"Our thoughts and prayers are with Joao's family at this unimaginably difficult time," said Peter McCabe, Chief Executive of Headway – the brain injury association.
"Everyone at Headway understands how agonising it is for a family to wait by the hospital bedside of their loved one, hoping and praying they will regain consciousness.
"Sadly, Joao is not the first fighter to lose his life as a direct result of catastrophic brain injury caused by deliberate blows to the head and he won’t be the last.
"MMA markets itself as a brutal, money-making spectacle. When the objective is to render opponents senseless by kicking and punching them in the head, it is no surprise when someone is seriously hurt and sustains fatal neurological damage.
"The very nickname of Joao's opponent, Charlie 'The Hospital' Ward, highlights the calculated brutality of this so called sport.
"There is clear evidence – backed by the BMA and numerous other medical associations across the world – that the cumulative effect of repeated blows to the head, as suffered by all MMA fighters and boxers, can cause permanent brain injury.
"Too many individuals are forced to struggle on a daily basis with the devastating effects of brain injuries sustained in unavoidable circumstances, such as accidents or illness. It is difficult for those families to comprehend why someone would willingly put themselves at risk of lifetime disability or death.
"If participants of MMA fully understood what it means to lose a loved one or struggle to walk or feed yourself, perhaps they would think twice before entering the ring.
"A 28-year-old man in the prime of his life has died after someone deliberately punched him in the head. If this had occurred in the street, the public's reaction would be one of horror and revulsion. The police would be called and the fighters arrested. Instead, as a society we continue to sit back and allow audiences to pay money to watch this violence in the name of entertainment. As the popularity of MMA has soared, there are people making vast sums of money by encouraging young people to risk their lives. How do they sleep at night?
"Published reports suggest that MMA fighters receive only a small fraction of the income generated. The time has come to turn a big spotlight on the finances of MMA. It cannot be ethical that MMA promoters sit comfortably on the sidelines counting their money while participants risk paying the ultimate price in the name of entertainment.
"If all protocols were followed by the referee, we must ask how such accepted rules can possibly be labelled 'safety regulations' if they allow a participant to die as a direct result of a brain injury sustained in the ring.
"Even UFC star Conor McGregor, who witnessed the fight, said before Carvalho's death that he 'thought it could have been stopped a little earlier and feel these referees need to be on the ball a little bit.'
"So often we hear calls that these blood-sports should have been stopped several rounds earlier – but it is a bit late when a young man has lost his life.
"At a time when responsible sports bodies are rightly taking action to improve their concussion protocols to ensure participants are properly cared for when accidental collisions occur, it seems perverse that MMA can be allowed to continue to encourage trauma to the brain.
"There is no conceivable way in which MMA can even remotely be considered safe. How many more young men need to die before we take action?”
Headway's position is supported by medical associations across the world, including the World Medical Association and the British Medical Association (PDF).
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