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Proposed medium-term strategic plan of the Western Pacific Region 2008-2013 and proposed programme budget 2008-2009

31 décembre 2007 Organisation mondiale de la santé

Texte intégral

WPR/RC58/4

Proposed Medium-term Strategic Plan of the Western Pacific Region 2008–2013

and

Proposed Programme Budget 2008–2009

World Health Organization Western Pacific Region

Manila 2007

The designations employed and the presentation of the material in this document do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. All figures under assessed contributions mentioned throughout this book include miscellaneous income.

LETTER OF AUTHORITY

In accordance with the Rules of Procedure of the Regional Committee for the Western Pacific, the Regional Director has the honour to present the proposed Medium-term Strategic Plan of the Western Pacific Region 2008–2013 and proposed Programme Budget for 2008–2009.

Shigeru Omi, MD, Ph.D. Regional Director

iii

TABLE OF CONTENTS

page Overview of the Proposed Medium-term Strategic Plan of the Western Pacific Region 2008–2013 Strategic objectives and regional expected results SO 1 SO 2 SO 3 SO 4 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning Organization, enabling it to carry out its mandate more efficiently and effectively. 2 8 14 20 1

SO 5 SO 6

26 31

SO 7

SO 8 SO 9 SO 10

41 46 51

SO 11 SO 12

59 63

SO 13

TABLE OF CONTENTS

page

Overview of the proposed Regional Programme Budget 2008–2009 Table 1. Financing sources summary: 2006–2007 and 2008–2009 Table 2. Regional allocation of assessed and voluntary contributions for 2006–2007 and 2008–2009 by organizational level Table 3. Budget 2008–2009 by strategic objective, location and source of financing (US$ thousand)

75 76 76 77 79 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162

2008–2009 Programme budget by regional expected results 2008–2009 Programme budget by countries and areas American Samoa Brunei Darussalam Cambodia China Cook Islands Fiji French Polynesia Guam Japan Kiribati Korea, Republic of Lao People's Democratic Republic Macao (China) Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru Niue Northern Mariana Islands, Commonwealth of the Palau Papua New Guinea Philippines Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam

MEDIUM-TERM STRATEGIC PLAN – OVERVIEW

OVERVIEW OF THE PROPOSED MEDIUM-TERM STRATEGIC PLAN OF THE WESTERN PACIFIC REGION 2008–2013 In May 2006, the Fifty-ninth World Health Assembly approved the Eleventh General Programme of Work1 covering a 10-year period from 2006 to 2015, coinciding with the time frame for achieving the Millennium Development Goals. The Eleventh General Programme of Work outlines a strategic framework and direction for the work of WHO, both Member States and the Secretariat, and a platform for dialogue with WHO partners in global health. The Fifty-ninth World Health Assembly directed that the Eleventh General Programme of Work be implemented through the development of a six-year Medium-term Strategic Plan for 2008–2013, with biennial programme budgets agreed with the governing bodies. The proposed Medium-term Strategic Plan of the Western Pacific Region 2008–2013 provides the strategic regional direction for the Organization for the six-year period within the context of the Eleventh General Programme of Work, the global strategic objectives and the Organization-wide expected results of WHO. It establishes a flexible, multibiennial programme structure to guide preparation of the Programme Budget and operational plans across the three bienniums. In focusing the work of the Organization in this manner over a six-year timeframe, the proposed Mediumterm Strategic Plan will better reflect the cross-cutting nature of WHO’s work and allow a more strategic and longerterm approach to effective collaborative programmes. The proposed Medium-term Strategic Plan of the Western Pacific Region identifies the regional expected results that will directly contribute towards the achievement of the Organization-wide expected results. The strategic objectives and Organization-wide expected results acknowledge the WHO core functions, its evolving role within the changing context of international health and the requirement for the Organization to capitalize on its comparative advantage. The interrelationship between health and development is clearly recognized by the central role for health within the Development Goals of the United Nations Millennium Declaration. The Millennium Development Goals have focused efforts on achieving significant, measurable improvements in people’s lives, with the elimination of poverty as the overarching priority. Through the Medium-term Strategic Plan, WHO will support Member States in creating an environment for poverty alleviation and in strengthening health systems as prerequisites for ensuring equitable access to efficient and high quality health services. In preparing the Medium-term Strategic Plan, WHO in the Western Pacific Region, a Framework for Action provided the regional orientation. 2 The Regional Committee for the Western Pacific, at its fiftieth session, endorsed the document WHO in the Western Pacific Region, a Framework for Action as a set of guiding principles for WHO's work in the Region in the early years of the 21st century. The Regional Director was requested to work closely with Member States to implement the approaches outlined in the Framework for Action, with particular attention to least developed countries and areas. Proposed global strategic objectives and Organization-wide expected results were examined by the Regional 3 Committee at its fifty-seventh session in Auckland in 2006. The Regional Committee requested the Regional Director to further develop a Regional Medium-term Strategic Plan of the Western Pacific Region 2008–2013 in accordance with the principles of results-based budgeting, including a clear focus on outcomes, taking into account the further discussions at the Executive Board and the Sixtieth World Health Assembly in 2007. Opportunity has been taken to simplify the management of Organizational efforts to improve health services by combining four of the proposed global strategic objectives that relate to financing, staffing, organization and governance of health services. This has reduced the number of global strategic objectives from 16 to 13.

1 2 3

Document WHA A59/25. Document WPR/RC50/2. Documents WPR/RC57/4 and WPR/RC57/4 Corr. 1.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 1

STRATEGIC OBJECTIVE 1 To reduce the health, social and economic burden of communicable diseases. Scope The work under this strategic objective focuses on prevention, early detection, diagnosis, treatment, control, elimination and eradication measures to combat communicable diseases that disproportionately affect poor and marginalized populations. The targeted diseases include but are not limited to: vaccine-preventable, tropical, zoonotic and epidemic-prone diseases, excluding HIV/AIDS, tuberculosis and malaria. Regional indicators and targets • • • • • Measles elimination and hepatitis B control by 2012 and vaccine-preventable disease mortality reduction by two thirds by 2013 (resolutions WPR/RC54.R3 and WHA58.15). Number of countries and areas maintaining certification of polio eradication: 100% by 2010 (resolution WHA41.28). Coverage of school-age children at risk with regular treatment against schistosomiasis and soil-transmitted helminth infections: 75% by 2010 (resolution WHA54.19). Number of countries and areas achieving elimination of lymphatic filariasis: 100% by 2020 (resolution WHA50.29). Number of countries and areas complying with the International Health Regulations (2005) core requirements for surveillance, reporting, notification, verification and response: 100% by 2013 (resolution WHA58.3).

Links with other strategic objectives • • • • • • Strategic objectives 2, 3, 4, 6 and 9: in relation to integrated disease control, surveillance and harmonized research initiatives. Strategic objective 5: in relation to mutual support in field operations and health security. Strategic objective 8: in relation to the adoption of adequate solutions for management of health-care waste. Strategic objective 9: in relation to water and sanitation aspects of zoonotic diseases. Strategic objective 10: in relation to the implementation of programmes through financially sustainable health system approaches. Strategic objective 11: in relation to access to safe and effective vaccines, medicines and interventions, as well as quality assurance of diagnostics and laboratory services.

Issues and challenges Communicable diseases (excluding HIV/AIDS, tuberculosis and malaria) account for a significant portion of childhood mortality. Without a reduction of this disease burden, the achievement of the health-related Millennium Development Goals and those in education, gender equality, poverty reduction and economic growth all will be in jeopardy. Experience shows that the prevention of communicable diseases is not only one of the most cost-effective public health interventions, but it also yields positive economic returns. Activities for the prevention, early detection, diagnosis, treatment, control, elimination and eradication of communicable diseases are among the most effective components of the public health system, especially in reaching marginalized, poor and young populations, as well as women. Challenges exist in those countries and areas of the Region that have weak health system structures. A move towards decentralization of public health programmes have proven to be counterproductive to strengthening the health systems of some countries and areas. A shortage of appropriately qualified health care practitioners has further weakened health systems. Serving hard-to-reach populations in remote areas and among minority groups remains a significant challenge. Through the International Health Regulations (2005) (IHR (2005)) which will come into effect in 2007, WHO will have a binding and legal obligation to strengthen its internal capacity on epidemic/public health emergency alert and response and to support Member States in the development and maintenance of minimum core capacities for detection, assessment, and response to public health risks and emergencies, the majority of which are due to communicable diseases. It will be critical to move beyond a vertical programme approach and create strategies for communicable disease control within integrated health systems, if strategic objective 1 is to be achieved.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 1

Strategic approaches Strategic approaches for Member States: • • • • • Invest in human resources and commit the political and financial resources necessary to ensure and expand equitable access to high quality and safe interventions for the prevention, early detection, diagnosis, treatment and control of communicable diseases among all populations. Establish and maintain effective coordination mechanisms with all partners and across all relevant sectors involved in communicable disease prevention and control at the country level. Adopt the necessary legal, administrative, financial, technical and political provisions for the development, strengthening and maintenance of integrated surveillance systems at all levels with the ability to detect, report and respond to public health risks and potential public health emergencies. Implement effectively the Asia Pacific Strategy for Emerging Diseases (APSED) to build and strengthen country core capacities necessary for effective preparedness, early detection of and rapid response to emerging diseases which threaten national, regional and global health security. To generate information for evidence-based policy decisions regarding public health interventions.

Strategic approaches for the WHO Secretariat:

•

Strengthen WHO collaboration with health partners, partnerships and civil society in joint work to articulate ethical and evidence-based policies for communicable diseases. Also, help expand community access to tools and strategies that meet acceptable standards of quality, safety, efficacy and cost-effectiveness, as well as expand access to such tools and strategies. Strengthen capacity to provide technical assistance, capacity-building and responsiveness to Member States for communicable diseases, including the facilitation of resource mobilization and advocacy efforts. Facilitate partnership with other United Nations agencies and partners, public health preparedness through the development, maintenance and administration of stockpiles of vaccines, medicines and drugs for response to public health emergencies. Provide Member States with tools, strategies and technical assistance for the evaluation, assessment and strengthening of monitoring and surveillance systems. Coordinate surveillance activities, including the collation, synthesis and dissemination of data to inform policy decisions and public health responses. Shape the research agenda on communicable diseases, stimulating and supporting the generation, translation and dissemination of knowledge. Maintain and strengthen an effective regional system for alert and response to outbreaks and other public health emergencies with immediate technical support to affected state(s) for verification, assessment, containment and control. Assist Member States in strengthening their surveillance and response capacities by effectively implementing APSED, as an important stepping stone to meet the core capacity requirements under the IHR (2005).

• • • • • • •

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 1

Organizationwide expected result 01.001 Regional expected result 01.001.WP01 Regional indicators

Policy and technical support provided to Member States in order to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential child-health interventions with immunization. Policy and technical support provided to Member States to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential child-health interventions with immunization. 01.001.WP01.01 Number of countries and areas that have reached at least 90% coverage in national vaccination coverage and at least 80% in vaccination coverage in each district unit. 01.001.WP01.02 Number of countries and areas that streamlined the delivery of immunization services by integrating with other health services (e.g. Vitamin A, bednet distribution, deworming). 01.001.WP01.03 Number of countries and areas that have a specified national budget line to ensure sustainable financing of immunization. 01.001.WP01.04 Number of countries and areas assisted with different activities (e.g. surveillance, cost effectiveness analysis) to facilitate decisions about appropriate changes and additions to the immunization schedule, including introduction of new vaccines and/or technologies. 14 20

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

14 28

1 5

28 32

In accordance with the global immunization vision and strategy, WHO will provide policy and technical support to Member States in order to increase protection against more diseases by making immunization available to all eligible people, introducing new vaccines and technologies, and linking immunization to the delivery of other health interventions. Effective coordination and support provided in order to achieve certification of poliomyelitis eradication, and destruction, or appropriate containment, of polioviruses, leading to a simultaneous cessation of oral poliomyelitis vaccination globally. Effective coordination and provision of support to Member States to retain certification of poliomyelitis elimination and to achieve destruction, or appropriate containment of polioviruses, leading to simultaneous cessation of oral polio vaccination. 01.002.WP01.01 Number of countries and areas that report zero cases of poliomyelitis. 01.002.WP01.02 Percentage of countries and areas using oral polio vaccine (OPV) concurring with an internationally agreed time line and process for cessation of routine OPV use. 0% 0% 01.002.WP01.03 Percentage of countries and areas submitting annual progress reports on maintenance of polio free status to the Regional Certification Commission. 100% 100% 01.002.WP01.04 Number of countries and areas maintaining up-todate national inventory of wild poliovirus infectious and potentially infectious materials. 36 36

Organizationwide expected result 01.002 Regional expected result 01.002.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

36 36

100% countries and areas still using OPV prior to commencement of cessation procedures

100%

Recent outbreaks of polio outside of the Region have delayed the global polio eradication initiative. It is, therefore, required that Western Pacific Region countries and areas continue to maintain high polio coverage rates and maintain strong acute flaccid paralysis (AFP) surveillance systems. It is expected that limited preventive polio supplementary immunization activities in some countries and areas may be conducted as response capacity to importation of wild poliovirus and emergence of circulating vaccine derived poliovirus must be maintained. Once global poliovirus transmission has been interrupted, there may be a reduction in Western Pacific Region's costs, but activities related to oral polio vaccine cessation (including laboratory containment and AFP surveillance will continue through to 2013).

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 1

Organizationwide expected result 01.003 Regional expected result 01.003.WP01 Regional indicators

Effective coordination and support provided to Member States in order to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases. Effective coordination and support provided to Member States to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases. 01.003.WP01.01 Number of countries and areas that have achieved elimination of leprosy at national and subnational levels. 01.003.WP01.02 Number of countries and areas receiving technical support for the development and implementation of national dengue prevention and control plans and assistance as needed in resource mobilization. 5 8 01.003.WP01.03 Number of countries and areas that have achieved 80% coverage over 5 consecutive rounds of MDA. 01.003.WP01.04 Number of countries and areas that have achieved LF elimination as a public health problem. 01.003.WP01.05 Number of countries and areas that have reached the WHO global target of deworming of at least 75% of school-age children at risk. 01.003.WP01.06 Number of countries and areas supported to complete the mapping of FBT infections in high risk areas.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

34 36

2 3

1 2

4 5

Dengue is a public health problem which is often overlooked and underestimated. Other neglected tropical diseases (NTDs) disproportionately affect the poor, particularly children, causing anemia and adversely affecting their growth and development. In adults, NTDs lower work capacity and are an important cause of anemia among women of child bearing age. Lymphatic filariasis is the second leading cause of disability. NTDs are often characterized by a high cumulative disease burden, as a result of co-infections with more than one agent. While WHO is targeting those NTDs which can be effectively controlled or even eliminated through low-cost treatment and health-promotional activities, major efforts need to be made as well to address dengue infection in the Region. Policy and technical support provided to Member States in order to enhance their capacity to carry out surveillance and monitoring of all communicable diseases of public health importance. Provision of policy and technical support to Member States to enhance their capacity to carry out surveillance and monitoring of all communicable diseases of public health importance. 01.004.WP01.01 Number of countries and areas receiving enhanced technical assistance from WHO in strengthening communicable disease surveillance and monitoring systems. 8 12 01.004.WP01.02 Number of countries and areas that have strengthened surveillance and monitoring of communicable diseases. 01.004.WP01.03 Number of countries and areas that have established a surveillance and information system and are regularly reporting to Dengue Net. 5 11 01.004.WP01.04 Number of countries and areas that have established a surveillance and information system for helminth infections.

Organizationwide expected result 01.004 Regional expected result 01.004.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

6 10

3 9

Communicable disease surveillance is essential for early warning of potential threats to public health and for programme monitoring function. Effective surveillance system provides useful information which acts as a basis for decision-making in identifying priority activities and allocating limited resources more efficiently.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 1

Organizationwide expected result 01.005 Regional expected result 01.005.WP01 Regional indicators

New knowledge, intervention tools and strategies that meet priority needs for the prevention and control of communicable diseases developed and validated, with scientists from developing countries increasingly taking the lead in this research. New knowledge, intervention tools and strategies that meet priority needs for the prevention and control of communicable diseases developed and validated, and scientists from developing countries and areas increasingly taking the lead in this research. 01.005.WP01.01 Number of studies/surveys being conducted that focus on intervention tools and strategies for control of communicable diseases in developing countries and areas. 2 6 01.005.WP01.02 Percentage of total research funds in the Region implemented at developing country research institutes or with developing country researchers. 10% 20% 01.005.WP01.03 Number of research projects supported, directly addressing programmatic gaps. 01.005.WP01.04 Regional research strategic plan in neglected diseases developed.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

10 15

0 1

40%

Even though 95% of the burden of disability and premature mortality affects the developing world, a very small percentage of research funding is actually devoted to communicable diseases those which constitute a major burden of disease in developing countries and areas. These diseases primarily affect the poor, who are not considered as a profitable market segment of society for the private sector. There are big gaps in the availability of tools to prevent, control or eliminate many communicable diseases. WHO has a significant role in helping the countries and areas address research gaps through a comprehensive plan and by supporting Member States to engage in policies that are evidence-based. Support provided to Member States in order to achieve the minimum core capacities required by the International Health Regulations (2005) for the establishment and strengthening of alert and response systems for use in epidemics and other public health emergencies of international concern. Support provided to Member States in achieving the minimum capacities and functions required by the International Health Regulations (2005) (IHR (2005)), specifically those related to advocacy, National International Health Regulations Focal Points and the core capacities for designated points of entry. 01.006.WP01.01 Number of Member States having a functional national International Health Regulations focal point. 5 15 01.006.WP01.02 Number of countries and areas supported by WHO in complying with the IHR (2005). 10 15

Organizationwide expected result 01.006 Regional expected result 01.006.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

The IHR (2005) request each Member State to designate or establish a National IHR Focal Point and perform the functions required, including urgent communications with WHO and with other ministries/sections within the country. Member States are expected to review and adjust (when necessary) their domestic legislations in line with the IHR (2005). In addition to the core capacity requirements for surveillance and response, each Member State is also expected to assess and develop the core capacities for designated points of entry by June 2012.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 1

Organizationwide expected result 01.007 Regional expected result 01.007.WP01 Regional indicators

Member States and the international community equipped to detect, assess, respond to and cope with major epidemic and pandemic-prone diseases (e.g. influenza, meningitis, yellow fever, haemorrhagic fevers, plague and smallpox) through the development and implementation of tools, methodologies, practices, networks and partnerships for prevention, detection, preparedness and intervention. Support provided to Member States to achieve the minimum capacities required for the preparedness, detection, assessment of and response to emerging diseases, including major epidemic and pandemicprone diseases such as influenza, by effectively implementing the Asia Pacific Strategy for Emerging Diseases (APSED). 01.007.WP01.01 Number of countries and areas implementing a country APSED workplan, including plans of action to meet the core capacity requirements for surveillance and response under the IHR (2005). 5 15 01.007.WP01.02 Number of countries and areas having the minimum core capacities for detecting, assessing and responding to emerging infectious diseases, including epidemic-prone diseases. 5 10 01.007.WP01.03 Number of countries and areas with laboratory networking between national reference and local laboratories established. 01.007.WP01.04 Number of countries and areas having national pandemic preparedness plans in place and validated.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

6 9

10 20

The Western Pacific Region continues to face threats from emerging infectious diseases and other public health emergencies, such as avian influenza A (H5N1) and pandemic influenza. The Asia Pacific Strategy for Emerging Diseases (APSED) was endorsed by the Regional Committee Meeting in September 2005 as a strategic framework and guide for countries and areas in strengthening core capacities for effective preparedness, early detection of and rapid response to emerging diseases. Implementation of the APSED will help countries and areas in meeting the core capacity requirements for surveillance and response under the IHR (2005). Regional and global capacity coordinated and made rapidly available to Member States for detection, verification, risk assessment and response to epidemics and other public health emergencies of international concern. Coordinated regional capacity rapidly available to Member States for detection, verification, risk assessment of and response to epidemics and other public health emergencies of regional and international concern. 01.008.WP01.01 Regional event management system (EMS) in place. 01.008.WP01.02 Number of partner institutions in the region participating in the Global Outbreak Alert and Response (GOARN). 01.008.WP01.03 Regional rapid response mechanism and standard operating procedures established and strengthened. 01.008.WP01.04 Percentage of requests for assistance from countries and areas for which WHO mobilizes coordinated regional and international response support within three days. 40% 70%

Organizationwide expected result 01.008 Regional expected result 01.008.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

0 1

25 30

0 1

90%

Communicable diseases do not respect international borders and can spread to other countries and areas rapidly. Experience with recent emerging diseases such as SARS and avian influenza clearly demonstrate that a coordinated international and regional response to epidemics and other public health emergencies of international concern are critical. WHO is mandated and obligated under the International Health Regulations (2005) to rapidly mobilize and coordinate international support and response to disease outbreaks, epidemics and other public health emergencies of international concern.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 2

STRATEGIC OBJECTIVE 2 To combat HIV/AIDS, tuberculosis and malaria. Scope Work under this strategic objective will focus on: scaling up and improving prevention, treatment, care and support interventions for HIV/AIDS, tuberculosis and malaria so as to achieve universal access, in particular for seriously affected populations and vulnerable groups; advancing related research; removing obstacles that block access to interventions and impediments to their use and quality; and contributing to the broader strengthening of health systems. Regional indicators and targets HIV/AIDS: • HIV-related deaths averted annually in low and middle income countries and areas due to antiretroviral therapy by 2013. • HIV prevalence reduction among vulnerable populations: all countries and areas with low prevalence and concentrated HIV epidemics have halted or reversed HIV prevalence among most at-risk populations (injecting drugs users, sex workers and men who have sex with men, mobile populations) by 2013. • Mother-to-child HIV transmission reduction: 60% reduction in the percentage of HIV-infected infants born to HIV-infected mothers, down to a level of 10% by 2013 (baseline of 25% in 2005). Tuberculosis: • TB mortality reduction: 50% reduction by 2010 (resolution WPR/RC51.R4). • TB prevalence reduction: 50% reduction in TB prevalence rate by 2010 (resolution WPR/RC51.R4). Malaria: • Malaria mortality reduction in endemic countries and areas: 50% reduction by 2013. • Malaria morbidity reduction in endemic countries and areas: 50% reduction of confirmed malaria cases by 2013. Links with other strategic objectives • • • • • Strategic objective 1: particularly work related to delivery of interventions; strengthening research capacity and expanding access to new strategies and tools, such as vaccines; and strengthening systems for monitoring and surveillance of communicable diseases. Strategic objective 4: particularly efforts related to supporting research and development of new tools and interventions; meeting specific needs of children, adolescents and women of child-bearing age; formulation and implementation of gender-sensitive interventions; and tackling sexually transmitted infections. Strategic objective 6: specifically relating to prevention of tobacco use and its relationship with tuberculosis; and prevention of unsafe sex. Strategic objective 7: specifically work relating to approaches that enhance equity and are pro-poor, genderresponsive, ethical and human rights based. Strategic objective 10: particularly efforts related to organization, management and delivery of health services; areas of human resources capacity strengthening, integrated training and widening of service provider networks; work related to minimizing the potential of financial catastrophe and impoverishment due to out-of-pocket health expenses. Strategic objective 11: specifically work related to essential medicines, medical products and technologies for the prevention and treatment of HIV/AIDS, tuberculosis and malaria.

•

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 2

Issues and challenges HIV/AIDS/STI, tuberculosis and malaria impose a heavy disease burden on the Western Pacific Region despite significant progress in control of these diseases. Reducing HIV/STI, TB and malaria is crucial to achieve the Millennium Development Goals, and will contribute to reducing poverty and alleviate the burden on individuals, communities, nations and their health systems. The HIV situation in the Region is diverse: Cambodia and Papua New Guinea have generalized epidemics. In China, Viet Nam and Malaysia the HIV epidemic is concentrated among injecting drug users, and it is at a low level in other countries and areas. Transmission of HIV is primarily linked to persons who engage in high-risk behavior, such as injection drug users, men having sex with men, and sex workers who are often socially marginalized or persecuted. Substantial progress has been achieved in HIV prevention among vulnerable groups, using strategies such as the 100% condom use (CUP) coupled with outreach services among sex workers and their clients, and harm reduction among injecting drug users. The effectiveness of CUP has been demonstrated in Cambodia with a decrease in HIV prevalence in the general population, in line with increased condom use among sex workers and their clients. Through the "3 by 5" Initiative, by December 2005 some 40 000 people in the Region, about 25% of those in need, were receiving antiretroviral therapy, compared to 15 000 in 2004. This progress was particularly notable in Cambodia where half of those in need are now receiving antiretroviral drugs. Great challenges lie ahead in ending the stigma associated with the disease, reaching marginalized groups, and increasing political commitment to achieve universal access to prevention, treatment and care. For TB control, strong leadership and political commitment contributed to the Region being the first to have met the intermediate targets of detecting 70% of estimated TB cases and successfully treating 85% of these cases, as well as region-wide population coverage of directly observed treatment, short-course (DOTS) in 2005. Further progress towards achieving the regional goal of halving TB prevalence and mortality by one half from the 2000 level, thus contributing to the achievement of the TB-related MDGs requires improvement in the quality of DOTS implementation, further increases in case detection, addressing weaknesses in health systems, multidrugresistant TB and TB-HIV co-infection, while ensuring equitable access to TB services involving a wider range of health providers, including the private sector. Malaria is endemic in 10 countries and areas of the Region. In the Mekong region, transmission occurs in remote forest fringe areas where ethnic minority groups and mobile populations are at major risk. The incidence is high in Papua New Guinea, Solomon Islands and Vanuatu. Falciparum malaria is predominant but vivax malaria is also widespread with re-emergence in central China and the Korean peninsula. Between 1992 and 2000, in most endemic countries and areas of the Region, malaria morbidity and mortality were reduced by over 50%. Challenges are high levels of antimalarial drug resistance and consequentially the shift to highly effective but more expensive artemisinin-based combination therapies based on laboratory diagnosis including rapid diagnostic tests, significant availability of counterfeit antimalarials, the threat of epidemics, achieving equitable access to interventions for those at greatest risk including through community-based interventions and sustaining the gains achieved. Cross-cutting issues that must be addressed include poor and vulnerable populations that are disproportionately affected and requiring public health policies to recognize their special needs and develop appropriate interventions with the involvement of other relevant sectors. Serious drug resistance occurs among all three diseases, requiring regular, good quality monitoring, as well as timely and appropriate changes in treatment policies. This must be linked with drug quality and drug use issues, quality assurance of diagnostic tests and microscopy, the development of approaches for cooperating with the wider range of health providers including private providers, sectors, programmes and communities to improve the availability of good quality drugs and their rational use. Effective surveillance and response systems are crucial for monitoring and dealing with epidemics. Improvements in programme monitoring and evaluation, including enhancement of information systems will be important. Operational and social research is needed to further develop and tailor interventions. Proven effective prevention and treatment interventions need to be scaled up to achieve universal access. This will depend on improving the management of programmes, building synergies with other programmes and integrating service delivery. It also will depend on strengthening health systems and political commitment and mobilizing necessary human and sustainable financial resources by engaging individuals, communities and national and international partners into effective cooperation.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 2

Strategic approaches Strategic approaches for Member States:

• •

Combating HIV/STI, TB and malaria will require ensuring and expanding equitable access to high quality and safe interventions for the prevention, early detection, diagnosis, treatment and control of the three diseases. Major impetus will be given to promoting the delivery and universal access of essential interventions for prevention, treatment, care and support to halt the spread and reduce morbidity and mortality from the three diseases. Harmonization between interventions and programmes will be encouraged to maximize the effectiveness of a given patient encounter with the health system. Special emphasis will be placed on ensuring that the services are also gender-sensitive and tailored and delivered to the poor, vulnerable groups and hard-to-reach populations and on ensuring relevance to sociocultural contexts. The use of evidence, norms and standards in policy and programme formulation will be encouraged. Strengthening and supporting human resources and provider networks and enhancing the public-private mix of services will be vital. This includes training and upgrading the skills of health professionals and community workers, widening the service provision networks and pool of providers, strengthening human resources management capacity, better engagement of and coordination with nongovernmental and private sector institutions, strengthening referral systems, tapping the potential of community health workers, persons living with the diseases and family members, and promoting strategies to retain health human resources. Facilitating the availability and promoting proper use of safe and affordable good quality medicines, diagnostics, insecticides and other health commodities, expanding quality-assured laboratory services, and ensuring well functioning public and private supply chains. Monitoring, evaluation and surveillance systems for decision-making, progress monitoring and accountability towards HIV/AIDS/STI, TB and malaria targets will be enhanced and effectiveness and efficiency of information systems improved. This includes generation and use of age and sex disaggregated data; strengthening epidemiological and behavioural surveillance (including the use of Geographical Information Systems) and monitoring of drug and insecticide resistance; strengthening data collection and analysis capacity (including financial tracking); assessing the impact of interventions and trends of the three diseases in special population groups, including poor and vulnerable populations; refining regional indicators for key new interventions; integrating monitoring and evaluation of HIV/AIDS/STI, TB and malaria programmes into existing national health information systems; and standardization to allow in country and cross country comparisons. Efforts to ensure sustained political commitment, better engagement of communities and affected persons and more effective partnerships will also be critical, as well as strengthening mechanisms for resource mobilization and utilization and action to increase absorption of available resources. Nurturing of HIV/AIDS/STI, TB and malaria partnerships and the involvement of stakeholders at country, regional and global levels will be required as well as engagement of communities and affected persons. Advocacy and concerted efforts to combat the three diseases will be a major factor for success. Enabling and promoting research to advance prevention, treatment and care will also be essential, particularly in areas of safe and effective prevention technologies, medicines (including simplified regimens) and diagnostic tools, as well as operations including social research to determine the effectiveness of service delivery approaches within different contexts.

