WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
•
ORGANISATION MONDIALE DE LA SANTE
REG IONAL COMMITTEE Seventh Session Manila 7-13 September 1956 MINUTES OF THE FIFTH MEETmG
wp/RC7/Min/5 Rev.l 28 September 1956 ORIGINAL: ENGLISH
Institute of Hygiene Wednesday, 12 September 1956 at 2:30 p.m. CHAIRMAN: Dr. J. Bierdrager
CONTENTS
1 2
Speeches by Representatives of other InterGovernmental Organizations • • • • • . • • Rights and obligations of Associate Members and other Territories in the World Health Assembly and the Executive Board, and in the Regional Organization ............... .
4
6 11 12
3 4
Speeches by Representatives of Non-Governmental Organizations in official relations with WHO • • . World health situation Relations with UNICEF
5
....
15 15 18
6 7
Amendments to the Rules of Procedure of the Regional Committee for the Western Pacific Future organizational studies; regionalization
wp/RC 7/Min/5 Page 2
Rev.l
Fifth Meeting
Wednesday, 12 September 1956 at 2:30 p.m.
PRESENT I
Representatives of Member States AUSTRALIA CHINA (TAIWAN)
Dr. H. E. lXlwnes Dr. L. C. Yen Dr. C. H. Yen Dr. Y. T. Kuo Medecin-Colonel R. Augere M6decin-Colonel Aretas
FRANCE JAPAN
Mr. A. Saita Dr. C. C. Lee Dr. K. Keola
KOREA LAOS NErHERLANDS NEW ZEALAND
Dr. C. S. Sayavongs Dr. J.
Bierdrager
Dr. F. S. Maclean Dr. R. Dr. E. Dr. T. Dr. A. Tumbokon Agustin Gomez C. Regala
PHILIPPINES
PORTUGAL UNITED KINGDOM
Dr. J. de Paiva Martins Dr. W. Glyn Evans Dr. Mohamed Din bin Ahmad
Dr. M. Doraisin@lam
Dr. A. R. EdI:londs Dr. G. Graham-Cumming
UNITED STATES
Dr. R. K. C. Lee Dr. K. Bain Dr. H. DeLi en Dr. L. K~ Quycn Dr. P. G. Can
VIEr NAM
WP/Rc7/M1n15 Rev.l Page 3 II Representati ves of other Inter-Governmental Organizations SOUflI PACIFIC COMMISSION
Dr. Thos C. Lonie
III
resentatives of Non-Governmental Or anizations in official relations wit WHO INTERNATIONAL COUNCIL OF NURSES MEDICAL WOMEN'S INTERNATIONAL ASSOCIATION Mrs. R. Ordiz
Dr. R. Rivera-Ramirez
Secretary:
Dr. I. C. Fang Regional Director
WP/RC7/Mln/5 Rev.l Page 4 1 SPEECHES BY REPRESENTATIVES OF OTHER INTER-GOVERNMENTAL ORGANIZATIONS
Dr. Thos. C. Lonie (South Pacific Commission) Dr. LONIE informed the Committee that there was no formal overall agreement or protocol between WHO and the Commission relating to technical assistance generally, but they hoped to co-operate increasingly closely in relation to projects of common interest in the future, probably by the holding of education and training courses in certain subjects, and at certain levels. The Commis.:.ion had asked the Technical Assistance Board
for assistance in health education in 1957, and provisionally for specific help for the mos~uito-borne
diseases project in 1958.
