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WMA meeting: Bioterrorism requires local and global response

The World Medical Assn. emphasizes the role of physician organizations, and physicians themselves, in combating biothreats.

Editorial. Oct. 28, 2002. Additional information

Disease does not know politics, does not respect boundaries and cannot be contained by treaties. These are basic truths about infectious illnesses that physicians well understand -- and a reality made more chilling when considered in the context of bioterrorism and biological weaponry.

The World Medical Assn.'s annual meeting, held earlier this month in Washington, D.C., was a landmark event for this reason. It was the first time the international physician community met to discuss its critical role in responding to these insidious threats.

Interestingly enough, the American Medical Association, the meeting's host organization, selected the theme for the WMA general assembly's scientific session long before the frightening concept of bioterrorism became a domestic reality last fall with an anthrax outbreak. Now, there seems to be an emerging consensus: Complacency is no longer an option.

A resolution passed by the WMA's general assembly underscores that there is a lot out there to worry about. Technology has afforded newfound potential for the production of microbial agents. Add to this the ease of travel and the globalization of society, making an outbreak in any one place a possible threat to all. Finally, any such outbreak on a large scale could exhaust entire health systems, both in the developing countries and the industrialized world.

But the WMA also developed marching orders based on the sessions that provide a promising framework for action.

In its resolution, the general assembly encouraged national medical associations to focus their policy-makers' attention on the implications of biological weapons and to mobilize universal support for condemning research, development or use of such weapons as morally and ethically unacceptable. International collaboration in this area is also necessary, including the establishment of a consortium of medical and public health leaders to monitor these threats, to identify actions likely to prevent bioweapons proliferation, and to develop a coordinated plan for monitoring the worldwide emergence of infectious diseases.

In addition, these groups should communicate to policy-makers the need to invest in their own countries' public health systems. The goal, of course, is to build capacity to detect, respond to and investigate disease outbreaks -- whether deliberately induced or naturally occurring.

Meanwhile, all physicians who participate in biomedical research are urged to consider the results of their labors and to weigh carefully the balance between the pursuit of scientific knowledge and ethical responsibilities to society.

In terms of what can result from this meeting, the reactions and responses of each of the 76 member organizations will vary, and much will depend on where they start -- whether they are industrialized or developing nations, said former AMA President Randolph D. Smoak, MD, the WMA council chair. For everyone, education is the underlying theme, and hopefully the WMA's messages will be plugged into existing public health systems to improve what is already there, he added.

Another clear-cut directive emerged. While physicians everywhere need to think globally about this issue, they should also be acting locally.

This includes being involved in local, state and national disaster preparedness and outbreak response planning. It also requires physicians to be aware of strange illness patterns among their own patients and know how to link with public health officials. Vulnerabilities persist where individual physicians, or nations, fail to be vigilant.

To underscore the importance of doctors in the trenches, AMA Immediate Past President Richard F. Corlin, MD, reminded the general assembly about America's own recent experience in identifying victims of anthrax. It was always a physician in practice who hadn't seen the disease but who was alert enough to contact the public health department. That's what made the difference.

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Copyright 2002 American Medical Association. All rights reserved.