•

• •

•

Strategic approaches for the WHO Secretariat:

• •

Adapting global HIV/AIDS/STI, TB and malaria policies, strategies and standards to the Western Pacific Region, and developing regional policies, standards and implementation guidelines where appropriate. Providing technical cooperation and coordination support to Member States for the implementation of locally appropriate policies, strategies and standards, and for scaling up HIV/AIDS/STI, TB and malaria programmes, particularly to reach populations most in need, including human resources capacity strengthening. Facilitating availability, access and proper use of high-quality related medicines and commodities. Measuring progress towards global and regional targets, especially for vulnerable and poor groups; assessing national programme and system performance, financing and impact initiatives; and providing Member States with tools, strategies and technical assistance for strengthening surveillance data monitoring and evaluation, including the monitoring of drug resistance. Facilitating and strengthening partnerships, advocacy and communications. Supporting global, regional, subregional and intercountry initiatives aimed at prevention and control of HIV/AIDS/STI, TB and malaria. Assisting Member States to strengthen their mechanisms for resource mobilization and utilization. Fostering and supporting research and building research capacity in target countries and areas.

• •

• • • •

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 2

Organizationwide expected result 02.001 Regional expected result 02.001.WP01 Regional indicators

Guidelines, policy, strategy and other tools developed for prevention of, and treatment and care for patients with, HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, and hard-to-reach and vulnerable populations. Regional guidelines, policies, strategies and other tools developed (adapting global ones, as appropriate) for prevention, treatment and care for HIV/AIDS/STI, malaria and TB (including innovative approaches for increasing coverage of the interventions among the poor, hard to reach and vulnerable populations). 02.001.WP01.01 Number of targeted countries and areas that have developed or updated HIV/AIDS/STI, malaria and TB policies, strategies or guidelines in line with WHO recommendations. HIV/AIDS/STI: 9 Malaria: 10 TB: 36 HIV/AIDS/STI: 9 Malaria: 10 TB: 36 HIV/AIDS/STI: 9 Malaria: 10 TB: 36 02.001.WP01.02 Number of WHO regional policies, strategies or guidelines for HIV/AIDS/STI, malaria and TB control developed, updated or adapted. HIV/AIDS/STI: 0 Malaria: 2 TB: 1 HIV/AIDS/STI: 6 Malaria: 5 TB: at least 3 HIV/AIDS/STI: 10 Malaria: 9 TB: at least 3

Baseline

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

WHO's normative function includes the development and coordination of relevant policies, strategies and guidelines to guide actions at global, regional and country levels. WHO, Western Pacific Region's leadership is crucial in bringing together expertise and the experiences to formulate policies, strategies and guidelines for prevention, treatment and care for HIV/AIDS/STI, malaria and TB which are specific to the context of the Western Pacific Region and which ensure that interests of poor and vulnerable populations are served.

Organizationwide expected result 02.002

Policy and technical support provided to countries towards expanded gender-sensitive delivery of prevention, treatment and care interventions for HIV/AIDS, tuberculosis and malaria, including integrated training and service delivery; wider service-provider networks; and strengthened laboratory capacities and better linkages with other health services, such as those for sexual and reproductive health, maternal, newborn and child health, sexually transmitted infections, nutrition, drug-dependence treatment services, respiratory care, neglected diseases and environmental health. Policy, technical and coordination support provided to countries and areas for the implementation of prevention, treatment and care interventions for HIV/AIDS/STI, malaria and TB and their scaling-up to reach the populations most in need (including integrated training and service delivery; wider service provider networks; strengthened laboratory capacities and better linkages with other health services). 02.002.WP01.01 Number of targeted countries and areas that have developed and are implementing integrated/coordinated policies on HIV/AIDS/STI malaria and tuberculosis. 2 02.002.WP01.02 Number of supported countries and areas verified to have expanded interventions identified in their national HIV/AIDS/STI, malaria and TB control plans. HIV/AIDS/STI: 9 Malaria: 8 TB: 28 HIV/AIDS/STI: 9 Malaria: 8 TB: 28 HIV/AIDS/STI: 9 Malaria: 8 TB: 28 02.002.WP01.03 Number of targeted countries and areas that have developed and are implementing health workforce strategies and plans incorporating HIV/AIDS/STI, malaria and TB needs. HIV/AIDS/STI: 1 Malaria: 5 TB: 0 HIV/AIDS/STI: 4 Malaria: 7 TB: 7 HIV/AIDS/STI: 9 Malaria: 10 TB: 7

Regional expected result 02.002.WP01 Regional indicators

Baseline

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

WHO has a firm commitment to maximize access to HIV/AIDS/STI, malaria and TB interventions, as outlined in the various World Health Assembly resolutions, the Global Health Sector for HIV/AIDS, the Global Plan and the Regional Strategic Plan to Stop TB; the Global Plan to Roll Back Malaria; articulation of WHO's Contribution to Universal Access to HIV/AIDS Prevention, Treatment; Care and Support and implementation of the Millennium Development Goals, and others.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 2

Organizationwide expected result 02.003

Global guidance and technical support provided on policies and programmes in order to promote equitable access to essential medicines, diagnostic tools and health technologies of assured quality for the prevention and treatment of HIV/AIDS, tuberculosis and malaria, and their rational use by prescribers and consumers, and, in order to ensure uninterrupted supplies of diagnostics, safe blood and blood products, injections and other essential health technologies and commodities. Guidance and technical support provided on policies and programmes to promote equitable access to essential medicines of assured quality for the prevention and treatment of HIV/AIDS/STI, malaria and TB, and their rational use by prescribers and consumers; and on uninterrupted supply of quality diagnostics, safe blood and other essential commodities. 02.003.WP01.01 Number of countries and areas supported to improve forecasting, procurement and supply management systems for HIV/STI, malaria and TB medicines and other essential commodities. HIV/AIDS/STI: 4 Malaria: 8 TB: 17 HIV/AIDS/STI: 7 Malaria: 9 TB: 27 HIV/AIDS/STI: 9 Malaria: 9 TB: 27 02.003.WP01.02 Number of countries and areas supported in the monitoring of the quality of drugs and other commodities for HIV/AIDS/STI, malaria and TB prevention and control, and in the screening of blood. HIV/AIDS/STI: 4 Malaria: 5 TB: 17 HIV/AIDS/STI: 7 Malaria: 9 TB: 27 HIV/AIDS/STI: 9 Malaria: 9 TB: 27

Regional expected result 02.003.WP01 Regional indicators

Baseline

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Achieving target times for HIV/AIDS/STI, tuberculosis and malaria prevention and control depends significantly on availability of and access to high-quality medicines, diagnostics and other essential health technologies. Expanding access and ensuring the quality of these is a major priority for WHO, as evidenced by various World Health Assembly and Regional Committee resolutions. This is an increasing priority area for Member States and there is enormous demand for WHO's support in this area at all levels of the Organization.

Organizationwide expected result 02.004 Regional expected result 02.004.WP01 Regional indicators

Global, regional and national systems for surveillance, evaluation and monitoring strengthened and expanded to keep track of progress towards targets and allocation of resources for HIV/AIDS, tuberculosis and malaria control and to determine the impact of control efforts and the evolution of drug resistance. Regional and national surveillance, evaluation and monitoring systems strengthened and expanded to monitor progress towards targets and resource allocations for HIV/AIDS/STI, malaria and TB control, including monitoring of drug and insecticide resistance and the impact of control efforts. 02.004.WP01.01 Number of countries and areas that regularly collect, analyse and report HIV/AIDS/STI, malaria and TB surveillance data and coverage, using WHO's standardized methodologies, including appropriate age and sex disaggregation. HIV/AIDS/STI: 8 Malaria: 6 TB: 36 HIV/AIDS/STI: 9 Malaria: 10 TB: 36 HIV/AIDS/STI: 9 Malaria: 10 TB: 36 02.004.WP01.02 Number of countries and areas that regularly collect and report HIV/AIDS/STI, malaria and TB programme monitoring and evaluation data (including financial data) and core indicators and targets. HIV/AIDS/STI: 5 Malaria: 4 TB: 36 HIV/AIDS/STI: 9 Malaria: 10 TB: 36 HIV/AIDS/STI: 9 Malaria: 10 TB: 36 02.004.WP01.03 Number of countries and areas reporting on surveillance and monitoring of HIV/STI, malaria and TB drug resistance.

Baseline

HIV/AIDS/STI: 3 (HIV); 10 (STI) Malaria: 7 TB: 16 HIV/AIDS/STI: 4 (HIV); 10 (STI) Malaria: 10 TB: 21 HIV/AIDS/STI: 5 (HIV); 10 (STI) Malaria: 10 TB: 25

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

WHO has a critical role in supporting and coordinating HIV/AIDS/STI, tuberculosis and malaria surveillance activities at the global, regional and country levels which includes supporting synthesis and dissemination of data for informing policy decisions and public health responses on these diseases; shaping the research agenda; stimulating and supporting the generation, translation and dissemination of knowledge, evidence and lessons learnt. Regional and in country support for strengthening surveillance and programme monitoring and evaluation activities is crucial to providing timely information for strategic and policy development, effective programme management and timely response to issues.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 2

Organizationwide expected result 02.005

Political commitment sustained and mobilization of resources ensured through advocacy and nurturing of partnerships on HIV/AIDS, tuberculosis and malaria at country, regional and global levels; support provided to countries as appropriate to develop or strengthen and implement mechanisms for resource mobilization and utilization and increase the absorption capacity of available resources; and engagement of communities and affected persons increased to maximize the reach and performance of HIV/AIDS, tuberculosis and malaria control programmes. Political commitment sustained and mobilization of resources ensured through advocacy and nurturing of HIV/AIDS/STI, malaria and tuberculosis partnerships at country, regional and global levels; support provided to countries and areas as appropriate to develop/strengthen and implement mechanisms for resource mobilization and utilization; and engagement of communities and affected persons increased to maximize the reach and performance of HIV/AIDS/STI, malaria and tuberculosis control. 02.005.WP01.01 Number of targeted countries and areas that receive WHO support in accessing financial resources or increasing absorption of funds for HIV/ AIDS/STI, malaria and TB control. 02.005.WP01.02 Number of targeted countries and areas with verifiable active involvement of communities, people living with HIV/AIDS, most at risk populations, civil society organizations, private sector in planning, design, implementation and evaluation of HIV/AIDS/STI, malaria and TB programmes. HIV/AIDS/STI: 5 Malaria: 5 TB: 17 HIV/AIDS/STI: 9 Malaria: 10 TB: 27 HIV/AIDS/STI: 9 Malaria: 10 TB: 27

Regional expected result 02.005.WP01

Regional indicators

Baseline

HIV/AIDS/STI: 9 Malaria: 6 TB: 17 HIV/AIDS/STI: 9 Malaria: 8 TB: 27 HIV/AIDS/STI: 9 Malaria: 8 TB: 27

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Partnerships to broaden technical and financial resources are critical to scaling up and reaching the intervention goals of the HIV/AIDS/STI, malaria and TB programmes. The Region, countries and areas actively participate and substantially contribute to the work of partnerships (such as UNAIDS, the Stop TB and Rollback Malaria Partnerships, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the U.S. President's Emergency Plan for AIDS Relief, the Global TB Drug Facility, the Malaria Medicines and Supply Service, and the AIDS Medicines and Diagnostics Service). Partnerships that exist in the regions and countries and areas need to be enhanced or expanded in order to further strengthen political commitment and to increase the level of resources, and accelerate actions towards achieving the relevant MDGs.

Organizationwide expected result 02.006 Regional expected result 02.006.WP01 Regional indicators

New knowledge, intervention tools and strategies developed and validated to meet priority needs for the prevention and control of HIV/AIDS, tuberculosis and malaria, with scientists from developing countries increasingly taking the lead in this research. Operational research for the prevention and control of HIV/AIDS/STI, malaria and TB supported and research capacity strengthened in target countries and areas. 02.006.WP01.01 Number of new operational research projects in the field of HIV/AIDS/STI, malaria or TB prevention and control supported by WHO in the Region. HIV/AIDS/STI: 2 Malaria: 14 TB: 0 HIV/AIDS/STI: 3 Malaria: at least 10 (1/country) TB: at least 4 HIV/AIDS/STI: 5 Malaria: at least 10 (1/country) TB: at least 7 02.006.WP01.02 Number of countries and areas actively pursuing operational research in the field of HIV/AIDS/STI, malaria or TB with verifiable involvement of local institutions. HIV/AIDS/STI: 2 Malaria: 10 TB: 0 HIV/AIDS/STI: 3 Malaria: 10 TB: at least 4 HIV/AIDS/STI: 5 Malaria: 10 TB: at least 4

Baseline

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Appropriately directed operational research can have a significant impact on HIV/AIDS/STI, malaria and TB control through the improvement, development and evaluation of new tools, interventions and strategies. WHO's facilitating role in this area is critical to finding the most effective and context-appropriate measures for combating these diseases and building a sustainable groundwork for developing countries and areas to undertake research of national and local relevance, and to the utilization of results for effective and efficient programme management.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 3

STRATEGIC OBJECTIVE 3 To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. Scope The work under this strategic objective focuses on the following activities: policy development; programme implementation; monitoring and evaluation; strengthening of health and rehabilitation systems and services; implementation of prevention programmes and capacity-building in the area of chronic noncommunicable conditions (including cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, hearing and visual impairment–including blindness, and genetic disorders, mental, behavioural and neurological disorders, and those provoked by psychoactive substance use; injuries due to road traffic crashes, drowning, burns, poisoning, falls, violence in the family, the community or between organized groups; and disabilities from all causes). Regional indicators and targets

• • •

A 2% annual reduction in global burden of disease (disability adjusted life years) from the major chronic, noncommunicable conditions over and above current trends. To halt and begin to reverse current increasing trends of mental, behavioural, neurological and psychoactive substance use disorders. To halt and begin to reverse current increasing trends in mortality from injuries.

Links with other strategic objectives

•

Strategic objective 6: in relation to population-wide approaches to combating tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity as risk factors; and in relation to approaches directed at individuals at high risk from these risk factors, as well as approaches directed at the prevention of other risk factors.

Issues and challenges In the Western Pacific Region, there is evidence of strong political commitment in many of these areas, but in most countries and areas, this commitment still needs to translate into effective policies and legislation, into operational plans and programmes, and into defined budget lines and investment. Many programmes in the Region are still dependent on external funding and are not sustainable. The areas represented in this strategic objective represent some of the greatest public health burdens in the world, and disproportionately affecting developing countries and areas, yet international and national investment is limited. There is a growing body of data in the Region (e.g. WHO STEPwise approach to surveillance of noncommunicable disease (NCD) risk factors (STEPS), Global Youth Tobacco Survey) in many of the areas covered by this strategic objective, but there are still challenges in data quality, systems of data collection, capacity for local work, and dissemination of data and findings. Health systems and capacities are still geared, in most developing countries and areas, around more traditional public health challenges and there is a need to reorient capacity-building. In developing countries in the Western Pacific Region, a person with diabetes, hypertension, or physical disability is usually unable to access effective services in their community. Health workers are often ill-equipped to deal with chronic disease, and the prevention of unintentional injury, physical and mental abuse, disability and mental illness. The scope of the work of WHO or of the health sector alone is limited due to the inherent multisectoral nature of the burden. WHO is therefore challenged to create and sustain networks and partnerships that span countries and areas and sectors and lead to effective action. Many countries and areas in the Western Pacific Region have developed NCD task forces and similar committees. The general rule is that these are still largely health-oriented and they must adopt ways of working that will involve wider multisectoral partnerships and action. A number of Regional Committee resolutions and enabling documents have mandated and developed the strategic approaches outlined below:

• • • •

WPR/RC51.R5: Prevention and Control of Noncommunicable Diseases The Tonga Commitment To Promote Healthy Lifestyles And Supportive Environment (March 2003, Nuku’alofa, Tonga) WPR/RC55.R7: Tobacco Control WPR/RC52.R5: Regional Strategy for Mental Health

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 3

Strategic approaches Strategic approaches for Member States:

• • • • •

Translating commitment into effective policies, legislation, operational plans and programmes. This includes the investment of national resources and the development of health financing systems that provide access to effective prevention and control in all themes under strategic objective 3. Improving capacity for surveillance through establishing systems for tracking risk factors, registers of key events and diseases, and mortality records of sufficient quality to permit evidence-based policy making. Strengthening and sustaining health promotion programmes including national and local efforts to raise awareness of healthy lifestyles and develop supportive environments. Strengthening and sustaining clinical prevention by developing evidence-based clinical guidelines, training staff, delivering efficient services and assuring quality. Strengthening and sustaining national networks that can extend the reach of health services into other sectors and into local communities.

Strategic approaches for the WHO Secretariat:

• • • • •

Providing advocacy and guidance in the development, implementation and monitoring of national policies, programmes and plans in these areas of work. Providing standard instruments for surveillance and supporting the development of surveillance systems. Assessing and strengthening the systems (health and other sectors) to prevent, manage and provide services, including rehabilitation. Supporting training and capacity-building in countries and areas through guidance and direct technical assistance to develop a health workforce better equipped to deal with these conditions. Building and supporting networks and partnerships with international, governmental, nongovernmental, and private organizations, and with the media.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 3

Organizationwide expected result 03.001 Regional expected result 03.001.WP01 Regional indicators

Advocacy and support provided to increase political, financial and technical commitment in Member States in order to tackle chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities. Advocacy and support provided to increase political, financial and technical commitment in countries and areas in order to address chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 03.001.WP01.01 Number of targeted countries and areas that have a focal point or unit for injuries and violence prevention with its own budget in the health ministry. 03.001.WP01.02 Number of countries and areas that participate in the development and implementation of The World Report on Disability and Rehabilitation. 03.001.WP01.03 Number of targeted countries and areas that have a unit for mental health with its own budget in the health ministry. 03.001.WP01.04 Number of targeted low to middle income countries and areas that have a unit or department for chronic noncommunicable conditions with its own budget in the health ministry. 7 10

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

10 20

0 5

8 18

The resources will be used to raise the profile of, and strengthen commitment for action on chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities at global, regional and national levels. Resources will also be used to support the activities of units in national health authorities with limited capacity to address chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. Finally, resources will be used for the development of tools, reports, and campaigns that describe the situation and make recommendations for action.

Organizationwide expected result 03.002 Regional expected result 03.002.WP01 Regional indicators

Guidance and support provided to Member States for the development and implementation of policies, strategies and regulations in respect of chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities. Guidance and support provided to countries and areas for the development and implementation of policies, strategies and regulations for chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 03.002.WP01.01 Number of targeted countries and areas that have and are implementing national plans to prevent unintentional injuries and violence. 03.002.WP01.02 Number of targeted countries and areas that have and are implementing national plans for disability and rehabilitation. 03.002.WP01.03 Number of countries and areas receiving and utilizing guidance on policies, strategies and regulations for mental, behavioural, neurological and psychoactive substance use disorders. 03.002.WP01.04 Number of targeted low to middle income countries and areas that have and are implementing a nationally approved policy document for the prevention and control of chronic, noncommunicable conditions. 5 10

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

2 4

0 3

8 15

National plans and policies are key to coordinated multisectoral responses to chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. A limited number of middle to low income countries and areas have developed such plans for noncommunicable diseases however several more are actively engaged in developing or completing plans. The resources will be used to support regional and country processes to advance development and initial implementation of policies and plans.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 3

Organizationwide expected result 03.003 Regional expected result 03.003.WP01 Regional indicators

Improvements made in Member States’ capacity to collect, analyse, disseminate and use data on the magnitude, causes and consequences of chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities. Improved capacity in countries and areas to collect, analyse, disseminate and use data on the magnitude, causes and consequences of chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 03.003.WP01.01 Number of targeted countries and areas that have published a national compilation of data on the magnitude, causes and consequences of injuries and violence. 03.003.WP01.02 Number of targeted countries and areas that have published a national compilation of data on the prevalence and incidence of disabilities. 03.003.WP01.03 Number of targeted countries and areas establishing or substantially strengthening national or regional information systems on the magnitude, causes and consequences of mental, behavioural, neurological and psychoactive substance use disorders. 0 5 03.003.WP.01.04 Number of targeted low to middle income countries and areas that have conducted WHO STEPwise or similar surveys and commenced national reporting on prevalence of noncommunicable disease and associated risk factors.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

2 5

0 3

8 16

Resources will be used to support countries and areas to better document the public health impact and costs of chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. More specifically the resources will be used to set up data collection systems, support data analysis and dissemination. Resources will also be used to monitor and provide feedback on regional trends.

Organizationwide expected result 03.004 Regional expected result 03.004.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Improved evidence compiled by WHO on the cost-effectiveness of interventions to tackle chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities. Improved evidence compiled by WHO on the cost-effectiveness of interventions to address chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 03.004.WP01.01 Evidence on the cost-effectiveness of a core package of interventions for chronic, noncommunicable conditions summarized and the regional cost of implementation estimated. Evidence gathered. Core package completed.

Expanded and desirable packages are completed, and overall approach is contextualized for country implementation. Resources will be used to support further research in low and middle income countries and areas on costeffectiveness of interventions. This will include training and workshops to refine methodology, studies, and compilation of results at national and regional levels, building on existing tools, methods and best practice documents and focused dissemination strategies. Resources will also be used to inform policy-makers at country level and to assist them with using this information for priority setting.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 3

Organizationwide expected result 03.005 Regional expected result 03.005.WP01 Regional indicators

Guidance and support provided to Member States for the preparation and implementation of multisectoral, population-wide programmes to promote mental health and to prevent mental and behavioural disorders, violence and injuries, together with hearing and visual impairment, including blindness. Guidance and support provided to countries and areas for the preparation and implementation of multisectoral population-wide programmes to prevent mental and behavioural disorders, violence and injuries and hearing and visual impairment. 03.005.WP01.01 Number of countries and areas that use guidelines on multisectoral interventions to prevent violence and unintentional injuries in their contexts with WHO support. 3 7 03.005.WP01.02 Guidance on the prevention of selected mental, behavioural, neurological and psychoactive substance use disorders prepared and made available. Guidance on 0 disorders Guidance on 2 disorders

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Guidance on 4 disorders

Resources will be used to support the implementation of prevention programmes at local, national and regional level, including the necessary training and workshops. They will also be used for global and regional guidelines and best practice documents, and for global coordination and monitoring of country experiences and lessons learnt.

Organizationwide expected result 03.006 Regional expected result 03.006.WP01 Regional indicators

Guidance and support provided to Member States to improve the ability of their health and social systems to prevent and manage chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities. Guidance and support provided to countries and areas to strengthen their health and social systems in order to prevent and manage chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 03.006.WP01.01 Number of targeted countries and areas that strengthened their health-care system response to unintentional injuries and violence using WHO guidelines. 03.006.WP01.02 Number of countries and areas that strengthened their rehabilitation services using the recommendations in The World Report on Disability and Rehabilitation and related WHO guidelines. 03.006.WP01.03 Number of countries and areas conducting a systematic assessment of their mental health systems using the WHO assessment instrument for mental health systems and utilizing the information to plan strengthening of national mental health systems. 03.006.WP01.04 Number of targeted low to middle income countries and areas implementing integrated primary health-care strategies recommended by WHO in the management of chronic, noncommunicable conditions, or that have significant demonstration projects designed to inform scaling up to national implementation. 5 10

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

2 5

0 2

5 12

Resources will be used for documents, training, workshops and direct support for the strengthening of health and rehabilitation services in low and middle income countries and areas, to ensure that they improve ways in which they address chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 3

Organizationwide expected result 03.006 Regional expected result 03.006.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 4

STRATEGIC OBJECTIVE 4 To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. Scope Work under this strategic objective will focus on action towards ensuring universal access to, and coverage with, effective public health interventions to improve maternal, newborn, child, adolescent, and sexual and reproductive health, with emphasis on reducing gender inequality and health inequities; development of evidence-based, gender-sensitive, coordinated and coherent approaches to addressing needs at key stages of life and improving sexual and reproductive health, using a life-course approach; fostering synergies between maternal, newborn, child, adolescent, sexual and reproductive health interventions and other public health programmes, and supporting action to strengthen health systems; and formulation and implementation of policies and programmes that promote healthy and active ageing for all individuals. Regional indicators and targets

• • • •

Proportion of births attended by skilled health personnel: at least 85% by 2013. Maternal mortality ratio: by 2013, four countries and areas or less have a maternal mortality ratio above 100 per 100 000 live births. Under-5 mortality rate: by 2013, 30 countries and areas are on track to meet the Millennium Development Goal (MDGs) Target 5 (reduce by two thirds, between 1990 and 2015, the under-5 mortality rate) or have an under-5 mortality rate lower than 20/1000 live births. Contraceptive prevalence rate: 60% by 2013.

Links with other strategic objectives

• •

Strategic objectives 1 and 2: in relation to ensuring the effective delivery, in an integrated manner, of immunization and other interventions for the control of major infectious diseases through services for maternal, newborn and child and adolescent health and sexual and reproductive health. Strategic objectives 6 to 9, especially 6, 7 and 9: sufficient attention needs to be given to: (a) social and economic determinants of ill-health that limit progress towards this strategic objective; (b) major risk factors, such as poor nutrition; and (c) human rights-based and gender-responsive approaches to ensure equitable access to key services. Strategic objectives 10 and 11: with attention to specific actions required to strengthen health systems so that they can rapidly expand access to effective interventions for maternal, newborn, child, adolescent and sexual and reproductive health, while ensuring a continuum of care across the life course and across different levels of the health system, including the community.

•

Issues and challenges Significant progress has been made over the years in reducing maternal and childhood mortality in the Western Pacific Region. Yet, nearly 50 000 mothers die every year from pregnancy- or childbirth-related complications, while around 360 000 newborn babies die during the first month of life and another 406 000 children who survive the first month do not see their fifth birthday. Although cost-effective interventions are available to respond to most of the health problems of mothers and young children, underdeveloped health systems in some countries and areas of the Region fail to ensure the accessibility, affordability and quality of essential services for mothers and children, and prevent unnecessary deaths. A joint WHO/UNICEF Regional Child Survival Strategy (resolution WPR/RC56.R5) provides a unified direction to guide countries and areas in accelerating and sustaining action to scale up an essential package of child survival interventions in an integrated way and in collaboration with all stakeholders, through the health system context. While the strategy is primarily targeted at intensifying action towards reducing child mortality, it outlines a strong link with efforts to reduce maternal mortality, and to intensify action towards reaching key health-related MDGs, especially MDGs 4 and 5, in the Region. There is significant morbidity and mortality among adolescents due to teenage pregnancy, unmet need for contraceptives, sexually transmitted infections including HIV/AIDS, injuries, suicide and violence. Many of these are preventable through improving access to information, skills and services as well as reducing the vulnerability of adolescents.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 4

Action towards universal access to and coverage with effective interventions faces the following challenges:

• • • •

There is an enormous burden of disease and high mortality in the vulnerable group of women, children and adolescents. Political will to make a difference is still lacking in many countries and areas as resources are largely insufficient. Progress towards this strategic objective is dependent on the overall strengthening of health systems and, in particular, action for dealing with the crisis affecting human resources for health. Competing health priorities, vertical programme approaches and lack of coordination between government and development partners result in programme fragmentation, missed opportunities and inefficient use of resources.

Strategic approaches Strategic approaches for Member States:

• • • • •

Commit resources and prioritize national action towards universal access to and coverage with reproductive, maternal, newborn, child and adolescent health care, while addressing health inequities that fuel high levels of mortality and morbidity. Work towards harmonization of programme efforts and the integration of service delivery. Ensure that the continuum of care runs through the life course, and spans the home, the community and different levels of the health system. Ensure the strengthening of adequate and equitable financing and delivery of quality health-supportive services. Promote community-based interventions to increase demand for services and to support appropriate care in the home across the life course.