Dr. LONIE stated that the Commission was an international body and was set up in 1948 by the six metropolitan governments - Australia, France, the Netherlands, New Zealand, the United Kingdom of Great Britain and the United States o£ America - who were between them responsible for the welfare and development of the Island Peoples of the South Pacific. The spheres of
work concerned related not only to health but also to economic and social development, and it was intended to maintain close liaison between these three aspects of welfare. It was run by the Governments through Commissioners
two for each Government - who met once or twice a year to consider the work programme, and to approve the budget whose total amount - round about £200 000 Stg or $560 000 - was met by the metropolitan governments in proportion to the extent of their commitments in the area. There was a Secretary-General and also Executive Officers responsible for three seetions into which the work was divided. A Research Council
wp/RC7/Mln/5 Rev.l Page
5
had also been established, of 'Which the Executive Officers would be permanent members With a f'urther eighteen - that meant one for each 'WOrk section, nOminated by the six Member Governments. There were, therefore,
six Research Council Members for the health section who were persons of knowledge and experience in island territory work, usually senior or principal medical officers. The Research Council met once a year to con-
sider and advise upon the 'WOrk programme for the ensuing year and finally to recommend a programme and budget to the Commission itself. Every three years the South Pacific Conference was held, where representati ves of the indigenous peoples of the seventeen or eighteen Pacific Island Territorial Governments met to discuss their common problems, and to express their minds to the Commission as to 'What work they would like to see done in the area and 'What their difficulties were. The Commission so far had functioned only as a consultant and advisory body. Much of its work had been in the employment of expert conSultants
to examine and assess what sppeared to be major problems in the fields of nutrition, mosquito-borne diseases, and with a top priority, health education. This latter activity was a departure from the policy of conThe CommiSSion did not work in the field of
sultation and advice only.
treatment 'Which it considered was the responsibility of territorial severnments and WHO. Dr. LONIE referred to the visit of the Regional Adviser on Health
Education 'Who, With Dr. Guy Loison, had undertaken a tour of territories ,in the South Pacific. As a result, WIIO, with,it was hoped, the su.pport of
the Technical Assistance Board, and the Commission were planning a health education course for the Island People.
wp/RC1/Mln/5 Rev.l Page 6
In closing, Dr. LONIE referred to the visit the Regional Director
would make to Noumea in October and stated that this meeting might be of very great importance in orientating the work of the future. 2 RIGHI'S AND OBLIGATIONS OF ASSOCIATE MEMlJERS AND OTHER TERRITORIES IN THE WORLD HEALTH ASSEMDLY AND TIlE EXECUTIVE BOARD, AND IN TIlE REGIONAL ORGANIZATION (wp/RC7/14 ) The SECRET.ARY stated that one of the main points under consideration was whether or not AssociaLe Members should have full voting rights in the regional. oormnittee meetings. The other was whether, if such add! tional
rights were to be granted, there should follow an increase in the financial contribution of Associate Members to the Or,zanization. The SECRETARY added
that in resolution WIIA9. 32 the Ninth World Health Assembly had requested the regional committees to study the subject and to report thereon. Medecin-Colonel ARETAS (France) said that the Committee should study only the proposals concerning the regional organizations. He wondered,
however, whether the Committee need study the matter further as it had
already passed a resolution on the question at the fourth session. Dr. F.S. MACLEAN (New Zealand) asked if there were any Associate Members in the Western Pacific ReGion and was informed that there were none. Dr. W. GLYN EVANS (United Kingdom) stated that this subject was
of particular interest to the United Kingdom delegation because it was
very probable that in the near future there might be some territories represented in the delegation now who would become Associate Members. Some of the territories in Africa had already become Associate Members of WIrO and the United Kingdom delegation was in favour of more territories becoming Associate Members. As far as the votes of Associate Members
WP/RC7/Min/5 Rev.l Page 7 in Regional Committees were concerned, the United Kingdom Government had no very strong view except that it believed that voting powers of Associate Members should not be at the World Health Assembly level, i.e., that they should come to Regional Committees and be able to express their views freely as Associate Members in Regional Committees but no higher. One great
advantage of associate membership was that the interests of the members were likely to be expressed muCh more clearly and originally.
Dr. A. C. REGALA (Philippines) asked if, after Associate Members had been given rights and privileges amounting to full membership, there would still be a need to differentiate between full members and Associate Members, or did the Constitution define the limits. Medecin-Colonel ARETAS pointed out that the answer to this question could be found in Annex II of the document. He was of the opinion that the
question of whether Associate Members should have the same rights as other Members was not a matter for regional committees to decide but should be decided by WHO or the Health Assembly.
