionary funding bids to enable collaborative work.

(6) 2021-22: Continue to look for opportunities to collaborate.

(7) 2020-2021: Continue to work with IFMSA and EMSA to support and collaborate.

Links have been lost due to pressures of Covid-19 and conference postponement.

2021:2022: Work to rebuild links and partnerships with IFMSA and EMSA.

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eHEALTH The aim of the working party is to have a holistic approach towards health care, taking the needs and preferences of patients into consideration and targeting their treatment and support.

Relevant patient-focused information and health IT tools are available to all.

Our objectives are to use advanced innovative technology to create personalised eHealth services that contribute to a sustainable, efficient and effective healthcare for all needed persons, especially patients with chronic conditions, to support those patients in their vitality, selfmanagement and independent living using a holistic personalised approach supported by technology, to support the health care providers in the decision making, using holistic monitoring strategies, combined with advanced technology and to support high quality and efficient patient care through the use of interoperable health IT and secure data exchange between and across all relevant stakeholders.

We have 15 new members added to the existing members of this working party. Due to the COVID19 pandemic we were unable to carry most out of our work face-to-face but somehow was able to contribute digitally.

Due to this pandemic, digital health has accelerated, which includes a broad concept and solutions for telemedicine and teleconsultation, remote monitoring, connected devices, digital health platforms and health apps. This concept also covers application in systems based on big data and health data analysis, for instance for epidemiological research and AI-enabled diagnosis support. Digital technologies are becoming critical in the fight against the ongoing pandemic. They have been used, among other things, for online medical consultations from

home and for increasing efficiency in diagnosis and treatment of patients through telemedicine, which, like teleworking and online education, has been a novel experience for many. Likewise, health workers have been using digital technology to diagnose the virus.

WONCA Working Party on eHealth support WONCA working party on quality and safety in successfully organising its webinar on June 24, 2020 on Quality and Safety where President Donald Li along with Nick Guldemon and Pramendra Prasad Gupta presented on behalf of WONCA Working party on eHealth.

Our members were involved in different eHealth Webinars done in different regions and focused on the use and importance of digital health. Our members were also involved in doing various research on digital health.

The 2020s may turn out to be the decade when digital technology reshapes the health system.

COVID-19 has certainly driven many developments in the first three months of 2020, as the digital health community continues to navigate how best to bolster classic public health measures. That’s why it is necessary to let family physicians know how we can reshape the digital health in the current status. With this concept WONCA Working party on eHealth organise a webinar in collaboration with WONCA Special Interest Group on Emerging practice models in family Medicine on ‘DIGITAL HEALTH IN PANDEMIC—A WAY LOOKING FORWARD’ in October 2020.

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In this webinar, we had versatile and experienced speakers who delivered their best on showing the importance and use of Telehealth, Artificial Intelligence and about Digital Health Literacy, chatbots on fight against COVID-19 pandemic and use of eHealth in emerging practice models in Family Medicine. This was followed by a panel discussion—Predicting Digital Health after the Pandemic, which was valuable information. Many participants from different regions took part in this webinar. The webinar can be listened and seen HERE. We tried to get involved in the different WONCA Regional Conferences but due to the COVID-19 pandemic most of the conferences were virtual.

We organised a workshop in WONCA Europe conference 2020 in Berlin led by Raquel Gomez Bravo on ‘Threats and opportunities of Social Media and Medicine’’, and also at WONCA Europe Conference 2021 in Amsterdam. Similar workshops on eHealth were also organised in other regional conferences.

WONCA e-Health Webinar Series

We are invited to organise a workshop on Artificial Intelligence in the WONCA WORLD CONFERENCE 2020.

We encourage family physicians / general practitioners in using digital health like Telemedicine for the management of COVID-19 patients in their region. To support this, we kept resources in the WONCA Website for the references.

We are planning to propose a guideline on various fields (like the use of mobile health and telemedicine, electronic health records) of digital health and will make this available in WONCA Website for references.

Our members from different regions are also working with their respective WHO regional office to develop and strengthen digital health.

We are hoping to expand further our working party by requesting those interested to join.

DR PRAMENDRA PRASAD GUPTA Chair, WWPeH

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ENVIRONMENT The WONCA Working Party on the Environment (WWPEnv) is steadily maturing into a friendly group with expertise in environmental and planetary health. We are growing in membership, output of actions, and cooperation within WONCA affiliated associations and other health organizations such as the Global Climate and Health Alliance, the Planetary Health Alliance and the World Organization of Health. As the climate emergency and the planetary crisis deepens, the general public, patients and doctors become more and more alert to impending health impacts. In this context, the WONCA executive board—advised by our working party on the environment—has shown sustained sensitivity as well as swift leadership, such as in recommending that the tragic COVID-19 health and economic toll finds a healthy recovery track that provides cobenefits for our patients and for our home planet.

See below some of our developments for the period of 2020–2021: 1) 1st WONCA Planetary Health Conference We have worked hard to organise this online conference held in August/2021.

2) Planetary Health for primary care – Online course WONCA Environment and TelessaúdeRS-UFRGS launched the Planetary Health course for primary care. With a focus on clinical practice and the reality of health professionals, the course is designed to introduce family doctors and other primary health care professionals and students to the topic of Planetary Health and to inspire and guide them to educate others or become advocates in various ways.

The development of the course was supported by $1000 from the WONCA Discretionary Funds.

3) WONCA Air Health Train the Trainers WONCA is significantly contributing to raise awareness and air health training. Here you can find a brief description. We are currently in discussion with WONCAWONCA CEO and a potential funder to scale up the Air Health Train the Trainer Program.

4) Two workshops in the WONCA Europe Conference.

5) One workshop in the Annual Planetary Health Alliance Meeting.

6) Four Workshops accepted for the WONCA World Conference November 2021.

7) WONCA Working Party on the Environment has 148 members, with dynamic discussions on stateof-the-art environmental science and planetary health, as well as educational initiatives for doctors, med students and health professionals.

8) Sao Paulo Declaration on Planetary Health (to be published soon).

9) Growing numbers of scientific articles, in peer review journals, from our members.

10) WONCA Action Call for COP26. This call by WONCA will help support the concept of the imperative of Climate Action to safeguard human health.

DR ENRIQUE FALCETO DE BARROS Chair, WWPEnv

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MENTAL HEALTH The aim of the working party is to enhance global equity of access to high quality primary mental health care.

Our objectives are to improve internal structures, to offer mental health guidance for WONCA members, and to provide global leadership on primary mental health care.

1. WWPMH INTERNAL STRUCTURES Our membership is currently over 270. Our largest groupings are from Europe, Latin America and Asia Pacific. Our most recent members are from UK and Qatar.

We have representation across all WONCA regions and constituencies.

Our current elected officer group is Chris Dowrick (UK, Chair), Christos Lionis (Greece, Vice-Chair), Jill Benson (Australia, Secretary) and Juan Mendive (Spain, Secretary).

Vice-chairs for each of the seven WONCA regions are Joseph Ariba for Africa, Cindy Lam for Asia-Pacific, Abdullah al Khatami for Eastern Mediterranean, Christos Lionis for Europe, Alfredo de Olivera Neto for Ibero-America, Kim Griswold for North America, and Pramendra Prasad for South Asia. Sonia-Roache Barker is vice-chair for the Caribbean sub-region.

We have specialist liaison with Sandra Fortes (Brazil).

James Jackson (USA) has joined us as liaison with WONCA Young Doctors.

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Christos Lionis is elected as the incoming Chair of the Working Party. He will take over at the beginning of the WONCA World Congress in November. There may be further changes in the officer group after this point.

Communication between WWPMH members involves structured e-meetings for officers every three months, and monthly e-bulletins circulated to all members. We also arrange ad hoc working party meetings at regional WONCA conferences.

2. MENTAL HEALTH WONCA MEMBERS

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WONCA COVID-19 webinar 6: WWPMH provide four panellists (Juan Mendive, Kim Griswold, Weng Chin and Jill Benson) for the sixth WONCA COVID-19 webinar on mental health, on 25 October 2020. The art teaser for this is here.

Jill Benson has subsequently led the creation of a multi-author paper on this subject, under consideration by Family Medicine and Community Health Journal: ‘Staying psychologically safe as a doctor during the COVID-19 pandemic’.

WWPMH, in collaboration with Ana Nunes Barata of WONCA Young Doctors, and Larry Green et al. from Farley Health Policy Centre in Colorado, with grant support from WONCA Executive, has pilot tested an educational program to equip motivated family doctors who wish to advance the integration of behavioural health care into routine primary care practice. We recruited 12 enthusiastic young family doctors, from all WONCA regions, and set up a virtual learning community to serve as a test bed for this programme. We have reported on this to WONCA Executive.

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We have submitted a paper for publication, and will present our findings at the virtual WONCA World Conference and the Besrour Family Medicine Forum.

We continue to search for funding to extend this project.

We continue to develop our practical guidance documents for family doctors on topics identified as important by WWPMH members.

In the past 12 months, we have published Chinese and Vietnamese translations of the non-drug intervention guidance, and a Vietnamese translation of the corecompetency document.

We encourage primary mental health care input to all WONCA conferences. We made a virtual presentation to the 2020 WONCA Europe conference, and plan further presentations for the WONCA World Congress in November 2021.

Alfredo de Oliveira Neto (Brazil) leads a task group on music and mental health, and provided a recent virtual workshop on the topic. This included the first performance of a specially created song, Tone of Mind.

We continue to collaborate with other WONCA groups, including Young Doctors, Education WP, Quality & Safety WP, Rural Practice WP and Migrant Care SIG. With the Migrant Care SIG, we recently led a webinar on family doctors and migrant mental health, which was produced by the Black Dog Institute in Australia.

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WONCA Mental Health - Music & Mental Health Project

3. LEADERSHIP ON GLOBAL PRIMARY MENTAL HEALTH CARE We continue to lead the expansion of primary mental health care, on behalf of family doctors and their patients: TRAIN THE TRAINERS The evaluation of our 2018 Train the Trainer programme on depression for family doctors in Japan, led by Ryuki Kassai and Evelyn van Weel-Baumgarten, has recently been accepted for publication in Patient Education and Counselling.

Our 2019 Train the Trainers’ initiative to improve family physicians’ management of patients with depression and anxiety across the Asia-Pacific region led to numerous local training sessions across the region. A report of the Nepalese experience, led by Pramendra Prasad, has been published:

Gupta PP, Jyotsana P, Larrison C, Rodrigues S, Lam C, Dowrick C. Effectiveness of mental health community training on depression and anxiety to the health care profession working in rural centres of eastern Nepal. J Family Med Prim Care. 2020 May 31;9(5):2416–2419.

With support from WONCA CEO, Harris Lygidakis, and in collaboration with the education NGO Mosaica, we are in the process of developing a proposal to Pfizer for an unrestricted education grant to run an online training programme on major depressive disorder (MDD Minds) for family doctors in Africa/EMR, Asia and Latin America.

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We continue to promote external collaborations, including with WHO, APEC, RCGP, WFMH and WPA. WHO: During the past few months I have taken part in expert consultations on Parkinson’s Disease, collaborative care for depression and chronic disease, and the update of the mhGAP Intervention Guide. Abdullah al Khatami (Saudi Arabia)continues to collaborate with WHO colleagues across EMR, through a combination of policy events and practical workshops. Christos Lionis has taken part in a WHO summit in Athens, contributing to a roundtable on mental health and the health care workforce.

APEC: Cindy Lam, Ryuki Kassai and I, with strong support from Garth Manning, are contributing to the APEC Digital HubWONCA Collaborative Framework on Integration of Mental Health into Primary Care in the Asia Pacific. We have published this position paper: Dowrick C, Kassai R, Lam CLK, Lam RW, Manning G, Murphy J, Ng CH, Thuraisingham C. The APEC Digital Hub-WONCA Collaborative Framework on Integration of Mental Health into Primary Care in the Asia Pacific. J Multidiscip Healthc. 2020 Nov 25;13:1693–1704.

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Lionis C, Fortes S, de Oliveira Neto A, Daniels-Williamson T, al Khatami A, Griswold K, Dowrick C. ‘Realising the Astana Declaration and mental health in an unequal world—The role of family doctors’.

WPA: I will contribute to a round table on mental health and comorbidities at the forthcoming WPA Congress in October. In collaboration with WPA colleagues Roger Ng and Helen Herrman, I have published a survey of psychiatrist opinions about family doctors’ mental health competencies: Ng RMK, Chan TF, Herrman H, Dowrick C. What do psychiatrists think about primary mental health competencies among family doctors?

A WPA-WONCA global survey.

BJPsych Int. 2021 Feb;18(1):18–22.

I continue to contribute to the WPALancet Clinical Commission on Depression, whose report is expected later this year.

PROF CHRISTOPHER DOWRICK Chair, WWPMH

RCGP: As President of RCGP, Amanda Howe continues to promote effective dialogue with psychiatric colleagues at national and international levels.

WFMH: We will contribute to the forthcoming WFMH conference in London, currently scheduled for July 2022. We have produced a paper to be published via WFMH for World Mental Health Day in October:

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QUALITY & SAFETY LECTURES & CONFERENCE PARTICIPATION Astier-Peña, María Pilar as Keynote Speaker at the Green Session of the Chilean Society for Healthcare Quality. How not to make a mistake in de-escalation? 24 July 2021.

[Internet]. Lecture: Primary care is key to deescalation: Rapid detection, surge response— will pandemics be part of the primary care service basket?

Astier-Peña, MP as a keynote speaker on the WONCA Covid19 webinar on Health Equity, September 20, 2021.

Astier-Peña, MP as a keynote speaker on the WONCA Covid19 webinar on Health Equity, September 20, 2021.

Astier-Peña, María Pilar as Keynote Speaker at Eight Cross-Strait Medicine Exchange Association-General Practice Branch Conference: ‘Deepening the Development of Disciplines, Promoting Quality Services and Building a Healthy China’ April 23, 2021.

RESEARCH PROJECT INVOLVEMENT Pre-COVID Study. European Study on Quality and Safety in Primary Care in COVID-19 Pandemic. Department of Public Health and Primary Care (G39) – Ghent University.

Unit ‘Equity in Health Care’. Dr Piet Vanden Bussche.

WONCA EUROPE CONFERENCE, BERLIN, DECEMBER 2020 [ONLINE]: Oral Presentations: ID 1198: Golden Rules for Healthy Junior Doctors. Astier-Peña, MP et al.

ID 1187: Can prescribing ‘don’ts’ (what should not be prescribed) cause harm to patients?

Assessing Family Medicine Don’ts on prescriptions in Aragon, Spain. Astier-Peña, MP, Bueno Ortiz JM et al.

ID 1743: Can we improve our referrals to cardiology? Impact of a massive care continuity project. Bueno Ortiz JM et al.

ID 913: What do parents need for the appropriate antibiotic management in their children in primary health care setting?

Bueno Ortiz JM et al.

Workshops: ID: 1139 First Management of Harmful Patient Safety Incidents in family practices. AstierPeña, MP and Bueno Ortiz JM. ID: 392: Understanding the principles of good financial management in Family Medicine.

Josep Vilaseca.

ID: 1777: Does education of primary care professionals to support patient selfmanagement improve patient outcomes in chronic disease management: updated systematic review.

Andrée Rochfort EQUIP Online Conference, March 19 and 20th 2021 Other WONCA Commitments: WHO Patient Safety Flagship Collaboration: World Patient Safety Day, September 17 : video on primary care and Covid19 Pandemic sent to WHO WPSD 2020 Campaign.

Patient Safety Statement on the WHO Board Committee, January 24, 2021

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Patient Safety Statement on the 74th WHA, May 2021.

2021 World Patient Safety Day: Collaboration on theme and activities.

‘Safe mothers, safe newborns’.

Steering Committee on WONCA Accreditation System for Family Medicine Training and Family Medicine Practice Publications: To T, Viegi G, Cruz A, Taborda-Barata L, Asher I, Behera D, Bennoor K, Boulet LP, Bousquet J, Camargos P, Conceiçao C, Gonzalez Diaz S, ElSony A, Erhola M, Gaga M, Halpin D, Harding L, Maghlakelidze T, Masjedi MR, Mohammad Y, Nunes E, Pigearias B, Sooronbaev T, Stelmach R, Tsiligianni I, Tuyet Lan LT, Valiulis A, Wang C, Williams S, Yorgancioglu A. A global respiratory perspective on the COVID-19 pandemic: commentary and action proposals.

Eur Respir J. 2020 Jul 23;56(1):2001704. doi: 10.1183/13993003.01704-2020.

PMID: 32586874; PMCID: PMC7315811.

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S A F E T Y

Ares-Blanco S, Astier-Peña MP, Gómez-Bravo R, Fernández-García M, Bueno-Ortiz JM. Gestión de los recursos humanos y estrategias de vacunación en atención primaria en Europa en la pandemia COVID-19 [Human resource management and vaccination strategies in primary care in Europe during COVID-19 pandemic]. Aten Primaria. 2021 Jun 9;53(10):102132. Spanish. doi: 10.1016/j.aprim.2021.102132.

Epub ahead of print. PMID: 34256236; PMCID: PMC8188304.

Social Media: @WONCA_QSafety (813 Followers) Spanish Society for Family and Community Medicine (Semfyc) Patient Safety Working Party: Blog on patient safety in primary care (Spanish): Blog Sano y Salvo: http://sano-ysalvo.blogspot.com/ Twitter: @sanoysalvoblog

Williams S, Tsiligianni I. COVID-19 poses novel challenges for global primary care. NPJ Prim Care Respir Med. 2020 Jun 18;30(1):30. doi: 10.1038/s41533-020-0187-x. PMID: 32555160; PMCID: PMC7303134.

COVID19 - Posts from the front line: Learn from this pandemic that primary care must be strengthened. April 8, 2020, ISQUA Blog.

Available at: https://isqua.org/blog/covid19/covid-19-blogs/covid19-posts-from-thefront-line-learn-from-this-pandemic-thatprimary-care-must-be-strengthened.html) Ares-Blanco S, Astier-Peña MP, Gómez-Bravo R, Fernández-García M, Bueno-Ortiz JM. El papel de la atención primaria en la pandemia COVID-19: Una mirada hacia Europa [The role of primary care during COVID-19 pandemic: A European overview]. Aten Primaria. 2021 Jun 12;53(8):102134.

Spanish. doi: 10.1016/j.aprim.2021.102134.

DR MARIA PILAR ASTIER PEÑA Chair, WWPQS

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RESEARCH STRUCTURE & MEMBERSHIP Little has changed since last year - the group membership is organised by entry into an excel spreadsheet and by membership of a Google Group (WONCA Research Assembly). We are looking forward to the new electronic communications system that we understand WONCA secretariat will be supplying. There are now a total of 101 members in the Working Party.

All members provide a brief bio which are listed on the website.

The WP-R Executive consists of Chair, Regional representatives (Marvin Reid, North America: Bob Mash, Africa; Mehmet Akman, Europe; Ryuki Kasai, Asia Pacific; Raman Kumar, South Asia; Jacqueline Ponzo, Iberoamericana), Young Doctor representative (Nagwa Nashat) and Chris van Weel as panel workshop convenor.

The Council includes other active members involved in the Ariadne Research project (Bob Phillips, Amanda Howe, Michael Kidd, Andrew Bazemore), members who are key players in WONCA (Shabir Moosa, WONCA Africa President) and others actively involved in WP-R projects.

The Council includes other active members involved in the Ariadne Research project (Bob Phillips, Amanda Howe, Michael Kidd, Andrew Bazemore), members who are key players in WONCA (Shabir Moosa, WONCA Africa President) and others actively involved in WP-R projects.

THE EFFECT ON OUTCOMES OF COUNTRY-SPECIFIC STRATEGIES AND PRIMARY HEALTH CARE STRENGTH IN COVID-19 PANDEMIC RESPONSE: AN INTERNATIONAL STUDY This WONCA-sponsored study, led by Felicity Goodyear-Smith, looked at the influence of PHC in a country’s successful response to COVID-19. A summary of the study can be found here, a presentation about findings here, and results published in peer-reviewed publications: 1. Goodyear-Smith F, Kinder K, Eden AR, et al.

Primary care perspectives on pandemic politics.

Global Public Health 2021:1-16. doi: https://dx.doi.org/10.1080/17441692.2021.187675 1 2. Goodyear-Smith F, Kinder K, Mannie C, et al.