Strategic approaches for the WHO Secretariat:

• • • • •

Provide technical guidance for the formulation and implementation of effective and evidence-based policies and interventions to improve reproductive, maternal, child and adolescent health. Develop synergies between programme areas to ensure continuum of care. Support countries and areas to develop their institutional capacity to deliver effective interventions, with particular attention to the strengthening of human resources for health. Support countries and areas to monitor their health situation and assess progress towards internationally agreed goals and targets relevant to this objective. Work with civil society and the private sector through partnerships to harmonize the work of United Nations agencies at the country level and to mobilize political leadership and resources as well as integration of poverty reduction strategies for improving reproductive, maternal, newborn, child and adolescent health.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 4

Organizationwide expected result 04.001

Support provided to Member States to formulate a comprehensive policy, plan and strategy for scaling up towards universal access to effective interventions in collaboration with other programmes, paying attention to reducing gender inequality and health inequities, providing a continuum of care throughout the life-course, integrating service delivery across different levels of the health system and strengthening coordination with civil society and the private sector. Support to Member States to develop a comprehensive policy, plan and strategy for scaling up towards universal access to effective interventions in collaboration with other programmes, paying attention to gender inequality and gaps in health equity, providing a continuum of care throughout the life-course, integrating service delivery across different levels of the health system and strengthening coordination with civil society and the private sector. 04.001.WP01.01 Number of target countries and areas that have an integrated policy on universal access to effective interventions for improving maternal, newborn and child health. 0 2 04.001.WP01.02 Number of target countries and areas that have a policy on universal access to sexual and reproductive health. 1 3

Regional expected result 04.001.WP01

Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Achievement of targets will require: advocacy and coordination of effective international efforts and the strengthening of collaboration with partners (e.g., through the Maternal Newborn and Child Health Partnership); and promotion of key initiatives and approved actions such as the strategy to accelerate progress towards the attainment of international development goals and targets related to reproductive health.

Organizationwide expected result 04.002 Regional expected result 04.002.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

National research capacity strengthened as necessary and new evidence, products, technologies, interventions and delivery approaches of global and/or national relevance available to improve maternal, newborn, child and adolescent health, to promote active and healthy ageing, and to improve sexual and reproductive health. National research capacity strengthened as necessary and new evidence, products, technologies, interventions and delivery approaches of global and/or national relevance available to improve maternal, newborn, child and adolescent health, to promote active and healthy ageing, and to improve sexual and reproductive health. 04.002.WP01.01 Number of target countries and areas carrying out studies on priority issues in the relevant fields 0 1

Country-led identification of research priorities and opportunities for strengthening national research capacity will have to be given greater attention and the setting of those research priorities, done in close consultation with national research partners and other stakeholders will have to be improved. Support will be needed for use of research findings in informing policies and programmes.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 4

Organizationwide expected result 04.003 Regional expected result 04.003.WP01 Regional indicators

Guidelines, approaches and tools for improving maternal care applied at the country level, including technical support provided to Member States for intensified action to ensure skilled care for every pregnant woman and every newborn, through childbirth and the postpartum and postnatal periods, particularly for poor and disadvantaged populations, with progress monitored. Technical and policy support provided to Member States for implementing national plans of action for the reduction of maternal and newborn mortality by achieving universal coverage of skilled attendants on maternal and newborn care. 04.003.WP01.01 Number of countries and areas implementing national plans of action through disseminating, adapting and implementing evidence-based standards and guidelines for the reduction of maternal and newborn mortalities. 1 7 04.003.WP01.02 Number of countries and areas supported to conduct training for skilled birth attendants (doctors, nurses and midwives) to improve maternal and newborn health care. 2 7

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

In the Western Pacific Region, every year there are 40 million to 50 million pregnancies with 50 000 maternal deaths and 300 000 newborn deaths on the first day of birth. As maternal mortality ratio reflects women's basic health status, access to health care and the quality of care that they receive, technical support to Member States is important, especially for skilled birth attendants.

Organizationwide expected result 04.004 Regional expected result 04.004.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Guidelines, approaches and tools for improving neonatal survival and health applied at country level, with technical support provided to Member States for intensified action towards universal coverage, effective interventions and monitoring of progress. Guidelines, approaches and tools for improving neonatal survival and health in use at country level, with technical support provided to Member States for intensified action towards the achievement of universal coverage along with effective interventions and progress monitoring. 04.004.WP01.01 Number of target countries and areas implementing strategies for neonatal survival and health. 1 3

Achievement of this expected result will require a continuum of care between maternal, newborn and child health services and strengthened links between these and other programmes such as immunization, family planning, nutrition, HIV/AIDS, syphilis elimination and malaria control. Furthermore, it will need community involvement and promotion of contact between mothers, their families and health workers, a continuum of care between communities and health facilities, provision of suitable facilities for maternal and newborn care at community and primary-care levels, especially for low birth-weight infants and systems for monitoring trends in neonatal survival, disaggregated by sex, that allow the detection of subpopulations at high risk.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 4

Organizationwide expected result 04.005 Regional expected result 04.005.WP01 Regional indicators

Guidelines, approaches and tools for improving child health and development applied at the country level, with technical support provided to Member States for intensified action towards universal coverage of the population with effective interventions and for monitoring progress, taking into consideration international and human-rights norms and standards, notably those stipulated in the Convention on the Rights of the Child. Policy and technical support provided to Member States for intensified action towards agreed goals ensuring universal access, coverage and quality of key public health interventions for newborn and child survival. 04.005.WP01.01 Number of countries and areas implementing coordinated strategies for newborn and child survival. 1 6 04.005.WP01.02 Number of countries and areas that have expanded geographical coverage of IMCI to more than 75% of target districts. 1 3

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Around 800 000 children under 5 years of age die every year in the Region from common preventable and treatable conditions. WHO/UNICEF Regional Child Survival Strategy has been adopted by the 56th session of the WHO Western Pacific Regional Committee as a unified direction and guide towards accelerated and sustained actions towards reduction of inequities in child survival and achieving national targets for MDG 4. Technical support provided to Member States for the implementation of evidence-based policies and strategies on adolescent health and development, and for the scaling up of a package of prevention, treatment and care interventions in accordance with established standards. Policy and technical support provided to Member States for coordinated implementation of evidence-based strategies, norms and standards for the prevention and care of diseases and health compromising behaviours in adolescents, as well the conditions that place adolescents at risk. 04.006.WP01.01 Number of target countries and areas that implement evidence-based policy recommendations and guidelines for the protection, prevention and care for the health of adolescents. 2 4

Organizationwide expected result 04.006 Regional expected result 04.006.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Adolescents are at high risk of morbidity and mortality from early pregnancy, sexually transmitted infections including HIV, injuries, suicide and violence. Achievement of MDGs 5 and 6 will depend on reduction of HIV transmission and maternal mortality among adolescents.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 4

Organizationwide expected result 04.007

Guidelines, approaches and tools made available, with provision of technical support to Member States for accelerated action towards implementing the strategy to accelerate progress towards the attainment of international development goals and targets related to reproductive health, with particular emphasis on ensuring equitable access to good-quality sexual and reproductive health services, particularly in areas of unmet need, and with respect for human rights as they relate to sexual and reproductive health. Technical support provided to Member States for accelerated action towards implementing the Global Reproductive Health Strategy and improving family planning and reproductive health care. 04.007.WP01.01 Number of countries and areas having obtained training or guidance on programme strategy analysis and policy review on reproductive health to update strategies and plans for strengthening universal access to and availability of high-quality family planning and reproductive health. 1 10 04.007.WP01.02 Number of countries and areas having translated, adapted and provided training in the evidence-based and updated manuals or guidelines on family planning and reproductive health developed by WHO. 2 6

Regional expected result 04.007.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Unsafe abortion is a leading cause of maternal mortality in the priority countries and areas. Implementing the global reproductive health strategy, improving universal access to and quality of family planning and reproductive health service are basic assumptions for maternal mortality reduction and achieving strategic objective 4.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 5

STRATEGIC OBJECTIVE 5 To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. Scope The joint efforts of the Member States and the Secretariat regarding this strategic objective involve the following: health-sector emergency preparedness; intersectoral action for reducing risk and vulnerability within the framework of the International Strategy for Disaster Reduction; responding to the health needs experienced during emergencies and crises (including nutrition-related needs as well as those concerning water and sanitation); assessing needs of affected populations; health actions during the transition and recovery phases following conflicts and disasters; fulfilling WHO’s mandate within the framework of the reform process to enhance the United Nations humanitarian response; the global alert and response system for environmental and foodsafety public health emergencies within the framework of the International Health Regulations (2005); risk reduction in respect of specific threats; and preparedness and response programmes for environmental and food safety public health emergencies. In this way, WHO is making an important contribution to health security that also has critical implications for efforts to promote peace. Regional indicators and targets

• • •

Proportion of countries and areas with health-related disaster preparedness, risk-reduction and mitigation plans: 60%. Proportion of countries and areas with declared emergencies receiving WHO emergency interventions: 60%. Proportion of countries and areas affected by crises in which avoidable mortality has been kept below emergency thresholds: 60%.

Links with other strategic objectives

• • • • •

Strategic objective 1: in relation to the International Health Regulations (2005) and responding to public health emergencies involving epidemics. Strategic objective 3: in relation to gender violence, responding to psychosocial needs of affected populations; responding to the health needs of the disabled; mass-casualty management; and health care for those suffering from chronic diseases. Strategic objective 4: in relation to the response to the health needs of vulnerable populations, especially mothers and children in emergency situations. Strategic objective 8: in relation to intersectoral action for emergency preparedness and risk reduction, and for dealing with environmental, chemical and radiological emergencies. Strategic objective 9: in relation to nutrition in emergency situations.

Issues and challenges Of the six WHO regions, the Western Pacific Region has the highest number of natural hazard events per year. The five main issues in the Region include: 1. 2. 3. 4. 5. Recurring natural hazards and increasing numbers of technological hazards that may cause emergencies and then become disasters in vulnerable and inadequately prepared communities. Insufficient preparedness for emergencies at provincial and community levels, aggravating the impacts of hazards on health and health services. Weak capacity of health authorities for emergency management, leading to ineffective or inappropriate emergency support. Lack of collaboration among partner agencies, leading to the inappropriate use of limited resources and hindering collective efforts. Shortages of systematic and reliable public health information on emergencies, making it difficult to measure their impact, develop sound policies or monitor activities.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 5

Strategic approaches Strategic approaches for Member States are:

• • •

Build national institutional capacity for effective preparedness, response and recovery efforts. Establish effective national coordination mechanisms including timely information sharing for response to emergencies. Promote health systems preparedness with a multi-hazard approach, including capacity to anticipate events and the use of early warning mechanisms.

Strategic approaches for the WHO Secretariat:

• • • •

Build capacity in the field of emergency preparedness and response through multisectoral, multidisciplinary and all-hazard approaches. Support the establishment and maintenance of national operational capacity of Member States for rapid response and for leading coordinated action of multiple stakeholders in public health emergencies, disasters, conflicts and other crises. Develop technical and operational capacity in support of countries and areas in crises, particularly in conducting health assessments, coordinating health action, filling gaps, providing guidance and in monitoring the performance of humanitarian action on the health of affected populations. Leverage the vast array of skills across WHO in support of response to health emergencies (mental health, nutrition, environmental health, water and sanitation, health promotion, food safety, essential medicines, violence and injury prevention, mass casualty management, noncommunicable diseases, communicable diseases, and maternal and child health).

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 5

Organizationwide expected result 05.001 Regional expected result 05.001.WP01 Regional indicators

Norms and standards developed, capacity built and technical support provided to Member States for the development and strengthening of national emergency preparedness plans and programmes. Norms and standards developed, capacity built and technical support provided to Member States for development and strengthening of national emergency preparedness plans and programmes. 05.001.WP01.01 Number of countries and areas with preparedness activities. 05.001.WP01.02 Number of countries and areas that have conducted national training courses/activities in health emergency management. 8 10 05.001.WP01.03 Number of guidelines, standards, protocols or references developed. 4 6

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

10 15

National preparedness for health emergencies should be strengthened through the development of norms and standards, training programmes/activities and other forms of technical support that can be provided by WHO.

Organizationwide expected result 05.002 Regional expected result 05.002.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Norms and standards developed, capacity built and technical support provided to Member States for a timely response to disasters associated with natural hazards and to conflict-related crises. Norms and standards developed, capacity built and technical support provided to Member States for a timely response to disasters associated with natural and human-generated hazards. 05.002.WP01.01 Number of international emergency events to which WHO provided support. 5 6

Effective and efficient response can be measured by the technical support provided and norms/standards developed.

Organizationwide expected result 05.003 Regional expected result 05.003.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Norms and standards developed, capacity built and technical support provided to Member States for assessing needs and for planning and implementing interventions during the transition and recovery phases of conflicts and disasters. Norms and standards developed, capacity built and technical support provided to Member States for assessing needs and for planning and implementing transition and recovery actions in post disasters and post conflict situations. 05.003.WP01.01 Number of projects where WHO provided support for development of norms and standards, capacity-building and actual planning/implementation of transition and recovery activities. 1 2

Improvements in transition and recovery activities can be seen in norms and standards developed and in capacity-building activities provided.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 5

Organizationwide expected result 05.004 Regional expected result 05.004.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Coordinated technical support provided to Member States for communicable diseases control in natural disaster and conflict situations. Coordinated technical support on communicable disease control in disasters resulting from natural and human-generated hazards provided to Member States. 05.004.WP01.01 Number of joint activities with WHO Communicable Diseases Surveillance and Response Unit (CSR) in emergency preparedness and response. 1 3

Response in emergencies will be strengthened with joint activities with CSR in the control and prevention of outbreaks and communicable diseases.

Organizationwide expected result 05.005 Regional expected result 05.005.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Support provided to Member States for strengthening national preparedness as well as alert and response mechanisms for food safety and environmental health emergencies. Coordinated technical support provided to Member States on environmental health and food safety in disasters resulting from natural and human-generated hazards. 05.005.WP01.01 Number of joint WHO divisional activities on food safety, environmental health and water/sanitation in emergency preparedness and response. 1 3

WHO has an essential role in strengthening global capacity for emergency and humanitarian action.

Organizationwide expected result 05.005 Regional expected result 05.005.WP02 Regional indicators

Support provided to Member States for strengthening national preparedness and for establishing alert and response mechanisms for food-safety and environmental health emergencies. Support provided to Member States for strengthening national preparedness, alert and response to food safety and environmental health emergencies. 05.005.WP02.01 Number of activities supported in the area of preparedness, alert and response to environmental emergencies. 1 2 05.005.WP02.02 Number of countries and areas in which protocols for food safety emergencies have been developed/adapted and training conducted. 0 1

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

WHO has an essential health technical support role in strengthening global preparedness for food safety and environmental health emergencies.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 5

Organizationwide expected result 05.006 Regional expected result 05.006.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Effective communications issued, partnerships formed and coordination developed with other organizations in the United Nations system, governments, local and international nongovernmental organizations, academic institutions and professional associations at the country, regional and global levels. Effective communications issued, partnerships formed and coordination developed with other United Nations agencies, governments, local and international nongovernmental organizations, academic institutions and professional associations at country, regional and global levels. 05.006.WP01.01 Number of collaborative activities in which WHO has been a participant. 4 6

Lack of collaboration among partner agencies can lead to inappropriate use of limited resources and can hinder collective efforts towards health security.

Organizationwide expected result 05.006 Regional expected result 05.006.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

05.006.WP02.01 Number of communications (press conferences, press releases, fact sheets) in emergency outbreak situations. Status at the end of 2007 10% above baseline

20% above baseline

WHO has been recognized and valued as an authoritative source of accurate and timely health information during emergency and outbreak situations.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 6

STRATEGIC OBJECTIVE 6 To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. Scope The work under this strategic objective focuses on integrated, comprehensive, multisectoral and multidisciplinary health-promotion and prevention processes and approaches across all WHO’s relevant programmes; and on the prevention or reduction of the occurrence of six major risk factors: use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diet, physical inactivity and unsafe sex. The main activities involve capacity building for health promotion across all relevant programmes, risk-factor surveillance, the development of ethical and evidence-based policies, strategies, interventions, recommendations, standards and guidelines for health promotion, prevention and reduction of the occurrence of the major risk factors. Regional indicators and targets

• • • • •

Health Promotion capacity score: increase in capacity in 30% of Western Pacific Region Member States that have completed the capacity mapping by 2013. Tobacco use prevalence: half of Western Pacific Region Member States reduce national tobacco use prevalence by 10% by 2013. Childhood obesity prevalence: 10% of Member States in the Western Pacific Region with a high burden of childhood obesity to stop the rise in childhood obesity by 2013. Level of harmful use of alcohol: 10% increase in the number of Western Pacific Region Member States that have stabilized or reduced harmful use of alcohol by 2013. Unsafe sex prevalence: Reduce by two thirds the percentage of men and women in Western Pacific Region Member States not wanting a child and not using a contraceptive method and increase to 70% correct and consistent condom use during the last sexual intercourse with a non-regular partner by 2013.

Links with other strategic objectives

•

Strategic objectives 2, 3, 4, 7, 8 and 9: although these seek to deal with the determinants of poor health and strengthen service provision, this strategic objective seeks in particular, to create healthy environments in order to enable individuals to make healthy choices.

Issues and challenges Strategic objective 6 includes the major risk factors that contribute to more than 60% of the mortality and more than 50% of the morbidity burden worldwide, affecting predominantly populations in low- and middle-income countries and areas. While much emphasis has been placed on the treatment of the effects of these risk factors, much less attention has been devoted to primary prevention and how to effectively modify the determinants for these risk factors. Tobacco use is the leading cause of preventable deaths worldwide, killing 4.9 million people every year. Some 1 million of those deaths are in the Western Pacific Region, with at least 50% of tobacco-attributable deaths occurring in developing countries and areas. The WHO Framework Convention on Tobacco Control (FCTC), now ratified by almost all Member States of the Western Pacific Region, is an evidence-based treaty designed to help reduce the burden of disease and death caused by tobacco use. Regional Committee resolution WPR/RC55.R7 called upon Members States to implement tobacco control measures beyond those required by the FCTC. In 2000, alcohol consumption was linked to 3.2% of total deaths globally and 58.3 million disability-adjusted life years lost. It also accounts for 5.5% of the overall disease burden in the Western Pacific Region. More than 15 million people worldwide suffer from drug use disorders. In a growing number of countries and areas, injecting drug use is the driving force behind the rapid spread of HIV infection, and up to 90% of HIV infections in many countries and areas are due to injecting drug use. Globally, 17% of the population is estimated to be physically inactive and an additional 41% is estimated be insufficiently active. This is estimated to cause 1.9 million deaths per year, thereby identifying physical inactivity as one of the leading risk factors for health. World Health Assembly resolution WHA57.17 endorsed the Global Strategy on Diet, Physical Activity and Health and urged Member States take actions that promote individual and community health through healthy diet and physical activity and to reduce the risks and incidence of noncommunicable diseases.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 6

Unsafe sexual behaviour leads to a major burden of disease associated with unintended pregnancy, sexually transmitted infections, including HIV/AIDS, and other social, emotional and physical consequences that are currently underestimated in present disease estimates. In the Western Pacific Region, Cambodia and Papua New Guinea are facing generalized HIV/AIDS epidemics. Other countries and areas in the Region have a low HIV prevalence. But there are concentrated epidemics in specific groups in China, Malaysia and Viet Nam that have the potential to bridge transmission to the general population. Resolution WPR/RC54.R5 called for the implementation of approaches that promote lifestyle choices that lead to reductions in transmission of sexually transmitted infections and HIV/AIDS, strengthened health promotion targeted at vulnerable groups, and continued reinforcement of the primary prevention of HIV transmission.

Strategic approaches Strategic approaches for Member States:

• •

Give priority to health promotion to improve health, reduce health inequalities, control major risk factors and ensure sustainable development at regional and country levels. Establish national systems of surveillance, monitoring and evaluation that can adequately identify at-risk populations through appropriately disaggregated data and develop responses for the prevention and control of common risk factors and associated health outcomes, giving priority to countries and areas with the highest or increasing burdens. Build multisectoral national capacities, partnerships and alliances to mainstream gender and equity perspectives and strengthen institutional knowledge and competence in surveillance, policy development, strategic and operational planning, programme management, monitoring and evaluation related to the major risk factors, and disseminate research findings to inform policy and service developments. Address policy and structural barriers, strengthen household and community capacity, and ensure access to education and information to promote safe sexual behaviours and manage individual and social consequences of unsafe sexual behaviours and practices. Implement the WHO Framework Convention on Tobacco Control in collaboration with the Permanent Secretariat for the WHO FCTC and for non-parties to strengthen their tobacco control policies and to become Parties to the Convention.

•

• •

Strategic approaches for the WHO Secretariat:

• • • • •

Provide leadership, technical assistance, coordination, communication, collaboration and advocacy. Encourage increased investment at all levels and build internal WHO capacity, especially in country offices. Strengthen the evidence base for health promotion interventions. Seek to significantly expand health promotion capacity to meet increased needs and activities across all relevant health programmes, including the recommendations of the 6th Global Conference on Health Promotion. Help prepare for the 7th Global Conference on Health Promotion and support implementation of the work of the WHO Commission on Social Determinants of Health.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 6

Organizationwide expected result 06.001 Regional expected result 06.001.WP01 Regional indicators

Advice and support provided to Member States to build their capacity for health promotion across all relevant programmes, and to establish effective multisectoral and multidisciplinary collaborations for promoting health and preventing or reducing major risk factors. Advice and support provided to countries and areas to strengthen their health promotion capacity across all relevant programmes, and to establish effective multisectoral and multidisciplinary mechanisms and collaborations to promote health and prevent and reduce the occurrence of major behavioural and structural risk factors. 06.001.WP01.01 Number of countries and areas supported to develop national outcome oriented health promotion strategies and/or activities. 2 5 06.001.WP01.02 Number of countries and areas supported to develop and/or expand methods/mechanisms to sustain financing of health promotion. 8 10 06.001.WP01.03 Number of networks at (a) country level; and (b) regional level strengthened for promotion of health and prevention of major riskfactors. (a) 6 (b) 1 (a) 8 (b) 2 (a) 12 (b) 4

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

The Regional Health Promotion Framework 2008–2013, (in progress), will provide guidance for the regional focus on building capacity across multiple intersecting human resources capacity domains and will be supported by a performance management plan to monitor and evaluate progress. Implementation at the regional level will be supported by new regional networks among Health Promotion Collaborating Centres and settings approaches, e.g. Healthy Cities and Health Promoting Schools. At the country level, multisectoral Health Promotion Boards/Foundations will be supported to strengthen and sustain financing.

Organizationwide expected result 06.002 Regional expected result 06.002.WP01 Regional indicators

Guidance and support provided in order to strengthen national systems for surveillance of major risk factors through development and validation of frameworks, tools and operating procedures and their dissemination to Member States where a high or increasing burden of death and disability is attributable to these risk factors. Guidance and support provided to strengthen national systems for major risk factor surveillance by developing, validating and disseminating programme and evaluation frameworks, tools and operating procedures to countries and areas with a high or increasing burden of premature death and disability attributable to major behavioural risk factors. 06.002.WP01.01 Number of target countries and areas supported that have developed a functioning national surveillance system for, and regularly reports on, major health risk factors in adults. 11 14 06.002.WP01.02 Percentage of target countries and areas supported that have developed a functioning national surveillance system for, or regularly reports on, major health risk factors in youth. 10% 35%

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

85%

Much of the work has already begun, but a substantial number of Member States will embark upon the development and implementation of reliable risk-factor and response surveillance systems during this planning and reporting period. Many Member States will continue to require assistance from WHO to sustain and perfect existing systems and others will require assistance from WHO to initiate these systems. It is anticipated that the level of effort, and material and human resources required for development, modification, validation and dissemination of standards and operating procedures will increase significantly in 2008–2009 and remain at that level during subsequent years.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 6

Organizationwide expected result 06.003

Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed, and technical support provided to Member States with a high or increasing burden of disease and death associated with tobacco use, enabling them to strengthen institutions in order to tackle or prevent the public health problems concerned; support also provided to the Conference of the Parties to the WHO Framework Convention on Tobacco Control for implementation of the provisions of the Convention and development and implementation of protocols and guidelines. Technical assistance, training and advocacy support provided to countries and areas with a high and increasing burden to strengthen institutions in order to address/prevent public health problems associated with tobacco. Support provided to the Conference of the Parties to the WHO Framework Convention on Tobacco Control for implementation of the provisions of the Convention. 06.003.WP01.01 Number of countries and areas that have adopted legislation or equivalent to ban smoking in health-care and educational facilities, to ban direct and indirect advertising in national media and health warnings on tobacco products consistent with the WHO Framework Convention on Tobacco Control. 10 20 06.003.WP01.02 Number of countries and areas with comparable national youth tobacco use prevalence data disaggregated by age and sex. 06.003.WP01.03 Number of countries and areas that have established or reinforced a national intersectoral coordinating mechanism for tobacco control.

Regional expected result 06.003.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

20 27

10 20

Significant additional investment will be required to adequately address the broad implementation needs in accordance with the decisions taken by the Conference of the Parties in its capacity as an independent governing body. WHO will be working closely with the Conference of Parties and the permanent secretariat of the WHO Framework Convention on Tobacco Control (FCTC) to provide the necessary support to Parties as they develop comprehensive tobacco control policies and programmes and surveillance systems that will allow them to fulfil their obligations under the FCTC. The increased work programme and the commensurate need for more resources was noted in decision FCTC/COP1(12).

Organizationwide expected result 06.004 Regional expected result 06.004.WP01 Regional indicators

Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed, and technical support provided to Member States with a high or increasing burden of disease or death associated with alcohol, drugs and other psychoactive substance use, enabling them to strengthen institutions in order to combat or prevent the public health problems concerned. Technical support provided to countries and areas with a high and increasing burden of major risk factors and disease in order to strengthen institutions for preventing public health problems associated with alcohol, drugs and other psychoactive substance use. 06.004.WP01.01 Number of countries and areas supported that have developed policies, plans and programmes for preventing public health problems caused by alcohol, drugs and other psychoactive substance use. 4 10 06.004.WP01.02 Number of countries and areas supported that have developed a surveillance system involving population-based surveys, hospital admissions and other available surveillance data, to provide information on alcohol use, drinking patterns and alcohol-related harm. 0 3

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Significant additional investment is urgently needed to ensure a credible global response commensurate with the burden of premature illness, disability and death attributable to alcohol, drug and other psychoactive substance use. This includes capacity-building and institutional strengthening at all levels of WHO, including collaborating centres, and especially in regional and country offices to enable the Organization to respond effectively to Member States' needs, and to support the implementation of relevant WHO resolutions. A comprehensive and integrated approach to the prevention and reduction of this group of risk factors will be encouraged, but a substantial increase in resource levels is required.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 6

Organizationwide expected result 06.005 Regional expected result 06.005.WP01 Regional indicators

Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed and technical support provided to Member States with a high or increasing burden of disease or death associated with unhealthy diets and physical inactivity, enabling them to strengthen institutions in order to combat or prevent the public health problems concerned. Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed and technical support provided to countries and areas with a high and increasing burden to strengthen institutions in order to address/prevent public health problems associated with unhealthy diets and physical inactivity. 06.005.WP01.01 Number of countries and areas supported that have developed and implemented policies, plans and programmes for improving diets and physical activity, including adoption of the Global Strategy on Diet, Physical Activity and Health. 15 20

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

WHO guidelines on interactions with external stakeholders will be revised and updated to better reflect the current environment, especially in relation to the food, alcoholic and non-alcoholic beverage industries to ensure that public health objectives are highlighted. The increase in resources expected in 2008–2009 is likely to remain at a similar level thereafter. WHO needs to strengthen its normative work on physical activity. Most of the work related to the revision of guidelines will involve consultations with Member States. Interactions also need to include international and national nongovernmental organizations and community groups.

