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REPORT OF THE SECOND SESSION OF THE GENERAL ASSEMBLY OF THE INTERNATIONAL COMMITTEE OF MILITARY MEDICINE HELD IN WASHINGTON DC
ON WEDNESDAY, SEPTEMBER 15TH, 2004 AT 1500 HOURS ON THE OCCASION OF THE XXXV WORLD CONGRESS ON MILITARY MEDICINE

Chairmanship: Chairman (Dr. William Winkenwerder, Jr) (permitted to vote); Secretary General (Dr. Jacques Sanabria); 2 Deputy-Chairmen LtGen Rinus Jansen Van Rensburg and ColGen Ivan Chizh) (permitted to vote) ; Deputy Secretary General (Temporary) (MajGen Timo Sahi) ; Chairman of Scientific Council(MajGen Andre Pasturel) (permitted to vote).

Members present and allowed to vote: 56

In alphabetical order:
Afghanistan, Australia, Austria, Albania, Algeria, Angola, Belgium, Brazil, Bulgaria, Burkina Faso, Chile, China, Croatia, Cyprus, Czech Republic, El Salvador, Estonia, Finland, France, FYROM, Germany, Ghana, Greece, Holy See, Hungary, India, Italy, Jordan, Latvia, Lebanon, Lithuania, Malaysia, Mali, Malta, Morocco, Nicaragua, Nigeria, The Netherlands, Peru, Poland, Romania, Russian Federation, Ivory Coast, Saudi Arabia, Serbia & Montenegro, Singapore, Slovenia, Switzerland, Spain, South Africa, Sweden, Tunisia, Turkey, Uruguay, United Kingdom and United States of America.

Members present but not permitted to vote: 9
Argentina, Bolivia, Cameroon, Chad, Dominican Republic, Honduras, Liberia, Paraguay and the Philippines.

Observers: 4
Canada, Guatemala, Namibia and WHO.

12. Commission of Accounts Report:
Audit of ICMM Accounts: Three nations volunteered to review the ICMM accounts: India, Tunisia and Nigeria. The Nigerian representative provided a report of their findings in which bank statements, deposits, withdrawals, etc were reviewed. They were satisfied that the accounts were accurate for the period January 2002 to December 2003. In addition, they found that 40% of the member states had not paid their dues.

The Audit Committee recommends:

a. A revised Standing Operating Procedure (SOP) to be prepared, documented and followed;
b. A running ledger system of accounting to include all financial transactions.

They wish to express their thanks to the Secretary General and his team for their assistance and cooperation.

The Chairman proposed a vote to approve the auditors’ report.
Approved=42 votes and Opposed=0 votes.

13. Debate:

(a) Objectives 2005-2006: Dr. Jacques Sanabria, Secretary-General; briefly reviewed the objectives outlined at the first session and asked for comments on the content of the objectives. The representative from the Holy See commented on the increasing gap between wealthy and poorer nations. His concerns were that there are many new developing technologies in the field of medicine, which could benefit people on a global basis and should not be just available to the wealthier nations. He recommended that this topic be added as a discussion idea for the next Congress.

Returning back to the 5 key words proposed during the first session in which the following proposed objectives for 2005-2006 were outlined:

1) ICMM = Forum of exchange
2) Training and Education
3) International Assessment of major disasters
4) National Medical Advisers

5) International Humanitarian Law

The Chairman asked for a vote on the proposed key words.
Approved=45 votes and Opposed=0.
The Chairman asked for a vote on the proposed objectives 2005-2006.
Approved=55 votes and Opposed=1.

(b) Permanent Working Group: The proposal was to establish a (Permanent) International Working Group whose membership would be based on the UN Security Council model with permanent national members and the other positions rotating amongst the nations.
Admiral Ocker, (Germany) agreed on the need for such a working group but was not pleased to use the Security Council model. He stated that it is a model, which is 60 years old and based on the political situation following the end of World War II. He further stated that something more modern was needed. He proposed that the group be made up of 15 members and three of the members would be drawn from former conference presidents’ who have hosted the ICMM, the current president and the future president. These 3 representatives would make up the basis of the working group for 6-year terms. Then the other 12 members would be selected from the six regions of the world:
  • Two from North and Central America (5 countries)
  • Two from South America (8 countries)
  • Two from Africa (20 countries)
  • Two from Asia (16 countries)
  • Two from Australia/Pacific (13 countries)
  • Two from Europe (39 countries)
Spain and Nigeria supported German’s proposal on the membership of this group; Nicaragua supported the model of Security Council at least temporarily, but asked that regional representation be taken into consideration when establishing the International Working Group.
The Secretary General will propose a revised text during the GA of St Petersburg.