Relationship between perceived strength of countries’ primary care system and COVID-19 mortality. British Journal of General Pactice Open 2020;Published online 9 Sep doi: 10.3399/bjgpopen20X101129 3. Kinder K, Bazemore A, Taylor M, et al.

Integrating primary care and public health to enhance response to a pandemic. Prim Health Care Res Dev 2021;22:e27. doi: 10.1017/S1463423621000311 [published Online First: 2021/06/10]

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With a 4th under review. A follow-up survey was launched in May 2021 and the results are currently being analysed. The research team would like to thank WONCA members for their support.

SCIENTIFIC WRITING WORKSHOPS The following workshops is accepted for 2021 WONCA World online conference, Nov 2020.

Scientific writing. Akman M, Goodyear-Smith F. COMPARATIVE PHC SYSTEM WORKSHOPS The WWP-R runs panels / workshops whereby different countries compare how their primary care is organised, using regional coordinators in the different WONCA regions but due to COVID-19, none have been run since 2019.

The WONCA Asia Pacific Regional Conference, Auckland, New Zealand 2020. Kassai R, Sairat N, Canhota C, Sharma N, Nicodemus L, GoodyearSmith F, L. Panel to cover Macau, Fiji, the Philippines and New Zealand was cancelled.

However the participants met virtually, combined their data, and wrote a paper which has now been published: Noknoy S, Kassai R, Sharma N, Nicodemus L, Canhota C, Goodyear-Smith F. The impact of COVID-19 on primary health care in six AsiaPacific countries. Br J Gen Pract Open.

2021.11 Jul:326-9.DOI: 10.3399/bjgp21X716417

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PHC RESEARCH CONSORTIUM WONCA holds one of the six seats on the steering committee Primary Health Care Research Consortium, represented by Felicity GoodyearSmith. The Bill and Melinda Gates Foundation has given the Consortium funding to establish itself over the next two years. Some projects have been delayed due to the pandemic but several research projects are now progressing.

See https://phcrc.world/ for updates.

PRACTICAL GUIDE TO PRIMARY CARE EDUCATIONAL RESEARCH Profs Mehmet Akman and Felicity GoodyearSmith, in collaboration with Prof Val Wass, Chair of the Working Party on Education, have edited a book entitled How to do Primary Care Educational Research: a Practical Guide. This is another in the WONCA series to be published by CRC Press, Taylor and Francis Publishing, as a companion to our previous books How to do Primary Care Research edited by F Goodyear-Smith and B Mash, 2018, and International Perspectives in Primary Care Research, edited by F GoodyearSmith and B Mash, 2016. A number of experts from around the world, including members of the Working Party on Research, have contributed chapters. The book is in press, due out 14 July 2021. https://www.routledge.com/How-To-Do-PrimaryCare-Educational-Research-A-PracticalGuide/Akman-Wass-GoodyearSmith/p/book/9780367627041 .

AFRIWON RESEARCH COLLABORATIVE ONLINE RESEARCH TRAINING AND MENTORSHIP The AfriWon Research Collaborative has an online research training curriculum for this program is based on our WONCA book How to do Primary Care Research. They are pairing their early career researchers from LMIC (mainly in Africa) with senior research mentors throughout the world. A number of WONCA WP-R members are serving as mentors.

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WONCA BESROUR PRIZE FOR EMERGING RESEARCHERS FROM LMIC Dr Sadok Besrour from the Besrour Centre for Global Family Medicine at the College of Family Physicians of Canada has made available awards for the best oral and poster presentations by an emerging researcher from a low or middle income country (LMIC). at the online WONCA World conference in November. Awards are $5000 (USD) for the best oral presentation, and $2000 (USD) for the best poster presentation. To be eligible, researchers must have·started their research career within the last five years are the first author, are from a LMIC and conducted their research predominantly or exclusively in a LMIC. Recipients of the Taiwan family Medicine Research award will not be eligible. The winners will be presented with their awards at the closing ceremony.

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SUCCESSION PLANNING At WONCA World in November 2021 Prof Felicity Goodyear-Smith will step down as Chair after two successive two-year terms. Her successor is Prof Mehmet Akman, School of Medicine, Marmara University, Turkey. Mehmet has been a very active member of the Working Party and will lead the group forward with innovation and enthusiasm.

PROF FELICITY GOODYEAR-SMITH Chair, WWP on Research

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RURAL PRACTICE The last year has been a disruptive one. As frontline health workers, rural Family Doctors have had to step up with our communities to treat, vaccinate, plan, advise and often provide leadership in the face of the Covid pandemic. Our rural academics have had to adjust to still give our rural students a meaningful clinical experience.

Our students have had to sometimes become part of the frontline efforts.

The pandemic has changed things - some for the better some not, some for ever while some are only short term. Rural has always used some telehealth, be it just a telephone in years gone past - this is now a more embedded part of practice; it has its risks and benefits to rural practice and communities.

Rural communities are by their nature more isolated but with often fragile services can be especially vulnerable. The increased workload of Covid on top of the existing workload can be a major strain in small facility or clinic.

Our last face to face meeting was in Albuquerque in 2019. It was great success as reported in last year’s report with a massive effort from our hosts the University of New Mexico (UMN) and the National Rural Health Association (NRHA) in collaboration with AAFP and their global summit.

In 2020 and 2021 we had planned to support our colleagues from low- and middle-income countries by bringing the conferences to them.

This is a major undertaking especially for our rural colleagues who reside away from the larger conference venues. Our conferences have always aimed to be showcases of what can be done and the aim for these two years was to learn from innovation in low resource environments and also help these countries with new ideas from elsewhere

The 17th World Rural Health Conference Bangladesh 2020 became a new form of conference - a long conference over some months allowing participants to have weekly bites of information and discussion. This democratised the participation at the conference in many ways allowing those who would not have been able to travel to attend although poor internet connectivity remained a problem It was organised by a young and enthusiastic group of volunteers from Primary Care and Rural Health Bangladesh led by our Council Executive member Prof Zakiur Raman During the wonderful 3 day opening we had a virtual tour of Brahmanbaria Medical College and heard of the significant rural health progress in Bangladesh.

17th World Rural Health Conference Bangladesh 2020

17th World Rural Health Conference Bangladesh 2020

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In Collaboration with Network: Towards unity for Health TUFH we then went onto a Lecture series built on key topics with inspirational presenters and excellent discussion:

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Rural Seeds also produced two wonderful Rural Cafes on The Joys of Practice and Rural Communities: How to engage young doctors?

Rural Training Pathways And Pipelines Bruce Chater: Learning In Rural Settings Ian Couper And Jana Muller Rural Workforce Retention Strategies Roger Strasser Supporting Young Health Professionals In Rural Settings Amber Wheatley; Mayara Floss; Veronika Rasic High Performing Rural Teams And Rural Workforce: Getting The Balance Right Bikash Gauchan Digital Health Ai And Telehealth: Improving Not Worsening Access Shannon Nott Rural Effects Of Climate Change Pratyush Kumar Role Of Family Medicine In Rural Health James Rourke Rural Generalist Family Care Paul Worley Establishing Family Medicine In Low And Middle Income Countries Raman Kumar Epidemiology And Public Health: Remote And Rural Health: Latin America Alejandro Avelino And the launch of additions to RURAL MEDICAL EDUCATION GUIDEBOOK .

Panelists Gender and Rural Culture: Susan Brumby.

Resourcing rural health: Couper and De Villiers.

Rural seeds: (Mayara Floss) Andressa Paz. Teaching Mental Health: Michael Jong.

Agricultural Health: Scott Kitchener.

Training in place: Ewen McPhee.

Mentor Mentee: (Karine Puls) Andressa Paz. Teaching Rural Determinants: Steve Reid.

The Socio-Economic Benefits of Rural Medical Education: Roger Strasser

Rural Café Digital Meetings

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The Declaration of the 17th World Rural Health Conference was Blueprint for Rural Health The Blueprint outlined the key elements in ensuring the effective provision of rural health services including: Key principles of Advocacy Primary Health Care Universal Health Care Public health and community infrastructure Access Workforce The important concepts contained in the Blueprint were End to end planning and integrity Clinical Courage Rural Health education in Rural For Rural Immersive Community Engaged Education (ICEE) Rural Exposure – any is good – more is better Grow your own Redundancy Stepladder education Engaging young doctors The right health worker Rural generalism Rural Origin Ruralisation Rural Policy Localising economic benefit The 18th World Rural Health Conference Uganda 2021 got off to a good start with an inspiring Opening session on 9 July 2021. The conference is another long conference this time in partnership with WHO/Headquarters Gender, Equity and Human Rights Team, and other partners including major UN agencies, are being joined by us, as civil society partners, to present a Webinar Series on Tackling Rural Health Inequities.

The Declaration of the 17th World Rural Health Conference

Lessons in rural proofing of health policies, strategies, plans and programmes Social participation and community engagement approaches for the health of the Indigenous populations in rural and remote areas Policies to develop, attract, recruit and retain health workers in rural and remote areas, and promote gender equality for rural women through health workforce policies Innovations in equity-oriented health service delivery in rural and remote areas in LMIC Intersectoral action with the agricultural sector for strengthening primary health care Improving rural health information systems for health equity Rural women and addressing inequities in health service coverage The WHO webinars are preceded by conference session focussing on, highlighting and celebrating the African experience and achievements.

The conference also will include a collaborative session with our colleagues in African Forum for Primary Health Care AfroPHC on Rural PHC in Africa

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Planning has started for the 19th World Rural health Conference in Limerick Ireland 2022, and we look forward to hopefully meeting face to face there.

19th World Rural health Conference in Limerick Ireland 2022

Communication has been important during the Pandemic, and we have established a resource page www.ruralWONCA.org as a source of information and Rural WONCA on YouTube for live streaming of our events. Our Facebook page, group and @ruralWONCA Twitter feed have proved popular.

Early in the pandemic our former Chair John Wynn Jones recognised the need to keep us connected through Rural Miscellany and his contribution was summed up in my thanks.

Thanks, John, for providing and sharing the facts, the feelings, the joys and sorrows and the humanity of Rural Practice. It has been a massive undertaking. A famous Australian Rural Bootmaker R M Williams one explained his life philosophy as “bite off more than you can chew and then chew like mad”. John kept chewing through this material – it was a lifeline, a joy in the day, an inspiration and a source of trusted information to so many.

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Last year was 25 years since the formation of the then named WONCA Working Party on Training for Rural Practice. From the start we have sought to develop and evidence-based policy for rural practice and published the Policy on Training for Rural Practice 1995 and the Policy on Rural Practice and Rural Health 1998. In 2010 the first evidence-based guidelines Increasing access to health workers in remote and rural areas through improved retention were published by WHO. In the last 2 years we produce Checklist Implementing rural pathways to train and support health workers in low- and middle-income countries commissioned by WHO and this year we were delighted to be involved the launch of WHO Guideline on health workforce development, attraction, recruitment and retention in rural and remote areas. This was supported by an inspiring video by Rural Seeds Why do we need rural health workers? (https://youtu.be/W3jSiFJpcm0 ).

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To quote our former chair Prof James Rourke, So much work has gone into getting to this, the WHO guideline seems like a lifetime achievement for rural WONCA, Still more to do but good to pause and reflect on when we started, and the journey we have had together.

Rural Seeds have continued to thrive despite the pandemic and the founding ambassadors Mayara Floss, Karine Puls, Veronica Rasic and Amber Wheatley have during this year recruited new ambassadors as succession planning. Due to the number of applications for these positions they decided to appoint a Rural Seeds Ambassador for each region. Additionally, each Ambassador will have Deputies to support them in their work. (This was not possible for all regions.)

AFRICA Mercy Wanjala (Ambassador) Celestine Todosia (Deputy) Mustapha Aminu Tukur (Deputy)

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In Albuquerque in 2019 we elected our first nurses on to Rural WONCA Council, published our WONCA endorsed Rural Nursing and Midwifery Albuquerque Statement 2019. We have subsequently joined our rural nursing colleagues in publishing Perspectives: Now is the time to raise our voices in the Journal of Research in Nursing. This was followed by a JRN- Rural WONCA conversation Webinar in June.

1. WONCA R, editor Blueprint for Rural Health 17th World Rural Health Conference; 2021 Bangladesh 2. Chater AB. To a Blueprint for Rural Health. Social Innovations Journal. 2021;8.

ASSOC PROF ALAN BRUCE CHATER Chair, WWP on Rural Practice

ASIA PACIFIC Alexandra Yeoh (Ambassador) IBEROAMERICA Marcela Araujo de Oliveira Santana (Ambassador) Marco Aurélio Ferreira Farnezi (Deputy) NORTH AMERICA Shoban Jayamohan (Ambassador) Caire Connors (Deputy) Alexandra Ferrara (Deputy) SOUTH ASIA Dr Sneha P Kotian (Ambassador) Nadira Begum (Deputy) Aman Mishra (Deputy) Over the next 12 months they plan to hold a monthly mentoring webinar for our new team and establish link to the areas not represented.

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INTERNATIONAL CLASSIFICATION WICC activities during 2021 continued to follow the stated mission and goals of the Committee, which were reaffirmed by WICC members at the 2020 WICC Annual Meeting in Erlangen, Germany.

MISSION To develop and maintain classifications that accommodate the complete domain of family/general practice and to ensure that these classifications are interoperable to the highest degree possible with standard international health care terminologies and classifications, in order to contribute to equitable quality health care worldwide.

GOALS To achieve widespread international use of ICPC; To maintain and revise ICPC to accommodate expanded health care knowledge; To develop productive working relationships with other international standards development organizations; To support the work of WICC and WONCA through licensing of ICPC; To create and disseminate additional classification tools as needed to capture and codify the complete domain of family/general practice.

WICC continued collaborating with the Consortium ICPC-3, SNOMED International and WHO. Different national projects are ongoing to combine ICPC with SNOMED and implement it in the primary health care systems. WICC members participated during the SNOMED CT expo in October 2020 and presented the project from the development in Belgium. Concerning the collaboration with WHO, this is an ongoing process with ups and downs. Most time input was given to the finalisation ICPC-3.

As chair and WICC executive of WICC (all are members of the Consortium ICPC-3), we are proud that ICPC-3 was finally released in the end of 2020 and approved by the WONCA executive in April 2021. The collaboration with the Consortium ICPC-3 has been constructive and seen as the only way possible the achieve the development of ICPC-3. We would like to thank the consortium ICPC-3 for the collaboration and the work done.

We explicitly want to thank Kees Van Boven and Huib ten Napel for the initiative and perseverance and we look forward to the collaboration in the future.

1. WICC structure and work 2021.

WICC is still organised as an ‘expert volunteer’ committee. Thomas Kuehlein resigned as chair and we would like to thank Thomas for leading the Committee these past years. Diego Schrans, Belgium was elected as the new chair at the Erlangen meeting 2020, Belgium, Deputy Chair Gustavo Gusso, Brazil, and 3 Executive Members Preben Larsen, Denmark, Laurent Letrilliart, France and Olawunmi Olagundoye, Nigeeria.

WICC has at present approximately 45 members.

The Nominations committee were also elected at the Erlagnen meeting 2020 (Øystein Hetlevik Norway, Nicola Buono Italy and François Mennerat France). Full Committee meetings are used for exchanging information, making core decisions, and establishing and maintaining consensus.

Due to the COVID-19 pandemic, conferences and meetings were postponed or had an online alternative, where possible WICC members attended and contributed, especially on the development of ICPC-3 by the Consortium ICPC-3 and WICC.

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Several members are setting up studies on the implementation of ICPC-3 in health care, which should result in original papers in international scientific papers. The WICC executive continued its practice of monthly conference calls via Zoom/MS Teams to manage work and planning, and participated in calls with WONCA.

Thomas Kuehlein, Kees van Boven and the WICC are still worried about the fact that still a contract is missing. The worries are about digging the grave of ICPC by helping develop and adding formal acknowledgement to a picklist of ICD-11, which in the end will be inferior to ICPC-2 and the more to ICPC-3.

2. Use of ICPC

5. Work on ICPC-3

ICPC remains the standard primary care classification in several countries; and limited use of ICPC for small-scale clinical or research projects continues. ICPC-3 will be implemented for now on, new licenses for ICPC will be most likely for version 3. Several countries have shown their interest.

As already said, ICPC-3 is available. Further cooperation between WICC and a yet to be established Foundation seems to be a logical and professional way to maintain and further develop ICPC-3. During the next meeting in Copenhagen, this cooperation will be an important point on the agenda.

3. Work with IHTSDO and WHO in 20/21 The International Family Practice/General Practice Special Interest Group of IHTSDO (GP SIG), chaired by WICC member Nick Booth, was created in 2009 by a formal agreement between WONCA and IHTSDO. Although the group consists of some WICC members, it is not formally part of the WICC. The International Family Practice/General Practice Special Interest Group of IHTSDO (GP SIG), who made the SNOMED-CT primary care reference set of terms (RefSet) and RefSet-to-ICPC map, was not very active. This product is being field tested at present. The next step is to work out the ‘governance’ process (responsibility for quality) for this product with IHTSDO.

DR DIEGO SCHRANS Chair, WICC

4. Work with WHO in 2016/17 Kees van Boven, Diego Schrans and Gustavo Gusso and Olawunmi joined the online WHO-FIC council in 2020. The informal PC working group had already formed into a formal working group.

However, ICD-11 PC Linearization was not an official topic at the conference. This concerns the status of Primary Care within the international classification specialist community and WHO.

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ADOLESCENT & YOUNG ADULT CARE DR MARIA VERONICA SVETAZ

Chair, SIG Adolescent & Young Adult Care

The marking event of the year was the COVID-19 epidemic, which affected adolescents and young adults (AYA) throughout the world. This included direct impact of the disease on AYAs and their families as well as indirect consequences related to confinement and isolation.

We observed an increase in mental health issues, including depression, anxiety, and disordered eating as well as more frequent physical and sexual abuse. Furthermore, the epidemic emphasised the health inequities that exist within this population both within and between countries.

For the SIG the year was one of collaboration. We lobbied and obtained WONCA to endorse a ‘Statement from the International Association of Adolescent Health (IAAH) and Family Planning 2020 on Adolescent Sexual and Reproductive Rights and COVID-19’.

Several of our members and other family physician colleagues reviewed and offered feedback on the WHO EURO Pocket Book of Primary Care for Children and Adolescents.

Finally, we presented in the WONCA Webinar series.

Veronica Svetaz, Susan Sawyer, President of IAAH and Pierre-Paul Tellier spoke on ‘Understanding and Communicating with Teenagers Using a Strength-based, Trauma Sensitive, and Culturally Informed Approach’.

© Darren Baker

Dr Tellier did two presentations at WONCA Europe last year, however we have chosen not to present at WONCA World this year due to human rights issues related to gender and sexually diverse populations in the United Arab Emirates where the conference was due to be held. Our goal for the upcoming year will be to continue collaborating on projects with other organizations working with AYA throughout the world and to expand our membership.

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AGEING & HEALTH In the past 12 months the SIG has been busy despite the many distractions of the pandemic.

We now have 53 members and they have been active in group discussions by email, in contributions to the WONCA newsletter and through presentations at WONCA conferences and webinars.

Our conference presentations and webinars have included:

CONTRIBUTIONS NEWSLETTER

WONCA

We have an abstract accepted for WONCA World in 2021

We have been submitting regular contributions to the WONCA newsletter this year. Titled “Ageing lines”, these contributions from a number of members in different countries have included a picture and a small amount of text about initiatives that might help WONCA members care better for their ageing populations. These include:

We also had an abstract accepted for WONCA Asia Pacific but this conference did not go ahead due to the pandemic.

TO

THE

JULY 2021 Mobile vaccination clinics. Contributed by Family Medicine Specialists with Special Interest in Primary Care Geriatrics from Malaysia JUNE 2021 Leveraging technology to deliver care to seniors during the Covid19 pandemic Contributed by SingHealth Polyclinics, Singapore MAY 2021 The Golden Angels Platform: Using technology for social support and well- being of older adults .

Contributed by Family Physicians from Pakistan APRIL 2021 Using mobile technology and social media to enhance social connections in older people. From Family Physicians in Singapore

Danica Rotar, Dimity Pond. Models of aged care. WONCA BERLIN (online) Dimity Pond (and co presenters not from the SIG). Roundtable on ethical issues in elderly care. WONCA Europe 2021 (online)

Other contributions: Webinar in 2020: Elder Abuse in the Pandemic Dimity Pond, University of Newcastle, Australia and Nena Kopcavar Gucek, University of Ljubljana, Slovenia, SIG Family violence.