Mr. A. SAlTA (Japan) said that this item had been referred by the Health Assembly to Regional Committees so that the latter could formulate recommendations as regards the voting rights of Associate Members in the regional committee meetings only and not in the Health Assembly. Although
the Committee had no power to decide on the question, it had been asked to make recommendations to the Health Assembly. It was his government's view
that since these two categories of members had been separated in the Constitution there should be a difference between the rights and privileges of each category. However, since this was not a political organization
but a health organization, his government believed that rights should be
wp/RC7/Min/5 Rev.l Page 8 accorded as much as possible to countries interested in the promotion of health. The question of granting voting rights should be studied carefully
and, since there were no Associate Members in the Western Pacific Region, it seemed that it would be rather premature for the Regional Committee to make any recommendations at this stage.
Dr. C. H. YEN (China) asked if, even without the presence of Associate Members at this stage, the territories represented by governments had found any difficulty in expressing their wishes or opinions, or whether they had not been receiving sufficient service or attention. If the answer was in
the negative, then his delegation would be inclined to think that it would be premature to consider the matter, and that consideration should be delayed until difficulties occurred. Medecin-Colonel ARETAS said tllat, while it was true that the Health Assembly had asked Regional Committees to consider the matter, there was no Associate Member in this region; in Africa, however, the matter 'VDuld be different.
Dr. H. E. DOWNES (Australia) stated that a number of the
members of the Committee had in effect asked for a defernlent of the consideration of this subject. However, tile Ninth World Health Assembly
had asked for the views of the Regional Committees and these should be expressed. The views of the Australian Government were that amendments to paragraph
3(2) of resolution WHA2.103 and paragraph 3(3) of Annex II to document WP/RC7/l4 would be a great help. It had conSistently supported the
extension of voting rights to Associate Members in regional committee meetings and considered that the financial obligations of these members should be extended to a degree commensurate with the elevation of their status.
WP/RC7/Min/5 Rev.l Page 9 Dr. EVANS pointed out that although in theory there were no Associate
Members present at this regional committee, in practice it might be said that there were Associate Members. The five members of the United Kingdom
delegation represented dependent countries that might at some future time become Associate Members. M6decin-Colonel ARETAS commented that at present Hong Kong, Sarawak and Singapore were not Associate Members and for the time being there were no such Members in this region. Referring to the point raised by the
representative of Australia that the Regional Committee should make a decision on the amendment since the World Health Assembly had asked for this, he drew attention to the fact that the amendment had not been 8ubmitted by the Regional Committee nor by the Health Assembly, but by a Member State of the Regional Committee. As he had already suggested previously, this
question should be deferred until there actually were Associate Members in the Regional Committee. He then asked that the proposal concerning the
deferment of this question be put to the vote.
Mr. SAITA stated that the proposal had not been submitted to this regional committee but that the Vietnamese Government had presented its proposal to the Health Assembly, which had asked the Regional Committees for comments. He referred to the suggestion made by the representative of
France to defer making a decision on the matter and said that the Committee could nevertheless draw up a resolution stating that it had no recommendations to make at the present time and then refer the matter back to the Health Assembly. Dr. MAClEAN supported this suggestion and said that it would have
been most appropriate if a working party had been established to study
wp/RC7/Min/5 Rev.l Page 10 the question. Since the session of the Committee would, however, terminate
tomorrow, it would be desirable to follow the proposal of the representative of Japan that the Committee report to the Director-General that it had no recommendations to make.
Dr. R. K. C. LEE (USA) asked if Associate Members, such as those in existence in Afric~,
contributed to the programme and budget as did the
regular members.
The SECRETARY replied that Associate Members paid three
units on the scale of assessments and the main assessment for full members was five units.
Dr. REGALA asked the representative of Viet Nam if he was introducing the amendment now or whether he only intended to refer to the stand of his government when it submitted the proposed amendment to the Health Assembly.
Dr. L. K. QUYEN (Viet Nam) replied that his government wished to maintain the amendment it had proposed to the Health Assembly, but owing to the difficulties arising from the matter and to the fact that there were no Associate Members in this region at present} he would like to have the diScussions deferred until the next session, or as soon as there were Associate Members in the Region. Medecin-Colonel ARETAS remarked that the Committee had nothing more to add since the representative of Viet Nam had already agreed to the deferment of the question.
Mr. SAITA proposed that the Committee reply to the
Health Assembly's request Simply by drawing up a resolution stating that it had no comments or recommendations to offer at this stage and suggested that the Secretariat attend to the preparation of the resolution.
