Colleagues, Honored Guests, Friends:

As President of MWIA I am delighted to welcome you to the 2001 Silver Jubilee Congress here in Sydney.

We have an illustrious history. MWIA is the oldest established international medical group, having been founded in 1919. We have members in all 5 continents (74 countries). We are an NGO in consultative status with the United Nations via its Economic and Social Council. We have liaison status with WHO, WMA, CIOMS and all organizations with human rights and health rights for women as their basis. Our Statements and resolutions are circulated and are recognized among all medical bodies giving visibility to our advocacy for women and children.

In this historic city we face immense challenges to the practice of medicine and to our association. As we look forward and set the stage for the future, we know we must also look back to know who we are and where we belong.

The theme of this Congress echoes the theme I chose for my Presidency triennium -Health care in a multicultural world and access to that health care for women’s needs. Multiculturalism along with globalization of health care raises questions about power, advocacy, facilitations of processes and rationalization of research.

The gaps between the health care that is possible and the health care that is delivered represent failures to translate scientific advances, improvements in education and the organization of health care into better health. To go from making simple insurance available to getting high quality care for those who need it can be achieved once there is careful understanding. The ability to embrace special interest, special needs and new programs to protect the health of women and children in our practices and to create the interactions that transcend separate cultural interests can be accomplished within the global bonds of MWIA and its members.

Access to medical care is an issue that international organizations have taken up as a priority. Health care leaders cannot be complacent with just providing access to basic insurance coverage, important as that is. Nor can they be satisfied with just a bill of rights that ensures individual access to the care insurance should cover.

We know that we must hold our individual governments and ourselves accountable for discouraging gender discrimination and lack of access.

We know we need to build networks, coalitions and cooperation with all sector of society to effect access to quality, affordable health care.

We know we need to coopt the globalization forces such as new technologies and instant communications to effect care, to spread the word and turn those words to deeds.

We know there is a wide gap between industrialized and developing countries especially in education and legislation.

We know violence against women and girls cuts all national, economic, cultural and social boundaries.

We know analysis of these problems requires a holistic approach around the common underlying causes of poverty, discrimination and lack of education.

The problems affecting access to health care are social, political, financial and physical. Inadequate facilities, budget, language barriers, corruption and purchasing power all damage access.

Information gaps, cost and price issues, intellectual property protection, non-competitive networks further impact on an unequal infrastructure.

Dr. Gro. Brundtland, Director-General of WHO, when addressing The Health, Technology and Pharmaceutical meeting in Geneva said ”There will be no quick fix”. To success in bridging the gap we will need to broaden the partnerships between governments of developing countries, financial institutions and the pharmaceutical industry.

Sustainable access will require not only creative financing and a reliable supply system but progress in all these dimensions.

Our diversity of language, cultural attitudes and educational levels can work to our advantage and be a positive force as we work together to emphasize our similar needs.

As important as the need to improve access for the widest possible populations is the work to ensure that what they gain access to is of quality that satisfies both safety and ethical standards. We will need to work at achieving evidence based treatment guidelines and drug selection to improve drug quality, strengthen supply systems and promote more rational use of drugs.

All players through research and development can act as advocates for developing countries, diverse populations and public health needs.

High quality health care will be achieved only if the barriers are addressed, the challenges met with careful attention and commitment to an active role, both by government and the private sector. Strong national leadership, better ways to measure the problems of quality and the strategies needed to address them.

This is our mandate for the future. As women physicians, our association can be a motivating player, lending our expertise, wherever needed to facilitate access, quality and well being for our patients and ourselves.

MWIA will position itself in the ensuing millennium to help bring the right care at the right time for the right person in the right way.

Lila Stein Kroser, M. D.
President, MWIA