Contribution to World Mental Health Day 2020 with a short video on primary care approaches to mental health in the elderly Discussion with WHO around collaboration in the roll out of the ICope initiative. Two discussions were held, one with WHO and one with WHO and including Felicity GoodyearSmith, Research working party. Further action will occur when WHO is ready to roll out a research project around ICope.

DR DIMITY POND

Chair, SIG Ageing & Health

MARCH 2021 Nature brings pleasure to older patients. From a GP in Australia.

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CANCER & PALLIATIVE CARE The Cancer and Palliative Care SIG has not been very active with only the following activities in the reporting period 1. Regular meeting of the chair (Alan Barnard) with the EAPC working group on palliative care 2. one set of lectures on Palliative Care in COVID given to Medicine Sans Frontiers in Cape Town as part COVID palliative care preparation 3. An online seminar/webinar on Palliative Care in COVID was delivered with the participation of all the SIGs. It was well received 4. Single contacts with individual colleagues about research and supervision and mentorship make up the balance GOALS 1. Ask the WONCA leadership to help me appoint a committee including young doctors and one senior member to support and encourage me in this work 2. Compile a list of potential active members of the SIG 3. Organise another webinar 4. Develop the cancer part of the SIG as it has been neglected 5. Improve relationships with other SIGs and collaborate as possible

DR ALAN BARNARD

Chair, SIG Cancer and Palliative Care

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COMPLEXITIES IN HEALTH 1. WONCA WEBINAR SERIES ON #COVID2019 on October 19th 2020. The fifth session of the new series of WONCA COVID-19 webinars focused on: Making Sense of Complexities of COVID-19 in Primary Care. https://www.youtube.com/watch? v=BOlwWeTRv5c

Martin CM, Stockman K, Hinkley N, Campbell D. A Telehealth/Coaching Capitated Hospital Readmission Service in Australia: A Pragmatic Controlled Evaluation. Journal of Medical Internet Research 2020;2020;22(12):e18046) doi: 10.2196/18046.

2. Planning for Joint Webinar WONCA SIG on Complexities/The Network: Towards Unity for Health and titled as “Using complexity theory to help build PHC teams for UHC in Africa

PROF CARMEL M MARTIN Chair, SIG Complexities in Health

3. Planned complexities workshop/ meetings in World WONCA Virtual Abu Dhabi Conference from 22 to 27 November 4. Online email communications among the group 5. Interactions with other groups – NAPCRG Committee on the Science of Family Medicine – joint membership of Chair and Co-Chair and other members Accepted presentation at NAPCRG Virtual Annual Conference CASFM Forum: Improving care for patients with diabetes and multi-morbidity: How can complexity and big data contribute?

6. Examples of Publications(1-5) Sturmberg JP, Martin CM. How to cope with uncertainty? Start by looking for patterns and emergent knowledge. J Eval Clin Pract. 2021.

Sturmberg JP, Martin CM. Implementing cardiovascular disease preventive care guidelines in general practice: an opportunity missed. Med J Aust. 2021.

Sturmberg JP, Martin CM. Universal health care - A matter of design and agency? J Eval Clin Pract. 2020.

Sturmberg JP, Martin CM. COVID-19 - how a pandemic reveals that everything is connected to everything else. J Eval Clin Pract. 2020;26(5):1361-7.

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CONFLICT & CATASTROPHE MEDICINE The impact of the COVID-19 pandemic, an unprecedented event in our lifetime, has brought significant challenges to the whole of Family Medicine/General Practice (FM/GP), including clinical work, training and examinations. Whilst international travel restrictions have led to constraints on face-to-face Special Interest Group on Conflict & Catastrophe Medicine (SIG on C&CM) meetings at WONCA meetings and other conferences, remote contact was maintained using Zoom and Microsoft Teams. Inspiring examples of SIG on C&CM members’ contributions across all Governmental lines of development (TEPIDOIL) became apparent throughout the reporting year. Examples include: TRAINING COVID-related Family Medicine exam cancellations and postponements have been a stressful time for FM/GP trainees. SIG on C&CM members have worked with their national professional bodies to make the necessary changes required by licensing bodies, while ensuring FM/GP assessments remain valid, reliable, cost-effective, feasible, transparent, balanced, reflective of the types of consultations now taking place in real life FM/GP; and futureproof to ensure assessments remain deliverable through further waves of COVID. EQUIPMENT SIG on C&CM members have supported their governments’ efforts to increase national testing capacity. They have worked with specialist pharmacists to train testing personnel, provide testers to Regional Testing Centres, and deliver vital testing equipment. They have helped to create a network of Mobile Testing Units (MTUs), which have travelled across countries to reach symptomatic and eligible people at sites where there is a high demand for testing.

PROF RICH WITHNALL Chair, SIG on Conflict & Catastrophe Medicine

PERSONNEL In addition to supporting testing, SIG on C&CM members have vaccinated people across their countries and overseas. Advice from the SIG on C&CM informed Vaccine Task Forces, Vaccine Quick Reaction Forces, Health Boards, vaccination centres, vaccine programmes and vaccine rollout. SIG on C&CM members also helped to deliver thousands of vaccine doses around the world, including across continental Europe and to remote territories, such as Ascension Island and the Falkland Island. SIG on C&CM members also supported strategic repatriation, such as a COVID-19 evacuation flight from Japan.

INFRASTRUCTURE In support of national health systems, SIG on C&CM members undertook reconnaissance visits to multiple sites, analysed potential COVID networks, and provided decision support in the coordination, building and establishment of COVID-19 Operations Centres. Catastrophe Medicine planning tools, ways-of-working, leadership techniques and coaching approaches helped secure effective Command and Control mechanisms as host nation hospital capacity swiftly became overwhelmed in many countries.

For example, SIG on C&CM members visited Amman, Jordan engaging with primary health care teams to reinforce areas of good practice and support areas for improvement in COVID-19 infection control and prevention.

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DOCTRINE/POLICY Increasing numbers of COVID-19 related clinical ‘good ideas’ landed indiscriminately across governments. The challenge was not to miss potential ‘game changers’ in the white noise of less promising suggestions. To manage incoming proposals in a more efficient and effective way, SIG on C&CM members introduced screening processes, such as the Clinical Research and Innovation Gateway (CRAIG).

Proposals underwent desirability, validity and feasibility analyses to inform an Opportunity Assessment (OA). Proposals passing the OA were categorised

by Technology Readiness Level (TRL) and subjected to deeper Value Proposition (VP) scrutiny. Discovery Science, Research and Development were considered TRL 1-6 inclusive.

Implementation and Innovation were considered TRL 7-9 inclusive. Over 200 ‘good ideas’ were analysed within the reporting period, delivering strategic benefit in: patient communication (e.g., Cardmedic, an award-winning communication tool designed to improve the transfer of vital information between health care staff and patients, across any barrier—whether visual, hearing or cognitive impairment, foreign language or Personal Protective Equipment); disease surveillance (e.g., Project OASIS, which collects data from third party app-providers to help the UK National Health Service respond to the COVID19 pandemic); and data sharing (e.g., PANDO, a secure, fit-for-purpose alternative to social messaging apps, such as WhatsApp, which are ubiquitously in use across health care organizations).

ORGANIZATION Military members of the SIG on C&CM were central to NATO collaboration, playing a key role in a workshop held by the Multinational Medical Coordination Centre, sharing their experience across a range of fields, including humanitarian response.

IT SIG on C&CM members have helped improve IT platforms to support: FM/GP, mental health,

occupational health, dental, rehabilitation, and pharmacy. They have further enhanced health care information exploitation and business intelligence, and augmented deployable health care solutions. These evergreen solutions can be updated and upgraded quickly, and represent a genuine step-change in patient care by improving connectivity, digitising information, sharing it across multidisciplinary teams, and optimising interoperability between coalition partners.

LOGISTICS SIG on C&CM members helped coordinate multidisciplinary teams and emergency medicine equipment, such as ventilators, infusion pumps, physiological monitors and full Personal Protective Equipment, to form Critical Care Transfer Teams. These teams enabled Intensive Care COVID-positive patients to be transferred (intubated and mechanically ventilated) from general hospitals to bespoke COVID facilities.

LOOKING AHEAD. The SIG on C&CM remains ready to support ongoing national and international efforts to manage the COVID-19 pandemic. Expert conflict and catastrophe medicine experience has, and continues to, help improve patient care. As in any population-level health care crisis, the expectation is that FM/GP will be first to respond, heavily engaged and the last to recover. SIG on C&CM members will continue to monitor and support the impact on service output and performance by working closely with the health care services in their own countries. Winter preparedness packages have been considered in order to ensure organizational planning is conducted in sufficient time to manage any further COVID waves or pressure, thus allowing FM/GP colleagues to continue to support both their regular commitments and those required as a result of further COVID disruption.

Representative scenarios have been worked through by SIG on C&CM members to help ensure national mitigations are in place.

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EMERGENCY MEDICINE The COVID-19 pandemic has greatly changed the direction and planned activities of the special interest group in 2020-2021 year. Prior to the pandemic, there were plans to organize another emergency medicine seminar in 2021, similar to the one that was held in Kathmandu in 2019. We recognized that most of our members, especially those who practice emergency medicine were under tremendous stress and that further ability to engage in activities beyond clinical work was limited. Like many other working parties and special interest groups within WONCA, the emergency medicine group has had to pivot. We focused our attention on three main areas: 1) engaging and acknowledging the work of our membership; 2) producing timely and relevant educational content related to COVID and 3) preparing for sessions at conferences.

Over the past year, engaging with our membership was important while acknowledging the important and crucial work they are doing in supporting their patients and communities during the pandemic. There were no previously learning that could have prepared family doctors entirely to manage the pandemic. True to the family medicine spirit, our colleagues were innovative and became a resource to their community. In one example, Dr. Will Leung and his colleagues led the development of a public COVID-19 testing centre in Hong Kong. His approach led to an improvement in the ability to offer surveillance for COVID-19 and enhanced access to testing for the community. His contribution was recognized by a publication in the Hong Kong Medical Journal.

Other projects include a publication in the Journal of Family Medicine and Primary Care where the SIG (EM) members collaborated with other colleagues to study the effectiveness of a short resuscitation course for rural family physicians. Despite the challenges of COVID-19, the SIG(EM) continue to support our rural colleagues in acquiring critical care skills that benefitted their communities.

SIG on Emergency Medicine Publication

The science and clinical management of COVID-19 has evolved greatly since the start of the pandemic in late 2019/early 2020. New information and clinical techniques were being suggested daily without a proper mechanism globally to offer knowledge translation and dissemination. In collaboration with the College of Family Physicians of Canada’s Besrour Centre for Global Family Medicine, Drs. Elena Klusova and Nisanth Menon shared expertise from what they have learned in their clinical environment in Spain and India respectively.

They offered lessons that were transferrable and can be applied in different context. This webinar was well received as information became democratized through social medica and open access for a global audience including all WONCA members.

SIG on Emergency Medicine Digital Session

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We continue to plan for the delivery of content at conferences. Despite the cancellation of several conferences, the recent WONCA Europe conference held virtually from Amsterdam was considered a success. Dr. Elena Klusova led an enjoyable, yet educational session entitled, “The Universe of Drugs” escape room – Game based learning session on the approach to recreational drug intoxications in the outpatient setting and the ED. This allowed participants to learn how to manage common toxicological conditions in a fun and interactive way. Additionally, Dr. Klusova collaborated with EURIPA at the WONCA (Berlin) conference to deliver the workshop “GP – When it really matters, Emergency Skills in Rural Practice”. This workshop focused on approaches to urgent and emergency care in rural and remote areas where health resources may be scarce.

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DR VICTOR NG Chair, SIG on Emergency Medicine

The COVID-19 year has been incredibly difficult for us all. The pandemic has changed the way we work and how we engage with our colleagues from around the world. I want to acknowledge the hard work of my executive committee, Dr. Elena Klusova (Spain), Dr. Pramendra Prasad (Nepal), Dr. Nisanth Menon (India), Dr. Joy Mugambi (Kenya) and Dr. Kim Yu (USA). I cannot think of a more engaged group of individuals to work with. We will continue to support the work of family doctors in emergency medicine and know that we will get through the pandemic together.

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EMERGING PRACTICE MODELS FOR FAMILY MEDICINE WONCA Executive Committee approved a Special Interest Group on Emerging Practice Models of Family Medicine during the meeting in Bangkok November 19th 2019.

DR DONALD LI Chair, SIG on Emerging Practice Models for Family Medicine

The active members are: Donald Li, President WONCA, Hong Kong Rich Roberts Past President, WONCA, USA Dr Wendy Gu, Worldwide Medical of Huashan Hospital , Shanghai, China . Chair, Society of Premium and Special Needs Primary Care of Cross Straits Medical Exchange Association.

Prof Mehmet Ungan, Immediate Past Regional President of WONCA Europe Dr Raman Kumar, Regional President of WONCA South Asia Dr Ling Qiu, Direcdtor of Family Medicine, Jishui Health, SHanghai, China

BACKGROUND Everyone deserves and desires high quality personalised health care. There are new strategies and emerging practice models of Family Medicine some of which are called Premium or Concierge or Special needs medical services. Commercial organised practices have been targeted to the wealthy, but we feel that this may be a useful construct for everyone (e.g., EHR, mobile telephony, web-based information, digital health, AI, etc.). One may say it is usually the more entrepreneurial who are most interested in developing a premium service practice or engaging in medical contracts, such as concierge medicine; but these financial arrangements can be associated with good incentives for quality care.

Concierge medicine is a private form of practice where doctors charge patients an out-of-pocket retainer fee for full access to their services. Patient loads typically decrease when a physician switches from more traditional fee-per-service practice to concierge medicine.

One of the reasons concierge patients like the system is because it is not just ‘sick care’. A concierge doctor typically has more time to work on holistic and preventative care than a traditional physician. The driving event is no longer that of a patient seeing a doctor only when the patient feels sick. The fundamental model of reducing the size of the practice to a smaller patient population, creates a personalised engagement model focused on prevention that will keep the patients out of the hospital or the Emergency Department reinforcing the gatekeeping role of the family doctor, the primary healthcare provider.

There are controversies as provision of care for a small population linked to financial incentives may pose ethical and moral hazards. Some may view this practice as not equitable or as detracting from Universal Health Coverage.

WONCA should take the lead in getting consensus amongst family doctors and to set some standards of practice. Different care models should be studied and the most important features of Premium Family Medicine Services and Concierge Medicine collated. We should also study what participating patients would want most.

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There are Family Medicine / general practice financial arrangements around the world that is similar to US concierge medicine. Examples include those in People’s Republic of China, in Europe, in the Middle East and in South Asia. Our group wishes to take the lead in studying and comparing different models of contract medicine, managed care, insurance led services.

While there may seem to be only a small number of physicians practicing concierge medicine today, there are estimated to be about 5,000 in the USA according to the American Academy of Family Physicians—and that number has grown in recent years.

Moreover, a survey of more than 20,000 physicians by Merritt Hawkins on behalf of The Physicians Foundation found that more than 20% of all US physicians today say they’re either currently practicing concierge medicine or plan to do so in the future.

Elsewhere in the world, for example, many doctors in Latin America see patients in a government health centre or work for a major corporation during the day and then see ‘premium’ patients in the evening at a private office.

Healthcare Clubs with a similar model to Concierge medicine is also rapidly emerging in China.

INTEREST IN A SPECIAL INTEREST GROUP IN EMERGING PRACTICE MODELS OF FAMILY MEDICINE KEY LEADERS OF THE SIG Donald Li, President WONCA, Hong Kong Rich Roberts Past President, WONCA, USA Dr Wendy Gu, Worldwide Medical of Huashan Hospital , Shanghai, China . Chair, Society of Premium and Special Needs Primary Care of Cross Straits Medical Exchange Association.

Prof Mehmet Ungan, Regional President of WONCA Europe Dr Raman Kumar, Regional President of WONCA South Asia Dr Ling Qiu, Direcdtor of Family Medicine, Jishui Health, SHanghai, China Dr Michael Coffey, MDVIP USA TBC Latin America: Javier Dominguez, Mexico Ezequiel Lopez, Argentina: Asia Pacific: Dada Leopando, Philippines WONCA SPECIAL INTEREST GROUP IN EMERGING PRACTICE MODELS OF FAMILY MEDICINE A) Ensure strong, diverse member engagement with representation from all WONCA regions which Premium Family Medicine and Concierge Medicine is being practised.

B) Organise Premium medicine / Concierge Medicine sessions /workshops at WONCA conferences with discussion on practice models, standards of care, ethical issues, produce guidelines, discuss equity issues and share experience.

C) Collaborate with WONCA members to develop guidelines/approaches relating to Premium Family Medicine and Concierge Medicine based on community need, market situations that are adaptable based on local resources available.

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D) Design and produce courses in Premium Family Medicine and Concierge Medicine and assess, accredit existing courses (already in China for example) that train family doctors to upgrade their care for patients through premium and concierge services.

E) Liaise with other WONCA working parties and SIGs to collaborate on overlapping principles, such as quality and Safety and Educational training.

Link up with eHealth. Role of Digital Health, I.T., A.I will enable efficient premium services with assured quality.

WAY FORWARD

G) Assist WONCA in policy and advocacy activities as Emerging Practice Models of Family Medicine may relate to quality care and care associated with financial arrangements. Advocate for quality family medical services which can command fair reimbursement and are equitable and accessible.

1. Organise workshop in WONCA World Conference in Abdu Dhabi. Huashan Hospital and Jiahui Health in Shanghai has constructed a higher training Family Medicine course for Family Doctors named ‘Huashan / Jiahui Family Medicine Enhancement Fellowship training Program’ (HS JH FMEFP), which will commence January 2020.

This course will undergo assessment by WONCA Education Working Party for accreditation in March 2020. Dr Gu and Dr Qiu can start discussion with an introduction of the core elements and objectives of the course. They can also lead discussions on premium medical services in China followed by presentations by Rich or Michael Coffey of US on the emergence of Concierge Medicine in the USA. We can then have panel discussion with contribution form Professor Mehmet, Turkey and Dr Ramen, South Asia.

H) Study different primary care healthcare financing models / influence behaviour of insurance companies.

2. We should discuss emerging practice models around the world and start taking stock and create a glossary.

I) Determine which organisational structures, services, tools, and methods of payment are most valued by patients and physicians, and how those that are most valuable might be applied to all populations.

3. We should comment on the HS JH FMEFP when the organisers share it with us.

F) Investigate and collaborate on adoption of new technologies to aid in quality care delivery in Emerging Practice Models of Family Medicine. For example, Digital Health, point of care testing and care such as ultrasound to optimise patient care and augment diagnostic abilities of general practitioners.

4. We will take note of comments of the WONCA Education WG when they do the accreditation.

POTENTIAL AREAS OF COLLABORATION WITH ESTABLISHED WONCA WORKING PARTIES AND SPECIAL INTEREST GROUPS: Link up with WONCA Education Committee, Quality and Safety WP to set up accreditation system. This will be a good business model for WONCA. As more and more practice models, premium medical services and Concierge Medicine plans emerge globally, there will be huge demand for accreditation.

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FAMILY VIOLENCE The Special Interest Group on Family Violence (SIG FV) continues to work, also during this challenging pandemic, expanding our global connections to systematically support family doctors, and empowering them to address family violence in practice and policy. Our Executive group consists of the co-chairs, Hagit DascalWeichhendler and Nena Kopcavar Gucek, and communications lead Raquel Gomez Bravo. In addition to this group, we have a steering committee with representatives from various regions of the world and ages.

Our current and future activities are structured under five main strategies: Connect, Resource & Support, Educate, Communicate, Evaluate.

CONNECT The current COVID-19 pandemic continues to impact heavily family violence rates all over the world. Members of the SIG have been connecting and exchanging information, ideas and resources and many of them are involved in a shared project, IMOCAFV (described below) now involving representatives from several continents and 24 countries. Despite going ‘virtual’, we are trying to maintain connections and strengthen collaborations with different WONCA Working Parties, SIGs and networks, as well as WHO and the European Parliament.