The Chairman asked for a vote on the proposal to create a Permanent International Working Group using the German proposal.
Approved=48 votes and Opposed=0 votes.

(c) Regional Working Groups: The Nigerian representative further stated that harmonisation between the regional groups and the international working group would be needed.

The Chairman asked for a vote regarding the need to reinforce links with the regional groups.
Approved=48 votes and Opposed=0.

There was a proposal on reinforcing the activities between ICMM and International organisations like Red Cross and WHO.
Approved=56 votes and Opposed=1

14. Debate: Budget 2005: Following a brief review of the budget requirements for 2005 and questions by the representatives of Germany and Netherlands, the Chairman asked for a vote to approve next year’s budget.

Approved=53 votes and Opposed=0.

15. New membership fees

On behalf of the Secretariat General, MajGen Marcel Merlin presented a proposal for new membership fees. During the discussion representatives of the Netherlands, South Africa, Brazil, Malaysia, United States, Austria, Nicaragua, Holy See, Switzerland, Belgium and Uruguay presented various comments and questions.

The Chairman concluded the debate and reviewed the proposed methods of handling the budgetary deficit and stated that several nations had failed to pay which has lead to a 25% shortage in the operating budget. He asked that the members vote on two options:

- the first option would be to maintain the current system with a 25% increase in membership fees and
- the second option is to use a new formula, which is based on World Bank data and will result in some of the larger, industrialised nations paying more and the developing nations paying less.

- Option 1 – maintain current formula + 25% increase : 12 Yes votes
- Option 2 – adopt new formula using World Bank data: 30 Yes votes

The second option passed with the majority of votes and was adopted by the General Assembly. It was also decided that for the remainder of calendar year 2004 the nations would continue to pay along the old system and for 2005 the membership fee payment system would be maintained on a provisional basis. Further more, the Assembly approved the principle of the new system as presented by General Merlin on behalf of the Secretariat General. This new system is based on the World Bank and International Monetary Fund data in which the size of the population is taken into consideration. The Assembly asked the Secretary General to present at the next Congress the new method of calculating the fees, which would include a thorough analysis of the data to include weighing and balancing the various criteria. This project should be formally adopted in St. Petersburg.

Dr. Winkenwerder stated that if nations have difficulty paying their membership dues then they should inform the ICMM regarding the reasons. In addition, there should be a more vigorous method of collecting dues and a method to enforce payment would be found.

16. Debate: New technical commissions: There was a great deal of debate regarding the numbers of commissions and whether or not there was even a need for the three new commissions. The Spanish representative restated his position that he was concerned that subgroups would serve only to fragment the ICMM’s efforts. The representative from the Netherlands agreed with the Spanish representative and saw no additional benefit to create more subgroups. Morocco made a proposal of 2 commissions and the German representative also agreed in principle with the Spanish position but thought 2 new commissions should be established: South Africa also supported the idea of two commissions.

The Chairman summarised the issues regarding the various positions of the members. There were two basic positions: those who supported the establishment of two new committees and those who did not support further expansion of subgroups. He called for a vote and the results were as follows:

1) Those nations in favour of the creation of two commissions as proposed by Germany: 27 votes.
2) Those nations not in favour of expansion: 36 votes.

The Chairman stated that although these subgroups had merit, the proposal needed to be refined and study further and perhaps discussed in St. Petersburg.

17. Debate: Cooperation with the WHO: The Chairman restated the proposed change made during the first session which was to replace the words “Member states” with “Members”. (A copy is attached).

Members who approved the change: 54 votes and those against the change: 4 votes.

18. Proposed Resolution - HIV/AIDS and Related Diseases: Ms. Ellen Embry, the US representative briefed that a proposed ICMM statement regarding cooperation and collaboration between member representatives. The statements were distributed in Spanish, French and English and were discussed in open forum. Several changes were made to the statement following discussions in which several members stated that they did not necessarily represent their nations in the political sense therefore, the cooperation must be strictly between member representatives vice member states. The changes were made by Ms. Embry during the discussion and the Congress voted. (A copy is attached).

Approved the statement: votes in favour and votes against.


19. Miscellaneous Points:

Russia: Welcome to St Petersburg with presentation of a video.

Nicaragua/Guatemala: The representatives from Nicaragua and Guatemala provided an excellent presentation on medical cooperation amongst the Central American nations of Costa Rica, El Salvador, Guatemala, Honduras and Nicaragua.

The Chairman expressed his thanks and appreciation to the Secretary General, the ICMM staff and the national representatives for their participation and support.

The meeting was adjourned at 1800 hours.

Washington, D.C. 15 September 2004.

Next General Assembly
June, 6 and 8, 2005 in St Petersburg (Russian Federation)