Dr. DOWNES
agreed with the suggestion of the representative of Japan and said that this would be in order, as the Health Assembly had asked the Committee for its views. He thought that it would be helpful if the minutes of this meeting
WP/RC7/Min/5 Rev.l Page 11
could be furnished to Headquarters, in order that the views of the members of the Committee could be made available to the Organization.
Dr. MACLEAN supported the views expressed by the representative of Japan. The following resolution was then presented to and passed by the
Committee: liThe Regional Committee, Having considered the rights and obligations of Associate Members in the regional organizations; DECIDES to make no recommendation on this matter at the present time."
3
SPEECHES BY REPRESENTATIVES OF NON -GOVERNMENTAL ORGANIZATIONS IN OFFICIAL RELATIONS WITH WHO
Dr. R. Rivera-Ramirez (Medical Women's International Association) Dr. RAMIREZ thanked the Committee for the invitation to attend the session and stated that the theme of the Technical Discussions in this seventh session, liThe Care of the Child from 1-6", was indeed a vital problem. Mothers who were in continuous contact with their children, The Medical
played an important role in the solution of this problem.
Women's International Association, most of the members of which were mothers with special scientific training and experience, might contribute to the fast solution of this subject on hand.
Dr. RAMIREZ pledged the
Association's whole-hearted support to the work of WHO. Mrs. R. Ordiz (International Council of Nurses) Mrs. R. CRDIZ, President of the Filipino Nurses Association and representative of the International Council of Nurses, expressed appreciation of the opportunity to attend the meeting. The emphasis on
WP /RC7/Min/5 Rev.l
Page 12
the training of nursing personnel and improvement of the quality of nursing education in the Western Pacific was noted and Mrs. ORDIZ transmitted the hopes of the International Council of Nurses for realization of increased assistance for the improvement of nursing service and education in the Region. <
4
WORLD HEALTH SITUATION (wp /RC7/15) The SECRETARY stated that the preparation of reports on the 'WOrld
health situation was in accordance with Article Gl of the Constitution, and it was hoped that Member Countries and territories in the Region 'WOuld be able to submit the information requested for the period 1954 to 1956. The list of headings which the Ninth 'It/orld Health Assembly
had recommended as a basis for the preparation of the reports is contained in the Annex to document wp/RC7/l5. The importance of such reports WO~d
could not be over-emphasized, as they
provide a baSis for appropriate
planning by Member States and the Regional Office, for discussions in the Assembly and 'WOuld permit the Director-General to prepare a report to be presented to the Economic and Social Coupcil. The information called for under this subject was not to be considered as a statistical return. The information to be submitted by It was fully
governments should be what was already available to them.
recognized that many governments were not in a position either to possess or even to have a fUll organization for collecting all the necessary information. In spite of that, goyernments did know what the health
. situation in their countries was in a general way, what their adm:inistrati ve set-up was, what medical care arrangements existed, what health control
WP/RC7/Mln/5 Rev.l Page 13 and. communicable ~sea.se
control programmes were operating.
Even a nar-
rative description of this information would be most valuable. It was also recognized that without some statistics, the information would be incomplete. So, wherever statistics were available, irrespective
of their degree of accuracy, they should be included, with necessary reservations. It was not the purpose of this questionnaire to set up in ~rovement
motion at once the
of organization and collection of statistics.
The improvement of statistics should be considered as a separate project in itself, for which the Member states could request assistance from the Organization by placing suCh projects in their future programmes. The Regional Office would be glad to offer governments all possible assistance in this matter and he wished to suggest that this was a question which the regional public-health administrators and area representatives could profitably discuss during their official visits. Dr. F. S. MACLEAN (New Zealand) expressed complete agre"elllent with the statement of the Secretary as to the importance of the information required and referring to Article 61 of the Constitution, expressed the hope that all the Member States in the Region would not fail to comply. He then moved that the resolution contained in document WP/RC7/15 be adopted. Medecin-Colonel AtlETAS (France) was not in agreement with Dr. Maclean as he thought that the resolution was a broad interpretation of resolution WHA9.27 and not in conformity with the thoughts of the Aseembly. The Assembly did not have in mind that reports should be sent
to the Regional Office.