RESOURCE AND SUPPORT: Members of FV SIG are involved in promoting incorporation of FV agenda, guidelines, training materials and other resources for health care teams and patients within their national colleges, in line with the Call-to-Action Statement of Recommendations on FV, which was approved by WONCA executive in March 2018.

Ongoing national and international publications, such as journal articles / book chapters represent continuous efforts of SIG members to raise awareness and provide educational resources. In order to provide resources for clinicians relevant to the Family Violence upsurge during the COVID19 pandemic, a summary with useful information and links was posted on the WONCA site, and is unfortunately due to circumstances still relevant.

Best practices for PHC on Family Violence, as well as other outcomes of the IMOCAFV project (described below), are planned to be displayed online for wide use. We have also been offering a framework for Family Violence consultancy work, which offers education, and training, policy and research through a three-tiered approach, both through face-to-face, online help and through secondary consultation.

EDUCATE Following our SIG's WONCA Webinar on ‘FAMILY VIOLENCE DURING COVID-19 CRISIS’ in May 2020, Dr Kopcavar represented the SIG in a WONCA Webinar hosted by the Special Interest Group on Ageing and Health, where she addressed with Dr Dimity Pond the topic of Elder Abuse. Several members participated in WONCA EUROPE BERLIN virtual conference in December 2020, with several presentations, among them was a keynote lecture

by Raquel Gomez Bravo. The IMOCAFV project has been presented in both EGPRN 2020 conferences as well.

COMMUNICATE We continue with online newsletters to our SIG LIST (146 subscribed members), as well as a Google group (74 members). During the pandemic we continue to meet regularly mainly via zoom.

Our executive participated in the WONCA meeting dedicated to communication strategies.

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EVALUATE Many SIG members are involved in different research projects and publications in their respective countries. Internationally, the SIG continues to lead the IMOCAFV PROJECT (‘Implementation of Primary Care for Family Violence’), in collaboration with EGPRN, EUROPREV, YDM’s, VdGM Family Violence SIG, SEMFYC, European Family Justice Centre Alliance and the World Society of Victimology. The project continues to progress now including representatives of 24 different countries, including an African sub-Saharan collaboration and an Arab country coordination being built. The project received recognition through discretionary funding by WONCA World, as well as funding from EGPRN and EUROPREV. The project reviews models of care for Family Violence in the participating countries, and it’s aims are: to define specific primary health care tasks and good practices; to promote PHC care for Family Violence; to develop consensus between professional groups while taking into account facilities, cultural and country differences in a person, and a family cantered approach. Due to the COVID-19 Pandemic, an extension for use of the discretionary funding was granted. A report of the project will be presented separately, but some highlights of the achievements in short include: Training regarding various aspects of project methodology; Key person questionnaires returned by 254 respondents from 9 countries; Central data management and analysis system established; Data collection in several countries; Formation of a research framework for other countries to join later on; Ongoing—scoping review about guidance for FV in PHC and its implementation (16 countries, 5 in Africa); Presentations were given about preliminary literature reviews in Portuguese;

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A specific nominal group training meeting was held discussing GP tasks in the African context due to its specific cultural and social background.

Additionally, a proposal for a Daphne EU call was submitted, called ‘Sharing health care experience to implement active collaborative relations between primary care and psychosocial advocacy for gender-based violence (SHERPA)’ aiming to orient the IMOCAFV research framework into an implementation strategy involving primary health care and specialised facilities.

Additionally, a proposal for a Daphne EU call was submitted, called ‘Sharing health care experience to implement active collaborative relations between primary care and psychosocial advocacy for gender-based violence (SHERPA)’ aiming to orient the IMOCAFV research framework into an implementation strategy involving primary health care and specialised facilities.

SIG on Family Violence Members

DR HAGIT DASCALWEICHHENDLE Co - Chair, SIG on Family Violence DR NENA KOPCAVAR GUCEK Co - Chair, SIG on Family Violence Raquel Gomez Bravo – Executive member Leo Pas – Past Convenor and Lead of IMOCAFV

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GENETICS DR IMRAN RAFI Chair, SIG on Genetics

The members of this group have been busy on various strands on work. All the core members were involved in a Future Learn Platform module on Genomics Scenarios in Primary Care. This was viewed by over 1000 people with positive feedback.

The module was kindly advertised by the WONCA newsletter to members. https://www.futurelearn.com/courses/genomicscenarios-in-primary-care Input was provided to an abstract submission on polygenic risk scores to a WONCA conference by Dr Aya Ayoub. This was unsuccessful on this occasion.

A GP group with an interest in Genomics has been set up by the Genomics Educational Programme.

These are GPs who have completed their MSc in Genomics. Dr Judith Hayward has been leading this group. Dr Hayward has been working with her regional genetic centre looking to lead education around familial hypercholesteremia.

Dr Will Evans has been successful in obtaining a National Institute Health Research grant to allow him to continue with his work and research around rare diseases. He has recently completed his in-practice fellowship.

Professor Nadeem Qureshi continues his work around ethics and diversity having worked with Genomics England ltd. More recently he is working on familial hypocholesteraemia looking to implement working with primary care academics and the Genomic Medicine Alliances.

Dr Rafi and Hayward are working on a two-year project on pharmacogenomics in primary care and managing polypharmacy. They have approved Research Ethics.

© Getty Images

Dr Rafi and Hayward are co-editors for the Oxford Handbook of Genetics and Genomics. We hope WONCA members buy the book!

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LGBTQ MEMBERSHIP

STRUCTURE

We are uncertain of the exact numbers in the SIG presently, as we put on hold adding new expressions of interest to join our Google group as we were hoping to use the new website functionality. We gather the project has been delayed a little but still hope for this to be a pilot SIG to do this transition.

We are in a phase of transition as this season we will be appointing new co-chairs, and also a few executive committee roles such as an education and academic research lead, a librarian to assist in forming a repository of resources, and a Trans Health lead. We feel it is important to make efforts to particularly encourage participation by women as there is a slight gender imbalance presently.

We were asking personal data, such as gender, sexual orientation and cis/trans status, which is obviously of relevance to our area of work, but the data handling would not comply with international legislation so we have stopped this.

We are concerned that the WONCA leadership is determined not to ask this data from members, which will then make it difficult for us as an organisation to determine if its membership, leadership, and activities are welcoming of all members, and take steps to remedy any indirect discrimination. Asking such legally protected characteristics is standard in many countries, and would be justifiable for a specific reason, and monitoring how WONCA persons in terms of Equality and Diversity for its membership would be an appropriate use. We believe this warrants further discussion. The CEO has assured us that ad hoc surveys for this purpose could be carried out in the future, however.

As is the nature of SIGs that gain membership through word of mouth, we have some countries that are well represented but some regions where there is underrepresentation in the SIG. We plan to remedy this by forming an executive subcommittee with representation from all the seven regions to particularly bolster our East Mediterranean and African membership. As a great deal of work is needed in Trans Health, we also actively seek membership from members who are themselves trans or have an interest in this area of healthcare.

WONCA CONFERENCES We are pleased to be able to take part in a virtual Abu Dhabi World Conference, which we could not do when it was planned to be a physical in-person event because of civil liberty concerns from our membership due to the anti-LGBTQ laws that exist in the UAE. We are developing an organisational LGBTQ equity paper, which we hope to take to the organisation committee, to avoid such situations happening again, as all members should be able to attend WONCA Conferences, regardless of their sexual orientation, for example.

We are already making plans for London WONCA Europe, and in particular feel it important to offer a safe space for LGBTQ delegates to meet, network and share ideas, both as a SIG but also in terms of social events.

TRANS WORK We have started exploring collaborations and possibly an MoU with WPATH who are designing their guide to primary care for trans people. We believe they needed to consult with family physicians more, and once such policy is done collaboratively, it might be possible for WONCA to support it actively amongst its members.

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HUMAN RIGHTS As a SIG we believe the impact specifically on medicine is small when as doctors we should also be agents of social change, as most of the health inequalities experienced by LGBTQ patients come from society treating people unfairly. We are exploring collaborating with Human Rights Watch or the ILGA to see how we can use our unique positions with WONCA to improve the lived experiences of our patients.

PLANS FOR THE COMING YEAR We see two collaborations being important: WONCA World Special Interest Group for Mental Health and the Vasco da Gama Movement Special Interest Group, Workforce Migration, and aim to reach out to these groups shortly.

DR JULIEN ARTIGNY Co - Chair, SIG on LGBTQ

DR RAFIK TAIBJEE Co - Chair, SIG on LGBTQ

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MIGRANT CARE, INT HEALTH & TRAVEL MEDICINE GENERAL INFORMATION This SIG aims to improve the knowledge and skills of general practitioners as well as the organisational and financial conditions to deliver culturally competent, equitable and good quality of primary care to migrants of all kinds: travellers, economic migrants as well as refugees including the undocumented.

ORGANIZATION AND MEMBERS The chair of our SIG, Guus Busser, retired in April 2020 from his university work. Rebecca Farrington agreed to be his successor as chair of the SIG. During the past year they divided tasks.

Dr Rebecca Farrington is GP and Senior Clinical Lecturer at the University of Manchester UK. She also works as a GP Specialist in the Asylum Seeker Service. Starting July 2021, Rebecca will be the chair, Maria van den Muijsenbergh will stay cochair.

By the end of 2020 the group has grown to 176 members from 35 nations.

Members come from all over the world with a good representation from the UK, the Netherlands, Portugal, USA, Turkey, Australia and Brazil.

Members are involved in international research, medical (postgraduate) education and health care delivery related to refugees and other migrants.

Surprising is the high participation of young family doctors, trainees and students.

This was actually our last meeting in real life. After March 2020, COVID had a big impact on our work and our SIG activities. Meeting each other was not possible and our work asked for extra efforts.

We met a core group of our SIG members online in December 2020. In this meeting we exchanged our COVID experiences and the effects COVID had on our migrant population and our work.

For WONCA Europe 2020 Berlin we had planned a workshop on sexual health and migrants. To our disappointment this could only be a published abstract.

We had hoped to initiate more and new activity’s, also outside the WONCA meetings. But COVID delayed all this.

Our Facebook page, still proves to be a well-read medium for sending information.

We have a WhatsApp group as ‘WONCA SIG Migrant care’. Within this group we exchange information and bring members of the SIG into contact with each other.

Both media were useful in sending info about online meetings and webinars related to our interests.

ACTIVITIES PLANNED AND IN PROGRESS IN 2021 At WONCA Europe 2021, we were involved in several activities related to migrant care. There was an online meeting of our SIG focusing on exchange of experiences during the past year.

DR GUSS BUSSER Co - Chair, SIG on MCIH&TM

ACHIEVEMENTS IN 2019/2020 We have organised a well-visited workshop at WONCA Europe Bratislava 2019 on communication and migrants: ‘Understanding the migrant patient’.

DR REBECCA FARRINGTON Co - Chair, SIG on MCIH&TM

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NON-COMMUNICABLE DISEASES 1. GROUPS & MEMBERS EXECUTIVE BOARD The executive board was elected in July 2013.

Chair : Domingo Orozco-Beltrán, Spain, Wonca Europe Secretary: Manuel Sanchez-Mollá, Spain, Wonca Europe 2. OBJECTIVES (JULY 2020–JUNE 2021) 1. To stimulate and promote standards of excellence in the primary care management of non-communicable diseases (NCDs), consistent with patient and professional values and in adherence to evidence-based health care.

2. To put people at the centre of health care by adopting, as appropriate, delivery models focused on the local and district levels that provide comprehensive primary health care services.

3. To address the fragmented nature of health care delivery.

4. To hold scientific meetings, including sessions and workshops during WONCA regional and world conferences; to present original papers and address broader educational issues through discussion, training and debate.

5. To promote active participation of everyone and re-emphasise the need to empower communities, especially women, for developing and implementing policies to improve health and health care.

6. To develop and promote appropriate literature for primary care professionals using a variety of resources, including WONCA Online.

7. To develop a training course on NCDs.

PROF DOMINGO OROZCO-BELTRÁN Chair, SIG Non-communicable Diseases

We have accomplished objectives 1, 2,3,4,5, 6.

Objective 7 has been proposed to the WONCA Council; we are now waiting for answers on how to organise it.

3.

CONFERENCES OR SCIENTIFIC MEETINGS (JULY 2020–JUNE 2021) Due to the pandemic, no activity or scientific meeting happened last year.

4. TRAINING ACTIVITIES Training Family Doctors Residents on chronic conditions (Spain).

Project with Dr Wolfgang Grisold, President of World Federation of Neurology, to design a course on ‘Prevention of Stroke in primary care’. This project is awaiting funding.

Project to conduct a training online course about NCDs through the WONCA web. This has been proposed to WONCA Board; we are awaiting answers to know how to organise it.

5. PUBLICATIONS Orozco-Beltrán D, Cinza-Sanjurjo S, EscribanoSerrano J, López-Simarro F, Fernández G, GómezGarcía A, Cedenilla-Horcajuelo M, Ferreira de Campos K. Experience of Patients with Diabetes and Other Cardiovascular Risk Factors with Health Professionals and Healthcare in Spain. J Clin Med. 2021 Jun 26;10(13):2831. doi: 10.3390/jcm10132831. PMID: 34206918; PMCID: PMC8267612.

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D I S E A S E S

Angullo-Martínez E, Carretero-Anibarro E, Sánchez Barrancos IM, Cos Claramunt X, Orozco Beltrán D, Torres Baile JL, Ezkurra Loiola P; en representación del Grupo de Trabajo de Diabetes de la SemFyC; en representación del Grupo de Trabajo de Diabetes de la SemFyC. Checklist para pacientes con diabetes mellitus tipo 2 en consulta telemática [Checklist for patients with type 2 diabetes mellitus for remote consultation]. Aten Primaria. 2021 Apr;53(4):101983. Spanish. doi: 10.1016/j.aprim.2021.101983. Epub 2021 Mar 18.

PMID: 33743202; PMCID: PMC7969144.

Orozco-Beltrán D, Arriero-Marin JM, CarrataláMunuera C, Soler-Cataluña JJ, Lopez-Pineda A, Gil-Guillén VF, Quesada JA. Trends in Hospital Admissions for Chronic Obstructive Pulmonary Disease in Men and Women in Spain, 1998 to 2018.

J Clin Med. 2021 Apr 6;10(7):1529. doi: 10.3390/jcm10071529. PMID: 33917437; PMCID: PMC8038653 Orozco-Beltrán D, Artola-Menéndez S, HormigoPozo A, Cararach-Salami D, Alonso-Jerez JL, Álvaro-Grande E, Villabrille-Arias C, de ToroSantos FJ, Galindo-Puerto MJ, Marín-Jiménez I, Gómez-García A, Ledesma-Rodriguez R, Fernández G, Ferreira de Campos K. Healthcare experience among patients with type 2 diabetes: A cross-sectional survey using the IEXPAC tool.

Endocrinol Diabetes Metab.

2021 Feb 15;4(2):e00220. doi: 10.1002/edm2.220. PMID: 33855220; PMCID: PMC8029499.

Gómez-García A, Ferreira de Campos K, OrozcoBeltrán D, Artola-Menéndez S, Grahit-Vidosa V, Fierro-Alario MJ, Alonso-Jerez JL, Villabrille-Arias MC, Zuazagoitia-Nubla JF, Ledesma-Rodríguez R, Fernández G. Impact of Advanced Diabetes Centers on the healthcare experience of patients with type 2 diabetes using the IEXPAC tool.

Endocrinol Diabetes Nutr. 2021 Jun-Jul;68(6):416427.

English, Spanish. doi: 10.1016/j.endinu.2020.04.003. Epub 2020 Jul 15.

PMID: 32682726.

de Toro J, Cea-Calvo L, García-Vivar ML, Pantoja L, Lerín-Lozano C, García-Díaz S, Galindo MJ, MarínJiménez I, Fernández S, Mestre Y, Orozco-Beltrán D. The Experience With Health Care of Patients With Inflammatory Arthritis: A Cross-sectional Survey Using the Instrument to Evaluate the Experience of Patients With Chronic Diseases. J Clin Rheumatol. 2021 Jan 1;27(1):25-30. doi: 10.1097/RHU.0000000000001155.

PMID: 31356399; PMCID: PMC7748048.

6. SOCIAL MEDIA AND WONCA WEBPAGE PARTICIPATION 1. WONCA webpage: Post on WHO conference on NCDs (English and Spanish); Post on new publications on NCDs; Information on NCDs SIG members about KAP Newsletter (www.who.int/kap).

OBJECTIVES 2021–2022 1. To develop an online training course on NCDs; 2. To develop an online training course on prevention of stroke; 3. To participate in international forums or statements about NCDs; 4. To develop a webinar about chronic conditions and COVID-19.

CONFERENCES 2021–2022 23rd WORLD Conference on Family Doctors.

Abu Dhabi. Virtual Conference. November 22– 27, 2021.

27th WONCA Europe Conference, London, June 28–July 1, 2022.

Participation in these conferences and other events will depend upon the course of the COVID-19 pandemic. and other events will depend on the evolution of the COVID pandemic.

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WONCA SPECIAL INTEREST GROUP ON

QUATERNARY PREVENTION & OVERMEDICALIZATION LEADERSHIP AND TEAM BUILDING LEVEL

Quaternary Prevention Youtube Playlist.

Being the WONCA SIG QO&O, a new interest group installed in 2016 and not having an official statement approved a proposal was submitted to establish the process for the succession. A Governance Committee will be installed to work independently and be responsible for the process of election of a new convenor.

Collaborative Database on Quaternary Prevention Resources and References. Editorial board; Pizzanelli M, Lavalle R, Jamoulle M. The project permit to collect, share and retrieve bibliographic references, papers and material with quaternary prevention orientation for educational or research purposes. Proposal available form: https://tinyurl.com/Tutorial-P4-Library

The pandemic has reduced all the activities and collaborations. Iberoamericana Region performed many online activities.

Quaternary prevention groups from Iberoamericana Region developed a tool to collect all the materials we are producing around the Quaternary Prevention and Overmedicalisation concepts. All the materials and communication we share in this report came from the database performed. Nevertheless, we assume it is possible to enhance the register.

A survey was conducted in order to obtain information to categorise groups in Latin America.

Responses were received from nine countries, regarding activities and impact. Countries that have responded: Argentina, Brazil, Chile, Colombia, Ecuador, Spain, Peru, Puerto Rico, Uruguay. More information available here.

We evaluate this survey as an important input in understanding and redesigning future challenges and development.

ONGOING PROJECTS & COMMUNICATIONAL LEVEL Quaternary Prevention Podcasts. Uruguayan Quaternary Prevention group developed a Podcast channel.

Available from: https://anchor.fm/miguel-pizzanelli

Quaternary Prevention web blog .

COLLABORATION WITH WONCA GROUPS QP&O leaders will attend the 16th Brazilian Family and Community Medicine Conference and the 1st WONCA Planetary Health Conference participating in a panel in with the WONCA Working Party on the Environment.

Activities and scientific production during the period June 2020 to July 2021.

TRAINING AND EDUCATION ACTIVITIES Interdisciplinary virtual course. Philosophy of Science. Health paradigms. Pizzanelli M, La Valle R, Bertolotto F, Consiglio E. Participant Universities, Universidad de la República (Uruguay), Universidad Nacional de Hurlingham, Buenos Aires, Argentina. Period: September to November 2020. Total 18 hours.

Course oriented to medicine students (pregraduate): Quaternary Prevention – primum non nocere. Grupo de trabajo en Prevención Cuaternaria Rosario, Argentina. Total 102 hours.

August 2020. Universidad Nacional de Rosario, Argentina, Facultad de Ciencias Médicas.

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Critical analysis of scientific literature. Course performed for Uruguayan Quaternary Prevention group members. Period: May to November 2021.

GtP4Uy. 30 hours.

LEADERSHIP AND TEAM BUILDING LEVEL Granero M, Alberto V. Medicalization of life and population damage: non-systematized bibliographic review. Revista del Hospital Italiano de Buenos Aires: [Internet].

Www1.hospitalitaliano.org.ar. 2021 [cited 15 January 2021]. Available here.

Tesser CD, Norman, AH. Quaternary prevention and integrative and complementary medicine (I): fundamental approach. Rev Bras Med Fam Comunidade.

2020;15(42):2551. https://doi.org/10.5712/rbmfc15(42)255

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Pizzanelli M. Prevención Cuaternaria. Quaternary Prevention, concept evolution. Prevention Quaternaire. Evolution du concept. Marc Jamoulle [Internet]. NotasL@cas/M@dNotes.