Organizationwide expected result 06.006 Regional expected result 06.006.WP01 Regional indicators

Evidence-based and ethical policies, strategies, interventions, recommendations, standards and guidelines developed and technical support provided to Member States to promote safer sex and strengthen institutions in order to tackle and manage the social and individual consequences of unsafe sex. Evidence-based and ethical policies, strategies, interventions, recommendations, standards and guidelines developed, and technical support provided to countries and areas to promote protected sex and strengthen institutions in order to address and manage social and individual consequences of unsafe sex. 06.006.WP01.01 Number of countries and areas supported that have initiated or implemented new or improved interventions at individual, family and community levels to promote safe sexual behaviours to prevent unintended pregnancy and to prevent infectious diseases. 5 10 countries and areas supported in developing evidence-based interventions and in assessing the implementation of interventions at individual, family and communities levels to promote safe sexual behaviours. 10 countries and areas supported by WHO that have implemented successfully WHO guidelines and scaled up interventions to promote safe sexual behaviours. The 1994 International Conference on Population and Development (ICPD) Programme of Action and subsequent reviews have clearly established the critical importance of integrating Reproductive Health and HIV, offering practical and effective models for linking services, systems and programmes to achieve increases in contraceptive prevalence, reduce unmet need for family planning, reduce sexually transmitted infections, prevent HIV infection and transmission to women and prevent mother-to-child transmission of HIV. Reproductive health and women’s health is severely under resourced given the high levels of maternal and infant morbidity and mortality in many countries and areas in the Region.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 7

STRATEGIC OBJECTIVE 7 To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches. Scope The work under this strategic objective focuses on leadership in intersectoral action on the broad social and economic determinants of health; improvement of population health and health equity by better meeting the health needs of poor, vulnerable and excluded social groups; connections between health and various social and economic factors (labour, housing and educational circumstances; trade and macroeconomic factors; and the social status of various groups such as women, children, elderly people, and ethnic minorities); formulation of policies and programmes that are ethically sound, responsive to gender inequalities, effective in meeting the needs of poor people and other vulnerable groups, and consistent with human-rights norms. Regional indicators and targets

•

Number of countries and areas supported to: (i) collect, analyse and use information on social determinants and health that is disaggregated by various relevant indicators of social exclusion, such as sex, age, ethnicity, income; (ii) adopt effective tools, methods, and strategies for action: 2 countries and areas per year. Processes and mechanisms for action across sectors and to facilitate international, regional and national collaboration to reduce health inequities by addressing social determinants of health, including gender: this is a qualitative indicator related to processes and thus will not have a quantitative target. Number of countries and areas supported to promote more equitable, pro-poor, gender-responsive and ethical human rights-based health policies, programmes and intervention, with participation by and accountability to all stakeholders: 2 countries and areas per year.

•

Links with other strategic objectives Issues of health equity, ethical standards, gender, pro-poor approaches and human rights are relevant to all other strategic objectives.

• •

Strategic objectives 1 to 5: notwithstanding the technical complexities, it is firmly established that health outcomes are powerfully influenced by social and economic determinants, as well as by the availability and quality of clinical services. Strategic objectives 6, 8 and 9: the present strategic objective is primarily concerned with the underlying determinants and structural factors (such as labour markets, education system, and gender inequality) defining people’s different positions in social hierarchies, which affect intermediate determinants such as the environment, including food (strategic objectives 8 and 9) and individual factors such as behaviours (strategic objective 6). Strategic objectives 10 and 11: health policies and systems need to include intersectoral action on health determinants. Coherent action on health inequities also depends on the availability of appropriately disaggregated health data and the capacity to analyse and use such data to develop policies and services that respond to the needs of different social groups and address structural factors.

•

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 7

Issues and challenges Rapid changes are occurring in the Region with the potential to greatly affect health outcomes. These include increased trade and globalization, the ageing of populations, and rapid urbanization due to rural-to-urban migration contributing to the rise of several mega-cities and urban poverty. At the same time, sparse populations and the isolation of far-flung communities are a challenge for health services, particularly in the Pacific and in countries and areas such as Mongolia. Demographic and ecological changes in the Region—such as increased population growth and mobility; urban crowding and poor sanitation; mass food production and global distribution; and increased exposure to animals and other disease vectors and reservoirs—favour the spread of communicable diseases. Many low-income countries and areas in the Region traditionally face a high burden of known communicable diseases such as TB, HIV/AIDS, and malaria. Simultaneously, new and emerging diseases pose significant challenges for public health and economic development. Alongside these trends, the burden of noncommunicable disease conditions is increasing in the Region and has outpaced communicable diseases, including in many low-income countries and areas. These observed trends are largely due to lifestyle changes associated with developments in global trade and marketing; rural-to-urban migration; dietary shifts; and reduced physical activity. The Region also faces important challenges in the form of increasing inequalities in access to health services and in health outcomes. Weak or inefficient health systems particularly disadvantage poor communities and households. Some progress has been made, but more can be achieved. Health must be recognized as central to the broader development agenda and to poverty reduction. In addition, countries and areas must ensure more equitable access to health services for all sections of the population and address financial or social barriers to access, including poverty, gender and ethnicity.

Strategic approaches Strategic approaches for Member States:

• • •

Since social determinants of health are multisectoral, health must be positioned as a common goal across sectors and addressed in national development strategies. Member States need to ensure coordinated integration of gender, poverty, ethics, and human rights-based perspectives into the design, implementation and monitoring of health policies, programmes and actions. Increase fairness, responsiveness, accountability and coherence by following the principles of human rights and ethics.

Strategic approaches for the WHO Secretariat:

• • •

Provide technical and policy support to Member States to strengthen their systems and capacity to collect, analyse and use health-related data and information that are disaggregated, and to develop, implement and monitor health policies based on a government-wide approach to health. Support technical programmes to incorporate equity-enhancing, pro-poor, gender-responsive and human rights-based approaches, by developing tools, enlarging the knowledge base, strengthening capacity and promoting coherent strategies. Use the recommendations of the Commission on Social Determinants of Health to support Member States to initiate policy actions on the underlying causes of health inequities. Collaborate with other United Nations agencies and programmes, multilateral and bilateral partners, civil society and the non-state sector in these efforts.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 7

Organizationwide expected result 07.001 Regional expected result 07.001.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Significance of social and economic determinants of health recognized throughout the Organization and incorporated into normative work and technical collaboration with Member States and other partners. Support provided to strengthen the capacity of the Organization and Member States to reduce health inequities, address socioeconomic determinants of health and promote more equitable and pro-poor policies, programmes and interventions. 07.001.WP01.01 Number of countries and areas supported to adopt effective tools, methods and strategies for action. Status at the end of 2007 3

Increased attention to health equity and to addressing the socioeconomic determinants of health is needed. Capacities of Member States and technical programmes within WHO in this regard need to be strengthened.

Organizationwide expected result 07.002 Regional expected result 07.002.WP01 Regional indicators

Initiative taken by WHO in providing opportunities and means for intersectoral collaboration at national and international levels in order to address social and economic determinants of health and to encourage poverty-reduction and sustainable development. Opportunities created and mechanisms used to facilitate action across sectors to reduce health inequities and address the socioeconomic determinants of health. 07.002.WP01.01 Extent of action across sectors to reduce health inequities, measured by (proxy indicator) number of countries and areas whose health policies target the social and economic determinants of health on an intersectoral basis. Status at the end of 2007 3

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Actions across sectors are needed to address the social determinants of health and improve health equity.

Organizationwide expected result 07.002 Regional expected result 07.002.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Initiative taken by WHO in providing opportunities and means for intersectoral collaboration at national and international levels to address social and economic determinants of health and to encourage povertyreduction and sustainable development. Opportunities created and mechanisms used to facilitate action across sectors to address the socioeconomic determinants of health in specific settings (e.g. urban setting). 07.002.WP02.01 Number of countries and areas receiving technical support from WHO. 0 1

Actions across sectors are needed to address the social determinants of health and improve health equity.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 7

Organizationwide expected result 07.003 Regional expected result 07.003.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Social and economic data relevant to health collected, collated and analysed on a disaggregated basis (by sex, age, ethnicity, income, and health conditions, such as disease or disability). Support provided to strengthen country capacity to collect, analyse and use information on health and social determinants that is disaggregated by various relevant indicators of social exclusion, such as sex, age, ethnicity, income, or location. 07.003.WP01.01 Number of countries and areas supported to analyse and use information on health and social determinants that is disaggregated by various relevant indicators of social exclusion. Status at the end of 2007 3

Appropriate policy analysis and action on health equity depends on the availability of information that is disaggregated by the needed and relevant indicators of social exclusion.

Organizationwide expected result 07.004 Regional expected result 07.004.WP01 Regional indicators

Ethics- and rights-based approaches to health promoted within WHO and at national and global levels.

Support provided to strengthen the capacity of the Organization and Member States to promote ethical human-rights based approaches to health. 07.004.WP01.01 Number of countries and areas supported to adopt effective tools, methods and strategies for action. Status at the end of 2007 3 07.004.WP01.02 Number of technical programmes supported to adopt effective tools, methods and strategies for action. Status at the end of 2007 2

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Increased attention to health as a human right and to adopting human-rights-based approaches in health is needed. Capacities of countries and areas and technical programmes in this regard need to be strengthened.

Organizationwide expected result 07.005 Regional expected result 07.005.WP01 Regional indicators

Gender analysis and responsive actions incorporated into WHO’s normative work and support provided to Member States for formulation of gender-sensitive policies and programmes. Support provided to strengthen the capacity of the Organization and Member States to promote more gender-responsive health policies, programmes and interventions. 07.005.WP01.01 Number of countries and areas supported to adopt effective tools, methods and strategies for action. Status at the end of 2007 3 07.005.WP01.02 Number of technical programmes supported to adopt effective tools, methods and strategies for action. Status at the end of 2007 2

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Increased attention to gender issues in health is needed in public health policy. Capacities of countries and areas and technical programmes in this regard need to be strengthened. Gender mainstreaming is an Organizational goal. The work under this regional expected result will be carried out in countries and areas in collaboration with technical units in regional and country offices.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 7

Organizationwide expected result 07.005 Regional expected result 07.005.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Gender analysis and responsive actions incorporated into WHO’s normative work and support provided to Member States for formulation of gender-sensitive policies and programmes. Support provided to build capacity of Member States to implement the Strategy For Integrating Gender Analysis and Actions into the Work of WHO, including support for Member States to mainstream gender and rights into reproductive, women, maternal and child health. 07.005.WP02.01 Number of countries and areas supported within the biennium. 3 8

Increased attention to gender issues in health is needed. Capacities of countries and areas and technical programmes in this regard need to be strengthened. Gender mainstreaming is an Organizational goal.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 8

STRATEGIC OBJECTIVE 8 To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. Scope This strategic objective is to reduce a broad range of traditional, modern and emerging hazards to health and the environment. The work will encourage strong health-sector leadership for primary prevention of disease through environmental management and impart strategic direction and give guidance to partners in non-health sectors for ensuring that their policies and investments also benefit health. Work will focus on the assessment and management of environmental and occupational health hazards, such as unsafe water and inadequate sanitation, indoor air pollution and solid fuel use, and vector transmission of diseases. Its scope also covers: health risks related to change in the global environment (e.g. climate change and biodiversity loss); development of new products and technologies (e.g. nanotechnology); consumption and production of energy from new sources and the increasing number and use of chemicals; and health risks related to changes in lifestyle, urbanization, and working conditions (e.g. deregulation of labour, an expanding informal sector and export of hazardous working practices to poor countries). Regional indicators and targets

•

Proportion of countries and areas achieving reductions in environmental risks that significantly impact health in the Region, including an increase in the proportion of urban and rural populations with access to improved water sources and improved sanitation and a decline in the proportion of the population using solid fuels: 75%. Number of national and regional processes and mechanisms that are put in place to reduce environmental health risks within different sectors (e.g. environment, transport, energy and agriculture) and development initiatives (e.g. poverty-reduction strategies): 20. Proportion of countries and areas taking action to ratify, implement and enforce international agreements related to health and environment (e.g. Stockholm Convention on Persistent Organic Pollutants, Rotterdam Convention, Kyoto Protocol: 90%. Proportion of countries and areas with strengthened capacity for environmental and occupational health policy-making and service delivery: 75%.

• • •

Links with other strategic objectives

• •

Strategic objective 5: preparedness and response to environmental health emergencies, crucial to achieving strategic objective 8, are linked with other aspects of emergency response. Strategic objectives 2 to 4: given that eliminating environmental hazards to health can prevent up to a quarter of the global burden of disease, work will contribute especially to the reduction in disease burden among children (strategic objective 4), from vector-borne diseases (strategic objective 2) and from noncommunicable diseases (strategic objective 3). Strategic objective 10: occupational and environmental health services are a key part of the preventive function of health services. Strategic objectives 5, 6, 7, 9 and 12: influencing sectors of the economy to reduce risks and promote health through their investments and policy decisions is essential in terms of work on determinants of health (strategic objectives 5, 6, 7 and 9) and for establishing partnerships to advance the global health agenda (strategic objective 12).

• •

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 8

Issues and challenges The Western Pacific Region includes some of the world's most rapidly developing countries, as well as developed and less developed countries. While traditional environmental health risks are still prevalent in less developed countries, rapidly developing countries face the challenge of more modern environmental and occupational risks. Emerging environmental risks can affect any country. In some instances, these environmental risks affect the health and safety of people beyond national borders, requiring concerted efforts of the countries involved. In 2002, an estimated 2.9 million deaths, or one quarter of the total deaths in the Region, were attributable to environmental and occupational health risks. Agenda 21, the Millennium Development Goals, the Johannesburg Plan of Implementation and a number of other international conventions and standards related to health, labour and the environment provide the international framework, goals, targets and strategies for action to reduce environmental and occupational health risks. Member States and the WHO Secretariat need to enhance health sector input to ensure that health issues are effectively incorporated into formulation and implementation of these international agreements. Many developing countries and areas, however, have limited resources and capacity in environmental and occupational health risk assessment and management to develop and implement national and local action plans and to provide input to international agreements on health and the environment. Also, in many countries and areas, multisectoral coordination to reduce environmental and occupational health risks is not always effective. In addition to responding to these country-specific needs, resolution WPR/RC56.R7 endorsed at the fifty-sixth session of the Regional Committee for the Western Pacific in 2005 encourages increased intercountry cooperation to share solutions to common environmental health problems and to harmonize policies to address trans-boundary and global environmental health issues. Strategic approaches Strategic approaches for Member States:

• • • • • •

Provide evidence that will lead to action to reduce priority environmental health risks; develop and apply norms and guidance on priority environmental health risks; implement interventions to reduce these risks; and provide health input to international agreements related to environmental health. Prepare for and respond to environmental emergencies and disasters; support environmental health assessments and management in emergencies, conflicts and disasters, focusing on prevention, preparedness, response and planning for post-emergency reconstruction. Focus primary prevention action through healthy settings approaches; lead integrated primary prevention action to reduce environmental health risks in specific human settings (e.g. urban and rural areas, workplaces, or in specific ecosystems). Assess and manage environmental and occupational health risks; upgrade the institutional and technical capacity for assessing environmental and occupational health risks; strengthen the capacity to develop occupational and environmental health policies; and deliver services to implement the policies. Provide health leadership on national environment and sectoral policies; advocate and establish partnerships for multisectoral actions and integrated policies that reduce health risks and promote development frameworks and strategies which benefit health. Identify and respond to emerging threats; facilitate and promote the development, sharing and use of knowledge, research and innovation and education about emerging environmental and occupational risks to health and equitable solutions among different stakeholders.

Strategic approaches for the WHO Secretariat:

• • •

Provide technical guidance and leadership. Enhance collaboration with other WHO regional offices, relevant United Nations agencies and regional partners. Promote cooperation among Member States.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 8

Organizationwide expected result 08.001

Evidence-based assessments made, and norms and guidance formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic fields, radon, poor-quality drinking-water and waste water reuse); technical support provided for the implementation of international environmental agreements and for monitoring progress towards achievement of the Millennium Development Goals. Evidence-based assessments made, and norms and guidance formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic force, radon, drinking water, waste water reuse); technical support provided for the implementation of international environmental agreements and for monitoring MDG 8. 08.001.WP01.01 Number of new or updated assessments of risk and/or environmental burden of disease. 1 2 08.001.WP01.02 Number of new or updated norms, standards and good practice guidelines. 1 2 08.001.WP01.03 Number of international environmental agreements whose implementation is supported by WHO. 1 2

Regional expected result 08.001.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

There is a need to develop and update the evidence base, guidelines and standards on priority environmental health hazards particularly in developing countries and areas of the Region. Support is also needed for developing countries and areas to monitor health-related environmental sustainability targets of the Millennium Development Goals and participate in the international and regional environmental health agreements.

Organizationwide expected result 08.002 Regional expected result 08.002.WP01 Regional indicators

Technical support and guidance provided to Member States for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings and among vulnerable population groups. Technical support and guidance provided to countries and areas for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings and among vulnerable population groups. 08.002.WP01.01 Establishment of regional initiatives for primary prevention of environmental health hazards in specific settings in targeted countries and areas. Regional strategy for reducing risk in 1 setting established. Regional strategies to reduce risk in at least 2 settings established, with country support activities in at least 3 countries. Regional strategies to reduce risk in at least 3 settings established with country support activities in at least 5 countries. 08.002.WP01.02 Number of new or maintained regional initiatives to prevent occupational and environmentally-related diseases implemented. 1 country initiative on arsenic. 1 regional initiative and 2 country initiatives started and maintained with WHO support. 08.002.WP01.03 Number of studies evaluating the costs and benefits of primary prevention interventions in specific settings conducted and the results disseminated. 1 cost-benefit study conducted and results disseminated. 2 cost-benefit studies conducted and results disseminated. 08.002.WP01.04 Number of target countries and areas following WHO guidance to prevent and mitigate emerging occupational and environmental health risks. No country.

Baseline

Targets to be achieved by 2009

2 countries where activities in support of environmental health for children developed.

Targets to be achieved by 2013

2 additional regional and 3 additional country initiatives started and maintained with WHO support.

3 cost-benefit studies conducted and results disseminated.

5 countries where activities in support of environmental health for children developed.

Justification

The healthy settings approach is widely used and many countries and areas implement various healthy settings activities. In developing countries and areas, environmental determinants of health are major factors in these settings, and there is a need to organize regional and national initiatives.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 8

Organizationwide expected result 08.003 Regional expected result 08.003.WP01 Regional indicators

Technical assistance and support provided to Member States for strengthening occupational and environmental health policy-making, planning of preventive interventions, service delivery and surveillance. Technical assistance and support to Member States for strengthening occupational and environmental health policy-making, planning of preventive interventions, service delivery and surveillance. 08.003.WP01.01 Number of priority countries and areas receiving support for developing and implementing policies and plans for strengthening the delivery of occupational and environmental health services and surveillance. No country receiving WHO support for strengthening occupational and environmental health services; 1 country receiving advice on strengthening surveillance. 2 countries receiving advice on strengthening occupational and environmental health services; 2 countries receiving advice on strengthening surveillance. 3 countries receiving advice on strengthening occupational and environmental health services; 3 countries receiving advice on strengthening surveillance. 08.003.WP01.02 Number of organizations in countries and areas implementing WHO-led initiatives to reduce occupational risks (e.g. those among workers in the informal economy to implement regional and global occupational health strategy, or to eliminate silicosis). 1

Baseline

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

The health sector's ability to address environmental and occupational health risks is limited. There is a need to increase and maintain effective coordination and collaboration particularly with environmental and labour sectors, respectively in developing and implementing environmental and occupational health policies, plans, service delivery and surveillance.

Organizationwide expected result 08.004 Regional expected result 08.004.WP01 Regional indicators

Guidance, tools and initiatives created in order to support the health sector to influence policies in priority sectors, assess health impacts, determine costs and benefits of policy alternatives in those sectors, and select investments in non-health sectors that improve health, the environment and safety. Guidance, tools, and initiatives created in order to support the health sector to influence policies in priority sectors, assess health impacts, determine costs and benefits of policy alternatives in those sectors, and select investments in non-health sectors that improve health, environment and safety. 08.004.WP01.01 Establishment of initiatives to develop and implement healthy policies in priority non-health sectors at the regional and national levels, using WHO's technical support. 08.004.WP01.02 Production and promotion in target countries and areas of sector-specific guidance and tools for assessments of health impacts, costs and benefits and promotion of health and safety. 08.004.WP01.03 Establishment of networks and partnerships to drive change in specific sectors or settings, including an outreach and communication strategy. 08.004.WP01.04 Number of regional or national events conducted with WHO's technical support with the aim of building capacity and strengthening institutions in health and other sectors for improving policies relating to occupational and environmental health in priority non-health sectors. No regional or national event conducted.

Baseline

Initiatives implemented regionally for 1 sector and nationally in 1 country. Initiatives implemented regionally for 2 sectors, and nationally in at least 2 countries. Initiatives implemented regionally for 3 sectors, and nationally in at least 3 countries.

Tools and guidance produced for 1 sector.

Networks established for 1 sector.

Targets to be achieved by 2009

Tools and guidance produced for 2 sectors.

Networks established for 2 sectors, with communications strategy implemented.

2 regional or national events conducted with WHO technical support.

Targets to be achieved by 2013

Tools and guidance produced for 3 sectors.

Networks established for 3 sectors, with communications strategy implemented.

4 regional or national events conducted with WHO technical support.

Justification

Environmental determinants of health are often controlled and influenced by other sectors (e.g. agriculture, transport and energy). There is a need for the health sector to increase advocacy for and provide inputs to healthier and safer policies of these other sectors.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 8

Organizationwide expected result 08.005 Regional expected result 08.005.WP01 Regional indicators

Health-sector leadership enhanced for creating a healthier environment and changing policies in all sectors so as to tackle the root causes of environmental threats to health, through means such as responding to emerging and reemerging consequences of development on environmental health, climate change, and altered patterns of consumption and production and to the damaging effect of evolving technologies. Health-sector leadership enhanced for creating a healthier environment and changing policies in all sectors in order to tackle the root causes of environmental threats to health, through means such as responding to emerging and re-emerging consequences of development on environmental health, climate change, and altered patterns of consumption and production and to the damaging effect of evolving technologies. 08.005.WP01.01 Impact, in terms of coverage by mass media, of outreach and communications strategy on occupational and environmental issues implemented regionally and in partnership. Mass media citation of work by WHO or partners on priority issues in occupational and environmental health in 2007. 5% increase in citations 08.005.WP01.02 Organization of regular high-level regional forum on health and environment for regional and national policy-makers and stakeholders. 1 regional forum held

Baseline

Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

1 regional forum held and 3 national forums held

10% increase over baseline in citations

2 regional forums held and 6 national forums held

Environmental and occupational conditions and associated health risks are constantly changing with social and economic development, technological advance, and production and consumption patterns. The health sector needs to enhance its leadership to address these emerging and evolving issues.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 9

STRATEGIC OBJECTIVE 9 To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. Scope Work under this strategic objective focuses on: nutritional quality and safety of foods; promotion of healthy dietary practices throughout the life-course, starting with pregnant women, breastfeeding and adequate complementary feeding, and considering diet-related chronic diseases; prevention and control of nutritional disorders, including micronutrient deficiencies, especially among biologically and socially vulnerable groups, with emphasis on emergencies, and in the context of HIV/AIDS epidemics; prevention and control of zoonotic and non-zoonotic foodborne diseases; stimulation of intersectoral actions promoting the production and consumption of, and access to, food of adequate quality and safety; and promotion of higher levels of investment in nutrition, food safety and food security at the global, regional and national levels. Regional indicators and targets

• • •

Proportion of countries and areas providing data that demonstrate a reduction in the proportion of underweight children of all ages: 25% by 2013. Proportion of countries and areas providing data that demonstrate a reduction in proportion of overweight children of all ages: 25% by 2013. Proportion of countries and areas providing data that demonstrate a reduction in the number of annual cases of foodborne illness, including diarrhoeal diseases: 25% by 2013.

Links with other strategic objectives Achievement of the strategic objective requires strong links and effective collaboration with other strategic objectives, in particular:

• • • • • •

Strategic objective 1: in relation to prevention of zoonoses and foodborne diseases; Strategic objective 2: especially in expanding and improving interventions related to HIV/AIDS prevention, treatment, care and support; Strategic objective 4: in relation to public-health interventions for maternal, newborn, child and adolescent health; Strategic objective 5: in relation to minimizing the impact of emergency situations on the nutritional status of populations; Strategic objective 6: in relation to promotion of healthy dietary practices throughout the life-course; Strategic objective 8: in relation to environmental health risks.

Issues and challenges Nutrition, food safety and food security are cross-cutting, lifelong issues. They apply equally to stable and crisis situations and should be addressed also in the context of the HIV/AIDS epidemics. In the Western Pacific Region, 2100 children under 5 years of age die each day as a result of common preventable and treatable conditions including diarrhoea, pneumonia and perinatal events. About half of these deaths could be prevented if the nutritional status of these children was good and if food and waterborne diseases could be prevented and properly treated. Hundred of millions of cases of food-borne and zoonotic diseases, many of which are fatal or lead to severe sequelae, affect both adults and children each year. Hundred of millions of people suffer damage, sometimes irreversible, from micronutrient deficiencies, so-called "hidden hunger", especially of iron, iodine, zinc and vitamin A. Undernutrition is still a major threat to health and well-being in middle- and low-income countries and areas. At the same time, obesity is increasingly becoming a major public health problem, even in low-income countries and areas, for adults and increasingly in children. Hundred of millions of adults are overweight or obese in the Region, with some of the highest rates of obesity and diabetes in the world seen in Pacific island countries and areas. Undernutrition and overnutrition are still perceived as separate problems. However, both are often rooted in poverty and coexist in communities, and even the same households, in most countries and areas; undernutrition in utero and in the early years of childhood can increase the likelihood of obesity and related noncommunicable diseases later in life. Access to safe food and adequate nutrition are fundamental human rights essential for health and development and necessary to achieve the Millennium Development Goals.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 9

The major obstacle to the achievement of this strategic objective is the current low level of investment, both in human resources and in funding, and the lack of leadership for the development and implementation of integrated policies and effective interventions. Despite the impact of malnutrition in all its forms on mortality, morbidity and national economies, only 1.8% of the total resources for health-related development assistance are allocated to nutrition activities. Of the World Bank's total assistance to developing countries and areas, only 0.7% is for nutrition and food security. At the country level, the financial commitment is even less. Stagnant investment at all levels will seriously compromise the achievement of goals throughout the Organization. For both malnutrition and unsafe food, individual behaviour plays a role but efficient preventive systems and a supportive environment are essential for ensuring the public's ability to make informed choices. Strategic approaches Strategic approaches for Member States:

• • • • • • • • • • • • • • • • • • •

Make nutrition, food safety and food security central to national development policies and to agricultural development and food production processes. Focus on the most biologically and socially vulnerable populations. Mobilize local human and financial resources to implement such policies. Ensure a human rights and gender perspective in all nutrition, food safety and food security planning and policies. Identify beliefs and practices that promote and hinder good nutrition and food safety and develop and implement ethically and culturally acceptable essential interventions. Scale up access to the essential interventions, build synergies, avoid duplication and strengthen links between programmes at the service delivery level. Promote improved understanding at the individual, household and community levels about the role of good nutrition, healthy eating practices and food safety to overall health and well-being, with particular focus on the nutritional values of available local foods. Promote interactions between health, environment and development actors to ensure safe and sustainable agricultural production methods that minimize occupational risk to health and maximize long-term health in terms of nutrition, food safety and food security. Ensure supportive regulatory and legal frameworks, based as appropriate on existing international regulations and mechanisms. Participate in international food standards-setting processes, including FAO/WHO Codex Alimentarius. Work with actors in food production, manufacturing and distribution to improve the availability of healthier foods, promote a balanced diet and ensure compliance with the International Code of Marketing of Breast Milk Substitutes. Develop and implement control programmes for foodborne diseases. Strengthen national capacity for the generation of evidence through surveillance and research.