wp/RC7/Mln/5 Rev.l Page 14 The SECRETARY said it was his belief that the resolution presented for consideration was in confomity with the Health Assembly resolution WHA9.27 except in the matter of implementation, in which the subject of regionalization was considered. Dr. C. H. YEN (China) agreed with the comments of M6decin-Colonel Aretas
but thought that the Assembly did not preclude the implementation of its recommendations by the Regional Office. For practical purposes the delegation
from China was inclined to utilize the services of the Regional Office. Dr. MACLEAN agreed with the comments of the French representative and
suggested the. deletion of the words "through the Regional Director of the Western Pacific" at the end of item I of the operational portion of the resolution. M6decin-Colonel ARETA~
commenting on the general subject, called the
attention of the group to the multiplicity of items in the list suggested as a guide in the preparation of the report. He also pointed out that as
far as the French Government was concerned a detailed medical report along statistical lines was sent to the Director-General each year for all French territories. A report was also prepared for the United Nations in which
other details such as the financial and economic situation of all territories in the French Union were included. At the tenth session of the Executive
Board, his delegation had proposed that the report on health situations in Member States should be submitted over a longer period of time. The CHAffiMAN presented the resolution as amended by Dr. Maclean and it was unanimously adopted.
WP/RC7/M1n/5 Rev.l Page 15
5
RELATIONS WITH UNICEF (wp/RC7/l7) The SECRETARY stated that document HP /RC7/17 contained the resolutions
adopted at the seventeenth session of the Executive Doard and the Ninth World Health Assembly on relations with UNICEF. He drew the attention of
the Committee to section 5.2.1, Part I of the Annual Report of the Regional Director in which reference was made to the assistance projects in the Region. g~ven
by UNICEF to
The Committee might therefore wish to adopt a
formal resolution expressing appreciation of such assistance given by UNICEF.
Dr. C.C. LEE (Korea) moved for the adoption of the draft resolution contained in document wp/RC7/l7 and expressed his governoent'e appreciation of the effective co-operation of UNICEF and WHO in the in the Region. G differen~
projects
The resolution was unanimously approvod.
AMENDMENTS TO THE RULES OF PROCEDURE OF THE REGIONAL COMMITrEE FOR THE WESTERN PACIFIC (wp/RC7/l6) Dr. L.K. QUYEN (Vietnam.) stated that his governoent had studied the
rules of procedure and felt that it might be better and more practical if the amendments as presented in document WP/RC7/l6 were approved. Medecin-Colonel ARETAS (France) thought that this involved erroneous interpretation of Rule present, he could vote. 14, as if the Chairman were the only representative The addition of the paragraph to Rule 10 might Some countries could
establish discrimination which should be avoided.
afford to send two, three and even four delegates and some could send only one. It was not advisable to raise distinctions ~iah
might lead to
embarrassing situations and even diplomatic difficulties.
WP/RC 7/Min/5 Page 16
Dr. C. H. YEN (China) and Dr. H. E. DOWNES (Australia) expressed complete agreement with the comments of Medecin-Colonel Aretas.
Mr. A. SAITA (Japan) was of the opinion that the idea behind the proposal was that the Chairman who had no alternate member might on behalf of his country, participate in the discussion and thereby influence the decisions reached. Experience in past Assemblies was that the Chairman He did not think, however, that
could only vote in the event of a tie.
it was advisable to approve the amendment.
Dr. W. GLYN EVANS (United Kingdom) recalled a previous meeting in which he attended as a member of the delegation and as the chief representative was elected Chairman, the rest of the delegation were left with no voice, no vote and no aeans of communication. He asked the
Secretary if there were any ways of getting around this situation. The SECRETARY stated that according to the rules of procedure, the representative may be accompanied by alternates and advisers. If the
chief representative was selected as an officer, he could delegate one of his party to alternate for him and this person could speak and vote for his country.
Dr. EVANS in the light of the Secretary's statement then formally objected to the proposed amendment as it might tend to give preference of selection to those countries who sent large delegations.
Dr. R. K. C. LEE (USA) fully agreed with the views of Dr. Evans and expressed the opinion that the Chairman had a right to debate and vote on all issues.