2020 [cited oct 2020]. Available form: https://notaslocasmadnotes.wordpress.com/202 0/10/10/prevencion-cuaternaria-evolucion-delconcepto-por-marc-jamoulle/ Pizzanelli M. Quaternary Prevention concept and levels to apply. Web Blog Notas Locas [Internet].

2020 Oct 22 [cited 0ct 2020]. Available form https://redi.anii.org.uy/jspui/handle/20.500.12381 /258 QUATERNARY PREVENTION CONTENTS IN CONFERENCES AND WEBINARS

Norman AH, Tesser CD. Family medicine and quaternary prevention: a long history. Rev Bras Med Fam e Comunidad [Internet]. 26 de enero de 2021 [cited feb de 2021]; 16 (43): 2502. Available from: https://rbmfc.org.br/rbmfc/article/view/2502

Pizzanelli, M. Prevención Cuaternaria. Rational use of medicines in COVID 19. Conference "Congreso Virtual Multidisciplinario de Tratamiento Ambulatorio y Domiciliario de Covid19 Ecuador". 17 de octubre 2020. Available form: https://www.slideshare.net/MiguelPizzanelli/ecua dor-pizzanelli

Norman AH. Quaternary prevention in mental health: drug centred model as a demedicalization tool. Rev Bras Med Fam e Comunidade [Internet].

26 de enero de 2021 [cited feb 2021]; 16 (43): 2430.

Available from: https://rbmfc.org.br/rbmfc/article/view/2430

Apprenticeships in the Syndemia. Cycle of Webinars, 5 in total, organized by the Uruguayan Quaternary Prevention Working Group. Held between February and July 2021. Participation of members of P4 CIMF. Available at: https://gtp4uy.wordpress.com/

Tesser CD. Convergences between quaternary prevention and health promotion. Rev Bras Med Fam e Comunidade [Internet]. 26 de noviembre de 2020 [cited may 2021]; 15 (42): 2515. Available forma: https://rbmfc.org.br/rbmfc/article/view/2515 Wagner Lima, H. Quaternary Prevention and Good Science. Am J Biomed Sci & Res. 2021 - 12(6).

AJBSR.MS.ID.001809.

DOI: 10.34297/AJBSR.2021.12.001809. Available from: https://biomedgrid.com/pdf/AJBSR.MS.ID.001809 .pdf

DR MIGUEL PIZZANELLI Chair, SIG QO&O

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WONCA SPECIAL INTEREST GROUP ON

WORKERS HEALTH FAMILY DOCTORS ARE ABOUT PRIMARY CARE

PASSIONATE

Many things have taken place since our last report. Every nation worldwide had to learn to prepare for and deal with a pandemic in a way never seen before.

In this sense, family doctors have played a preponderant role, having to assume different roles in part due to our great capacity to adapt to new circumstances.

In relation to our task of taking care of the health of workers, our job has been arduous, having to learn quickly how to take care of ourselves and how to take care of others.

Beyond our efforts, all of our health teams have faced contagious situations and many of us have lost co-workers, family and friends.

For all this, it is vitally important to recognise ourselves as workers exposed to certain risks and diseases. Furthermore, as caregivers we have experienced numerous problems including exhaustion and burnout after having endured long and continuous working hours.

In this framework and in this special time of virtual meetings, we have had the possibility of having participated in the webinar organised by WONCA CIMF in April 2020, always trying to reinforce the concept of the power of primary care to be able to provide solutions to the health system. During this time, we have made efforts to disseminate and reinforce the importance of personal protection measures to take care of the health of all workers, especially health workers.

Different materials have been posted on our sites.

At the same time and as always we have maintained our communication even more through social networks.

We have established and maintained an SIG email Group for enhancing communication between members which can be accessed through our web page.

We reinforce the promotion of SIG activities through social networks. Join us.

Twitter LinkedIn We need to be prepared to go along with our patients and communities in the profound changes that will surely take place in the future in terms of health and work.

Therefore, we continue to recruit and welcome new members from all WONCA regions who wish to work together to strengthen the discipline of Family Medicine with a special interest in Workers’ Health.

Personally, here ends a beautiful personal journey leading this incredible group of professionals and people. As I write these lines we are heading towards a transition, so I wish my successor the best of luck as Chair of this Group.

SIG on Workers Health Session

PROF EZEQUIEL LOPEZ Chair, SIG on Workers Health

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WONCA

YOUNG DOCTORS' MOVEMENTS

© Getty Images

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REPRESENTATIVE We have continued to struggle, facing the global pandemic and its effects. United, we have looked into ways to return back to the status quo—virtual initiatives have united us, we have broken new barriers in digital technologies, working towards connecting everyone in the four corners of the world.

The Young Doctors’ Movements (YDMs) has promoted global webinars where young doctors had the opportunity to share their expertise on different topics. The topics of the webinars were selected after a global selection process and each webinar was promoted by a regional YDM or a collaboration between two YDMs. The results were fantastic and the feedback was impressive!

Plus, we had a great opportunity to record these events for future reference and they are all available on WONCA’s YouTube page.

As for other innovative ideas, the YDMs are planning to hold, for the first time, a virtual global preconference prior to WONCA Abu Dhabi Conference. Organising a virtual event like this will make many activities possible and we will be counting on the expertise of previous virtual regional preconference organisers. Who knows, maybe we can even make a virtual global exchange happen? Keep tuned!

Not only that, but this preconference will also mark the launch of the ‘WONCA World Rising Star Award’. This year, a young doctor will receive this award as it will mark his/her drive for excellence in health care. We hope that this award will inspire other young doctors to start their journey in Family Medicine and to be motivated to collaborate with WONCA. We carried on connecting with our members through the YDM newsletter, bringing the latest regional updates to everyone. Plus, more and more young doctors have requested to join the YDMs through the link found on WONCA’s webpage.

DR ANA NUNES BARATA YDM Representative

Innovating, we have looked into reaching out in different, popular platforms. This years’ WFDD topic was ‘Building the Future with Family Doctors’ and what better way to celebrate it than to use one of the most social media popular platforms at the moment?

Structurally, we have worked closely with the bylaws committee in order to review the election process of the Young Doctor Representative. As young doctors, we feel it is important to make our voice heard in major decisions, especially when it comes to electing our representative on WONCA World. As such, a motion will be put forward to Member Organisations in the next council meeting.

As for the work with the WHO, there has been ongoing collaboration with WHO’s Youth Hub Steering Committee.

All in all, the young doctors, despite all challenges, have always been there this year, marking their presence in different occasions.

As for myself, I can’t help feeling a little nostalgic… This year marks the end of my term as the Young Doctor representative and, at the same time, it’s also my last year as a young doctor. I have no words to express my gratitude for everyone who I have met in this journey… Each moment has truly been unforgettable… as a firstyear resident, I joined Europe’s Young Doctors’ Movement and now I am walking out as the Young Doctor Representative in WONCA World. I truly will cherish this journey for all my life.

Thank you, and see you soon!

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AFRIWON RENAISSANCE AFRIWON EXCO 1. Dr Nana Kwame Ayisi-Boateng (Ghana) – Chair 2. Dr Mariita Douglas Oimeke (Kenya) – Vice Chair 3. Dr Ore Makinde (Nigeria) - Secretary 4. Dr Nana Kofi Edu Affare (Ghana) – Deputy Secretary 5. Dr Pius Ameh (Nigeria) – Research Theme Lead 6. Dr Lilian Kaliisa (Uganda) – Country Representative 7. Dr Bola Fatusin (Nigeria) – Education and Training Theme Lead 8. Dr Ettang Enwongo (South Africa) - Image Theme Lead 9. Dr Jessie Mbama (Malawi) - Exchange Theme Lead 10. Dr Joy Mugambi (Kenya) - Ex-officio 11. Dr Oteju Aramide (Nigeria) – Ex-Officio 12. Dr Nancy Matillya (Tanzania) -Treasurer 13. Dr Helena Alabono, (Ghana) - Country Representative 14. Dr Murtaza Haiderbhai (Tanzania) - Country Representative 15. Dr Ibrahim Banaru (Nigeria) - Country Representative 16. Dr Chelsea McGuire (Lesotho) – Beyond Africa Lead 17. Dr Benjamin Oluwatosin (Nigeria) – Rural Theme Lead At the beginning of our tenure as executives, we outlined three priority areas to focus on: increase membership, education/training and research.

Our activities have therefore focused on these areas.

MEMBERSHIP We created two AfriWon WhatsApp Chat platforms whose membership is now 326. These platforms are very active and serve as the main media for disseminating information about AfriWon and interacting with all members across Africa.

EDUCATION AND TRAINING The Education and Training Theme Group of AfriWon has been very active. Every month, the group develops and shares multiple choice questions (MCQs) for residents to participate and support their learning. Results of the MCQs are announced based on country participation. It has been quite competitive and Ghana and Nigeria are usually the strongest contenders.

RESEARCH AfriWon’s Research Theme Group has initiated the AfriWon Research Collaborative (ARC) Programme with the objective of building research capacity among young doctors in Africa. The group has also designed a mentorship programme, which makes it possible for young family doctors to have research mentors to guide them in research proposal writing, study design and scientific writing.

Exploring gaps, strategies and solutions for primary care research mentorship in the African Context: a workshop report ; Implementation of Online Research Training and Mentorship for Sub-Saharan African family physicians; Motivational interviewing: Exploring its relevance for improving Family Medicine trainees’ motivation in Sub-Saharan Africa.

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2021 ELECTION OF AFRIWON EXCO The tenure of 2018 AfriWon EXCO will end this year. An election committee has been put in place that has outlined timelines for the elections.

Guidelines and criteria have been advertised on all social media platforms to make the process transparent and competitive.

YDM WEBINARS AfriWon has so far participated fully and had speakers present at all the webinars organised by the global YDM. We have had webinars on Lifestyle Medicine, Family Medicine Identity and Family Medicine during COVID. These webinars have been very useful and well attended by YDMs across the globe.

ABU DHABI 2021 CONFERENCE The 2021 WONCA conference is scheduled to be fully virtual. Six AfriWon members have been awarded bursaries to participate in the World Conference. AfriWon will participate in a workshop for the global YDM. Individual AfriWon members have submitted abstracts for poster and oral presentations and will be part of other workshops at the conference.

DR NANA KWAME AYISI-BOATENG Chair, AfriWon

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AL RAZI NEW MEMBERSHIP OF AL RAZI COUNCIL Dr Marwa Mohasseb had completed her term of service for the past two years as the chair of Al Razi YDM (from November 2018 to November 2020) and Dr Anas Almohtaseb, the elect chair, has started his task as the new chair of the group for the next term. Meanwhile, Dr Nagwa Nashat, the founder and the first chair of Al Razi group, has been nominated and selected by WONCA EMR as the WONCA EMR five-star doctor for 2019 and 2020.

Beside previous members, Dr Reina Alameddine from Lebanon and Dr Adel Yasky from Saudi Arabia, new members have joined Al Razi YDM Council over the last year as representatives for their member organisation countries instead of the previous ones, namely, Dr Beesan Maraqa from Palestine, Dr Ahmad Fakhreddine from Kuwait, Dr Mohammed Al Ghafri from Oman, and recently Dr Dana Al-Daghlise from Jordan, Dr Gehad Farid from Egypt and Dr Nouf Al Noun from UAE. The council held regular monthly meetings since December 2020.

PARTICIPATION WEBINARS

IN

YDM

LEADS

Anas in the first webinar—'Silver Linings: Lessons Learned from the Pandemic’, Jordan experience (November 29, 2020).

Reina in the 2nd webinar—‘Alternative Career for Young Doctors’, Health policy career (January 24, 2021).

Hella Al Othman (Saudi team) in the 3rd webinar—'Lifestyle Medicine’, reducing stress (28 Mar 2021).

Organising YDM leads Webinar ‘Family Medicine Identity (May 30, 2021) in collaboration with Waynakay YDM: Adel was the organiser and moderator of the webinar and its preparatory meetings from Al Razi’s side. Salam Khashan (Palestine team) represented Al Razi in her talk about ‘Family Medicine in Conflict areas’.

MAIN ACTIVITIES Celebrating World Family Doctors Day 2021 Al Razi YDM Webinar ‘Meet The Expert’, led

by Reina. The first session was on April 10, 2021 in which Beesan shared local studies in Palestine that shaped the government response to the COVID-19 pandemic.

WONCA World Rising Star Award: Setting the evaluation framework for applications in EMR region, Reina.

Formulation of Abu Dhabi Pre-Conference Working Group. Reina named as the PreConference Manager and Nouf nominated to facilitate communication with the HOC. Future activities: Fellowship database, Dana.

Al Razi Journal Club, Anas.

Email and Social Media: Moderated by Adel.

Email: alrazi@WONCA.net, alraziydm@gmail.com Facebook Twitter Instagram YouTube

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LOCAL TEAMS ACTIVITIES Oman Participants in Oman Family Medicine Society meeting; two young doctors elected in the board.

Team: Hamed AL Qanobi, Anas AL Kimyani , Issa AL Busaidi , Ahmed AL Kharousi, and Yaqoob AL Luwahi.

Bi-weekly educational quiz.

Jordan Team: Mahmmoud Al-Soqor, Ehab Jarar, Haneen Taher, Enas Ammar and Maram Smairat (new).

Five meetings since December 2020.

Awareness video about COVID-19 home isolation, December 2020.

Video about COVID-19 vaccines in Jordan, January 2021.

Awareness video targeting general public about vaccination, April 2021.

Celebrating WFDD 2021 by creating a poster, participating in JSFM activity and distributing roses for attendees.

A poster celebrating World No Tobacco Day (WNTD), in collaboration of MOH / FM department.

YDM Webinars

Lebanon Team: Mohamad Ali Jardaly, Mohamad Ramadan, Theodora Bou Saba, Rana Jarrah, and Rim Taleb.

Members were engaged in advocacy groups to push for a ‘zeroCOVID’ strategy in the country.

Saudi Arabia Recruitment of new members. Hila Al Othman, Samiah Al Mehmadi, Abdulaziz Al Alwan, Abdulaziz Al Otaibi.

Al Razi - World Family Doctor Day 2021

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Palestine Team: Salam Khashan, Tasneem Yahia, Layali Qaddoim, Kholoud Ayesh, and Tariq Deres.

First online workshop: ‘Discussing COVID-19 truth and worries’, April 2021.

Second online workshop: ‘CBT in Primary Care: A Brief Introduction’, June 2021.

Several meetings planning CBT training for Palestinian family doctors.

Building Al-Razi members’ in Gaza Research Capability: virtual course over several weeks in June and July 2021.

UAE Team: Aala Khalaf, Aisha Al Falasi, Asma Al Ameri, Ebtihal Makki, Jawaher Al Mulla, Lamya AL Marzooqi, Najma Al Rahmani.

Planning for internal activity, a CME accredited webinar in the name of Al Razi group.

Al Razi - Meet the Expert

Egypt Team: Asmaa Abo Bakr, Basma Shokry, Narmean Bebars, Rofida El Saqa, Manal Hamdy, Eman Elsaket, Marwa Tarek.

Celebrating WFDD: video about telemedicine and poster of family physician’s pictures during COVID pandemic.

DR ANAS ALMOHTASEB Chair, Al Razi

YOUNG DOCTORS' MOVEMENTS

POLARIS 2018-2019 EXECUTIVE USA Medical Student: Brett Lewis USA Resident: Steffano Motl USA First Five Years: Ngozi Margarete Ezinwa CAN Medical Student: Rohini pasricha CAN Resident: Paula Ann Slaney CAN First Five Years: Vacant Caribbean Resident: Amber Wheatley Caribbean First Five Years: Vacant ASPIRE liaison Uma Senthil

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STATE OF THE MOVEMENT Polaris was created to promote Family Medicine globally, enhance international collaborations, facilitate exchanges, form leaders, identify and adopt best practices, and to represent North America’s medical students, Family Medicine residents, and junior physicians to the rest of the world.

‘Connecting North American young doctors and trainees to the global Family Medicine community.’

Today we are at a pivotal point as we regroup to build a vibrant community and a sustainable structure.

MEMBERSHIP All medical students, Family Medicine residents and those in their first five years of practice.

CONNECTING WITH MEMBERS This year, Polaris will be formally represented at: FMX - AAFP National Conference for Students and Residentspresentation on Careers in Global Health.

YDM Webinary: Integrated Care After COVID— Equity AAFP Global Health Summit, Panel on Equity in the eyes of young physicians globally WONCA World—YDM Preconference

WEBSITE In the Spring of 2019 on World Family Doctor Day, Polaris launched our independent website: https://www.WONCApolaris.org The website features links to all of Polaris’ activities: current and past newsletters, information about upcoming conferences, links to WONCA activities and contact information including our social media accounts.

NEWSLETTER Launched again this year as a quarterly Polaris Newsletter, after a brief hiatus.

Each newsletter has a theme that aligns with the WONCA working parties and special interest groups in a North American context.

Each newsletter includes a featured young Family Medicine doctor who is providing excellent primary care in their respective region.

HEALTH EQUITY Polaris members have been active in the Inaugural CGHI Health Equity Group within AAFP Polaris is leading a webinar on Integrated Care After COVID—Health Equity DECLARATION ON HEALTH EQUITY Polaris members have been active in the Inaugural CGHI Health Equity Group within AAFP Polaris is leading a webinar on Integrated Care After COVID—Health Equity ATTACHMENTS Polaris Strategic Plan 2021 Polaris newsletters Declaration on health equity

DR MARGARETE EZINWA Chair, Polaris

This year on World Family Doctors day we made a brief video.

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THE RAJAKUMAR MOVEMENT 1. General Profile of The Rajakumar Movement members are as follows: Medical Training Status of Members About 61.9% (39) of members have finished training/post-certification and are in the first five years of medical practice; 28.6% (18) are still under training as a medical resident in family and community medicine, general practice training, and public health; lastly, 9.5% (6) are medical students.

2. Agenda, Activities and Programs: In line with the objectives to exchange ideas, perspectives and best practices in Family Medicine, the Rajakumar Movement has launched three programs: 1. Entrepreneurship skills for young doctors 50 young doctors in Asia Pacific region participated and were asked to formulate and modify business plans based on the entrepreneurship online sessions. It is led by Dr Erfen from Indonesia (Incumbent Chair of TRM) with some guest speakers, including WONCA executives.

2. Journal and Research This track is still in the process of developing plans on how to go about and how to involve active participation of members.

The Rajakumar Movement Research Group headed by Dr Mya Win Hnit, in collaboration with the Philippine Academy of Family Physicians Residents’ Organisation represented by Dr Michael Angelo Arteza, and the Myanmar Primary Care Research Unit; conducted a series of Basic Online Medical Research Sessions for the young doctors in the Asia Pacific Region. It was supplemented with some guest speakers, including WONCA executives.

3. Case Discussion and Management Dr Loretta Chan spearheaded the three case discussions: Localised Lyme Disease Effect of Climate Change and Disaster Medicine COVID-19 Other TRM Programs FM 360 16 young doctors have applied: 7 successfully conducted 1 on waiting list 3 cancelled 4 host not available 1 changed country Average duration of successfully conducted exchange program: 24 days Minimum duration: 15 days Maximum duration: 30 days ASPIRE: WONCA World preconference simultaneous workshop with ASPIRE: Five people from Asia Pacific will be selected to take part in the workshop.

Special Interest Group in Mental Health: As with the other young doctors in the world, most of the Rajakumar Movement young doctors are also front liners in the COVID-19 pandemic. Frequent catchingup, sharing of experiences, and providing emotional support to one another were conducted via social media. To provide further emotional support, online session on emotional well-being and stress management was launched last April 19, 2020 by Dr Erfen Suwangto. 40 people have participated.

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WONCA Conventions: Cancelled plan for WONCA Auckland: TRM preconference session and workshops on: Indigenous Health, Young Family Doctors as Emerging Leaders in Global Health, and Wellness for Young Doctors.

Plans for WONCA Abu Dhabi: Entrepreneurship workshop for young doctors—handling finances.

Plans for WONCA Myanmar: Entrepreneurship workshop for young doctors—human resource development.

Participation in various conventions in Asia Pacific Region: The Rajakumar executive committee members and representatives of various local young doctors’ organisation participated in the following conventions and conferences: Indonesian Association of Family Physicians; Philippines Academy of Family Physicians ; Academy of Family Physicians of Malaysia; Japan Primary Care Association; Hongkong Primary Care Conference.