Strategic approaches for the WHO Secretariat: Build partnerships and provide leadership. Develop norms, standards and knowledge. Promote the integration of actions and approaches. Provide policy development and technical support. Support capacity-building. Strengthen food control systems.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 9

Organizationwide expected result 09.001 Regional expected result 09.001.WP01 Regional indicators Baseline Targets to be achieved in 2009 Targets to be achieved by 2013 Justification

Partnerships and alliances formed, leadership built and coordination and networking developed with all stakeholders at country, regional and global levels, in order to promote advocacy and communication, stimulate intersectoral actions, increase investment in nutrition, food-safety and food-security interventions, and develop and support a research agenda. Partnerships formed and advocacy and support provided to countries to increase political, financial and technical commitment to address nutrition, food safety and food security through intersectoral action. 09.001.WP01.01 Number of countries and areas able to demonstrate that nutrition, food safety and security are addressed intersectorally in an integrated manner in national policies, plans of action and funding. 0 5

Organizationwide expected result 09.002 Regional expected result 09.002.WP01 Regional indicators

Norms, including references, requirements, research priorities, guidelines, training manuals and standards, produced and disseminated to Member States in order to increase their capacity to assess and respond to all forms of malnutrition, and zoonotic and non-zoonotic foodborne diseases, and to promote healthy dietary practices. Evidence-based norms, assessments and guidance developed, adapted where appropriate and disseminated, to enable countries and areas to implement cost effective interventions responding to all forms of malnutrition and foodborne diseases, and to promote healthy dietary practices in the Western Pacific. 09.002.WP01.01 Number of countries and areas where costeffectiveness has been demonstrated in relation to nutrition programmes and/or where normative food safety guidance has been initiated and evaluated. 09.002.WP01.02 Number of new guidance documents/manuals developed, adapted where appropriate and disseminated, to enable countries and areas to implement cost-effective interventions responding to all forms of malnutrition and food-borne diseases, and to promote healthy dietary practices in the Western Pacific. 0 2

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

4 5

Resources will be used to support projects aimed at showing costs-effectiveness of interventions. This will include training and workshops to refine methodology, pilot projects, and compilation of results at national and regional levels, building on existing tools, methods and best practice documents and focused dissemination strategies. Resources will also be used to inform policy-makers at country level and to assist them with using this information for priority setting.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 9

Organizationwide expected result 09.003 Regional expected result 09.003.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Monitoring and surveillance of needs and assessment and evaluation of responses in the area of nutrition and diet-related chronic diseases strengthened, and ability to identify best policy options improved, in stable and emergency situations. Improved capacity in countries and areas to collect, analyse, disseminate and use data on the magnitude, causes and consequences of under-nutrition and over-nutrition, inappropriate diets and physical inactivity. 09.003.WP01.01 Number of countries and areas conducting periodic nutrition surveys and using these results as a basis for planning interventions to improve the nutrition situation. 8 10

Information on the prevalence, distribution and causes of nutrition-related diseases is essential for advocacy and for planning, monitoring and evaluation of nutrition programmes. Resources will be used to support countries and areas to better document the public health impact and costs of nutrition problems, to set up or improve data collection systems, support data analysis and dissemination. Resources will also be used to monitor and provide feedback on regional trends.

Organizationwide expected result 09.004 Regional expected result 09.004.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Capacity built and support provided to target Member States for the development, strengthening and implementation of nutrition plans, policies and programmes aimed at improving nutrition throughout the lifecourse, in stable and emergency situations. Capacity built and support provided to target Member States for the development, strengthening and implementation of nutrition plans, policies and programmes aimed at improving nutrition throughout the lifecourse, in stable as well as humanitarian crisis situations. 09.004.WP01.01 Number of targeted countries and areas that have a current national plan of action for nutrition (NPAN) or related policies implemented and funded. 5 7

The majority of countries and areas in the Region have developed NPAN or related policies, but not many countries and areas conduct regular reviews of the implementation and achievements of these plans and have sustained funding for programmes. The resources will be used to support regional and country processes to advance development and implementation of policies and plans, building on the successful experience of the training course on NPAN implementation in the Pacific.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 9

Organizationwide expected result 09.005 Regional expected result 09.005.WP01 Regional indicators

Systems for surveillance, prevention and control of zoonotic and non-zoonotic foodborne diseases strengthened; food-hazard monitoring and evaluation programmes established and integrated into existing national surveillance systems, and results disseminated to all key players. Foodborne disease surveillance and food contamination monitoring programmes strengthened regionally and in targeted countries and areas. 09.005.WP01.01 Number of targeted countries and areas that have initiated action on foodborne disease surveillance and food contamination monitoring as defined by reports available to WHO. 4 6 09.005.WP01.02 A surveillance and monitoring network in the Region has been set up.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

0 1

Data collected from the foodborne disease surveillance and food contamination monitoring programmes can better direct food control strategies and actions in countries and areas of the Region.

Organizationwide expected result 09.006 Regional expected result 09.006.WP01 Regional indicators

Capacity built and support provided to Member States, including their participation in international standardsetting in order to increase their ability to assess risk in the areas of zoonotic and non-zoonotic foodborne diseases and food safety, and to develop and implement national food-control systems, with links to international emergency systems. National capacity built to enable food control systems to: be based on risk-analysis principles, implement effective food safety education and to operate food safety emergency response systems with links to international systems. 09.006.WP01.01 Number of countries and areas that have initiated action to strengthen their food control systems with regard to legislation and enforcement based on risk analysis principles; food safety education and their response to food emergencies. 0 4

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

To enhance food safety in the Region, effective food control systems (i) with modern laws, regulations and standards; (ii) based on risk analysis principles; (iii) with effective food safety education; and (iv) with appropriate food emergency response protocols need to be in place and being enforced by competent authorities.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

STRATEGIC OBJECTIVE 10 To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research.

Scope The work under this objective aims to improve management and organization of health service delivery, reflecting the principles of integrated primary health care, so as to scale up coverage, equity and quality of health services and improve health outcomes. The work will improve national capacities for governance and leadership, improve the various mechanisms for coordination (including donor assistance) that support Member States in their efforts to achieve national targets. Work will contribute to strengthened country health-information systems, and will contribute to better knowledge and evidence for health decision-making. This will include global and regional work on generation, comparative analysis and synthesis of health statistics and evidence from research. Work will strengthen national health research knowledge management and e-health policies for health-systems development. The health workforce information and knowledge base will be strengthened and technical support to Member States will be provided to improve the production, distribution, skill mix and retention of their health workforce. Health systems financing will be improved through evidence-based policy, norms, standards and related measurement tools, and technical support, resulting in higher availability of funds, social and financial risk protection, equity, and better access to services and efficiency of resource use. Steps will also be taken to advocate for additional funds for health where necessary. Regional indicators and targets

• • • • • • •

Expanded coverage of key interventions including quality measures. Evidence of improved performance of governance and regulatory systems. Improved information on health workforce and increased number of countries and areas with health workforce strategic planning processes in place. Increases in health research funding focused on priority problems for individual countries and areas. Increased availability and use of sound health statistics and evidence. Increased health care funding available, out-of-pocket payment for health care reduced, smaller numbers of people impoverished from catastrophic expenditure, and improved information on health care financing. Increased number of countries and areas implementing knowledge management.

Links with other strategic objectives

• • • • •

All strategic objectives concerned with the achievement of specific health outcomes, primarily strategic objectives 1 to 4. All health- and disease-related strategic objectives: the work provides a platform for close collaboration with the evidence component. Strategic objective 5: complementing the specific circumstances of service delivery in fragile states. Strategic objective 7: particularly in relation to equity, pro-poor health policies and the progressive realization of the right to health – the work translates achievements in those areas into service delivery. Strategic objective 12: particularly work on providing leadership, strengthening governance and encouraging partnerships and collaboration in engagement with countries and areas.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

Issues and challenges The changing role of Ministries of Health due to public sector reforms, globalization, and increasing privatization is an issue. The capacity to handle a more complex environment calls for different skills in leadership, management and regulation, so-called stewardship, while not neglecting the basic role of health service organization, financing, and delivery which in many states is still a major role of government. In some countries and areas the complexity of donor assistance provides an additional challenge as it has contributed to an increasingly fragmented health sector. Within the United Nations system joint planning and programming is attempting to address this issue. The knowledge base and dissemination mechanism to manage the health sector based on research and evidence is inadequate. Information and evidence may not be available to those who need it. When it is available, it may not be appropriate to individual country or area needs or may not be accurate and timely. And, when information and evidence is available and appropriate it may not be used by decision-makers. The health workforce is often typified by one or all of the following: shortages, maldistribution, inappropriate skill mix, low quality, excessive migration, low salaries and remuneration packages, poor working environments, and inadequate supervision. Often there is a lack of sufficient information on human resources for health and inadequate processes for comprehensive health workforce planning. Health care financing is typified by too little spending in some countries and areas, misallocation of expenditure so that health gain is not maximized, excessive reliance on out-of-pocket payments, and the lack of social safety nets to protect against catastrophic expenditure. The information base to analyse and manage health care financing is improving but still inadequate.

Strategic approaches Strategic approaches for member states:

• • • • • • • • •

Develop and maintain health systems with a focus on equity, efficiency, accountability, quality, and patient safety. Develop improved mechanisms for working with partners, both external and internal including participation in United Nations reform. Strengthen systems for policy formulation, organization, management, planning, and governance, emphasizing the use of information and evidence for decision-making. Ensure adequate financial resources through appropriate funding mechanisms. Ensure an adequate, competent, productive, equitably distributed and supported health workforce.

Strategic approaches for WHO Secretariat: Maintain a country and area specific approach and ensure technical expertise supports national counterparts and national plans and policies within internationally established norms and standards to the degree possible. Assist in building national health systems that meet national needs and also meet international norms and standards where practicable. Facilitate establishing mechanisms to ensure that health system needs are identified and prioritized comprehensively and assist in building capacity for managing all aspects of health systems within countries and areas. Develop partnerships at international, regional, national, and subnational levels to define and reach common goals in a more efficient and cost-effective manner in line with the principles of alignment and harmonization.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

Organizationwide expected result 10.001 Regional expected result 10.001.WP01 Regional indicators

Management and organization of integrated, population-based health-service delivery through public and nonpublic providers and networks improved, reflecting the principles of integrated primary health care, scaling up coverage, equity and quality of health services, and enhancing health outcomes. Improved management and organization of health service delivery, through both public and non-public providers and networks, reflecting the principles of integrated primary health care with increased coverage, equity, and quality of health services leading to better health outcomes. 10.001.WP01.01 Number of countries and areas provided technical assistance for improving coverage, access and quality of health services to be measured through an agreed set of composite indicators over a range of interventions. 0 12 10.001.WP01.02 Number of countries and areas with plans and actions for embedding sustainable disease-specific programmes within general health services to increase sustainability and effectiveness. 0 4

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

The management and organization of health services is a crucial factor in health outcomes. It is a complex issue and must be approached in a manner appropriate to each individual country or area within the context of its political, socioeconomic and cultural frameworks. However, composite indicators are being developed which will be used across countries and areas to assess progress in improving management and organization of health services. The disease-specific programmes have brought needed resources to the health sector and have improved outcomes for their particular area of interest, but the sustainability of these programmes is at risk with any decrease in funding. Unless such programmes become more fully embedded in the health sector there is a risk of increased fragmentation of the health sector with an attendant loss of efficiency and effectiveness.

Organizationwide expected result 10.002 Regional expected result 10.002.WP01 Regional indicators

National capacities for governance and leadership improved through evidence-based policy dialogue, effective governance and leadership, institutional capacity-building for policy analysis, greater transparency and accountability for performance, and more effective intersectoral collaboration. Improved national capacities and practices for governing, steering, and regulating the health sector through (i) evidence-based policy dialogue, (ii) policy analysis, (iii) greater transparency and accountability for performance, and (iv) more effective intersectoral collaboration. 10.002.WP01.01 Number of countries and areas provided technical assistance to improve institutional capacity for policy analysis and formation, for strategic planning, and for regulation. 10.002.WP01.02 Number of countries and areas provided technical assistance to improve accountability for performance and increased participation of civil society, community, consumers, and professional organizations in shaping policy and its implementation. 0 4 10.002.WP01.03 Number of countries and areas that have received technical assistance that has led to revisions or changes in law, regulation, policy formulation, and policy implementation. 10.002.WP01.04 Number of countries and areas that have had technical assistance to assess or establish effective intersectoral collaboration mechanisms, including the private sector, to improve health systems performance for improved health outcomes. 0 2

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

0 4

Although individual actions are necessary within Member States, certain principles in governance and leadership are well established and can be fostered by WHO. Progress will be assessed in an objective way using country- or region- specific benchmarks. Areas to be assessed include service delivery models; essential public health functions; policies concerning pharmaceuticals, infrastructure, and health technologies; human resources policies; financing policies; and policies coordinating the contributions of all major stakeholders. Assessment will include the use of evidence, accountability, participation, and collaboration. As WHO’s capacity to provide support grows it is likely that demand for such capacity-building will grow and the level of support will need to increase.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

Organizationwide expected result 10.003 Regional expected result 10.003.WP01 Regional indicators

Coordination of the various mechanisms (including donor assistance) that provide support to Member States in their efforts to achieve national targets for health-system development and global health goals improved. Improved coordination of the various mechanisms (including donor assistance) that support Member States in their efforts to achieve national targets for health system development and global health goals. 10.003.WP01.01 Number of countries and areas where the inputs of major stakeholders are harmonized and aligned with national policies in line with the Paris Declaration. 0 2 10.003.WP01.02 Number of countries and areas in which documentation of methods of coordination of inputs from the multiple stakeholders in the health sector, including donors has been completed. 0 4

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

The diverse set of inputs into the health sector can lead to fragmentation and inefficiency. This decreases the chance of reaching national, regional, and worldwide health targets such as the MDGs. Partner coordination is one of the primary stewardship roles of governments and WHO must support the Ministry of Health in taking a lead on these issues in the health sector. Increasing compliance with the Paris Declaration on Aid Effectiveness will change how donors, including WHO, interact with countries and areas.

Organizationwide expected result 10.004 Regional expected result 10.004.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Country health-information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major international goals strengthened. Contribute to strengthened country health information systems that provide and use high quality and timely information for health planning and for monitoring of country and major international goals. 10.004.WP01.01 Number of countries and areas that have developed national plans for health information systems and defined core health indicators to facilitate health monitoring and reporting. 4 5

All countries and areas need a well functioning health information system to support planning, management, monitoring and evaluation. The increasing demand for health information is likely to continue, and only through a major effort will health information systems become stronger.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

Organizationwide expected result 10.005 Regional expected result 10.005.WP01 Regional indicators

Better knowledge and evidence for health decision-making assured through consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas, and global leadership in health research policy and coordination, including with regard to ethical conduct. Contribute to better knowledge and evidence for health decision-making, by consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas and leadership in health research policy and coordination, including ensuring ethical conduct. 10.005.WP01.01 Utilization and quality of organization-wide WHO database system of core health statistics and evidence that covers all high priority issues. 10 15 10.005.WP01.02 Number of countries and areas in which the Regional Office for Western Pacific plays a key role in supporting the generation and use of information and knowledge, including promotion of standards such as the International Classification of Disease. 10 15 10.005.WP01.03 Number of coordination and leadership mechanisms established and maintained at the regional level to improve knowledge and evidence for health-related decision-making. 2 3

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

All countries and areas should have the capacity to create knowledge, to review and summarize available evidence, and to use available evidence in health policy-making and in health care management. WHO’s core function of contributing to better knowledge and evidence for health decision-making will expand modestly in this area, maintaining WHO’s position as a world and regional leader in monitoring the health situation.

Organizationwide expected result 10.006 Regional expected result 10.006.WP01 Regional indicators

National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society. Strengthened national health research for health systems development, within the context of regional and international research and engagement of civil society. 10.006.WP01.01 Number of low and middle income countries and areas with national health research councils and functional health research systems. 6 8 10.006.WP01.02 Number of countries and areas complying with the Mexico Summit commitment to dedicate 2% of national health budget to research and research capacity-building. 0 2

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

All Member States should have the capacity to produce locally relevant research and use the results for health planning, monitoring and evaluation. Overcoming the limitations of national health research for health systems development within the context of individual countries and areas and the Region is a major objective of this expected result.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

Organizationwide expected result 10.007 Regional expected result 10.007.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Knowledge management and eHealth policies and strategies developed and implemented in order to strengthen health systems. Improved use of e-health applications (such as electronic medical records and distance learning) and networking - including the network of WHO collaborating centres - to strengthen health systems. 10.007.WP01.01 Number of countries and areas adopting knowledge management strategies to bridge the know-do gap. Status at the end of 2007 6 above the baseline 10.007.WP01.02 Number of countries and areas with evidence-based eHealth frameworks and services. Status at the end of 2007 3 above the baseline

15 above the baseline

9 above the baseline

All countries (both the policy-makers and health managers, and the public) should have access to scientific health information and knowledge.

Organizationwide expected result 10.007 Regional expected result 10.007.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Knowledge management and e-health policies and strategies developed and implemented to strengthen health systems. Implementation of knowledge management strategy, including improved access to health information via portals such as the Global Health Library, Regional Index Medicus, and HINARI. 10.007.WP02.01 Number of activities supported to improve access. Status at the end of 2007 10% above the baseline

20% above the baseline

WHO’s work in knowledge management including policies and strategies to improve health care locally, regionally, and worldwide by using information and communication technology (eHealth) will initially be largely normative, but will gradually shift to provision of support to countries and areas for implementation.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

Organizationwide expected result 10.008 Regional expected result 10.008.WP01 Regional indicators

Health-workforce information and knowledge base strengthened, and country capacities for policy analysis, planning, implementation, information-sharing and research built up. Support provided to strengthen health workforce information, knowledge base and the capacity of countries and areas for policy development and planning, and the enhancement of research, networking and information-sharing. 10.008.WP01.01 Number of countries and areas with reliable health workforce database and information system that produce validated HRH statistics and reports. Status at the end of 2007 At least 3 above the baseline. 10.008.WP01.02 Number of countries and areas with updated health human resource policies, guidelines, and strategies that are being implemented, monitored and evaluated. Status at the end of 2007 At least 3 above the baseline. 10.008.WP01.03 Number of countries and areas and partnerships and networks engaged in research and the sharing of information, evidence, and good practices. Status at the end of 2007 At least 3 more countries and areas have undertaken and/or shared information and good practices and at least 1 partnership or network above the baselines. At least 8 more countries and areas and 2 more network or partnership formed above the baseline.

Baseline Targets to be achieved by 2009

Targets to be achieved by 2013 Justification

At least 8 above the baseline.

The knowledge base in human resources for health (HRH) development needs to be further strengthened in many countries and areas. Areas such as assessment, planning, production, regulation and management of the health workforce need to be better understood. Aspects of health workforce development and management cut across domains of various organizational systems, functions and sectors (such as education, finance, training institutions, regulatory bodies, private sector, labour and immigration), so they cannot be dealt with by the health sector alone. Besides, many developing, low and middle-income countries and areas need the support of partners, including financial and technical resources to sustain adequate, competent, supported and productive health workforces to improve health outcomes. Therefore, dialogue between partners and stakeholders and working across sectors are necessary. Technical support provided to Member States, with a focus on those facing severe health-workforce difficulties in order to improve the production, distribution, skill mix and retention of the health workforce. Technical support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces. 10.009.WP01.01 Number of countries and areas using evidence-informed practices, tools and guidelines to develop and retain an adequate, balanced and responsive health workforce to meet population health needs. 10.009.WP01.02 Number of countries and areas with the capacity or established national mechanism to regulate, monitor and set norms/standards with regard to the education, training, performance and practice of different categories of health occupations, including managing migration. Status at the end of 2007 At least 3 above the baseline. 10.009.WP01.03 Number of partnerships, collaborating centres and networks established at country and regional levels for research, advocacy, resources mobilization and for facilitating a common and coordinated approach to strengthen the health workforce capacity of countries and areas. Status at the end of 2007 At least 3 with network/centres above the baseline. At least 8 countries and areas and 1 more network/partnership formed above the baseline.

Organizationwide expected result 10.009 Regional expected result 10.009.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Status at the end of 2007 At least 3 above the baseline.

At least 8 above the baseline.

There is strong evidence that the availability of motivated and skilled health workers contribute to improved health outcomes such as increased maternal, infant and child survival, and is critical for the implementation of health programmes. The World Health Report 2006 – Working together for Health, the World Health Assembly resolutions (WHA57.19; WHA59.23; WHA59.27) and the Western Pacific Regional Committee resolution (WPR/RC57.R7) urged Member States to take concerted actions to address health worker shortages through rapid scaling up of production, and the strengthening of nursing and midwifery as well as workforce management (including migration of health workers). The WHO Western Pacific’s Regional Strategy on Human Resources for Health 2006–2015, endorsed by the Regional Committee, provides Member States with a range of policy options and strategic actions from which to choose in the development and management of their health workforces if they wish to do so.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 10

Organizationwide expected result 10.010 Regional expected result 10.010.WP01 Regional indicators

Evidence-based policy and technical support provided to Member States in order to improve health-system financing in terms of the availability of funds, social and financial-risk protection, equity, access to services and efficiency of resource use. Technical support provided to improve health system financing in terms of the availability of funds, social and financial risk protection, equity, access to services and efficiency of resource use. 10.010.WP01.01 Number of countries and areas provided with technical support in improving health financing and social protection arrangements based on WHO technical briefs and regional strategy. 5 10 10.010.WP01.02 Reduced out-of- pocket payments and extended prepayment schemes in health financing.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Status at the end of 2007 At least 3 additional countries

At least 6 additional countries

Increasing number of countries and areas indicates their need to improve existing health financing arrangements. The regional strategy on health care financing that covers the period of 2006–2010 provides strategic policy interventions in the Region. Reduction of excessive out of pocket payment and expansion of prepayment in financing health services are the most important technical area of work for most low income developing countries and areas in the Region. Norms, standards and measurement tools developed for tracking resources, estimating the economic consequences of illness, and the costs and effects of interventions, financial catastrophe, impoverishment, and social exclusion, and their use supported and monitored. Norms, standards and measurement tools are used for tracking resources and estimating economic consequences of illness, cost and effects of interventions, financial catastrophe and impoverishment, and social exclusion. 10.011.WP01.01 Number of countries and areas provided with technical support for using WHO tools and methods advocated. 4 8 10.011.WP01.02 Number of studies supported and discussed. 2 4

Organizationwide expected result 10.011 Regional expected result 10.011.WP01 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Many countries and areas need country-specific evidence and estimates to assess and improve their health financing performance with appropriate tool and methodologies. This demand needs to be responded to with expanded technical support both in developing appropriate norms, standards and methodologies and building capacities for their application to produce evidence and estimates. Steps taken to advocate additional funds for health where necessary; to build capacity in framing of healthfinancing policy and interpretation and use of financial information; and to stimulate the generation and translation of knowledge to support policy development. Health financing data, information and evidence are used for developing, implementing and monitoring health financing policies and strategies. 10.012.WP01.01 Number of countries and areas that have established reliable health financing data and information systems such as national health accounts. 6 12 10.012.WP01.02 Number of countries and areas that have developed health financing policies and strategies. 0 6

Organizationwide expected result 10.012 Regional expected result 10.012.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Improvements to health systems financing will result in higher availability of funds, social and financial risk protection, equity, and better access to services and efficiency of resource use.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 11

STRATEGIC OBJECTIVE 11 To ensure improved access, quality and use of medical products and technologies. Scope Medical products include chemical and biological medicines; vaccines; blood and blood products; cells and tissues mostly of human origin; biotechnology products; traditional medicines and medical devices. Technologies include, among others, those for diagnostic testing, imaging, and laboratory testing. The work undertaken under this strategic objective will focus on making access more equitable (as measured by availability, price and affordability) to essential medical products and technologies of assured quality, safety, efficacy and costeffectiveness, and on their sound and cost-effective use. For the sound use of products and technologies, work will focus on building appropriate regulatory systems; evidence-based selection; information for prescribers and patients; appropriate diagnostic, clinical and surgical procedures; vaccination policies; supply systems, dispensing and injection safety; and blood transfusion. Information includes clinical guidelines, independent product information and ethical promotion. Regional indicators and targets

• •

Number of countries and areas that include access to essential medical products and technologies as part of the right to health, through recognition of such in the national constitution or in legislation: five countries and areas or more in 2013. Number of countries and areas with a functional regulatory system for medical products including vaccines and traditional medicines, and technologies including blood transfusion, adopting international norms and standards for the safety, quality and efficacy into national standards: 50% of developing countries and areas in 2013. Number of countries and areas with sufficient capacity to provide an adequate supply of affordable vaccines of assured quality and immunization equipment: 4 countries and areas in 2013. Number of countries and areas that have established nationally coordinated blood transfusion services based on full voluntary nonremunerated blood donation: 50% of developing countries and areas in 2013. Number of countries and areas that have adopted and implemented policies to develop integrated laboratory systems that are well organized and managed at the national level: 50% of developing countries and areas in 2013.

• • •

Links with other strategic objectives

•

Strategic objectives 1 to 5 (health outcomes): none of these objectives can be achieved without essential medical products, medicines and health technologies. With regard to access, work under this strategic objective will focus on “horizontal” issues such as comprehensive supply systems, pricing surveys and national pricing policies. On quality assurance and regulatory support, all WHO’s work is covered by this strategic objective. Work on rational use will focus on general aspects such as evidence-based selection of essential medical products and technologies, development of clinical guidelines, patient safety, compliance with long-term treatment regimens and containing antimicrobial resistance. Strategic objective 10: work also contributes to health service delivery; sustainable financing of products and technologies, on which access also depends. Strategic objective 7: good governance. Strategic objective 12: global public policy.

• • •

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 11

Issues and challenges Medical products and technologies save lives, reduce suffering and improve health only if they are of good quality, safe and effective, available in the health care system, affordable, and properly utilized by providers and consumers. Although in many countries and areas expenditures on medical products and technologies account for over half of overall health expenditures, there are problems with reliable access to good quality medicines, vaccines and medical technologies. The provision of basic services through primary health care, as well as scaling up interventions to control priority diseases such as HIV/AIDS, tuberculosis, malaria and childhood illnesses, require the timely delivery of good quality medical products and technologies and their appropriate utilization. Problems of access to good quality essential medicines and vaccines and the irrational use of medicines by providers and consumers are frequently encountered in the Western Pacific Region. Despite the availability of safe, effective and low-cost vaccines, at least 50 000 children die annually from vaccine-preventable illnesses in the Region. The prices of many essential medicines are often too high in relation to local purchasing power. Public funding remains low and medicines financing is mainly out-of-pocket. Several countries and areas continue to face difficulties in ensuring a stable supply of essential medicines and vaccines. Weak regulatory systems and enforcement result in the production, distribution and sales of substandard products and counterfeit products. The Regional Strategy for Improving Access to Essential Medicines in the Western Pacific Region 2005–2010, provides guidance to WHO and Member States for improving access to needed essential medicines. There is an increasing awareness of the need to standardize different aspects of traditional medicines in the Western Pacific Region. A combination of traditional medicines and modern medicine provides a new therapeutic modality to meet consumer health needs. Yet more systematic efforts are needed to integrate the traditional medicines into existing modern health care systems. In the Western Pacific Region, especially among the developing countries and areas, equitable access to safe and appropriate health technologies are challenged by weak health infrastructures, a lack of financial and skilled human resources, poor management systems, and a lack or absence of comprehensive equipment management and maintenance. A lack of sufficient voluntary nonremunerated blood donors from low-risk populations and the absence of well-organized national blood transfusion services make the blood supply in many countries and areas unsafe or unavailable. Overuse of injections and unsafe injection practices in many countries and areas in the Region pose unnecessary health risks and waste the limited resources for health that instead could be used for more essential services. For some areas of health technologies, such as laboratory services, a balance needs to be struck between the short-term gain in special vertical programmes and a long-term development of comprehensive national policies and systems. Strategic approaches Strategic approaches for Member States:

• • • • • • • •

Implement the Regional Strategy for Improving Access to Essential Medicines. Ensure the safe and proper use of blood and blood products. Establish internationally harmonized standards of traditional medicines into national legislation. Ensure equitable access to safe health technologies.

Strategic approaches for the WHO Secretariat: Advocate and support the establishment and implementation of national policies, programmes and systems on medical products and technologies; the adoption and use of international standards, norms and guidelines relating to quality, safety and efficacy; and the appropriate use of medical products and technologies. Facilitate the exchange of information and sharing of experiences in medical products and technologies through meetings, newsletters, electronic communication networks and other means. Promote subregional and intercountry collaboration in the area of medical products and technologies. Promote and support the monitoring of policy implementation and evaluate the impacts with standardized methodology, including relevant surveillance systems.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 11

Organizationwide expected result 11.001 Regional expected result 11.001.WP01 Regional indicators

Formulation and monitoring of comprehensive national policies on access, quality and use of essential medical products and technologies advocated and supported Support provided to countries and areas to develop, monitor or revise a comprehensive policies on access, quality and use of essential medical products and technologies. 11.001.WP01.01 Number of countries and areas that have received WHO support to develop, revise, implement, and monitor national medicines policies and to improve access to essential medicines using the Regional Strategy as a guide. 18 21 11.001.WP01.02 Number of countries and areas supported to develop or strengthen policies/programmes on traditional medicine using the Regional Strategy as a guide. 11.001.WP01.03 Number of countries and areas that have received support to develop, revise, implement, and monitor national policies to improve access to, quality and use of blood, blood products and health technologies. 6 9

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

13 17

Access to good quality medical products and health technologies, including among others medicines, vaccines, blood and blood products, traditional medicines, medical devices, diagnostic and laboratory tests, remain problematic in many countries and areas in the Western Pacific Region. In the area of medicines and vaccines, resolution WPR/RC/55.R4, requested the Regional Director to support Member States to improve access to essential medicines using the Regional Strategy for Improving Access to Essential Medicines in the Western Pacific Region, 2005–2010, as a guide.

