Indian Medical Association: time to clean house

The IJME editorial in the January-March 2011 (1) issue calls on the Indian Medical Association (IMA) to reform itself in order to be able to play a more proactive role in health activism in the country. As the largest body representing (allopathic) doctors in India, the IMA can use the leverage of numbers and presence across the country to push for much needed health reform. This would be in line with its theme for the year as mentioned on its website (2) “Be in Health, Be active in Public Health. “For this, the IMA needs to go beyond its current narrow focus on its primary constituency, doctors in private practice, to a more comprehensive approach to public health in the country.

The recent controversy around the introduction of the Bachelors in Rural Health Care (BRHC) course saw the IMA condemn it as a “move to produce half-baked doctors for the rural population” (3). Interestingly, when the Medical Council of India (MCI) was initially working on the concept of the course, Ketan Desai, who headed the MCI and was actively involved with the IMA had criticised the existing medical education model as being too “urban-centric” (4). It Is not very clear what alternative the IMA prefers to cater to the health needs of the rural population; though it does mention an initiative called ‘Aao Gaon Chalen’ on its website (2) where local branches have been encouraged to adopt a village each. The Revised National Tuberculosis Control Programme (RNTCP) has also collaborated with the IMA through a public-private mix model to engage with the private sector for tuberculosis control in the country (5).

However, the controversies about brand endorsements by the IMA have cast a shadow over the organisation. The election of Ketan Desai (who continues to be prominently featured on the IMA website) to the position of president elect of the World Medical Association in 2009, as an IMA representative, was also deplorable. As an aftermath of his arrest, Desai’s inauguration as incoming president was suspended indefinitely by the WMA in its annual meeting in Vancouver, in October 2010. It is high time the IMA did an organisation-wide introspection and cleaned house.

There is little doubt that the IMA could use its resources, public profile and membership strength to galvanise public health reform in India. It is crucial that, in its 83rd year of existence, the leadership of the IMA takes on the challenge of devising a new path for the organisation that incorporates ethics and a core commitment to equity in healthcare.