3. Meetings So far 30 online meetings have been conducted from 2018 up to the present.

4. Image Update Created the following social media platforms to further enhance the Rajakumar Movement: 2 Facebook accounts created.

Open access.

Closed group Twitter: @WoncaTRM Closed Website because of choosing WONCA web as 1 gate system.

Whatsapp: The Rajakumar Movement (for committee members) 5. 2020 Election Result : Dr Wong Ping Foo as the chair elect of TRM with his team of new executive members (attached picture). They will be inaugurated in WONCA World 2021. TRM rising star winner: Dr Noor Harzanah Harrun (Malaysia).

DR MEL ACUAVERA Secretary, TRM

The Rajakumar Movement Representatives

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THE SPICE ROUTE MOVEMENT The Spice Route is the YDM of South Asia Region.

Bangladesh, India, Nepal, Pakistan, Sri Lanka, and Bhutan have well-established Spice Route Movements contributing actively to promote young doctors of the region. Each country has their own board of office bearers at least consisting of Chair, Secretary and FM 360 coordinator. All national chairs/ representatives meet on video conference every month to discuss future plans.

OUR VISION To be a YDM which produces world leaders in Family Medicine by collaborating, updating and researching.

OUR BOARD MEMBERS Regional Chair: Sankha Randenikumara (Sri Lanka) Regional Secretary: Zainab Anjarwala (Pakistan) Regional FM 360 coordinator: Jyotika Gupta (India) Editor/Image Coordinator: Rupak Bhandari (Nepal) Treasurer: Anik Biswas (Bangladesh) ASPIRE Regional Representative: Kinley Bhuti (Bhutan) OUR SAR REPRESENTATIVES AND THE UPDATE ON INDIVIDUAL COUNTRIES Bangladesh: Bangladesh Spice Route , led by Zakiur Rahman, appointed Anik Biswas as the National Secretary of the Spice Route team.

Zakiur contributed actively to the WONCA World Rural Conference 2020 to be held in Dhaka which was postponed initially and then later organi s ed as a virtual conference in February 2021.

DR SANKHA RANDENIKUMARA Chair, TSR Movement

India: The Spice Route India, headed by Serin Kuriakose expanded the Spice Route Movement in India and developed multiple State Chapters with State Council for each chapter. They introduced the Spicy Tuesday program with the introduction of a new Spice Route member every week through social media messages as well as virtual Classroom sessions as an ongoing CPD activity.

Nepal: The Spice Route Nepal closely works with the General Practitioners Association of Nepal in organi s ing its activities. The Spice Route Nepal chaired by Rupak Bhandari (Editor/Image Coordinator) contributed actively in designing the website for the Spice Route.

Pakistan: The Spice Route Pakistan led by Zainab Mohammad appointed new committee members in the Spice Route team representing each province to reach out to the young doctors of the country. They initiated virtual sessions by the name of The Lounge as a regular online activity.

Sri Lanka: Sankha Randenikumara continues as the Chair of the Spice Route Sri Lanka ably supported by Aruni de Silva (National Secretary) and Dilini Baranage (FM 360 Coordinator). The Spice Route Sri Lanka conducted ‘The GPs’ Café as a regular CPD activity.

Bhutan : The Spice Route Bhutan appointed their new office bearers. Kinley Bhuti continues to be the Chair, however Sonam Choki and Wangdi Norbu were appointed as National Secretary and FM360 National Coordinator respectively .

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R O U T E

OUR ACTIVITIES AND CONTRIBUTIONS TO THE INTERNATIONAL EVENTS The Spice Route initiated a fresh project of identifying some important days and celebrating them as regional activities from last June. Such commemorations are in the form of either circulating social media messages or videos benefiting the general public or conducting virtual sessions for family doctors. Zoom sessions and WONCA Webinar were conducted on days like International Youth Day on 12th August, World Mental Health Day on 10th October, World Diabetes Day on 14th November and World AIDS Day on 6th December, hosted by India, Nepal, Pakistan and Sri Lanka respectively. To celebrate World Immunization week from 24th -30th April, a session was held on 24th April hosted by the Spice Route Bhutan team.

The WONCA Young Doctor Movement holds regular webinar sessions every other month and the Spice Route Movement made active contributions in organising these webinars. Also Dr Serin Kuriakose (the Spice Route Chair India) and Dr Zainab Mohammad (the Spice Route Chair Pakistan) contributed in the webinars as speakers. The webinar on ‘Lifestyle Medicine: A leap towards a healthy life’ was hosted by the Spice Route and AfriWon on 28th March 2021.

FUTURE PLANS Initiating a research collaboration within the regional YDMs; Structuring and improving the FM 360 exchange programme in every country; Organising a regional YDM gathering.

The Spice Route Representatives

Kinley Bhuti designed a module with a series of presentations on ‘Leadership Skills’. These presentations were informative, also reflected the qualities of a true leader and presented in regular council monthly.

The Spice Route designed a website by the name of WONCAspiceroute.org and was launched on World Family Doctor Day (May 19, 2021).

In order to appreciate the efforts of young doctors in promoting Family Medicine, the Spice Route initiated The Spice Route Star Award. The winner of this award was then nominated for the WONCA World Rising Star Award to be presented in WONCA World Conference 2021.

The Spice Route Star Award

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THE VASCO DA GAMA MOVEMENT In spite of the challenges of the COVID pandemic —indeed probably because of them—VdGM has had a very busy year! Having events cancelled due to the pandemic was quite difficult to accept, but we responded strongly, and found ourselves innovating more and developing into a stronger organisation.

We responded to the pandemic as a community by creating a space for our members to share information, guidelines and ideas to deal with the challenges of the pandemic. We also organised meditation sessions and support group sessions.

We were due on our Executive elections, and so we innovated by having an online council meeting with online elections. For this we approved a new organisational policy for elections, which included provisions for online elections. This election, held in September 2020 elected: Nick Mamo - President-elect (taking over early as President in January 2021) Kerry Greenan - Secretary Nadia Toumi - Treasurer Marta Kurdzielewicz - Awards & Fundraising Officer Alessio Platania - Events Officer Rocío García-Gutiérrez - Exchange Officer Christian Rechtenwald - Image Officer In December, VdGM held its first virtual preconference organised by the great team in Germany, and during this we also held our first virtual exchange. This was very well received and since then we have held other virtual exchanges, including our first collaboration with Waynakay YDM in Iberoamerica. VdGM members also had a strong presence at WONCA Conferences, with many workshops and presentations.

Unfortunately, the VdGM Forum planned to take place in Edinburgh in February has been postponed, but we hope this will still be a great event in January 2022.

To whet our appetites, the Host Organising Committee held an online event with inspiring talks and Ceilidh dancing.

We have had two further virtual council meetings in February and June 2021, during which we ratified a new bylaws document replacing our old constitution, elected a new Good Governance Committee (GGC) to continue the work of our first GGC, and a brand new finance committee supporting the treasurer. We have also had some deep discussions about the future of our organisation, including an agreement to look into options for registering our organisation officially. We also elected our new Policy Officer— Ana Cristina Franco Spinola.

The Bridge Project: Currently in its pilot phase, with the first round of this project starting in April 2021, this brings together mostly VdGM members, but also others, from around the world, forming groups to discuss, share and learn together. The aim is to create something after six months of communicating and collaborating; the outcome is up to the group! We hope this project will be successful and will expand!

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In July, a number of us managed to meet face-toface, with others joining online for our hybrid pre-conference in Amsterdam. This was a great experience with some fascinating workshops, very good learning and discussion. Our presence during the virtual WONCA Europe Conference following this was also strong!

NEW DOCUMENTS: VdGM Guide: In 2020, the idea came about to create a guide to our organisation that is accessible. This has been completed and published on our website. It includes a two-page summary which will be translated into all languages represented in VdGM. Event Guide: We have also created a guide to support Host Organising Committees (HOCs), and potential HOCs as well, to ease the process of organising a VdGM Event.

VdGM Members

Our family continues to grow. In the last few months, we have welcomed representatives from countries previously unrepresented in VdGM. These include: Armenia, Bosnia and Herzegovina, Hungary, Iceland, Latvia, Estonia and North Macedonia.

Finally, we would also like to announce a few awards that were given during the WONCA Europe Conference 2021:

Countries Represented in VdGM

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Marina Jotic Ivanovic—Fons Sips Outstanding Achievement Award. This is an award given every two years to a VdGM member who has inspired us.

Someone who has worked hard both within the organisation as well as within clinical practice.

Marina has been an inspiration and is truly deserving of this award!

Peter Kurotschka—Junior Researcher Award.

For a qualitative study on the experience of GPs across Italy during the early stages of the COVID pandemic with a thematic analysis.

VdGM World Family Doctors Day 2021

Runners-up were Ebrahim Mulla looking at predicting frailty, and Aviel Nagar looking at a UTI diagnostic tool.

Joana Silva Guerra (went to Washington D.C.) and Eva Leceaga Gaztambide (went to Sri Lanka, visiting different cities)—FM360 Exchanges Awards.

Marina Jotic Ivanovic—Fons Sips Outstanding Achievement Award

We also awarded two VdGM Fund bursaries for attendance at our pre-conference in Amsterdam and online to Jonathan Brill (Israel) and Sara Simonovska (North Macedonia).

DR NICK MAMO Chair, The Vasco da Gama Movement

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YOUNG DOCTORS' MOVEMENTS

WAYNAKAY Waynakay young doctors in Latin America within the context of the pandemic have been able to keep on working. We believe that this has been possible because of the defining characteristics of the young doctors specialised in family and community medicine.

During the last 12 months, we have met bimonthly within Waynakay Regional Council meetings using Zoom. We have also participated in different COVID related activities, such as CIMF's online meetings and COVID-19 ad hoc CIMF workgroup.

Waynakay contributed to WONCAWONCA YDM webinars and thanks to these wonderful activities we were able to start new relationships with the rest of the world. We worked together with colleagues from the Rajakumar Movement and carried out one of these webinars together with the Al Razi Movement. Also, we collaborated with the online translation of the sessions from English to Spanish. Today we are helping Polaris with the next webinar planification.

Since December 2020, Waynakay has been developing an interview session biweekly where young doctors from Latin America can tell the rest of the world how a family and community doctor works in each country. Each session is broadcast on Waynakay’s facebook live on Friday nights.

Hernán Giacomelli, who is a journalist from Argentina, has already interviewed more than 13 people from 10 different countries like Mexico, Costa Rica, Panamá, Uruguay, Brazil, Bolivia, Colombia and Argentina. These sessions seem to be very interesting, and the vast majority has gathered at least 500 views.

By the time of completing the first 6 months of interview sessions we decided to take stock by interviewing the Waynakay board of directors, integrated by Dr Juliana Valverde, Dr Gleydi Lu Santos and Dr Gabriela Di Croce.

During 2020, Waynakay launched the call to integrate Balint groups, which would be coordinated by colleagues from the movement with the support of other family physicians. These groups started working during the second part of the year are still functioning with about 10 to 15 members.

Coming to the end of this report, we are pleased to share that for the immediate future, the most important activities are linked to the organisation of the 7th Ibero-American Congress of Family Medicine, the Waynakay pre-conference and the nomination of a colleague for the Rising Star award.

It will be during the next Ibero- American Congress that Waynakay will vote for a new board of directors for 2021–2023 period.

Waynakay Members

DR GABRIELA DI CROCE Chair, Waynakay

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Credit: Vasco da Gama Movement

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THE CAMPAIGN

T H E C A M P A I G N

World Family Doctor Day (FDD) – 19th May - was first declared by WONCA in 2010 and it has become a day to highlight the role and contribution of family doctors and primary care teams in healthcare systems around the world.

Every year, this celebration is the perfect opportunity to acknowledge the central role of Family Doctors in the delivery of personal, comprehensive and continuing health care for all patients. It’s also a chance to celebrate the progress being made in family medicine and the special contributions of primary care teams globally.

Our 2021 theme was Building the Future with Family Doctors, aligned with the Year of the Health and Care Workers 2021 declared by the World Health Organization (WHO).

For more than a decade, we have been witnessing all the celebrations, events and activities that our colleagues around the world have shared on collaborations, reports and photographs from many countries. All of them represent an essential part of the history and memory of the WONCA family, shown in multiple editions of our WONCA News.

Credit: Programa de Residência de Medicina de Família e Comunidade / Joinville - SC (PRMFC Joinville)

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T H E F O U R P I L L A R S We officially launched the #WorldFamilyDoctorDay 2021 campaign on the 19 April, 2021, with the announcement of the theme Building the Future with Family Doctors.

t

s ctor Do

Build ing

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We wish to highlight that family doctors working together with multidisciplinary teams of health and care professionals are key to strengthening health systems and delivering high quality and affordable care to all.

and Primary Care Teams!

s ctor Do

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Family Doctors adopt a people-centred approach, provide ongoing support to patients and communities, and ensure continuity of care over lifetime. Patients are at the centre of this celebration.

and Patients!

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Amid the COVID-19 pandemic, new technologies have emerged

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professionals to continue their mission.

and New Technologies!

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What are the building blocks that YOU consider key for the future? Get involved, raise your voice, share your activities and efforts, and contribute to building the future with family doctors!

and YOU!

THE 4 PILLARS

ure with Fa m Fut il he

This year’s theme was based on four fundamental pillars with key elements to move forward and overcome the challenges towards a better future.

The pillars were available in 4 languages: English, Spanish, French, and Chinese.

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W O N C A M E S S A G E S We released two videos: one with a message from WONCA President, Dr Donald Li, and a second one with an interview from WONCA President-Elect, Dr Anna Stavdal. Both videos highlighted the crucial role of Family Doctors and Primary Care teams in building a better and healthier future!

WONCA MESSAGES

To help tailor every communication and simplify all the advocacy efforts, in this 2021 edition we created a Media Kit with all the campaign elements. The graphic identity and messages of the “Building the Future with Family Doctors” campaign were present on the 19th of May worldwide, in multiple languages ​and creative formats!

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H A N D S W F D D 2 0 2 1

: Kim Yu

The gesture was widely shared by thousands of people on social media. Doctors, primary care teams, colleagues, patients, and members of the WONCA family, joined our campaign by joining hands!

The impact was such that the hand gesture became an emblem of our 2021 campaign. dit

We invited everyone to join our campaign "Building the Future With Family Doctors" by posting pictures with a hand sign representing care and protection. The hand sign simulated building a house, a roof, a home, our future!

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Credit: residencia.lucarelli

Credit: rocio.3g

Credit: Philippine Academy of Family Physicians Cahayan Chapter

Credit: Dr Pratyush Kumar

Credit: Unidade de Cuidados de Saúde Personalizados de Vouzela

Credit: mfcjoinville

Credit: FEU-Nrmf Community and Family Medicine Department

Credit: Academy of Family Physicians of Malaysia (AFPM)

Credit: dra.robertaw WONCA President, Dr Donald Li

WONCA President-elect, Dr Anna Stavdal

Credit: Val Wass

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AROUND THE WORLD

A R O U N D

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Member Organizations from all the WONCA regions shared their efforts and activities on the occasion of World Family Doctor Day 2021.

WONCA AFRICA The Association of General and Private Medical Practitioners of Nigeria (AGPMPN), which celebrated with a virtual Zoom webinar with a good number of attendees and members across all geopolitical zones of Nigeria.

According to Dr Oluwaseun Olusola, AGPMPNWONCA Liaison Officer, the webinar was anchored by Secretary-General of AGPMPN, Dr Ned Okoro. It also had the participation of the AGPMPN President, Amb. Dr Iyke Odo, who extended their congratulations to the WONCA President, Dr Donald Li and his team; WONCA Africa President, Prof Shabir Moosa, the members of the Executive Committee, and all family doctors at large.

Continue reading more about this activity here.

The Society of Family Physician of Nigeria (Cross-State Chapter) celebrated with a radio broadcast in two stations (Cross River Broadcasting Corporation and Sparkling FM) creating awareness on Building the Future with Family Doctors and emphasising the four pillars. The transmissions were followed by a hybrid conference (virtual and physical) with five speakers who

Association of General and Private Medical Practitioners of Nigeria

gave an overview of the four pillars of Primary Care. Dr Archibong Felix wrote that the "conference was well attended, and five credits on continuous development points were awarded to participants".

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Society of Family Physician of Nigeria (Cross-State Chapter

For their part, the Association of Family Physicians of Uganda celebrated WFDD on 14th May 2021, with a one-day symposium that aimed to share experiences and activities to design a strategy to highlight family practice in Uganda.

General Secretary, Innocent Besigye, mentioned that they also awarded senior Family Doctors for their distinguished contribution to Family Practice in Uganda.

Association of Family Physicians of Uganda

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WONCA ASIA PACIFIC The Hong Kong College of Family Physicians celebrated World Family Doctor Day 2021 with a short video to recognise the outstanding contributions of Family Doctors in Hong Kong in the combat of the COVID-19 pandemic.

The Academy of Family Physicians of Malaysia (AFPM), the Malaysian Family Medicine Specialists Association (FMSA), the Rajakumar Movement (TRM) and the Organizing Committee of WFDD 2021 Malaysia shared a detailed report of their multiple activities for this important celebration, including weekly virtual educational and social programs, a Public Forum Who is Family Doctors? Family Doctors role in the COVID-19 pandemic and COVID-19 Vaccine, a continuous professional development webinar on noncommunicable diseases, a motivational video, a virtual WFDD run, musical performances, and many other activities! Discover their full report here.

Hong Kong College of Family Physicians

From their part, the Royal New Zealand College of General Practitioners started World Family Doctor Day with a 5 am breakfast email and video to all their members from College President, Dr Sam Murton. They also shared videos on social media from well-known New Zealanders, such as Prime Minister Jacinda Ardern, and Director-General of Health, Dr Ashley Bloomfield. The footage was reshared many more times, making special mention of the doctors in their whanau, extending the message of gratitude to their teams.

Royal New Zealand College of General Practitioners

New Zealand Prime Minister Jacinda Ardern

New Zealand Director-General of Health, Dr Ashley Bloomfield

Academy of Family Physicians of Malaysia

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The Philippine Academy of Family Physicians (PAFP) Tacloban City Chapter, celebrated WFDD2021 with the Tree Planting activity, also related to their campaign “60 Trees for PAFP’s 60th”, with the collaboration of their local chapter members and the chairman of the Environmental Protection Committee, Lory L. Ruetas, who also wrote: because of Covid19 lockdown, we could not plant the trees together in one location, but we encouraged people to plant at least two fruit trees in their backyard, garden, farm or any area before 19 May 2021.

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Philippine Academy of Family Physicians

WONCA EAST MEDITERRANEAN WHO Regional Director for Eastern Mediterranean, Dr Ahmed Al-Mandhari, sent WONCA President, Dr Donald Li a support message on the occasion of World Family Doctor Day. You can read the message from Dr Ahmed Al-Mandhari here. On his part, WONCA President Dr Donald Li answered with an appreciation note in which he highlighted the crucial role of family doctors and primary care teams and the perfect opportunity that the World Family Doctor Day represents to importance of health for all.

The image, based on the pillar of Building the Future with Family Doctors and Primary Care Teams, aimed to thank these professionals for their efforts.

Under the pillar of Building the future with family doctor and you!, the EFMA conducted a virtual zoom to discuss the merits and demerits of COVID-19 Vaccination, a fruitful discussion with attendees from Lebanon, Bahrain, Saudi Arabia, Iran and Egypt. Watch the session here.

The Egyptian Family Medicine Association designed a poster for family physicians and primary health care providers, while working wearing the personal protective equipment.

Egyptian Family Medicine Association

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On their end, the Jordan society of Family Medicine (JSFM) celebrated WFDD with a presentation by JSFM Deputy President, Dr Oraib Alsmadi, on the role of Family Physicians during COVID 19 pandemic, and the building capacity of family physicians during the pandemic.

Members of Jordan AlRazi YDD movement participated on this virtual discussion.

Jordan society of Family Medicine

WONCA EUROPE The Greek College of General Practitioners (GCGP) celebrated with Facebook and Instagram posts, a video and a newspaper article about the essential role of about the role of Family Doctors and interdisciplinary teams.

The Portuguese Association of General and Family Medicine (APMGF) was heavily invested, during World Family Doctor Day (WFDD) 2021, in creating public awareness about the importance of family doctors for the strengthening of health services and systems and for the well-being of citizens, especially during a pandemic. This was mainly done through press releases for mainstream and specialized media outlets.