Organizationwide expected result 11.002 Regional expected result 11.002.WP01 Regional indicators

International norms, standards and guidelines for the quality, safety, efficacy and cost-effective use of medical products and technologies developed and their national and/or regional implementation advocated and supported. Support provided to countries and areas to implement internationally accepted norms, standards and guidelines for the quality, safety, efficacy and cost-effectiveness, and to strengthen the national regulatory system and quality assurance of medical products and technologies. 11.002.WP01.01 Number of countries and areas that have received WHO support to improve medicines regulation and quality assurance system. 11.002.WP01.02 Number of countries and areas that have received WHO support including standards and guidelines to secure quality, safety, efficacy and cost-effectiveness and to improve regulations on traditional medicine. 5 9 11.002.WP01.03 Number of countries and areas that have received WHO support to improve the regulation and quality assurance system for blood, blood products and health technologies. 11.002.WP01.04 Number of vaccineproducing countries and areas that have a national regulatory authority that have successfully met all six critical functions as prescribed by WHO.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

18 20

3 5

Medical products and technologies save lives, reduce suffering and improve health only if they are of good quality, safe and effective. Ensuring efficacy, safety and quality of medical products and health technologies through strengthening the national regulation and quality assurance system in the Western Pacific Region is essential to prevent the health system and the market from being flooded with products of doubtful safety and efficacy, of substandard quality or that are counterfeit. In the area of medicines, for instance, the sale and distribution of sub standard and counterfeit products due to weak regulation and law enforcement in many countries and areas has become a serious public health threat.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 11

Organizationwide expected result 11.003 Regional expected result 11.003.WP01 Regional indicators

Evidence-based policy guidance on promoting scientifically sound and cost-effective use of medical products and technologies by health workers and consumers developed and supported within the Secretariat and regional and national programmes. Support provided to countries and areas to promote evidence-based, scientifically sound and cost-effective use of medical products and technologies and traditional medicine by health workers, practitioners and consumers. 11.003.WP01.01 Number of countries and areas that have received WHO support to improve the use of therapeutically effective, safe, and cost-effective medicines by health care providers and consumers. 18 24 11.003.WP01.02 Number of countries and areas that have received WHO support to promote evidence-based, scientifically sound and costeffective use of traditional medicine by practitioners and consumers. 7 10 11.003.WP01.03 Number of countries and areas that have received WHO support to promote evidence-based scientifically sound and costeffective use of blood, blood products and health technologies. 4 7

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

Inappropriate and irrational use of medical products and health technologies by both providers and consumers drain limited resources for health and jeopardize the quality of health services. A number of studies and assessments have demonstrated the widespread occurrence of irrational prescribing practices in health facilities and medicines use in communities in many countries and areas. There is an obvious need to promote rational use of medical products and technologies through well proven effective interventions, and such interventions should be systematically and continuously undertaken as part of related national policies and programmes.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 12

STRATEGIC OBJECTIVE 12 To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. Scope This strategic objective facilitates the work of WHO to achieve all other strategic objectives. Responding to priorities in the Eleventh General Programme of Work, it recognizes that the context for international health has changed significantly. The scope of this objective covers three broad, complementary areas: leadership and governance of the Organization; WHO’s support for, presence in, and engagement with individual Member States; and the Organization’s role in bringing the collective energy and experience of Member States and other actors to bear on health issues of global and regional importance. The main innovation implicit in this objective is that it seeks to harness the depth and breadth of WHO’s country experience in order to influence global and regional debates, thereby to influence positively the environment in which national policy-makers work, and contribute to the attainment of the health-related Millennium Development Goals and other internationally agreed health-related goals. Regional indicators and targets

• • • •

Proportion of countries and areas that adopt health as a high priority in their national development agendas: 100% by 2013. Number of countries and areas that have adjusted their work plans and reallocated resources in order to address priority issues identified in the Country Cooperation Strategy: 25 by 2013. Proportion of health partnerships functioning in alignment with the WHO mandate in advancing the regional health agenda: 100% by 2013. Proportion of countries and areas accessing and sharing relevant knowledge bases and publications, including health research: 100% by 2013.

Links with other strategic objectives

•

This strategic objective is intrinsically linked to all the other objectives, as it builds on and supports the entire work of the Organization. As such it is closely related and complementary to strategic objective 13, to develop and sustain WHO as a flexible, learning Organization, enabling it to carry out its mandate more effectively and efficiently. The latter objective is more inward-looking, geared towards managerial and administrative issues, whereas strategic objective 12 is more outward-looking, focusing on issues of WHO leadership and governance, on work in Member States, and collaboration with partners, including the United Nations System, at global, regional and country levels.

Issues and challenges Effective political and technical leadership is required to maintain good quality health services and to develop the health infrastructure necessary to achieve the health-related Millennium Development Goals. There is a need for WHO, as the specialized agency of the United Nations responsible for directing and coordinating international health, to provide leadership that reflects the priorities of Member States through the synergistic strengths of all levels of the Organization. Guided by the Regional Committee, Member States and the Secretariat should formulate and implement effective policies and strategic directions for health development throughout the Region. Health should be a priority in the national social and economic development plans of countries and areas in the Region. WHO country offices in the Region need appropriate leadership, as well as the technical and administrative capacity, to respond effectively and in a timely manner to the emerging health needs of countries and areas. The WHO Country Cooperation Strategy is now well established in the Region. By placing country health needs at the centre of WHO’s work there will be a country perspective in all aspects of the Organization’s work.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 12

A key challenge for WHO is to mobilize and enable the Organization to support countries and areas to reach national health and development goals. With the increased recognition of the essential role of health in promoting social and economic development, there are more interregional and bilateral agencies, as well as private sector organizations, involved financially and technically in the health sector at all levels. There is the potential for both the duplication of effort and the reduced harmonization of health programmes and implementation of activities that are not in line with the national health strategic plans of countries and areas. WHO should continue to coordinate and harmonize public health work within the United Nations system, and with other intergovernmental agencies, civil society organizations, nongovernmental organizations and other partners in the areas of health and development, through new and innovative approaches. Access to knowledge between and within countries and areas must be improved and sharing of health information must be strengthened. Strategic approaches Strategic approaches for Member States:

• • •

• • • • • •

Strengthen the governance of WHO and regional health policy-making through active engagement in the preparation and conduct of meetings of the Regional Committee. Support WHO in directing and implementing regional health policies, strategic programmes and initiatives that reflect the priorities of countries and areas as outlined in Country Cooperation Strategies. Work together with the Secretariat to coordinate planning, development and implementation of activities supported and executed by various partners and partnerships in the health sector according to the national health development plan and the approved Medium-term Strategic Plan and Programme Budget in line with the priorities outlined in Country Cooperation Strategies. Increase collaboration with WHO and among Member States in sharing relevant knowledge bases.

Strategic approaches for the WHO Secretariat: Strengthen the regional governance of WHO through improved communication and coordination between Member States and the Secretariat, and through effective Secretariat support in the organization and conduct of the Regional Committee. Provide leadership and direction to the work of WHO at country and regional levels. Orient the work of WHO around Country Cooperation Strategies that reflect national needs and priorities and provide appropriate support to countries and areas in building national capacity for governance and health development through WHO's core country presence. Promote multisectoral approaches to advance the global health agenda and harmonized approaches to health development in the Region by developing and fostering strategic alliances, coordinating functional partnerships and effectively communicating the work of WHO. Facilitate access to knowledge bases and publications, including health research.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 12

Organizationwide expected result 12.001 Regional expected result 12.001.WP01 Regional indicators

Effective leadership and direction of the Organization exercised through enhancement of governance, and the coherence, accountability and synergy of WHO’s work. Effective leadership and direction of WHO in the Region through enhancement of governance, coherence, accountability and synergy of the work of WHO. 12.001.WP01.01 Percentage of resolutions adopted by the Regional Committee that support the global agenda as articulated in the 11th General Programme of Work. 100% 100% 12.001.WP01.02 Percentage of countries and areas that adopt health as a high priority in their national development agendas. 100% 100%

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

100%

The main regional-level mechanism for the formal contribution of Member States to the good governance, policies and work of WHO is the Regional Committee. Regional Committee deliberations and decisions must be cognizant of the global agenda set by the World Health Assembly for WHO and be relevant to the needs and feasible responses for Member States in the Region. Communication and other barriers to Member States’ participation in policy implementation must be minimized.

Organizationwide expected result 12.002 Regional expected result 12.002.WP01 Regional indicators

Effective WHO country presence established to implement WHO country cooperation strategies that are aligned with Member States’ health and development agendas, and harmonized with the United Nations country team and other development partners. WHO country presence is effectively led at the country level, harmonized with other development partners and guided by WHO Country Cooperation Strategies that support the national health agendas of Member States in the context of the 11th General Programme of Work. 12.002.WP01.01 Percentage of countries and areas where WHO country presence, including regional support reflects the respective Country Cooperation Strategies. 40% 60% 12.002.WP01.02 Number of countries and areas where a Country Cooperation Strategy process is actively used as a basis for planning WHO's work and for harmonizing WHO's cooperation with development partners. 17 18

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

100%

National health priorities as set by a country are a critical component in determining WHO country focus and WHO Country Cooperation Strategies. A WHO presence in-country facilitates close working relationships with government and partners to ensure ongoing and timely relevance of WHO activities and also provides strong leadership and support of the WHO technical collaboration.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 12

Organizationwide expected result 12.003 Regional expected result 12.003.WP01 Regional indicators

Global health and development mechanisms established to provide more sustained and predictable technical and financial resources for health on the basis of a common health agenda which responds to the health needs and priorities of Member States. Global and regional health development architecture effectively providing more sustained and predicable technical and financial resources for health based on a common health agenda which responds to the health needs and priorities of Member States in the Region. 12.003.WP01.01 External aid flows to health supplied through flexible and long-term instruments in the Region. 12.003.WP01.02 Number of regional health partners that WHO is working with implement coordinated health activities in line with priorities identified in the WHO Regional strategic objective and work plans. 11 15 12.003.WP01.03 Number of countries and areas where WHO is leading or actively engaged in health and development partnership (formal and informal), including within the context of United Nations Reform. 10 12

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

US$ 30 million US$ 40 million

US$ 50 million

An increasing number of multilateral and bilateral agencies and entities in the private sector have become more interested in and involved financially and technically in the health sector at both regional and country levels, which has brought about challenges related to coordination with those partners to avoid duplication of activities, waste of limited resources, and incoherent policy and technical guidance at regional and country levels. WHO has an important role to play in facilitating coordination, communication and cooperation among different partners and ensuring that increasing and sustainable resources made available for priority health programmes at regional and country levels and Member States can make the best possible use of technical and financial resources based on a common health agenda.

Organizationwide expected result 12.003 Regional expected result 12.003.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

20% above baseline

WHO has an important role to play in facilitating coordination, communication and cooperation among different partners to achieve a common underlying health agenda in the context of globalization.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 12

Organizationwide expected result 12.004 Regional expected result 12.004.WP01 Regional indicators

Essential multilingual health knowledge and advocacy material made accessible to Member States, health partners and other stakeholders through the effective exchange and sharing of knowledge. Essential multilingual health knowledge and advocacy material made accessible to Member States, regional health partners and other stakeholders in the Region through effective exchange and sharing of knowledge. 12.004.WP01.01 Number of names on the WHO Public Information Officer's media directory regularly receiving relevant health information and advocacy materials. 225 names and complete contact details (2006) 20% above the baseline 12.004.WP01.02 Average number of page views/visits to the Regional Office for Western Pacific websites. 12.004.WP01.03 Number of WHO and WHO, Regional Office for the Western Pacific publications sold per biennium. Status at the end of 2007 20% above the baseline

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

1 144 270 visits by the end of 2006 20% above the baseline

40% above the baseline

Public opinion on critical health issues can be changed and strengthened using WHO publications, websites and advocacy material.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 13

STRATEGIC OBJECTIVE 13 To develop and sustain WHO as a flexible, learning Organization, enabling it to carry out its mandate more efficiently and effectively. Scope The scope of this objective covers the functions that support the work of the Secretariat in country and regional offices and at headquarters. Work is organized according to entire results-based management framework and processes, from strategic and operational planning and budgeting to performance monitoring and evaluation; management of financial resources through monitoring, mobilization and coordination Organization-wide, ensuring an efficient flow of available resources throughout the Organization; management of human resources, including human resources planning, recruitment, staff development and learning, performance management, and conditions of service and entitlements; provision of operational support, ranging from the management of infrastructure and logistics, language services, staff and premises security, and staff medical services, to the management of information technology; and appropriate accountability and governance mechanisms across all areas. The strategic objective also covers broad institutional reform that will ensure that the above functions are continuously strengthened and provide better, more efficient and cost-effective support to the Organization. It is closely linked to broader reforms within the United Nations system at both country and global levels. Regional indicators and targets

• • •

Cost effectiveness of operational support services, ensuring best value for money: increase by 2013 compared to 2008. Resources aligned to the Programme Budget: increase by 2013 compared to 2008. Managerial and administrative capacity at the country level: increase by 2013 compared to 2008.

Links with other strategic objectives

•

This objective should not be considered in isolation from the other strategic objectives, as its scope reflects and is responsive to the needs of the Organization as a whole. In particular, it should be read in conjunction with strategic objective 12, to provide leadership, strengthen governance and foster partnership and collaboration with countries and areas and to fulfil the mandate of WHO in advancing the global health agenda. Strategic objective 13 is more inward-looking, geared towards managerial and administrative issues, whereas strategic objective 12 is more outward-looking, focusing on issues of WHO leadership and governance and on collaboration with Member States and partners at global, regional and country levels.

Issues and challenges The Organization must continue to evolve in a flexible and responsive manner to successfully respond to the evolving regional health challenges. Harmonization efforts in the development community and broader reforms within the United Nations system influence the way other stakeholders act. WHO needs to actively participate in these developments and ensure it works proactively to reflect this changing environment. The Western Pacific Region is being held to a higher standard by our governing body (the Regional Committee) and donor agencies vis-à-vis transparency and accountability in terms of measurable results and the use of financial resources. In addition, given that approximately 70% of our financial resources are voluntary contributions, mechanisms need to be in place to ensure better alignment of resources with the Programme Budget and to lower transaction costs. While progress has been made in implementing human resources reforms, there remains a need to develop better human resources planning and a culture that promotes learning, manages performance and facilitates greater staff mobility. In addition, more work needs to be done to create an environment that attracts suitable qualified women in the professional workforce, which has been a challenge in the Region. Given the vast differences in capacity of country offices in the Region and the decentralization agenda of the Organization, training and the articulation of clear guidelines on responsibility and authority need to be developed and communicated. In order to maximize efficiency and effectiveness, much thought needs to be given to determining at which locations decision-making and programme implementation should take place.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 13

Strategic approaches Strategic approaches for the WHO Secretariat:

• • • • • •

Shift from management through tight, overly bureaucratic controls to post facto monitoring in support of greater delegation and accountability, resulting in shifting responsibility and decision-making on the use of resources closer to where programmes are implemented. Strengthen managerial and administrative capacities and competencies in the Region with specific emphasis on country offices. Provision of increased operational support to country offices and technical units through clearly articulated policies and procedures. Increased site visits to assess the situation at the country level and propose pragmatic solutions that enable work at the country level. Strengthen the results-based approach which emphasizes joint planning, importance of learning and collaboration. Ensure that adequate mechanisms are in place to ensure that accountability is an integral part of the system. This goes hand in hand with appropriate delegation of authority and support from management.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 13

Organizationwide expected result 13.001 Regional expected result 13.001.WP01 Regional indicators

Work of the Organization guided by strategic and operational plans that build on lessons learnt, reflect country needs, are elaborated across the Organization, and used to monitor performance and evaluate results. Work towards achievement of WHO strategic objectives in the Region is supported by effective programme planning and development, reflecting country needs, and including strategic and operational planning through a results-based approach, performance monitoring and evaluation. 13.001.WP01.01 Percentage of organizational units for which workplans have been developed and monitored to contribute towards WHO strategic objectives. 100% 100% 13.001.WP01.02 Percentage of country offices that actively and effectively use the programme planning and development systems and processes. 100% 100% 13.001.WP01.03 Number of thematic evaluations completed during the period from 2008 to 2013.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

0 1

100%

With the WHO commitment to move resources to regions, countries and areas, progress towards the identified global health agenda and strategic objectives requires the consistent application of effective results-based management systems at all levels of the Organization. Work of the Organization guided by strategic and operational plans that build on lessons learnt, reflect country needs, are elaborated across the Organization, and used to monitor performance and evaluate results. Support for roll-out, implementation and further development of the Global Management System (GSM) for implementation, monitoring and evaluation of WHO's collaborative programmes in the Region through the Programme Budget. 13.001.WP02.01 The GSM is developed and refined to adequately meet regional needs. Regular regional participation on GSM project team. Mechanism in place and routinely used to resolve regional issues and refine GSM. High level of regional satisfaction in GSM function and use. 13.001.WP02.02 Regional roll out and training is planned and successfully executed. Regional rollout plans in place. Introductory level information and training is available. 100% adherence to agreed rollout plans. Staff have access to GSM information and are trained in its use. Refinements are routinely and successfully rolled out. Training needs analyses reveal minimum gaps in GSM information and resources.

Organizationwide expected result 13.001 Regional expected result 13.001.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

The GSM will renew WHO's administrative processes and the related information systems in order to better support the technical programmes in country and regional offices and in Headquarters. Sound financial practices and efficient management of financial resources achieved through continuous monitoring and mobilization of resources to ensure the alignment of resources with the programme budgets. Sound financial practices and efficient management of financial resources is facilitated in the Region through timely and accurate guidance and the provision of relevant management reports. 13.002.WP01.01 Timely and relevant calculation of budget estimates for costing of workplans. 4 days 3 days 13.002.WP01.02 Timely reporting to internal management. 3 days prior to meeting 6 days prior to meeting 13.002.WP01.03 Donor reports submitted and accepted according to standards agreed with donors. 70% 80%

Organizationwide expected result 13.002 Regional expected result 13.002.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

2 days

8 days prior to meeting

100%

In order to ensure that transparent and accurate reports are available to all stakeholders, thereby raising donor confidence and aiding the technical programmes to operate efficiently and effectively.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 13

Organizationwide expected result 13.003 Regional expected result 13.003.WP01 Regional indicators

Human resource policies and practices in place to attract and retain top talent, promote learning and professional development, manage performance, and foster ethical behaviour. Human resources policies and practices in place to attract and retain top talent, promote learning and professional development, manage performance and foster ethical behaviour. 13.003.WP01.01 To increase percentage of females recruited in the Region. 13.003.WP01.02 Efficient staff development and learning programmes made accessible to all staff members of the Region. 65% of staff 80% of staff 13.003.WP01.03 Proficient and effective use of the Global Management System to process and monitor various human resources activities. 0% 100%

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

22% of Fixed-term Professional Staff 25% of Fixed-term Professional Staff 35% of Fixed-term Professional Staff

100% of staff

100%

It is critical to ensure that the right people are in place/trained and supported to deliver the expected results of the Organization. Management strategies, policies and practices in place for information systems, that ensure reliable, secure and cost-effective solutions while meeting the changing needs of the Organization. Country-level ongoing support and development of secure and cost-effective solutions that meet the changing needs of the Organization. 13.004.WP01.01 Availability of online, real time, relevant regional information systems for management and administrative purposes in all country offices. 80% 100% 13.004.WP01.02 Percentage of country offices within a region-wide standard information and communication environment that reflects their practical needs. 25% 100%

Organizationwide expected result 13.004 Regional expected result 13.004.WP01 Regional indicators

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

100%

Country-level provision of information technology systems and required information management support is essential to the work of the Organization Management strategies, policies and practices in place for information systems, that ensure reliable, secure and cost-effective solutions while meeting the changing needs of the Organization. Development of secure and cost-effective solutions that meets the changing needs of the Organization. Ongoing support to regional, country, and global information systems and their users. Information products and their effective use is supported within a Knowledge Management System (KMS). 13.004.WP02.01 Effective coordination of regional and global information and communication technology projects. 80% 100% 13.004.WP02.02 Number of information products disseminated in the appropriate language and format to target users. Status at the end of 2007 10% above baseline

Organizationwide expected result 13.004 Regional expected result 13.004.WP02 Regional indicators Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

100%

20% above baseline

Provision of information technology systems and required information management support is essential to the work of the Organization. Information products generated by the Organization must suit the intended audiences and also be within the overall organizational knowledge management systems.

MEDIUM-TERM STRATEGIC PLAN – STRATEGIC OBJECTIVE 13

Organizationwide expected result 13.005 Regional expected result 13.005.WP01 Regional indicators

Managerial and administrative support services necessary for the efficient functioning of the Organization provided in accordance with service-level agreements that emphasize quality and responsiveness. Provision of management and administrative support at both regional and country level through Service Level Agreements (SLAs). 13.005.WP01.01 Number of SLAs concluded. 13.005.WP01.02 Client surveys to assess the extent to which SLAs have been complied with. 13.005.WP01.03 Number of training courses for country office staff and Regional Office staff to develop the skills to achieve the SLAs. 0 4 13.005.WP01.04 Accounts payables are paid according to contract terms.

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

0 15

0 4

7 days 5 days

3-4 days

Programmes should be provided with efficient service delivery to allow them to achieve their expected results.

Organizationwide expected result 13.006 Regional expected result 13.006.WP01 Regional indicators

Physical working environment conducive to the well-being and safety of staff in all locations.

A safe environment in the Regional Office and country offices for all staff.

13.006.WP01.01 Achievement of Minimum Operating Security Standards (MOSS) compliance in country offices. 9 country offices Increased to 12 country offices. Increased to all country offices.

13.006.WP01.02 Timeliness of implementation of the Capital Master Plan.

13.006.WP01.03 Renovation of the Regional Office conference hall.

13.006.WP01.04 Maintenance of satisfactory working conditions in the regional and country offices (continuing activity). 70% satisfaction 80% satisfaction

Baseline Targets to be achieved by 2009 Targets to be achieved by 2013 Justification

0 country offices All country offices

Architectural plans 80% of work completed

Compliance with the study recommendation.

100% of work completed

90% satisfaction

Provision of a safe and secure office environment is an essential component for maintaining a motivated workforce within the Organization.

2008–2009 Programme Budget

2008–2009 PROGRAMME BUDGET – OVERVIEW

OVERVIEW OF THE PROPOSED REGIONAL PROGRAMME BUDGET 2008–2009 This proposed Programme Budget of the Western Pacific Region 2008–2009 was developed through a process of close consultation involving Member States, WHO country offices, the Regional Office and WHO Headquarters. It builds on the contribution of the Regional Office to the collaborative process involving the six WHO regions and Headquarters for the development of the global Programme Budget for 2006–2007. Preparation of the regional Programme Budget was guided by the draft global Medium-term Strategic Plan 2008–2013 and the Overview of the proposed Medium-term Strategic Plan of the Western Pacific Region 2008–2013 examined by the fifty-seventh session of the Regional Committee for the Western Pacific, at which the Regional Director was requested to further develop a regional Programme Budget for 2008– 2009. The Programme Budget 2008–2009 will be the first biennial budget period under the six-year proposed Medium-term Strategic Plan and it will be the fifth successive biennial budget to follow an Organization-wide results-based approach. The Organization-wide expected results of the Programme Budget 2008–2009 are the outcomes to which the WHO Secretariat collectively (country offices, regional offices, and Headquarters) is committed over the biennium and they form the basis for estimating and costing resource requirements. They also justify resource allocation. The proposed regional Programme Budget 2008–2009 has been prepared on the basis of the priorities of Member States within the Region as reflected in the resolutions adopted by the World Health Assembly and by the Regional Committee. Since the fifty-seventh session of the Regional Committee, additional strategic planning developments have occurred and the Director-General has highlighted specific areas in the strategic objectives which are reflected as priorities within the proposed Programme Budget. These priorities are: (1) reducing maternal and child mortality; (2) addressing the epidemic of chronic noncommunicable diseases; (3) implementing the International Health Regulations (2005); (4) improving health systems; and (5) improving the performance of WHO. During the development of the country programme budgets for 2008–2009, national priorities and needs of the Region's individual Member States were taken into account, identified through Country Cooperation Strategies and other country exercises. Strategies and planned programmes of other United Nations agencies and major partners in health were also considered. In this way WHO efforts in the Region will be harmonized and aligned along with others towards country priorities, regional health priorities and the global health agenda. The Programme Budget 2008–2009 has been prepared according to the principles of results-based management. For each regional expected result, the planned efforts of the country offices and regional office are separately identified together with their associated budgets. Thus efforts at the office level are clearly and collectively linked through to the Organization-wide expected results and 13 strategic objectives that support the global health agenda. Fuller details of the planned efforts at the country offices and regional office through the office-specific expected results can be accessed at the WHO Western Pacific Region website (http://www.wpro.who.int/sites/oser). Actual performance in achieving results will be measured by objective performance indicators, baselines and targets that have been identified for each expected result. The indicators will be used to monitor progress regularly and as the basis of assessments of programme budget implementation conducted at six-month intervals. WHO is committed to achieving the strategic objectives of the Medium-term Strategic Plan through attainment of the expected results for the programme areas of collaboration with the countries and areas of the Region. Budgetary aspects In May 2007, the Sixtieth World Health Assembly adopted an appropriation resolution for the financial period 2008–2009. The regional allocation of assessed contribution funds for the Western Pacific Region is US$ 80 159 000 (Table 1). This is a 4.8% increase over the allocation for 2006–2007. The estimated increase in voluntary contribution funds is 71.2%. Table 2 shows the distribution of the assessed contribution and voluntary contribution regional allocation for 2006–2007 and 2008–2009 by organizational level. 57% of the total assessed contribution resources have been allocated to country activities with the remaining 43% allocated to regional and intercountry activities. Table 3 shows the allocation of funds from assessed and voluntary contributions 2008–2009 by strategic objective and organizational level. Note that figures for funding from voluntary contributions for both 2006–2007 and 2008–2009 are estimations. 1

Resolution WHA60.12.

2008–2009 PROGRAMME BUDGET – OVERVIEW

Table 1: Financing sources summary: 2006–2007 and 2008–2009 Sources of financing Assessed contributions Estimated voluntary contributions Total 2006–2007 US$ 76 505 000 156 356 000 232 861 000 2008–2009 US$ 80 159 000 267 679 000 347 838 000 3 654 000 111 323 000 114 977 000 Increase

Table 2: Regional allocation of assessed and voluntary contributions for 2006–2007 and 2008–2009 by organizational level 2006–2007 Assessed contributions US$ % of total (000) budget DISTRIBUTION OF REGIONAL ALLOCATION Country activities including WHO's presence in countries (included in strategic objectives 12 and 13) Regional Office and intercountry activities Total Voluntary contributions US$ % of total (000) budget 2008–2009 Assessed contributions US$ % of total (000) budget Voluntary contributions US$ % of total (000) budget

42 745

55.87

93 548

59.83

45 377

56.61

161 767

60.43

33 760

44.13

62 808

40.17

34 782

43.39

105 912

39.57

76 505

100.00

156 356

100.00

80 159

100.00

267 679

100.00

DISTRIBUTION OF COUNTRY ACTIVITIES Country programmes WHO's core presence in countries Total 31 407 41.05 89 468 57.22 32 907 41.05 154 457 57.70

11 338

14.82

4 080

2.61

12 470

15.56

7 310

2.73

42 745

55.87

93 548

59.83

45 377

56.61

161 767

60.43

DISTRIBUTION OF REGIONAL AND INTERCOUNTRY ACTIVITIES Regional Director's development programme 663 0.87 0 0 697 0.87 0 0

Regional Committee Regional Office and intercountry activities

414

0.54

0.02

433

0.54

300

0.11

32 683

42.72

62 783

40.15

33 652

41.98

105 612

39.46

Total

33 760

44.13

62 808

40.17

34 782

43.39

105 912

39.57

Table 3: Budget 2008–2009 by strategic objective, location and source of financing (US$ thousand) Country Strategic Objective Assessed contributions 4 625 3 612 Voluntary contributions 28 835 33 703 Total Assessed contributions 3 414 2 629 Regional Voluntary contributions 16 651 19 388 Total Assessed contributions 8 039 6 241 Total Voluntary contributions 45 486 53 091 Total

1. To reduce the health, social and economic burden of communicable diseases. 2. To combat HIV/AIDS, tuberculosis and malaria. 3. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. 4. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. 5. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. 6. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. 7. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rightsbased approaches.