WP/RC7/Min/5 Rev.l Page 17 Dr. F. S. MACLEAN (New Zealand) registered disagreement to the amend-
ment proposed by Viet Nam and referring to the remark of the representative for the United States, asked the Secretary whether the Chairman had the right to participate in discussion and voting. The SECRETARY stated that according to Rule 12, the Chairman could designate the vice-chairman to act as Chairman, only if he were absent. The proposed amendment to Rule 10 was then put to the vote and defeated. Dr. R. K. C. LEE supported the proposed amendment of Rule 13 as it
provided for the contingency of the Chairman's inability to continue in office in the event of illness, incapacity, etc. Dr. Maclean.
This was supported by
Dr. H. E. DOWNES (Australia) pOinted out that Rule 12 dealt with the short absence of the Chairman and Rule 13 if aoended would deal with a more prolonged absence. He referred to Rule 27 which provided for temporary
absence and for prolonged absence and moved that the rules of procedure remain in status quo. Dr. MACLEAN stated that the term of office was one year and during
this period, the Chairman was expected to perform certain functions.
In
the event of illness, incapacity or death of the Chairman, the Vice-Chairman would automatically assume chairmanship.
Dr. EVANS thought that in the case of short absence the Vice-Chairman could act in place of the Chairman but in the event of permanent absence the proper procedure would be to elect a new Chairman. The amendment was then put to the vote and was approved.
wp/RC7/Min/5 Rev.l Page 18 7 FUTURE ORGANIZATIONAL STUDIES; REGIONALIZATION (wp/RC7/12) Dr. F. S. MACLEAN (New Zealand) as convenor of the working group on
regionalization, presented the draft report of his group for acceptance by the Committee.
Dr. H. E. DOWNES (Australia) called the attention of the Committee to Article 50 of the Constitution and pointed out that all deliberations and decisions made should be in line with the Constitution. He suggested,
therefore, the inclusion of the phrase "under the supervision of the Regional Committee" before the enumeration of the fUnctions of the Regional Office. Dr. R. K. C. LEE (USA) asked the Secretary whether the relationship of the Regional Committee to the Regional Office was supervisory or purely advisory. The SECRETARY referred to Article 50 (b) to (g) of the Constitution, and Dr. R. K. C. LEE asked whether the representative of Australia would agree to amending item 2 of the report to include the portion of the Constitution quoted.
Dr. MACLEAN thought that it would be a misuse of the report to quote large portions of the Constitution which was in the possession of every Member Government and its representatives. He suggested amending the words
"offices" and "office" to "organizations" and "organization".
Dr. DOWNES suggested the incorporation of another paragraph which would read "The Working Group outlined the functions of the Regional Office as outlined in Article 50 of the Constitution".
wp/RC7/Min/5 Rev.l Page 19
Dr. R. K. C. LEE thought that the Regional Committee was an important portion of any study on regionalization yet there was no mention of the Cormnittee in the report although in the basic document about two pages were devoted to the subject.
Dr. MACLEAN reminded Dr. Lee
th~t
during deliberations of the
working group it was felt that there might be some advantage in setting up at the beginning of the report a statement on the functions of the Regional Office. This statement was not essential to the report and it it was not If it were
acceptable to the Committee it would be deleted completely.
suggested that the group should start working out the exact functions of the Regional Office on one hand end the Regional Committee on the other, then it would mean a great many more hours to work on the report.
Mr. A. SAITA (Japan) agreed with Dr. Maclean's statement and proposed the deletion of item 2 of the report. This was unanimously approved.
The rest of the report was considered item by item and accepted by the Committee. Item 1 of the operative part of the resolution was then
amended to read "ADOPTS its report on the subject as amended" and the resolution unanimously approved.
Mr. SAITA informed the Chairman of a situation which had always faced him on return from meetings such as this and that was the lack of ready information to give the press of his home country which he thought some of the other members had faced too. He asked the Regional Director whether a
press release of a general nature on the Regional Committee Meeting giving the highlights, points of interest, etc., prior to the departure of the representatives could be prepared. The SECRETARY assured Mr. Saita and other interested members of the Committee that t~is
would be done.
The meeting rose at 5:15 p.m.