Elected officials of the National Board of APMGF were interviewed by TV news services and newspaper journalists regarding this subject.

Greek College of General Practitioners

The APMGF also organised the National Conference of Family Medicine Residents and Young Doctors between May 19 and 21, to further bolster the landmark celebration. Discover more about their activities here.

Portuguese Association of General and Family Medicine

Book “Happy Family Doctors… Why Not?”, written by Portuguese family doctor Alexandra Fernandes

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In Romania, the National Center for Studies in Family Medicine (CNSMF) used their official website and social media to post WFDD messages in Romanian.

They also created a video and share it with their colleagues at the Business Association of Family Doctors, FNPMF. The Romanian Minister of Health, Dr Ioana Mihăilă, also recorded a video message for WFDD to thank family doctors, with key messages that included "Building the future with family doctors".

National Center for Studies in Family Medicine (CNSMF)

Romanian Minister of Health, Dr Ioana Mihăilă

On their part, the Turkish Association of Family Physicians (TAHUD) celebrated World Family Doctor Day, alongside a national festival called “Youth And Sports Day”, a special day dedicated to youth and sports set by Ataturk, the founder of Republic of Turkey.

Inspired by this, and the WONCA 5-star family physician competition, TAHUD selects a 5 Star Family Physician Resident since 2018. This year the winner was Muzaffer Oncu Donmez.

They also celebrated with virtual meetings, poster competitions, karaoke and many activities more! Discover more here.

5 Star Family Physician Resident - Turkish Association of Family Physicians (TAHUD)

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WONCA IBEROAMERICANA – CIMF On May 19, the Chilean Society of Family Medicine (Sociedad Chilena de Medicina Familiar SOCHIMEF) launched the Book "Applied Bioethics in Primary Care", authored by DrCarmen Nadal, partner of SOCHIMEF. The celebration featured Dr Paula Daza (Subsecretary of the Chilean Ministry of Health), Dr Mario Cruz Peñate (WHO/PAHO representative in Chile), Dr Rodolfo Armas (President of the Chilean Academy of Medicine) and Dr Jacqueline Ponzo.

(President of the Ibero-American Confederation of Family Medicine). Read more about their activities here.

Chilean Society of Family Medicine - Sociedad Chilena de Medicina Familiar Ibero-American Confederation of Family Medicine

Members of the Colombian Society of Family Medicine (Sociedad Colombiana de Medicina Familiar – SOCMEF) joined our campaign with various images through social media, as well as family doctors in Costa Rica, like Dr Marina Alemenas, the Vice-president Mexican Federation of Specialists and Residents in Family Medicine (Federación Mexicana de Especialistas y Residentes en MF), Dr Gad Gamed Zavala Cruz and members of the CIMF (Confederación Iberoamericana de Medicina Familiar - IberoAmerican Confederation of Family Medicine).

Dr Marina Alemenas - Costa Rica

Sociedad Colombiana de Medicina Familiar

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Venezuelan Society of Family Medicine

On their end, the Paraguayan Society of Family Medicine (Sociedad Paraguaya de Medicina Familiar) carried out multiple activities during the Family Doctor Week, from videos regarding the importance of the family doctor to a message from the Dean of the National University, and multiple communication efforts from the teaching assistants and all the community.

The Venezuelan Society of Family Medicine (Sociedad Venezolana De Medicina Familiar – SOVEMEFA) organised a “conversatorium”, a discussion session related to the four pillars of Building the Future with Family Doctors. Read all the details here (Spanish).

Paraguayan Society of Family Medicine

WONCA NORTH AMERICA On the occasion of World Family Doctor Day, the American Academy of Family Physicians (AAFP) created a video and shared it on their social medial channels, along with three different Facebook posts where the video was embedded.

American Academy of Family Physicians

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WONCA Regional President for North America, Dr Marvin Reid also shares the activities and efforts from Jamaica, where a special supplement on World Family Doctor Day was published.

WFDD Jamaica Highlights

WONCA SOUTH ASIA

Bangladesh Academy of Family Physicians

Meanwhile, the College of General Practitioners of Sri Lanka held a Webinar on 16 May 2021, focusing on home management of Covid patients "Sharing the Caring of COVID19 Patients at home”. The webinar panellists were from local South Asian contexts. This virtual event was well-received, with around 500 participants from both Sri Lanka and other countries.

College of General Practitioners of Sri Lanka

The Bangladesh Academy of Family Physicians (BAFP) and the Bangladesh Institute of Family Medicine and Research (BIFMR) celebrated ‘World Family Doctors Day on 28 May 2021 in two phases. According to Prof. Kanu Bala, the first phase involved a lecture session by Prof. Md. Mushtuq Husain, a renowned Epidemiologist of Bangladesh. During a session presided by Prof.

Md. Falahuzzaman Khan, Prof. Md. Mushtuq Husain on COVID-19 Situation. The second phase included discussions with Prof.

Kanu Bala, Prof. Md. Nurul Islam and Dr Md. Kabir Ahmed Khan regarding the importance of the World Family Doctor Day. This session was presided by Prof.

Firoz Ahmed and coordinated by Dr Amir Ali Gazi.

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Despite not being member organization of WONCA, we appreciate the participation of Praava Health, who celebrated WFDD2021 con webinar series, talk panels and on-line live discussions.

We also thank Naga Vamshidhar Ratakonda, from Bengaluru Area, India, for the Poem: Family Doctor:

Family Doctor

Praava Health

WONCA YOUNG DOCTORS MOVEMENTS Our Young Doctors Movements joined the World Family Doctor Day Campaign with multiple messages and creative formats.

For example, representatives of these movements created a joined TikTok . Watch the full video here.

Wholistic Health, Forever a Factor; Family Doctor, A Need of the Hour; To Answer the call, At Any Hour!

Beyond Matters Of Health, A Friend in Many Quarters, Personal & Private;

Engage In Occassions, Emergencies Cared; Relationship in Vogue, Diseases don't Provoke!

Find for All in Family, Fond of All in Family, Bond with All in Family, Family Doctor Smiley, Favourite of All Happily!

Attachment of, Long-term History; Appointment Hassle, Not an Issue At All! Bee-Line Lengths, Happily Surpassed; Awaiting Hours, Bypassed in Seconds; Treatments Done, At Special Discounts, With Quick Attention!

Sweet Casual Talk, An Early Head Start; Casuality Ward, Not on Prescription Platter!

Young Doctors Movements

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Waynakay Ecuador shared messages regarding WFDD2021 on social media and sent a special communication in collaboration between EcuadorMexico-Colombia to a digital newspaper regarding the importance of Family Medicine during the pandemic and formal academic processes.

The Spice Route Movement of South Asia celebrated by launching their official website (http://woncaspiceroute.org) on the 19th of May 2021, with the patronage of WONCA South Asia Regional President D Raman Kumar.

On their end, members of the Vasco da Gama Movement joined hands and shared their pictures on social media. They also created a collages with different images from their members. (See on page 8) The Spice Route Movement

Waynakay Ecuador

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M E D I A

World Family Doctor Day a had relevant presence on six social platforms, mainly Twitter, Facebook and Instagram. Top hashtags #WorldFamilyDoctorDay and #WFDD2021 had a total reach of 8.1 million users.

WORLDFAMILYDOCTORDAY

3,744

8.3 K

6.8 M

8.3 K

mentions

interactions

reach

shares

3.2 K likes

WFDD2021

1,683 mentions

9.3 K interactions

CONTEXT OF MENTIONS

1.3 M reach

7.3 K shares

2K likes

*ALL PLATFORMS. SOURCE: BRANDMENTIONS

1,700 USERS OF WFDD FACEBOOK FRAME

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WORLD FAMILY DOCTOR DAY 2021 We want to thank you all for being a part of the World Family Doctor Day 2021. It was not possible to include in one single edition the countless expressions of support to all the Family Doctors and Primary Care teams around the world!

Despite the adverse circumstances, the 2021 edition of World Family Doctor Day was one to remember. But this is not about one day. We will continue spreading the word. It’s necessary to support Primary Care and support health workforce to build a healthier future for all!

THANK YOU

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WONCA

ACCREDITATION & CERTIFICATION WONCA accreditation provides a professional, collegial context within which individual practices and postgraduate programmes can review their standards, improve them where necessary, and gain approval from our global organisation.

When WONCA accreditation schemes were being developed, with intense inputs from our Working Party (WWP) on Quality and Safety and our WWP on Education, they were originally intended to support practices and programmes which were being developed in countries which did not yet have their own formal standards or national templates for delivery of comprehensive primary care. In some countries the development of professional family medicine has depended on far-sighted clinicians and community-based professionals taking the lead to establish primary care teams. In these circumstances, there may be no formal standards available against which family medicine practices can be assessed.

Achieving specialty status for family medicine can take much longer in countries which are historically hospital oriented, or where there is a strong hospital doctor lobby which does not yet recognise or acknowledge the powerful role that providing comprehensive primary care in the community can play in improving the health status of the population.

The first post graduate programme to apply for WONCA Programme Accreditation, after the process was developed and thoroughly peer reviewed, was Shanghai Medical College in China, which was re-accredited this year, having been postponed from 2020 due to the pandemic.

The formal title of programme accreditation is ‘WONCA Global Standards for Postgraduate Family Medicine Education’. The standards are freely accessible on the WONCA website.

ACCREDITATION OF FAMILY MEDICINE PROGRAMS GLOBAL STANDARDS FOR PRACTICE ACCREDITATION DIGITAL CERTIFICATION PROGRAM The original intention was for programme accreditation to be a support to those who were developing post graduate programmes for the first time. However, a number of Colleges and Departments which are subject to their own national standards, have used the WONCA standards to assist with their internal quality improvement programmes.

Professor Stuart Murdoch, Director of Post Graduate Education at Toronto, a wellestablished family medicine residency programme, said of their experience in 2019:

WONCA accreditation is an amazing experience that provides constructive feedback in a very safe and positive environment. Programs that have their own accreditation standards within their country should consider WONCA as a means for an external review for continuous quality improvement

In 2021 the Jiahui Department of Family Medicine (Shanghai) resident training programme undertook both the WONCA programme accreditation process and the WONCA practice accreditation process.

149

W O N C A A C C R E D I T A T I O N C E R T I F I C A T I O N

&

The programme accreditation team included Dr Garth Manning, Prof Doris Young and Prof Samuel WONG, while the practice accreditation team included Dr Garth Manning, and Dr Anna Stavdal. Dr Ling Qiu, Chief of the Department of Family Medicine, who led the process for Jiahui, said of programme accreditation,

We had a great experience with WONCA accreditation… The process helped us to set a milestone for premium family medicine training in China. And it has helped Jiahui to be the leader in premium family medicine training.

She pointed out that undertaking the process helped the faculty to revise the rotation and teaching schedule and helped to provide support for other specialists who contribute to teaching on the programme. Having WONCA accreditation is now helping Jiahui to recruit high quality fellows to the residency programme.

Full formal accreditation is dependant on a satisfactory site visit, when circumstances permit. Dr Ling Qiu said

We sincerely welcome the WONCA committee for the site visit next year after the pandemic

The Yuma Regional Medical Center in Arizona, USA, which underwent the programme accreditation process in 2021, also reported having a really beneficial experience. The WONCA assessment team for Yuma Center included Dr Garth Manning, Prof Val Wass and Dr Victor Ng. Due to travel restrictions during the pandemic, the assessment visits were carried out over three days, virtually. Despite the lack of face-to-face meetings, the process was undertaken in exactly the same way as for faceto-face assessments.

ANNUAL REPORT | 2020-2021

The programme staff collated and submitted prescribed documentation, the documentation was reviewed by the assessment team and followup questions for the programme were issued.

Following the desk review, a structured virtual visit took place, covering the full range of inputs, structures and personnel associated with the programme including, separately, residents themselves. As with Jiahui, the Yuma Regional Medical Center received provisional accreditation, until a successful in-person site visit can take place. When asked about the process of undertaking programme accreditation, Dr Natalaia Galarza, Clinical Lead for Family Medicine, said

WONCA accreditation highlighted how closely knit our team has become… The WONCA accreditation opportunity reaffirms the idea of who we are, what we represent and the culture that we have fostered. Taking the time to evaluate our program also allowed us to evaluate what it means to be a family doctor in Arizona and the USA. After going through this process, we can honestly say our residents / alumni and faculty can stand shoulder to shoulder with any FM physician in the world, with their heads held high, knowing they are meeting international standards’

The Japan Primary Care Association (JPCA) undertook programme accreditation in late 2019 and they are proud to be the first to receive accreditation at national level for their post graduate programme.

Atsushi Igaki, on behalf of President Dr Tesshu Kusaba, told us that JPCA was concerned that family medicine training programmes in Japan were not specifically tailored to the specialty of family medicine and there was concern about quality. As a result, JPCA, as the only academic organisation in the field of family medicine in Japan, developed their own post graduate programme.

150

W O N C A A C C R E D I T A T I O N C E R T I F I C A T I O N

&

We made the decision to be certified by WONCA in order to prove that we provide an internationalstandard training program and to help us further improve its quality. It gave us great confidence that JPCA's efforts were officially recognized as meeting international standards throughout the certification process. Also, the improvements pointed out were very helpful for the future development of our programme’.

Adapting the standards of the World Federation of Medical Education (WFME) to fit with the needs specific to family medicine training, the WWP on Education set out standards across nine areas and 38 sub-areas. The areas are defined as broad components in the structure, process and outcome of postgraduate medical education and training. They include: Mission and outcomes Training process Assessment of trainees Trainees Staffing Training settings and educational resources Evaluation of training process Governance and Administration and Continuous renewal In developing and adapting the standards, the WWP on Education indicated that a variety of applications were possible, including selfassessment and programme quality improvement; new programme development; peer review; or recognition and accreditation.

It was not assumed that everyone who accessed the standards, which are freely available on the WONCA website, would proceed to the full accreditation process.

Practice accreditation standards were developed in response to demand from Member Organisations, under the aegis of the WWP on Quality and Safety and WWP on Education.

ANNUAL REPORT | 2020-2021

The standards were developed with technical inputs and support of a large number of individuals and Colleges, with ongoing peer review. Practice accreditation was originally intended for areas where formal standards have not yet been established or where practices are unregulated by any formal mechanism. For those practices which undergo WONCA Practice Accreditation, it is intended that the standards inherent in the accreditation process provide support to individual practices until such times as nationals standards and regulations are developed and implemented. Indeed, WONCA Practice Accreditation standards are reported as being used to help define national standards for family medicine practices. Achieving WONCA Practice Accreditation shows patients that the family medicine practice is serious about providing high quality, safe and effective care, in the context of the local environment, as measured against the standards determined by the family medicine profession.

The process of practice accreditation – from the expression of interest by a practice, through compilation and submission of documentation, assessment by WONCA professional colleagues, and awarding of accreditation - is intended to be a supportive tool to help individual family medicine practices to assert their achievements, and to provide clear indications for improvement to reach and maintain international standards.

It is acknowledged that health systems in each country can be markedly different; methods of delivery of care at all levels of the system and the financing of health care can vary enormously from one country to another and even within countries.

The delivery of family medicine in individual countries is entirely context specific and the accreditation process is sympathetic to those individual contexts.

151

W O N C A A C C R E D I T A T I O N C E R T I F I C A T I O N

&

Any practice may express an interest in being accredited. Practices are entitled to apply for accreditation irrespective of the financing process for delivery and providing care. They can apply if they are publicly funded, have copayment systems in place, are privately run, are funded under a health insurance scheme or by a not-for-profit organisation, by an NGO, or by a mixture of any of these mechanisms. The role of WONCA accreditation is not to judge or overtly promote preferred systems: rather accreditation is a way to reflect the standards of care being delivered in context.

As with the standards for WONCA Programme Accreditation, the standards for WONCA practice Accreditation are available, freely, on the WONCA website.

Practices are assessed against a range of criteria, under the general headings of: Practitioners (which refers to the professions providing care and their qualifications) Patients (services provided meet the needs, values and beliefs of their patients) Provider activity (scheduling of care, patient records, tests and follow up, referrals) and Premises (accessibility, privacy, accommodation, toilet facilities, equipment) On completion of the assessment visit, the applicant is advised about the outcome and, where necessary, the improvements needed to achieve accreditation. A formal report is produced by the accreditation assessment team and sent to the applicant within two weeks of the accreditation visit, detailing the current situation and how it matches against WONCA criteria, and also suggests steps for further improvements, where needed, with a roadmap to re-accreditation.

Dr Ling Qiu said of the WONCA practice accreditation process in Jiahui, that it :

ANNUAL REPORT | 2020-2021

recognised our care quality and helped us promote patient-centred care. It encouraged us to continually seek improvement. The accreditation will promote premium primary care coverage by national and commercial insurance organisations for patient care

Certification of digital health solutions is a growing need in family medicine, as the use of technology and digital health applications become increasingly available. It is important that WONCA is involved early in their development so that applications specifically produced for family medicine are appropriate, that we help to define the standards, rather than letting standards be defined for us. For those applications and platforms which are already available, their evaluation is increasingly important to improve their quality, to ensure patient safety and to strengthen public and professional trust. WONCA is positioning itself to play a key role in developing standards for a certification programme and applying those standards to platforms which become available.

Development of standards has been undertaken by a group of experts and the WONCA Working Party on eHealth, and these standards and the assessment process have been piloted for robustness with one of the largest digital health platforms, Ping An Healthcare and Technology Company, based in China. Their ‘Pin An Good Doctor’ consultation system (PAGD), is a digital service with an artificial intelligence (AI) based consultation facility for the assistance of online doctors.

The assessment process consists of 11 domains which incorporate 112 free text questions. These 11 domains are:

152

W O N C A A C C R E D I T A T I O N C E R T I F I C A T I O N

&

General Intended use Users Services Organisation and governance Ethical aspects Evidence Privacy and data protection Technology Financial aspects and Implementation

ANNUAL REPORT | 2020-2021

For each of our accreditation and certification schemes there is a built-in system of peer review, ensuring that both the standards being applied and the implementation of the programmes are robust, realistic and reflect the profession of family medicine.

The President of WONCA, Dr Donald Li, established the Accreditation Committee, which he chairs. The Accreditation Committee oversees all processes, approves assessment teams and considers all reports for sign-off and approval.

During the pilot, the ratings under each domain were then reported on in terms of (a) whether or not the PAGD systems was scalable to other settings, countries and healthcare systems; (b) the comprehensiveness of the services provided, and (c) the validity and available evidence of issues such as cost effectiveness.

Based on the learning from this successful pilot and testing of the assessment methods, WONCA continues to develop the digital health assessment framework with individual WONCA members with relevant expertise and with inputs from a range of WONCA Working Parties and Special Interest Groups. WONCA is playing a pivotal role in developing a certification programme to ensure that systems which are being contemplated for use in family medicine – or which are already being used - meet the service requirements and clinical needs of our family medicine colleagues.

The WONCA accreditation and certification schemes are available to any post-graduate programme, practice or clinic, and to any organisation developing systems and technology for application in primary care and family medicine. The schemes contribute to quality improvement, to expansion and improvement of services and, ultimately, to push towards the target of achieving universal health coverage.

If you are interested in WONCA accreditation schemes, please contact the WONCA Secretariat.

WONCA CERTIFICATION AND ACCREDITATION ACCREDITATION OF FAMILY MEDICINE PROGRAMS GLOBAL STANDARDS FOR PRACTICE ACCREDITATION DIGITAL CERTIFICATION PROGRAM DOWNLOAD OUR BROCHURE HERE

153

THE WONCA TRUST

ANNUAL REPORT | 2020-2021

THE WONCA TRUST FINANCIAL STATEMENT FOR THE YEAR ENDING 1 JAN 2020 - 31 DEC 2020

154

THE WONCA TRUST

FINANCIAL STATEMENT FOR THE YEAR ENDING r JANUARY

2O2O

TO 31 DECEMBER

2O2O

THE WONCA TRUST FINANCIAL STATEMENT FORTHE YEAR ENDING 1 IANUARY 2020 TO 31 DECEMBER 2020

Index Report of the Trustee I ndependent Auditor's Report Statement of Financial Position Income statement Statement of Changes In Trust's Accumulated Statement of Cash Flow Note to the Financial Statements

JNN

Auditing Office Limited

Certified Public Accountants Bangkok, Thailand

Page

2-3

Funds

6

B-17

WONCA INTERNATIONAL INC.