33 460 37 315

20 065 22 017

53 525 59 332

3 570

10 060

13 630

2 615

5 490

8 105

6 185

15 550

21 735

2 493

13 407

15 900

1 802

7 514

9 316

4 295

20 921

25 216

2008-2009 PROGRAMME BUDGET – OVERVIEW

993

8 960

9 953

820

5 949

6 769

1 813

14 909

16 722

3 661

16 297

19 958

2 662

9 109

11 771

6 323

25 406

31 729

1 517

1 581

878

915

101

2 395

2 496

78 Table 3: Budget 2008–2009 by strategic objective, location and source of financing (US$ thousand) Country Strategic Objective Assessed contributions Voluntary contributions Total Assessed contributions Regional Voluntary contributions Total Assessed contributions Total Voluntary contributions Total 8. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. 9. To improve nutrition, food safety and food security throughout the life-course, and in support of public health and sustainable development. 10. To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research. 11. To ensure improved access, quality and use of medical products and technologies. 12. To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out and articulated in the Eleventh General Programme of Work. 13. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Total 1 794 5 830 7 624 1 367 3 373 4 740 3 161 9 203 12 364 1 711 10 450 12 161 1 236 5 876 7 112 2 947 16 326 19 273 8 994 20 926 29 920 6 228 10 459 16 687 15 222 31 385 46 607 1 390 4 472 5 862 1 184 2 943 4 127 2 574 7 415 9 989 5 975 2 542 8 517 2 493 4 626 7 119 8 468 7 168 15 636 6 495 4 768 11 263 8 295 13 656 21 951 14 790 18 424 33 214 45 377 161 767 207 144 34 782 105 912 140 694 80 159 267 679 347 838

2008-2009 PROGRAMME BUDGET – OVERVIEW

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS STRATEGIC OBJECTIVE 1 To reduce the health, social and economic burden of communicable diseases. REGIONAL EXPECTED RESULT 01.001.WP01 Policy and technical support provided to Member States to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential child health interventions with immunization. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Lao People's Democratic Republic Marshall Islands Micronesia, Federated States of Mongolia Nauru Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 519 000 519 000 1 000 65 000 17 000 173 000 9 000 10 000 342 000 2 000 2 000 1 000 8 000 12 000 52 000 1 000 8 000 703 000 1 222 000 Voluntary contributions 2 532 000 2 532 000 181 000 3 101 000 125 000 24 000 0 0 184 000 0 42 000 7 000 3 000 16 000 22 000 2 000 677 000 4 384 000 6 916 000 Total 3 051 000 3 051 000 182 000 3 166 000 142 000 197 000 9 000 10 000 526 000 2 000 44 000 8 000 11 000 28 000 74 000 3 000 685 000 5 087 000 8 138 000

REGIONAL EXPECTED RESULT 01.002.WP01 Effective coordination and provision of support to Member States to retain certification of poliomyelitis elimination and to achieve destruction, or appropriate containment of polioviruses, leading to simultaneous cessation of oral polio vaccination. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Philippines Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 463 000 463 000 1 000 376 000 107 000 142 000 626 000 1 089 000 Voluntary contributions 2 256 000 2 256 000 1 191 000 208 000 221 000 2 288 000 3 908 000 6 164 000 Total 2 719 000 2 719 000 1 192 000 584 000 328 000 2 430 000 4 534 000 7 253 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 01.003.WP01 Effective coordination and support provided to Member States to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Fiji Lao People's Democratic Republic Marshall Islands Micronesia, Federated States of Papua New Guinea Philippines Tonga Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 497 000 497 000 5 000 78 000 9 000 8 000 254 000 10 000 147 000 66 000 96 000 673 000 1 170 000 Voluntary contributions 2 423 000 2 423 000 1 601 000 31 000 1 027 000 0 0 136 000 161 000 22 000 1 219 000 4 197 000 6 620 000 Total 2 920 000 2 920 000 1 606 000 109 000 1 036 000 8 000 254 000 146 000 308 000 88 000 1 315 000 4 870 000 7 790 000

REGIONAL EXPECTED RESULT 01.004.WP01 Provision of policy and technical support to Member States to enhance their capacity to carry out surveillance and monitoring of all communicable diseases of public health importance. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji French Polynesia Lao People's Democratic Republic Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru Papua New Guinea Philippines Solomon Islands Tuvalu Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 342 000 342 000 7 000 37 000 15 000 45 000 127 000 24 000 5 000 8 000 61 000 3 000 6 000 18 000 21 000 48 000 4 000 35 000 464 000 806 000 Voluntary contributions 1 669 000 1 669 000 95 000 1 592 000 18 000 0 737 000 1 000 0 0 61 000 0 127 000 53 000 7 000 0 8 000 191 000 2 890 000 4 559 000 Total 2 011 000 2 011 000 102 000 1 629 000 33 000 45 000 864 000 25 000 5 000 8 000 122 000 3 000 133 000 71 000 28 000 48 000 12 000 226 000 3 354 000 5 365 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 01.005.WP01 New knowledge, intervention tools and strategies that meet priority needs for the prevention and control of communicable diseases developed and validated, and scientists from developing countries and areas increasingly taking the lead in this research. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Papua New Guinea Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 50 000 50 000 18 000 51 000 69 000 119 000 Voluntary contributions 248 000 248 000 358 000 70 000 428 000 676 000 Total 298 000 298 000 376 000 121 000 497 000 795 000

REGIONAL EXPECTED RESULT 01.006.WP01 Support provided to Member States in achieving the minimum capacities and functions required by the International Health Regulations (IHR 2005), specifically those related to advocacy, National International Health Regulations Focal Points and the core capacities for designated points of entry. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Marshall Islands Micronesia, Federated States of Papua New Guinea Philippines Solomon Islands Tonga Tuvalu Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 548 000 548 000 3 000 228 000 44 000 5 000 151 000 13 000 21 000 2 000 22 000 54 000 15 000 5 000 1 000 178 000 742 000 1 290 000 Voluntary contributions 2 670 000 2 670 000 885 000 2 156 000 40 000 0 830 000 0 0 257 000 11 000 4 000 0 0 6 000 435 000 4 624 000 7 294 000 Total 3 218 000 3 218 000 888 000 2 384 000 84 000 5 000 981 000 13 000 21 000 259 000 33 000 58 000 15 000 5 000 7 000 613 000 5 366 000 8 584 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 01.007.WP01 Support provided to Member States to achieve the minimum capacities required for the preparedness, detection, assessment of and response to emerging diseases, including major epidemic and pandemic-prone diseases such as influenza, by effectively implementing the Asia Pacific Strategy for Emerging Diseases (APSED). 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Malaysia Niue Papua New Guinea Philippines Solomon Islands Tokelau Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 488 000 488 000 3 000 76 000 41 000 5 000 111 000 19 000 3 000 2 000 53 000 59 000 3 000 1 000 285 000 661 000 1 149 000 Voluntary contributions 2 380 000 2 380 000 274 000 2 006 000 40 000 0 915 000 3 000 0 40 000 78 000 5 000 0 8 000 753 000 4 122 000 6 502 000 Total 2 868 000 2 868 000 277 000 2 082 000 81 000 5 000 1 026 000 22 000 3 000 42 000 131 000 64 000 3 000 9 000 1 038 000 4 783 000 7 651 000

REGIONAL EXPECTED RESULT 01.008.WP01 Coordinated regional capacity rapidly available to Member States for detection, verification, risk assessment of and response to epidemics and other public health emergencies of regional and international concern. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Papua New Guinea Philippines Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 507 000 507 000 169 000 119 000 399 000 687 000 1 194 000 Voluntary contributions 2 473 000 2 473 000 3 295 000 658 000 329 000 4 282 000 6 755 000 Total 2 980 000 2 980 000 3 464 000 777 000 728 000 4 969 000 7 949 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

SUMMARY STRATEGIC OBJECTIVE 1 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 3 414 000 4 625 000 8 039 000 Voluntary contributions 16 651 000 28 835 000 45 486 000 Total 20 065 000 33 460 000 53 525 000

STRATEGIC OBJECTIVE 2 To combat HIV/AIDS, tuberculosis and malaria. REGIONAL EXPECTED RESULT 02.001.WP01 Regional guidelines, policies, strategies and other tools developed (adapting global ones, as appropriate) for prevention, treatment and care for HIV/AIDS/STI, malaria and TB (including innovative approaches for increasing coverage of the interventions among the poor, hard to reach and vulnerable populations). 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Lao People's Democratic Republic Malaysia Micronesia, Federated States of Papua New Guinea Philippines Solomon Islands Tonga Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 384 000 384 000 15 000 37 000 20 000 72 000 85 000 29 000 73 000 31 000 145 000 0 20 000 527 000 911 000 Voluntary contributions 2 831 000 2 831 000 593 000 504 000 147 000 215 000 79 000 0 330 000 2 522 000 45 000 1 000 485 000 4 921 000 7 752 000 Total 3 215 000 3 215 000 608 000 541 000 167 000 287 000 164 000 29 000 403 000 2 553 000 190 000 1 000 505 000 5 448 000 8 663 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 02.002.WP01 Policy, technical and coordination support provided to countries and areas for the implementation of prevention, treatment and care interventions for HIV/AIDS/STI, malaria and TB and their scaling-up to reach the populations most in need (including integrated training and service delivery; wider service provider networks; strengthened laboratory capacities and better linkages with other health services). 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Lao People's Democratic Republic Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru Papua New Guinea Philippines Samoa Solomon Islands Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 765 000 765 000 19 000 130 000 30 000 137 000 25 000 18 000 42 000 70 000 10 000 91 000 93 000 42 000 222 000 102 000 20 000 1 051 000 1 816 000 Voluntary contributions 5 642 000 5 642 000 1 796 000 2 203 000 173 000 569 000 53 000 0 0 59 000 0 1 167 000 2 369 000 11 000 154 000 42 000 1 211 000 9 807 000 15 449 000 Total 6 407 000 6 407 000 1 815 000 2 233 000 203 000 706 000 78 000 18 000 42 000 129 000 10 000 1 258 000 2 462 000 53 000 376 000 144 000 1 231 000 10 858 000 17 265 000

REGIONAL EXPECTED RESULT 02.003.WP01 Guidance and technical support provided on policies and programmes to promote equitable access to essential medicines of assured quality for the prevention and treatment of HIV/AIDS/STI, malaria and TB, and their rational use by prescribers and consumers; and on uninterrupted supply of quality diagnostics, safe blood and other essential commodities. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Kiribati Papua New Guinea Samoa Solomon Islands Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 379 000 379 000 12 000 134 000 0 73 000 127 000 54 000 101 000 19 000 520 000 899 000 Voluntary contributions 2 791 000 2 791 000 1 737 000 1 375 000 20 000 683 000 9 000 198 000 21 000 810 000 4 853 000 7 644 000 Total 3 170 000 3 170 000 1 749 000 1 509 000 20 000 756 000 136 000 252 000 122 000 829 000 5 373 000 8 543 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 02.004.WP01 Regional and national surveillance, evaluation and monitoring systems strengthened and expanded to monitor progress towards targets and resource allocations for HIV/AIDS/STI, malaria and TB control, including monitoring of drug and insecticide resistance and the impact of control efforts. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 436 000 436 000 11 000 81 000 16 000 87 000 15 000 41 000 64 000 39 000 100 000 67 000 69 000 10 000 600 000 1 036 000 Voluntary contributions 3 219 000 3 219 000 974 000 740 000 186 000 155 000 70 000 38 000 569 000 2 208 000 9 000 34 000 34 000 578 000 5 595 000 8 814 000 Total 3 655 000 3 655 000 985 000 821 000 202 000 242 000 85 000 79 000 633 000 2 247 000 109 000 101 000 103 000 588 000 6 195 000 9 850 000

REGIONAL EXPECTED RESULT 02.005.WP01 Political commitment sustained and mobilization of resources ensured through advocacy and nurturing of HIV/AIDS/STI, malaria and tuberculosis partnerships at country, regional and global levels; support provided to countries and areas as appropriate to develop/strengthen and implement mechanisms for resource mobilization and utilization; and engagement of communities and affected persons increased to maximize the reach and performance of HIV/AIDS/STI, malaria and tuberculosis control. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Lao People's Democratic Republic Papua New Guinea Solomon Islands Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 376 000 376 000 10 000 164 000 96 000 139 000 90 000 18 000 517 000 893 000 Voluntary contributions 2 772 000 2 772 000 1 740 000 1 430 000 138 000 786 000 150 000 576 000 4 820 000 7 592 000 Total 3 148 000 3 148 000 1 750 000 1 594 000 234 000 925 000 240 000 594 000 5 337 000 8 485 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 02.006.WP01 Operational research for the prevention and control of HIV/AIDS/STI, malaria and TB supported and research capacity strengthened in target countries and areas. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Lao People's Democratic Republic Papua New Guinea Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 289 000 289 000 8 000 94 000 50 000 114 000 114 000 17 000 397 000 686 000 Voluntary contributions 2 133 000 2 133 000 1 739 000 908 000 116 000 534 000 17 000 393 000 3 707 000 5 840 000 Total 2 422 000 2 422 000 1 747 000 1 002 000 166 000 648 000 131 000 410 000 4 104 000 6 526 000

SUMMARY STRATEGIC OBJECTIVE 2 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 2 629 000 3 612 000 6 241 000 Voluntary contributions 19 388 000 33 703 000 53 091 000 Total 22 017 000 37 315 000 59 332 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 3 To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. REGIONAL EXPECTED RESULT 03.001.WP01 Advocacy and support provided to increase political, financial and technical commitment in countries and areas in order to address chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Cook Islands Fiji Samoa Solomon Islands Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 523 000 523 000 4 000 370 000 73 000 69 000 98 000 97 000 3 000 714 000 1 237 000 Voluntary contributions 1 098 000 1 098 000 31 000 1 981 000 0 0 0 0 0 2 012 000 3 110 000 Total 1 621 000 1 621 000 35 000 2 351 000 73 000 69 000 98 000 97 000 3 000 2 726 000 4 347 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 03.002.WP01 Guidance and support provided to countries and areas for the development and implementation of policies, strategies and regulations for chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Malaysia Marshall Islands Mongolia Nauru Philippines Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 392 000 392 000 5 000 176 000 27 000 85 000 8 000 16 000 7 000 92 000 4 000 20 000 43 000 31 000 3 000 18 000 535 000 927 000 Voluntary contributions 824 000 824 000 5 000 1 286 000 0 0 22 000 0 0 4 000 0 177 000 0 0 0 15 000 1 509 000 2 333 000 Total 1 216 000 1 216 000 10 000 1 462 000 27 000 85 000 30 000 16 000 7 000 96 000 4 000 197 000 43 000 31 000 3 000 33 000 2 044 000 3 260 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 03.003.WP01 Improved capacity in countries and areas to collect, analyse, disseminate and use data on the magnitude, causes and consequences of chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Brunei Darussalam Cambodia Fiji Lao People's Democratic Republic Malaysia Micronesia, Federated States of Mongolia Papua New Guinea Philippines Solomon Islands Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 262 000 262 000 42 000 9 000 24 000 19 000 16 000 10 000 77 000 35 000 19 000 45 000 3 000 58 000 357 000 619 000 Voluntary contributions 549 000 549 000 0 43 000 0 48 000 0 0 100 000 26 000 85 000 0 0 704 000 1 006 000 1 555 000 Total 811 000 811 000 42 000 52 000 24 000 67 000 16 000 10 000 177 000 61 000 104 000 45 000 3 000 762 000 1 363 000 2 174 000

REGIONAL EXPECTED RESULT 03.004.WP01 Improved evidence compiled by WHO on the cost-effectiveness of interventions to address chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Fiji Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 392 000 392 000 4 000 128 000 404 000 536 000 928 000 Voluntary contributions 823 000 823 000 240 000 0 1 269 000 1 509 000 2 332 000 Total 1 215 000 1 215 000 244 000 128 000 1 673 000 2 045 000 3 260 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 03.005.WP01 Guidance and support provided to countries and areas for the preparation and implementation of multisectoral population-wide programmes to prevent mental and behavioural disorders, violence and injuries and hearing and visual impairment. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Mongolia Samoa Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 262 000 262 000 3 000 17 000 185 000 152 000 357 000 619 000 Voluntary contributions 549 000 549 000 418 000 294 000 294 000 0 1 006 000 1 555 000 Total 811 000 811 000 421 000 311 000 479 000 152 000 1 363 000 2 174 000

REGIONAL EXPECTED RESULT 03.006.WP01 Guidance and support provided to countries and areas to strengthen their health and social systems in order to prevent and manage chronic noncommunicable conditions, mental and behavioural disorders, violence and injuries and disabilities. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Lao People's Democratic Republic Malaysia Papua New Guinea Philippines Solomon Islands Tokelau Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 744 000 744 000 3 000 468 000 45 000 42 000 61 000 99 000 78 000 117 000 75 000 3 000 991 000 1 735 000 Voluntary contributions 1 547 000 1 547 000 276 000 1 324 000 0 306 000 0 545 000 447 000 0 0 0 2 898 000 4 445 000 Total 2 291 000 2 291 000 279 000 1 792 000 45 000 348 000 61 000 644 000 525 000 117 000 75 000 3 000 3 889 000 6 180 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 03.006.WP02 Guidance and support provided to countries and areas to strengthen health-system services for the management and treatment of tobacco dependence, including behavioural and pharmacological interventions. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Fiji Philippines Papua New Guinea Solomon Islands Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 40 000 40 000 36 000 19 000 5 000 10 000 10 000 80 000 120 000 Voluntary contributions 100 000 100 000 50 000 0 20 000 50 000 0 120 000 220 000 Total 140 000 140 000 86 000 19 000 25 000 60 000 10 000 200 000 340 000

SUMMARY STRATEGIC OBJECTIVE 3 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 2 615 000 3 570 000 6 185 000 Voluntary contributions 5 490 000 10 060 000 15 550 000 Total 8 105 000 13 630 000 21 735 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 4 To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. REGIONAL EXPECTED RESULT 04.001.WP01 Support to Member States to develop a comprehensive policy, plan and strategy for scaling up towards universal access to effective interventions in collaboration with other programmes, paying attention to gender inequality and gaps in health equity, providing a continuum of care throughout the life-course, integrating service delivery across different levels of the health system and strengthening coordination with civil society and the private sector. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Lao People's Democratic Republic Mongolia Philippines Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 142 000 142 000 39 000 95 000 10 000 12 000 4 000 2 000 34 000 196 000 338 000 Voluntary contributions 592 000 592 000 141 000 463 000 106 000 76 000 151 000 25 000 94 000 1 056 000 1 648 000 Total 734 000 734 000 180 000 558 000 116 000 88 000 155 000 27 000 128 000 1 252 000 1 986 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 04.002.WP01 National research capacity strengthened as necessary and new evidence, products, technologies, interventions and delivery approaches of global and/or national relevance available to improve maternal, newborn, child and adolescent health, to promote active and healthy ageing, and to improve sexual and reproductive health. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Brunei Darussalam Cambodia Mongolia Papua New Guinea Philippines Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 35 000 35 000 3 000 4 000 15 000 11 000 4 000 12 000 49 000 84 000 Voluntary contributions 148 000 148 000 0 96 000 16 000 129 000 19 000 4 000 264 000 412 000 Total 183 000 183 000 3 000 100 000 31 000 140 000 23 000 16 000 313 000 496 000

REGIONAL EXPECTED RESULT 04.003.WP01 Technical and policy support provided to Member States for implementing national plans of action for the reduction of maternal and newborn mortality by achieving universal coverage of skilled attendants on maternal and newborn care. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Cook Islands Fiji Lao People's Democratic Republic Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 454 000 454 000 36 000 134 000 70 000 13 000 7 000 26 000 27 000 11 000 16 000 150 000 70 000 2 000 66 000 628 000 1 082 000 Voluntary contributions 1 893 000 1 893 000 281 000 1 117 000 0 0 0 611 000 471 000 486 000 0 249 000 0 163 000 0 3 378 000 5 271 000 Total 2 347 000 2 347 000 317 000 1 251 000 70 000 13 000 7 000 637 000 498 000 497 000 16 000 399 000 70 000 165 000 66 000 4 006 000 6 353 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 04.004.WP01 Guidelines, approaches and tools for improving neonatal survival and health in use at country level, with technical support provided to Member States for intensified action towards the achievement of universal coverage along with effective interventions and progress monitoring. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Philippines Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 234 000 234 000 127 000 67 000 2 000 128 000 324 000 558 000 Voluntary contributions 976 000 976 000 528 000 637 000 46 000 531 000 1 742 000 2 718 000 Total 1 210 000 1 210 000 655 000 704 000 48 000 659 000 2 066 000 3 276 000

REGIONAL EXPECTED RESULT 04.005.WP01 Policy and technical support provided to Member States for intensified action towards agreed goals ensuring universal access, coverage and quality of key public health interventions for newborn and child survival. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Malaysia Micronesia, Federated States of Mongolia Papua New Guinea Philippines Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 454 000 454 000 161 000 155 000 29 000 8 000 5 000 0 6 000 57 000 6 000 17 000 40 000 139 000 1 000 4 000 628 000 1 082 000 Voluntary contributions 1 893 000 1 893 000 948 000 208 000 0 0 894 000 20 000 0 175 000 786 000 120 000 159 000 0 5 000 64 000 3 379 000 5 272 000 Total 2 347 000 2 347 000 1 109 000 363 000 29 000 8 000 899 000 20 000 6 000 232 000 792 000 137 000 199 000 139 000 6 000 68 000 4 007 000 6 354 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 04.006.WP01 Policy and technical support provided to Member States for coordinated implementation of evidence-based strategies, norms and standards for the prevention and care of diseases and health compromising behaviours in adolescents, as well the conditions that place adolescents at risk. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Lao People's Democratic Republic Micronesia, Federated States of Mongolia Papua New Guinea Philippines Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 277 000 277 000 67 000 183 000 26 000 6 000 40 000 38 000 6 000 3 000 14 000 383 000 660 000 Voluntary contributions 1 154 000 1 154 000 445 000 359 000 436 000 0 42 000 428 000 141 000 11 000 196 000 2 058 000 3 212 000 Total 1 431 000 1 431 000 512 000 542 000 462 000 6 000 82 000 466 000 147 000 14 000 210 000 2 441 000 3 872 000

REGIONAL EXPECTED RESULT 04.007.WP01 Technical support provided to Member States for accelerated action towards implementing the Global Reproductive Health Strategy and improving family planning and reproductive health care. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Mongolia Nauru Papua New Guinea Philippines Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 206 000 206 000 28 000 41 000 22 000 1 000 46 000 43 000 1 000 103 000 285 000 491 000 Voluntary contributions 858 000 858 000 0 252 000 307 000 0 556 000 333 000 82 000 0 1 530 000 2 388 000 Total 1 064 000 1 064 000 28 000 293 000 329 000 1 000 602 000 376 000 83 000 103 000 1 815 000 2 879 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

SUMMARY STRATEGIC OBJECTIVE 4 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 1 802 000 2 493 000 4 295 000 Voluntary contributions 7 514 000 13 407 000 20 921 000 Total 9 316 000 15 900 000 25 216 000

STRATEGIC OBJECTIVE 5 To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. REGIONAL EXPECTED RESULT 05.001.WP01 Norms and standards developed, capacity built and technical support provided to Member States for development and strengthening of national emergency preparedness plans and programmes. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 172 000 172 000 3 000 0 0 0 0 40 000 35 000 3 000 74 000 0 44 000 0 2 000 8 000 209 000 381 000 Voluntary contributions 1 249 000 1 249 000 0 85 000 3 000 10 000 11 000 0 292 000 336 000 143 000 5 000 195 000 5 000 18 000 779 000 1 882 000 3 131 000 Total 1 421 000 1 421 000 3 000 85 000 3 000 10 000 11 000 40 000 327 000 339 000 217 000 5 000 239 000 5 000 20 000 787 000 2 091 000 3 512 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 05.002.WP01 Norms and standards developed, capacity built and technical support provided to Member States for a timely response to disasters associated with natural and human-generated hazards. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Papua New Guinea Philippines Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 279 000 279 000 104 000 157 000 0 76 000 337 000 616 000 Voluntary contributions 2 022 000 2 022 000 11 000 708 000 2 298 000 29 000 3 046 000 5 068 000 Total 2 301 000 2 301 000 115 000 865 000 2 298 000 105 000 3 383 000 5 684 000

REGIONAL EXPECTED RESULT 05.003.WP01 Norms and standards developed, capacity built and technical support provided to Member States for assessing needs and for planning and implementing transition and recovery actions in post disasters and post conflict situations. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Philippines Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 172 000 172 000 137 000 0 72 000 209 000 381 000 Voluntary contributions 1 249 000 1 249 000 20 000 1 834 000 28 000 1 882 000 3 131 000 Total 1 421 000 1 421 000 157 000 1 834 000 100 000 2 091 000 3 512 000

REGIONAL EXPECTED RESULT 05.004.WP01 Coordinated technical support on communicable disease control in disasters resulting from natural and humangenerated hazards provided to Member States. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Papua New Guinea Philippines Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 82 000 82 000 52 000 47 000 0 99 000 181 000 Voluntary contributions 595 000 595 000 3 000 196 000 697 000 896 000 1 491 000 Total 677 000 677 000 55 000 243 000 697 000 995 000 1 672 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 05.005.WP01 Coordinated technical support provided to Member States on environmental health and food safety in disasters resulting from natural and human-generated hazards. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Papua New Guinea Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 40 000 40 000 21 000 19 000 9 000 49 000 89 000 Voluntary contributions 292 000 292 000 10 000 425 000 4 000 439 000 731 000 Total 332 000 332 000 31 000 444 000 13 000 488 000 820 000

REGIONAL EXPECTED RESULT 05.005.WP02 Support provided to Member States for strengthening national preparedness, alert and response to food safety and environmental health emergencies. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Philippines Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 17 000 17 000 21 000 0 21 000 38 000 Voluntary contributions 125 000 125 000 0 188 000 188 000 313 000 Total 142 000 142 000 21 000 188 000 209 000 351 000

REGIONAL EXPECTED RESULT 05.006.WP01 Effective communications issued, partnerships formed and coordination developed with other United Nations agencies, governments, local and international nongovernmental organizations, academic institutions and professional associations at country, regional and global levels. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Papua New Guinea Philippines Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 49 000 49 000 59 000 0 59 000 108 000 Voluntary contributions 354 000 354 000 131 000 402 000 533 000 887 000 Total 403 000 403 000 190 000 402 000 592 000 995 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 05.006.WP02 Effective communications in emergency and outbreak situations. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Papua New Guinea Philippines Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 9 000 9 000 10 000 0 10 000 19 000 Voluntary contributions 63 000 63 000 0 94 000 94 000 157 000 Total 72 000 72 000 10 000 94 000 104 000 176 000

SUMMARY STRATEGIC OBJECTIVE 5 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 820 000 993 000 1 813 000 Voluntary contributions 5 949 000 8 960 000 14 909 000 Total 6 769 000 9 953 000 16 722 000

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 6 To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. REGIONAL EXPECTED RESULT 06.001.WP01 Advice and support provided to countries and areas to strengthen their health promotion capacity across all relevant programmes, and to establish effective multisectoral and multidisciplinary mechanisms and collaborations to promote health and prevent and reduce the occurrence of major behavioural and structural risk factors. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Fiji Kiribati Lao People's Democratic Republic Malaysia Marshall Islands Mongolia Niue Papua New Guinea Philippines Tonga Tuvalu Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 665 000 665 000 410 000 40 000 91 000 18 000 40 000 32 000 42 000 63 000 16 000 14 000 54 000 6 000 4 000 85 000 915 000 1 580 000 Voluntary contributions 2 278 000 2 278 000 320 000 21 000 3 000 206 000 18 000 2 000 40 000 7 000 72 000 338 000 2 919 000 113 000 5 000 10 000 4 074 000 6 352 000 Total 2 943 000 2 943 000 730 000 61 000 94 000 224 000 58 000 34 000 82 000 70 000 88 000 352 000 2 973 000 119 000 9 000 95 000 4 989 000 7 932 000

REGIONAL EXPECTED RESULT 06.002.WP01 Guidance and support provided to strengthen national systems for major risk factor surveillance by developing, validating and disseminating programme and evaluation frameworks, tools and operating procedures to countries and areas with a high or increasing burden of premature death and disability attributable to major behavioural risk factors. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Fiji Marshall Islands Papua New Guinea Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 333 000 333 000 0 115 000 135 000 182 000 26 000 458 000 791 000 Voluntary contributions 1 138 000 1 138 000 767 000 6 000 2 000 1 224 000 38 000 2 037 000 3 175 000 Total 1 471 000 1 471 000 767 000 121 000 137 000 1 406 000 64 000 2 495 000 3 966 000