[A Company incorporated in the British Virgin Islands) [Trusree and Manager of the WONCA TRUST) General Information

REGISTERED OFFICE

Trustnet Chambers P O Box 3444,Road Town Tortola, British Virgin Islands

BOARD OF DIRECTORS Dr. Donald KT Li Prof. Amanda Howe Dr. Anna Stavdal Dr. Garth Manning Prof. Valerie fean Wass

Dr Pratyush Kumar Dr. Viviana Martinez Bianchi Prof. Shabir Ahmed Hassim Moosa Dr. Meng-Chih Lee Prof. finan Usta

Prof. Mehmet Ungan Prof. Maria Myrna Ponzo G6mez Dr. Raman Kumar

Prof. Marvin Ellsworth Guildford Reid Dr. Ana Nunes Barata BANKER

Citibank

This page is for information only

REPORT OF THE TRUSTEE

Forthe financial period

l

fanuary 2O2Oto 3l December2O2O

THE WONCATRUST

Wonca International Inc. [the TrusteeJ is under a duty to take into custody and hold the assets of the WONCA TRUST in trust for the relief of sickness, for the advancement of education and for

the general benefit of the public in such manner as may be charitable in particular hut not so as

to limit the generality of the foregoing for the fostering of high standards of medical care in general practice and family medicine in such manner as may be charitable. In accordance

the terms and conditions as stipulated in a Trust Deed dated

1-

with

October 2004, the Trustee shall

also manage the WONCA TR.UST"

To the best knowiedge of the Trustee,

it

has

in all material respects, managed the WONCA

TRUST during the financial year covered by these financial statements for the financial year

L

fanuary 2020 to 3 L December 2020 as set out on pages 4 to LTin accordance with the provisions

ofthe Trust Deed.

These financial statements have been prepared in accordance

with the Thai Financial Reporting

Standard for Non-publicly Accountable Entities ITFRS for NPAEs) as issued by Federal of Accounting Professionals [FAP) and correspond with the trnternational Accounting Standards flAS) and the Internationai Financial Reporting Standards flFRSl.

For and behalfofthe Trustee WONCA INTERNATIONAL INC.

DR. GARTH ALEXANDER. KENNETH MANNING

Director Date: 13

lannry 2021

JNru

JNN AUDITING OFFICE LIMITED Certified Public Accountants

INDEPENDE NT AUDITOR'S REPORT To the Trustee of THE WONCA TRUST

0pinion I have audited the financial statements of TIIE WONCA TRUST ["the Trust"), which comprise the statement of financial position as at 3 L December 2020, and the statement of income, statement of changes in the Trust's accumulated fund, and statement of cash flow for the year then ended, and notes to the financial statements, including a surnmary of significant accounting policies.

In my opinion, the accompanying financial statements present fairly, in all material respects, the financial position of the Company as at 31 December 2020, and its financial performance for the year then ended in accordance withThai Financial Reporting Standardsfbr Non-Publicly Accountable Entities.

Basis for Opinion

I conducted my audit in

accordance with Thai Standards on Auditing. My responsibilities under those standards are f'urther described in the Auditor's Responsibilities for the Audit of the Financial Statements section of my report. I am independent of the Company in accordance with the Federation of Accounting Professions under rhe Royal Patronage of his Majestythe King's Code of Ethics for Professionai Accountantstogether witlr the efhical requirements that are relevant to my audit of the financial statements, and I have fulfilled my other ettrical responsibilities in accordance

with these requirements.l believe that the audit evidence

I

have obtained is sufficient and

appropriate lo provide a basis for my opinion.

Responsihilities of Management for the Financial Statements Management is responsible fbr the preparation and fair presentation of the financial statements in accordance with Thai Financial Reporting Standardsfor Non-Publicly Accountable Entities, and for such internal control as management determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, management is responsible for assessing the Company's ability to continue as a going concern, disclosing, as applicable, matters relatr:d to going concern and using the going concern basis of accounting unless management either intends to liquidate the Company or to cease operations, or has no realistic alternative but to do so.

Auditor's Responsibilities for the Audit of the Financial Statements My objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error,and to issue an auditor's report that includes my opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with Thai Standards on Auditingwill always detect a material misstaternent when it exists ,Misstatements can arise from fraud or error and are considered material il individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements .

with Standards on Auditing, I exercise prof'essional judgment and professional skepticism throughout the audit .l also: maintain

As part of an audit in accordance

c "

o

Identify and assess the risks of material misstatement of the financial slatements, whether due to fiaud or erroq, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provirtre a basis for my opinion.The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from erron as fraud may involve collusion, {brgery intentional omissions, misrepresentations, or the override of internal control, Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not fbr the purpose of expressing an opinion on the ef'fbctiveness of the Company's internal control Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by management, Conclude on the appropriateness of management's use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the Company's ability to continue as a going concern, If I conclude that a material uncertainty exists, I am required to draw attention in my auditor's report to the related disclosures in the financial statements oc if such disclosures are inadequate, to modifu my opinion. My conclusions are based on the audit evidence obtained up to the date of my auditor's report Howeveq, future events or conditions may cause the Company to cease to continue as a going concern, Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements repre.sent the underlying transactions and events in a manner that achieves fair presentation.

I communicate with management regarding, among other matters, the pianned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that I identifu during my audit.

Miss Nisna Norchoovech Certified Public Accountant (ThailandJ No.B508

'I3lanuary

ZOZT

The Wonca Trust Statement of Financial Position As At 31 DecemberzDz0

ASSETS

Unit: Notes

2020

USD

2019

CURRENT ASSETS

Cash and cash equivalents Member organizations' dues receivables Other receivables and prepayment

708,844

3

988,553

43,294

21_,068

54,45L

12,460

806,589

1.,022,226

806,589

4,266 4,447 8,7L3 L,030,939

Inventory

1,45

Total current assets NON.CURRENT ASSETS

Equipment, net Deposils

Total non-current assets TOTAL ASSETS

LIABILITIES AND TRUST'S ACCUMULATED FUNDS Notes

2020

2019

CURRENT LIABILITIES

Other payables and accruals Membership dues received in advance

Total current iiabilities TOTAL LIABILITIES

25,599 20,337 45,936 45,936

53,603 27.678 BI,2BT

379,732

487,778 461,880

81,281

TRUST'S ACCUMULATED FUNDS

Trust's accumulated funds Income and expenditure account Total shareholders' equity TOTAL LIABILITIES AND TRUST'S ACCUMUTATED FUNDS

380,921 760,653 806,589

949.658 030,939

[Notes to the financial statements are an integral part of these financial statements)

,......." Director

xander Ke

Manning) +

The Wonca Trust Income Statement For the year ending 31 December 2020

Unit:

USD

Notes

2020

2919

REVENUES

Subscription incomes 0ther incomes Total revenues

.|

President, executive and regional expenses Secretariat expenses Special projects' and working parties' Publications and communication expenses

9

B

649,956 986

767,78'J.

650,942

774,972

55,990

'J"68,626

7,I91

EXPENSES

0ther operating expenses

10

531_,613

11

44 36,070 108,184

T2 13

Total expenses

737,9Ar

lqqpSgl

Surplus for the year

[Notes to the financial statements are an integral part of these financial statementsJ

......., DirecLor

Manning)

376,042 4,534 40,69I 96,764 686,657 BB,31s

The Wonca Trust Staternent of Changes In Trust's Accumulated Funds For the year ending 31 December 2020

Unit:USD Income and

Trust's funds Beginning balance as at L lanuary Z0L9 Fund paid to Asia Pacific Regional Reserves Fund Fund received from WF - Environment Fund received from WP - Education Fund received from WWP in Mental Health

325,530

expense

account

373,565

Total 699,095

8,666

8,666

L22,626

I22,626

6,r70

6,170

17,306

Fund received from EMR

8,196

17,306 g,Ig6

Fund received from Africa

1,015

1,015

Fund paid to Atai Bursary Fund paid to WP- Rural Practice Fund

[1e)

487,778

89,315 98,315 46L,g80 949,658

356

s56

Surplus for the year Fund received from Asia Pacific Regional Reserves Fund Fund received from WP - Environment

[1e) [1,7L2)

(1,71.2)

(11.2,2_4I)

(1,1"2,24I)

Fund received from WP - Education Fund received from WWP in Mental Health

3,459

3,459

380

380

Fund received from EMR Fund received from Africa Fund paid to Atai Bursary Fund paid to WP- Rural Practice Fund

Deficit for the year As at 31 December 2020

[80,959)

_ 3??,?32_:Jqq,e4

(80,9591

_:?60p53

The Wonca Trust Statements of Cash Flows For the year ending 31 December 2020

Unit r USD

2029 Cash flows

2019

from operating activities

Net profitQoss) for the year Adjustments for:

(B0,ese)

Depreciation

1-,851

Loss on disposal of plant and equipment Changes in operating assets and liabilities: Member organizations' dues receivables

2,415

Other receivables and prepayment

Inventories Other payables and accruals Membership dues received in advance Deposit Cash flows

from operating activities

(r3,123)

(4L,997) 745 (28,004) (7,34L) 4 44'/ (r71,,663)

46,553 55

17,288

(2,758)

, 138,810(e'l _(5,1"691 [5,169.)

from financing activities

Fund received from (paid to) Asia Pacific Regional Reserves F'und Fund received from WP - Environment Fund received from WP - Education Fund received from r/VWP in Mental Health Fund received from EMR Fund received from Africa Fund paid to Atai Bursary Fund received from [paid to) WP- Rural Practice Fund Cash flows

2,489

(22,226)

Cash flows from investing activities Purchases of property and equipment Cash flows frorn investing activities Cash flows

88,3,I5

from financing activities

Net increase [decrease) in cash on hand and at banks Cash on hand and at banks - beginning balance Cash on hand and at banks - ending balance

356

(t12,241)

8,666 122,626 6,'1,7O

3,459 380

77,306 8,196 1,015

[1e] [108,0461

(279,709) 988,553 708,844

(1,7L2L 162,248 295,889 692,664

The Wonca Trust Note To The Financial Statements 3l December2A2O

1"

General information The Wonca Trust ("The Trust") is a Charitable Trust created by a Declaration of Trust Deed

and governed by the Iaws of the British Virgin Islands on 1 Octob er 2004 with Wonca International Inc; a Company incorporated in the British Virgin Islands as the Tru.stee which

holds and manage the assets of the Charitable Trust fbr the relief of sickness, fbr the advancement of education and for the general benefit of the public in such manner as may be

charitable in parlicular but not so as to limit the generaliry of the foregoing for the fostering of high standards of medical care in general practice and family medicine in such manner as may be charitable.

L.

2.1 Basis of preparation These financial statements have been prepared in accordance with the Thai Financial

Reporting Standard for Non-publicly Accountable Entities (TFRS for NPAEs) as issued by

Federal

of

Accounting Professionals (FAP) and correspond

Accounting Standards (IASJ

ar-rd

with the

International

the International Financial Reporting Standards (lFRSJ.

The financial statements have been prepared under the historical cost convention.

Where necessary, comparative figures have been reclassified to conform with changes

in presentation in the current year.

Signed{..

(Mr.Garth

The Wonca Trust Note To The Financial Statements 3l December2O2O

2.

2.2 Foreign currencies translation The financial statements of the Trust are measured and presented in the currency of the

primary economic environment in which the Trust operates (its functional currency). The financial statements of the Trust are presented in United States of American dollars which is the functional currency of the Trust

In preparing the financial statements of the Trusg transactions in foreign currencies other than the Trust's functional currency are recorded at the rate of exchange rate prevailing at the date of transactions. At statement of financial position date, monetary assets and liabilities denominated in foreign currencies are re-translated at the exchange rates prevailing at the Statement of financial position date. Non-monetary items that are measured in terms of historical cost in a foreign currency are not re-translated.

Exchange difl'erences arising from the settlement of monetary items, and on retranslation of monetary items, are included in the profit and loss account for the period.

Exchange differences arising on the retranslation of non-monetary items carriecl at fair

value are included in the income statement account for the period except for diff'erences arising on the retranslation of non-monetary items in respect of gains and losses ane recognized directly in equity. For such non-monetary items, any exchange component of that loss or gain is also recognize in equi$'.

2.3 Cash and cash equivalents Cash comprises cash on hand, depositheld

atcallwith banks butexcludes deposits with

banks that are held to maturity, and certificates of deposit issued by commercial banks and

financial institutions, and restricted deposits. Cash equivalents comprise short-term highly liquid investments with maturities of three months or less from the date of acquisition.

..

Director nningJ

The Wonca Trust Note To The Financial Statements 31 Decernber 2020

L

2.4 Trade account receivables

Trade accounts receivable are initially recognised at the fair value of the consideration received or receivable and subsequently measured at the remaining amount less any allowance

for doubtful receivables based on a review of all outstancling amounts a[ the year end. The amount of the allowance is the difference between the carrying amount of the receivable and the amount expected to be collectible. Bad debts are written-off during the year in which they are identified and recognised in the income statemenL

2.S

lnventories lnventories are stated at the lower of cost or net realisable value .Cost is determined by the weighted average method. The cost of purchase comprises both the purchase price and costs directly attributable

to the acquisition of the inventory such as import duties

and

transportation charges, less all attributable discounts, allowances or rebates. Net realisable value is the estimate of the selling price in the ordinary course of business, less the cosls of completion and selling expen.ses. The amount of any write down of inventories to net realisable value is recognised as an expense in the period the write down occurs and presented as cost of sales.

Signed

/.

[Mr.Garth

...

nder Ken

Director nningJ f,U

The Wonca Trust Note To The Financial Statements 3l December2O2O

2

2,6 Equipment An item of equipment is stated at cost less any accumulated depreciation.

The cost of an item of equipment comprises its purchase price, import duties and non-

ref'undable purchase taxes [after deducting trade discounls and rebates) and any costs directly attributable to bringing the asset to the location and condition necessary for it to be capable of operating in the manner intended by management.

Depreciation is calculated on the straight-line basis to write-ofT the cost of each asset to its residual value by using the estimated useful lif'e of the equipment. The estimated useful lives are as fbllows: OfTice

furniture and equipment

5 Years

Computer and equipment

3 Years

2.7 Provision Provisions, are recognised when the Trusthas a

a

presentlegal or constructive obligation as

result of past events, it is probable that an outflow of resources will be required to settle the

obligation, and a reliable estimate of the amount can be made.

2.8 Revenue recognition Revenue comprises the fair value of the consideration received or receivable for the sale

ofgoods and servicenetofoutputtax, rebates and discounts. Revenue from sales ofgoods is recognised when .significant risks and rewards of ownership of the goods are transferred to

the buyer. Revenue from rendering services is based on the stage of completion determined by referring to services perfbrmed to date

as a percentage of

total services to be performed.

Director Manning) 1.r

The WoncaTrust Note To The Financial Statements

31 December 2O2O

2 2 "9

Measurement currency The measurement currency of the Trust is the United States (US) dollars. As the Trust's

investments and funds flrom financing activities are denominated primarily in [.JS dollars, the Trustee is of the opinion that the US dollar reflects the economic substance of the underlying events and circumstances relevant to the Trust.

3

Cash and cash equivalentg

Unit:

Cash on hand Cash at Paypal Cash at banks - current accounts Cash at banks - saving account

Total cash and cash eouivalents

USD

2Q20 7,8L5 62,247

638,792 ..

708,944

201.9

7,487

36,969 Bg3,g00

5A,Ig7 gBB,553

!z

The Wonca Trust Note To The F'inancial Statements 31 December 2020

4. Eouinment. net

furniture

Computer and and equipment equipment

Office,

USD

Total USD

Cost: As at 31 December 2019

74,944

Writen off

18,401.

(L4,944)

[18,401l

lI0,687)

[14,135)

As at 3L December 2020

Accumulated depreciation As at 3L December 20L9 Depreciation for the year Depreciation on written off As at 31- December 2020 :

(3,448)

3,448

Net book value : As at 31" December 2019 As at 31 December 2020

[1,85 L)

12,538

4,257

Depreciation - Assets for the year 20L9 Depreciation - Assets for the year 2020

[1,85].1

15,986

4,266 2,489 1,851-

{

Signed

...

[Mr.Garth

Director Manning)

1,.,,....

L3

The Wonca Trust Note To The Financial Statements

3l

5

December2O2O

Otherpayahlesandac Unit:

USD

2020 Taiwan FM Research award Professional cost Besrour WONCA Prize Accrued personnel expenses Deferred revenue 2018 HOC Support Young Doctor Activities WONCA Europe Other accrual Total other payables and accruals

6

4,1.58

6,995 523

994 33,865

5,000

5,000

700

486

3,3 B1

100 53,603

25,599

Trustls aeeumulated frlnds

Unit:

2020

Advance from Advance from Advance from Advance from

Asia Pacific Regional Reserves Fund WP - Environment WP - Education WP - Rural Practice Fund Advance fiom East Mediterranean Advance ftom WP - Mental Health Advance from WP - Women and Familv Medicine

Atai Bursary Africa Capital Stock

Total trust s accumulated fund

7

20L9 9,000

9,000

USD

1,95,350

2019 195,004 122,626 6,L70 25,57A

10,384 6,L70 25,570 1.7,BBB 77,BBB 27,650 24,190 1,91, 191 842 842 95 1,015 94,282 94,282 379,732 487,778 1-,3

Subscrintion incomes

Member organizations' dues Member academies'dues Direct individuals' membership dues

Unit:USD 2020 201,9 462,41_4 457,623 3,428

32,975

Conference levies

Sponsorship income Licences and royalties Consultanry income

Total subscription income

3,815 49,675 49,201,

21,640 7,028 722,47L 649,956

22,600 3,370 1,81,,497

767,7Br

t4

The Wonca Trust Note To The Financial Statements 31 December 2O2O

I

0ther income Unit:USD

202Q 465 521,

Sales - WONCA guidebooks and merchandise

Interest income Other income Total other income

2AL9

1,2AI

8L6 5,'J.74

986

7,1_97

I Unit:

2020

USD

2019

Executives' expenditures

President President Elect

6,844 478

19,858

CEO

4,000 8,618

L4,757 36,683 64,483

World Health Organisation Liaison Members' of executive Young Doctor Movements Young Doctor Website

24,74r 2,469

5,354

2,r58

47,r5A

r43,293

A[rica North America

6,755

7,934

Asia Pacific

1,000

Regional expenditures 3,271,

Ibero-Americana

L,000

6,000

South Asia East Mediterrannean

1,085 B,B40

Total President executive and reglonal expenses

55,990

3,L28 4,000 25,333 168,626

Director Manning) 15

The WoncaTrust Note To The Financial Statements

3l

DecemberZA2O

10 Secretariat expenses Unit:USD

2020 Secretariat rental Secretariat general budget Secretariat transition b udget ICPC Maintenance and development Total secretariat expenses

2019

20,232

347,606 164,775 5,000 531,613

20,492 342,493 8,457 5,000

376,042

tI Unit: Rural practices Quality in Family Medicine Education Committee E - Health Mental Health Total special projects' and working parties' expenses

USD

2020 44

2A19 1,000

534 1,000 L,000 1,000

44

4,534

12

Unit:USD

Editor's professional fee Webmaster and hosting WONCA Communication Total publications and communication expenses

Signed

f..

[Mr"Garth

2020

20t9

26,166 3,916

26,000 4,569

5,988 36,070

].0,L22

40,691

Director Manning) _LO

The WoncaTrust Note To The Financial Statements 31 December 2OZO

13 Other olerating expenses Unit:USD

2020

Bank charges Exchange loss

1_2,964

2019 14,067

1,507

Professional fee Discretionary Fund

2,502 30,000 4,267

Audit fee Postage and courier charges

Stationary expenses Insurance expenses Depreciation expenses Registration fees WONCA souvenirs Consultanry Expenses

351

4,L58 893

5,357

5,000

3,115 L,851

3,07!

200 39,298 L45

Cost ofgoods sold

Corporate income tax Non-refundable and other expenses Total operating expenses

2,r05

5

2,489

750 194 63,955 55 33

6,622

108,184

96,764

Director Manning)

t7

Thank you to the WONCA Executive, Chairs/Conveners of WONCA Working Parties, Special Interest Groups, and Young Doctor Movement Groups for their assistance in the completion of this report.