100

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 06.003.WP01 Technical assistance, training and advocacy support provided to countries and areas with a high and increasing burden to strengthen institutions in order to address/prevent public health problems associated with tobacco. Support provided to the Conference of the Parties to the WHO Framework Convention on Tobacco Control for implementation of the provisions of the Convention. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Cook Islands Fiji Lao People's Democratic Republic Marshall Islands Niue Philippines Samoa Tokelau Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 582 000 582 000 22 000 18 000 196 000 7 000 8 000 8 000 26 000 34 000 110 000 5 000 2 000 365 000 801 000 1 383 000 Voluntary contributions 1 993 000 1 993 000 415 000 1 409 000 0 0 508 000 0 32 000 976 000 105 000 0 3 000 117 000 3 565 000 5 558 000 Total 2 575 000 2 575 000 437 000 1 427 000 196 000 7 000 516 000 8 000 58 000 1 010 000 215 000 5 000 5 000 482 000 4 366 000 6 941 000

REGIONAL EXPECTED RESULT 06.004.WP01 Technical support provided to countries and areas with a high and increasing burden of major risk factors and disease in order to strengthen institutions for preventing public health problems associated with alcohol, drugs and other psychoactive substance use. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Mongolia Vanuatu Vietnam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 333 000 333 000 172 000 0 176 000 1 000 109 000 458 000 791 000 Voluntary contributions 1 138 000 1 138 000 848 000 514 000 114 000 0 561 000 2 037 000 3 175 000 Total 1 471 000 1 471 000 1 020 000 514 000 290 000 1 000 670 000 2 495 000 3 966 000

101

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 06.005.WP01 Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed and technical support provided to countries and areas with a high and increasing burden to strengthen institutions in order to address/prevent public health problems associated with unhealthy diets and physical inactivity. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Fiji Marshall Islands Micronesia, Federated States of Solomon Islands Tuvalu Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 333 000 333 000 0 83 000 19 000 29 000 70 000 10 000 3 000 243 000 457 000 790 000 Voluntary contributions 1 139 000 1 139 000 728 000 0 0 0 121 000 185 000 0 1 003 000 2 037 000 3 176 000 Total 1 472 000 1 472 000 728 000 83 000 19 000 29 000 191 000 195 000 3 000 1 246 000 2 494 000 3 966 000

REGIONAL EXPECTED RESULT 06.006.WP01 Evidence-based and ethical policies, strategies, interventions, recommendations, standards and guidelines developed, and technical support provided to countries and areas to promote protected sex and strengthen institutions in order to address and manage social and individual consequences of unsafe sex. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Vanuatu Vietnam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 416 000 416 000 131 000 441 000 0 572 000 988 000 Voluntary contributions 1 423 000 1 423 000 453 000 1 299 000 795 000 2 547 000 3 970 000 Total 1 839 000 1 839 000 584 000 1 740 000 795 000 3 119 000 4 958 000

SUMMARY STRATEGIC OBJECTIVE 6 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 2 662 000 3 661 000 6 323 000 Voluntary contributions 9 109 000 16 297 000 25 406 000 Total 11 771 000 19 958 000 31 729 000

102

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 7 To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches. REGIONAL EXPECTED RESULT 07.001.WP01 Support provided to strengthen the capacity of the Organization and Member States to reduce health inequities, address socioeconomic determinants of health and promote more equitable and pro-poor policies, programmes and interventions. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Malaysia Philippines Vanuatu Vietnam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 9 000 9 000 2 000 7 000 0 6 000 1 000 0 16 000 25 000 Voluntary contributions 220 000 220 000 42 000 40 000 237 000 0 19 000 41 000 379 000 599 000 Total 229 000 229 000 44 000 47 000 237 000 6 000 20 000 41 000 395 000 624 000

REGIONAL EXPECTED RESULT 07.002.WP01 Opportunities created and mechanisms used to facilitate action across sectors to reduce health inequities and address the socioeconomic determinants of health. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Papua New Guinea Vietnam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 4 000 4 000 6 000 0 6 000 10 000 Voluntary contributions 87 000 87 000 0 150 000 150 000 237 000 Total 91 000 91 000 6 000 150 000 156 000 247 000

103

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 07.002.WP02 Opportunities created and mechanisms used to facilitate action across sectors to address the socioeconomic determinants of health in specific settings (e.g. urban setting). 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Papua New Guinea Tonga Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 2 000 2 000 3 000 0 3 000 5 000 Voluntary contributions 45 000 45 000 0 77 000 77 000 122 000 Total 47 000 47 000 3 000 77 000 80 000 127 000

REGIONAL EXPECTED RESULT 07.003.WP01 Support provided to strengthen country capacity to collect, analyse and use information on health and social determinants that is disaggregated by various relevant indicators of social exclusion, such as sex, age, ethnicity, income, or location. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Malaysia Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 5 000 5 000 6 000 4 000 10 000 15 000 Voluntary contributions 131 000 131 000 227 000 1 000 228 000 359 000 Total 136 000 136 000 233 000 5 000 238 000 374 000

REGIONAL EXPECTED RESULT 07.004.WP01 Support provided to strengthen the capacity of the Organization and Member States to promote ethical human-rights based approaches to health. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 7 000 7 000 3 000 10 000 13 000 20 000 Voluntary contributions 176 000 176 000 0 303 000 303 000 479 000 Total 183 000 183 000 3 000 313 000 316 000 499 000

104

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 07.005.WP01 Support provided to strengthen the capacity of the Organization and Member States to promote more genderresponsive health policies, programmes and interventions. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Malaysia Mongolia Samoa Solomon Islands Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 5 000 5 000 1 000 0 0 0 1 000 3 000 1 000 0 1 000 1 000 8 000 13 000 Voluntary contributions 109 000 109 000 0 5 000 5 000 5 000 0 170 000 0 5 000 0 0 190 000 299 000 Total 114 000 114 000 1 000 5 000 5 000 5 000 1 000 173 000 1 000 5 000 1 000 1 000 198 000 312 000

REGIONAL EXPECTED RESULT 07.005.WP02 Support provided to build capacity of Member States to implement the Strategy For Integrating Gender Analysis and Actions into the Work of WHO, including support for Member States to mainstream gender and rights into reproductive, women, maternal and child health. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Mongolia Solomon Islands Vanuatu Vietnam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 5 000 5 000 2 000 1 000 2 000 1 000 2 000 0 8 000 13 000 Voluntary contributions 110 000 110 000 1 000 1 000 45 000 25 000 2 000 116 000 190 000 300 000 Total 115 000 115 000 3 000 2 000 47 000 26 000 4 000 116 000 198 000 313 000

105

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

SUMMARY STRATEGIC OBJECTIVE 7 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 37 000 64 000 101 000 Voluntary contributions 878 000 1 517 000 2 395 000 Total 915 000 1 581 000 2 496 000

STRATEGIC OBJECTIVE 8 To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. REGIONAL EXPECTED RESULT 08.001.WP01 Evidence-based assessments made, and norms and guidance formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic force, radon, drinking water, waste water reuse); technical support provided for the implementation of international environmental agreements and for monitoring MDG 8. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 137 000 137 000 11 000 71 000 15 000 9 000 5 000 31 000 5 000 11 000 21 000 179 000 316 000 Voluntary contributions 337 000 337 000 227 000 116 000 94 000 114 000 0 3 000 23 000 3 000 3 000 583 000 920 000 Total 474 000 474 000 238 000 187 000 109 000 123 000 5 000 34 000 28 000 14 000 24 000 762 000 1 236 000

106

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 08.002.WP01 Technical support and guidance provided to countries and areas for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings and among vulnerable population groups. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Kiribati Lao People's Democratic Republic Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tuvalu Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 410 000 410 000 18 000 57 000 31 000 132 000 20 000 28 000 190 000 18 000 22 000 4 000 19 000 539 000 949 000 Voluntary contributions 1 012 000 1 012 000 1 340 000 0 172 000 4 000 31 000 3 000 0 195 000 0 0 4 000 1 749 000 2 761 000 Total 1 422 000 1 422 000 1 358 000 57 000 203 000 136 000 51 000 31 000 190 000 213 000 22 000 4 000 23 000 2 288 000 3 710 000

REGIONAL EXPECTED RESULT 08.003.WP01 Technical assistance and support to Member States for strengthening occupational and environmental health policymaking, planning of preventive interventions, service delivery and surveillance. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Lao People's Democratic Republic Malaysia Papua New Guinea Philippines Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 410 000 410 000 12 000 322 000 51 000 26 000 57 000 10 000 49 000 3 000 8 000 538 000 948 000 Voluntary contributions 1 012 000 1 012 000 608 000 818 000 92 000 176 000 0 47 000 3 000 0 5 000 1 749 000 2 761 000 Total 1 422 000 1 422 000 620 000 1 140 000 143 000 202 000 57 000 57 000 52 000 3 000 13 000 2 287 000 3 709 000

107

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 08.004.WP01 Guidance, tools, and initiatives created in order to support the health sector to influence policies in priority sectors, assess health impacts, determine costs and benefits of policy alternatives in those sectors, and select investments in non-health sectors that improve health, environment and safety. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Mongolia Philippines Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 273 000 273 000 0 133 000 64 000 162 000 359 000 632 000 Voluntary contributions 675 000 675 000 450 000 199 000 93 000 424 000 1 166 000 1 841 000 Total 948 000 948 000 450 000 332 000 157 000 586 000 1 525 000 2 473 000

REGIONAL EXPECTED RESULT 08.005.WP01 Health-sector leadership enhanced for creating a healthier environment and changing policies in all sectors in order to tackle the root causes of environmental threats to health, through means such as responding to emerging and reemerging consequences of development on environmental health, climate change, and altered patterns of consumption and production and to the damaging effect of evolving technologies. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Micronesia, Federated States of Nauru Papua New Guinea Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 137 000 137 000 18 000 11 000 62 000 76 000 12 000 179 000 316 000 Voluntary contributions 337 000 337 000 449 000 117 000 0 0 17 000 583 000 920 000 Total 474 000 474 000 467 000 128 000 62 000 76 000 29 000 762 000 1 236 000

SUMMARY STRATEGIC OBJECTIVE 8 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 1 367 000 1 794 000 3 161 000 Voluntary contributions 3 373 000 5 830 000 9 203 000 Total 4 740 000 7 624 000 12 364 000

108

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 9 To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. REGIONAL EXPECTED RESULT 09.001.WP01 Partnerships formed and advocacy and support provided to countries to increase political, financial and technical commitment to address nutrition, food safety and food security through intersectoral action. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Kiribati Lao People's Democratic Republic Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 248 000 248 000 115 000 0 108 000 2 000 117 000 342 000 590 000 Voluntary contributions 1 175 000 1 175 000 1 091 000 10 000 22 000 0 967 000 2 090 000 3 265 000 Total 1 423 000 1 423 000 1 206 000 10 000 130 000 2 000 1 084 000 2 432 000 3 855 000

REGIONAL EXPECTED RESULT 09.002.WP01 Evidence-based norms, assessments and guidance developed, adapted where appropriate and disseminated, to enable countries and areas to implement cost effective interventions responding to all forms of malnutrition and foodborne diseases, and to promote healthy dietary practices in the Western Pacific. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Papua New Guinea Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 185 000 185 000 106 000 69 000 2 000 80 000 257 000 442 000 Voluntary contributions 881 000 881 000 784 000 5 000 3 000 776 000 1 568 000 2 449 000 Total 1 066 000 1 066 000 890 000 74 000 5 000 856 000 1 825 000 2 891 000

109

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 09.003.WP01 Improved capacity in countries and areas to collect, analyse, disseminate and use data on the magnitude, causes and consequences of under-nutrition and over-nutrition, inappropriate diets and physical inactivity. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Papua New Guinea Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 123 000 123 000 99 000 4 000 1 000 67 000 171 000 294 000 Voluntary contributions 588 000 588 000 1 040 000 5 000 0 0 1 045 000 1 633 000 Total 711 000 711 000 1 139 000 9 000 1 000 67 000 1 216 000 1 927 000

REGIONAL EXPECTED RESULT 09.004.WP01 Capacity built and support provided to target Member States for the development, strengthening and implementation of nutrition plans, policies and programmes aimed at improving nutrition throughout the life-course, in stable as well as humanitarian crisis situations. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Cook Islands Malaysia Marshall Islands Micronesia, Federated States of Niue Papua New Guinea Philippines Samoa Solomon Islands Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 309 000 309 000 169 000 94 000 30 000 9 000 3 000 5 000 1 000 1 000 21 000 86 000 7 000 1 000 1 000 428 000 737 000 Voluntary contributions 1 469 000 1 469 000 1 647 000 492 000 0 10 000 0 0 26 000 5 000 398 000 0 22 000 12 000 0 2 612 000 4 081 000 Total 1 778 000 1 778 000 1 816 000 586 000 30 000 19 000 3 000 5 000 27 000 6 000 419 000 86 000 29 000 13 000 1 000 3 040 000 4 818 000

110

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 09.005.WP01 Foodborne disease surveillance and food contamination monitoring programmes strengthened regionally and in targeted countries and areas. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Fiji Lao People's Democratic Republic Mongolia Papua New Guinea Philippines Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 124 000 124 000 10 000 33 000 23 000 49 000 16 000 2 000 38 000 171 000 295 000 Voluntary contributions 587 000 587 000 5 000 23 000 10 000 5 000 209 000 5 000 788 000 1 045 000 1 632 000 Total 711 000 711 000 15 000 56 000 33 000 54 000 225 000 7 000 826 000 1 216 000 1 927 000

REGIONAL EXPECTED RESULT 09.006.WP01 National capacity built to enable food control systems to: be based on risk-analysis principles, implement effective food safety education and to operate food safety emergency response systems with links to international systems. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Fiji Lao People's Democratic Republic Malaysia Mongolia Philippines Samoa Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 247 000 247 000 22 000 4 000 62 000 50 000 36 000 85 000 5 000 78 000 342 000 589 000 Voluntary contributions 1 176 000 1 176 000 5 000 32 000 10 000 10 000 229 000 20 000 0 1 784 000 2 090 000 3 266 000 Total 1 423 000 1 423 000 27 000 36 000 72 000 60 000 265 000 105 000 5 000 1 862 000 2 432 000 3 855 000

SUMMARY STRATEGIC OBJECTIVE 9 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 1 236 000 1 711 000 2 947 000 Voluntary contributions 5 876 000 10 450 000 16 326 000 Total 7 112 000 12 161 000 19 273 000

111

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 10 To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. REGIONAL EXPECTED RESULT 10.001.WP01 Improved management and organization of health service delivery, through both public and non-public providers and networks, reflecting the principles of integrated primary health care with increased coverage, equity, and quality of health services leading to better health outcomes. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Samoa Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 652 000 652 000 442 000 83 000 18 000 43 000 49 000 48 000 36 000 56 000 4 000 163 000 942 000 1 594 000 Voluntary contributions 1 096 000 1 096 000 774 000 113 000 25 000 804 000 92 000 56 000 0 126 000 2 000 200 000 2 192 000 3 288 000 Total 1 748 000 1 748 000 1 216 000 196 000 43 000 847 000 141 000 104 000 36 000 182 000 6 000 363 000 3 134 000 4 882 000

REGIONAL EXPECTED RESULT 10.002.WP01 Improved national capacities and practices for governing, steering, and regulating the health sector through (i) evidence-based policy dialogue, (ii) policy analysis, (iii) greater transparency and accountability for performance, and (iv) more effective intersectoral collaboration. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Fiji Korea, Republic of Lao People's Democratic Republic Malaysia Papua New Guinea Philippines Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 1 048 000 1 048 000 528 000 44 000 45 000 62 000 261 000 75 000 80 000 418 000 1 513 000 2 561 000 Voluntary contributions 1 759 000 1 759 000 800 000 0 0 235 000 905 000 159 000 102 000 1 319 000 3 520 000 5 279 000 Total 2 807 000 2 807 000 1 328 000 44 000 45 000 297 000 1 166 000 234 000 182 000 1 737 000 5 033 000 7 840 000

112

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 10.003.WP01 Improved coordination of the various mechanisms (including donor assistance) that support Member States in their efforts to achieve national targets for health system development and global health goals. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Lao People's Democratic Republic Mongolia Papua New Guinea Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 244 000 244 000 22 000 143 000 23 000 25 000 25 000 5 000 109 000 352 000 596 000 Voluntary contributions 409 000 409 000 70 000 124 000 220 000 91 000 13 000 1 000 300 000 819 000 1 228 000 Total 653 000 653 000 92 000 267 000 243 000 116 000 38 000 6 000 409 000 1 171 000 1 824 000

REGIONAL EXPECTED RESULT 10.004.WP01 Contribute to strengthened country health information systems that provide and use high quality and timely information for health planning and for monitoring of country and major international goals. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Kiribati Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Samoa Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 527 000 527 000 1 000 425 000 38 000 16 000 2 000 1 000 2 000 13 000 260 000 1 000 2 000 761 000 1 288 000 Voluntary contributions 885 000 885 000 0 0 1 000 0 235 000 0 0 0 0 23 000 1 513 000 1 772 000 2 657 000 Total 1 412 000 1 412 000 1 000 425 000 39 000 16 000 237 000 1 000 2 000 13 000 260 000 24 000 1 515 000 2 533 000 3 945 000

113

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 10.005.WP01 Contribute to better knowledge and evidence for health decision-making, by consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas and leadership in health research policy and coordination, including ensuring ethical conduct. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Fiji Malaysia Micronesia, Federated States of Philippines Solomon Islands Vanuatu Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 264 000 264 000 223 000 17 000 64 000 8 000 44 000 23 000 1 000 380 000 644 000 Voluntary contributions 443 000 443 000 0 0 773 000 0 0 0 112 000 885 000 1 328 000 Total 707 000 707 000 223 000 17 000 837 000 8 000 44 000 23 000 113 000 1 265 000 1 972 000

REGIONAL EXPECTED RESULT 10.006.WP01 Strengthened national health research for health systems development, within the context of regional and international research and engagement of civil society. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Malaysia Mongolia Papua New Guinea Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 430 000 430 000 194 000 79 000 62 000 113 000 1 000 171 000 620 000 1 050 000 Voluntary contributions 722 000 722 000 0 242 000 0 0 119 000 1 082 000 1 443 000 2 165 000 Total 1 152 000 1 152 000 194 000 321 000 62 000 113 000 120 000 1 253 000 2 063 000 3 215 000

114

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 10.007.WP01 Improved use of e-health applications (such as electronic medical records and distance learning) and networking including the network of WHO collaborating centres - to strengthen health systems. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 65 000 65 000 13 000 81 000 94 000 159 000 Voluntary contributions 110 000 110 000 1 000 218 000 219 000 329 000 Total 175 000 175 000 14 000 299 000 313 000 488 000

REGIONAL EXPECTED RESULT 10.007.WP02 Implementation of knowledge management strategy, including improved access to health information via portals such as the Global Health Library, Regional Index Medicus, and HINARI. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Vanuatu Viet Nam Countries and Areas subtotal Total - Regional and countries and areas Assessed contributions 34 000 34 000 10 000 39 000 49 000 83 000 Voluntary contributions 56 000 56 000 20 000 93 000 113 000 169 000 Total 90 000 90 000 30 000 132 000 162 000 252 000

REGIONAL EXPECTED RESULT 10.008.WP01 Support provided to strengthen health workforce information, knowledge base and the capacity of countries and areas for policy development and planning, and the enhancement of research, networking and information sharing. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal China Malaysia Mongolia Papua New Guinea Singapore Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 751 000 751 000 471 000 42 000 366 000 131 000 45 000 4 000 26 000 1 085 000 1 836 000 Voluntary contributions 1 261 000 1 261 000 25 000 577 000 357 000 1 345 000 0 4 000 216 000 2 524 000 3 785 000 Total 2 012 000 2 012 000 496 000 619 000 723 000 1 476 000 45 000 8 000 242 000 3 609 000 5 621 000

115

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 10.009.WP01 Technical support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal American Samoa Cambodia China Cook Islands Fiji Guam Japan Lao People's Democratic Republic Macao (China) Marshall Islands Micronesia, Federated States of Nauru Niue Northern Mariana Islands, Commonwealth of the Palau Papua New Guinea Philippines Samoa Solomon Islands Tokelau Tonga Tuvalu Vanuatu Vietnam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 1 028 000 1 028 000 84 000 6 000 147 000 114 000 74 000 45 000 35 000 13 000 45 000 79 000 63 000 16 000 21 000 45 000 135 000 0 112 000 142 000 87 000 29 000 143 000 48 000 1 000 0 1 484 000 2 512 000 Voluntary contributions 1 726 000 1 726 000 0 10 000 25 000 0 0 0 0 502 000 0 0 0 0 0 0 0 2 011 000 123 000 0 0 0 22 000 0 0 761 000 3 454 000 5 180 000 Total 2 754 000 2 754 000 84 000 16 000 172 000 114 000 74 000 45 000 35 000 515 000 45 000 79 000 63 000 16 000 21 000 45 000 135 000 2 011 000 235 000 142 000 87 000 29 000 165 000 48 000 1 000 761 000 4 938 000 7 692 000

116

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 10.010.WP01 Technical support provided to improve health system financing in terms of the availability of funds, social and financial risk protection, equity, access to services and efficiency of resource use. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Mongolia Papua New Guinea Philippines Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 416 000 416 000 7 000 102 000 46 000 221 000 36 000 35 000 2 000 152 000 601 000 1 017 000 Voluntary contributions 698 000 698 000 262 000 616 000 0 0 0 0 0 519 000 1 397 000 2 095 000 Total 1 114 000 1 114 000 269 000 718 000 46 000 221 000 36 000 35 000 2 000 671 000 1 998 000 3 112 000

REGIONAL EXPECTED RESULT 10.011.WP01 Norms, standards and measurement tools are used for tracking resources and estimating economic consequences of illness, cost and effects of interventions, financial catastrophe and impoverishment, and social exclusion. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia Lao People's Democratic Republic Micronesia, Federated States of Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 297 000 297 000 3 000 38 000 16 000 374 000 431 000 728 000 Voluntary contributions 501 000 501 000 40 000 154 000 0 808 000 1 002 000 1 503 000 Total 798 000 798 000 43 000 192 000 16 000 1 182 000 1 433 000 2 231 000

117

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 10.012.WP01 Health financing data, information and evidence are used for developing, implementing and monitoring health financing policies and strategies. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Micronesia, Federated States of Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 472 000 472 000 3 000 647 000 21 000 3 000 2 000 6 000 682 000 1 154 000 Voluntary contributions 793 000 793 000 60 000 10 000 0 0 105 000 1 411 000 1 586 000 2 379 000 Total 1 265 000 1 265 000 63 000 657 000 21 000 3 000 107 000 1 417 000 2 268 000 3 533 000

SUMMARY STRATEGIC OBJECTIVE 10 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 6 228 000 8 994 000 15 222 000 Voluntary contributions 10 459 000 20 926 000 31 385 000 Total 16 687 000 29 920 000 46 607 000

118

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 11 To ensure improved access, quality and use of medical products and technologies. REGIONAL EXPECTED RESULT 11.001.WP01 Support provided to countries and areas to develop, monitor or revise a comprehensive policies on access, quality and use of essential medical products and technologies. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 592 000 592 000 6 000 178 000 33 000 138 000 12 000 7 000 53 000 223 000 35 000 0 3 000 7 000 695 000 1 287 000 Voluntary contributions 1 471 000 1 471 000 478 000 412 000 0 47 000 75 000 16 000 238 000 0 263 000 10 000 0 697 000 2 236 000 3 707 000 Total 2 063 000 2 063 000 484 000 590 000 33 000 185 000 87 000 23 000 291 000 223 000 298 000 10 000 3 000 704 000 2 931 000 4 994 000

119

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 11.002.WP01 Support provided to countries and areas to implement internationally accepted norms, standards and guidelines for the quality, safety, efficacy and cost effectiveness, and to strengthen the national regulatory system and quality assurance of medical products and technologies. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Kiribati Malaysia Mongolia Papua New Guinea Philippines Solomon Islands Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 237 000 237 000 5 000 118 000 33 000 3 000 32 000 56 000 16 000 5 000 3 000 7 000 278 000 515 000 Voluntary contributions 589 000 589 000 192 000 164 000 34 000 7 000 91 000 0 113 000 0 0 293 000 894 000 1 483 000 Total 826 000 826 000 197 000 282 000 67 000 10 000 123 000 56 000 129 000 5 000 3 000 300 000 1 172 000 1 998 000

120

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 11.003.WP01 Support provided to countries and areas to promote evidence-based, scientifically sound and cost-effective use of medical products and technologies by health workers and consumers. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Malaysia Papua New Guinea Philippines Solomon Islands Tuvalu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 355 000 355 000 4 000 214 000 15 000 13 000 125 000 28 000 9 000 3 000 6 000 417 000 772 000 Voluntary contributions 883 000 883 000 287 000 247 000 0 10 000 0 158 000 0 0 640 000 1 342 000 2 225 000 Total 1 238 000 1 238 000 291 000 461 000 15 000 23 000 125 000 186 000 9 000 3 000 646 000 1 759 000 2 997 000

SUMMARY STRATEGIC OBJECTIVE 11 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 1 184 000 1 390 000 2 574 000 Voluntary contributions 2 943 000 4 472 000 7 415 000 Total 4 127 000 5 862 000 9 989 000

121

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 12.002.WP01 WHO country presence is effectively led at the country level, harmonized with other development partners and guided by WHO Country Cooperation Strategies that support the national health agendas of Member States in the context of the 11th General Programme of Work. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Korea, Republic of Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 120 000 120 000 558 000 559 000 649 000 39 000 0 25 000 127 000 543 000 572 000 547 000 557 000 384 000 385 000 426 000 568 000 5 939 000 6 059 000 Voluntary contributions 2 257 000 2 257 000 203 000 210 000 182 000 182 000 15 000 527 000 542 000 15 000 24 000 111 000 189 000 11 000 11 000 0 270 000 2 492 000 4 749 000 Total 2 377 000 2 377 000 761 000 769 000 831 000 221 000 15 000 552 000 669 000 558 000 596 000 658 000 746 000 395 000 396 000 426 000 838 000 8 431 000 10 808 000

122

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 12.003.WP01 Global and regional health development architecture effectively providing more sustained and predicable technical and financial resources for health based on a common health agenda which responds to the health needs and priorities of Member States in the Region. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 157 000 157 000 0 0 0 0 0 0 0 0 13 000 0 0 0 23 000 36 000 193 000 Voluntary contributions 335 000 335 000 1 000 3 000 2 000 1 000 1 000 2 000 1 000 1 000 1 000 15 000 1 000 1 000 5 000 35 000 370 000 Total 492 000 492 000 1 000 3 000 2 000 1 000 1 000 2 000 1000 1 000 14 000 15 000 1 000 1 000 28 000 71 000 563 000

REGIONAL EXPECTED RESULT 12.003.WP02 Support is given to the development of trade agreements of countries and areas that reflect public health interests, as outlined in WHO guidance. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Malaysia Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 40 000 40 000 0 0 40 000 Voluntary contributions 5 000 5 000 15 000 15 000 20 000 Total 45 000 45 000 15 000 15 000 60 000

123

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 12.004.WP01 Essential multilingual health knowledge and advocacy material made accessible to Member States, regional health partners and other stakeholders in the Region through effective exchange and sharing of knowledge. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 291 000 291 000 0 291 000 Voluntary contributions 456 000 456 000 0 456 000 Total 747 000 747 000 0 747 000

SUMMARY STRATEGIC OBJECTIVE 12 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 2 493 000 5 975 000 8 468 000 Voluntary contributions 4 626 000 2 542 000 7 168 000 Total 7 119 000 8 517 000 15 636 000

124

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

STRATEGIC OBJECTIVE 13 To develop and sustain WHO as a flexible, learning Organization, enabling it to carry out its mandate more efficiently and effectively. REGIONAL EXPECTED RESULT 13.001.WP01 Work towards achievement of WHO strategic objectives in the Region is supported by effective programme planning and development, reflecting country needs, and including strategic and operational planning through a results-based approach, performance monitoring and evaluation. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Korea, Republic of Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 547 000 547 000 92 000 109 000 424 000 33 000 0 212 000 119 000 57 000 120 000 46 000 56 000 7 000 2 000 19 000 67 000 1 363 000 1 910 000 Voluntary contributions 1 227 000 1 227 000 77 000 342 000 50 000 29 000 1 000 77 000 22 000 66 000 59 000 68 000 28 000 85 000 21 000 29 000 383 000 1 337 000 2 564 000 Total 1 774 000 1 774 000 169 000 451 000 474 000 62 000 1 000 289 000 141 000 123 000 179 000 114 000 84 000 92 000 23 000 48 000 450 000 2 700 000 4 474 000

REGIONAL EXPECTED RESULT 13.001.WP02 Support for roll-out, implementation and further development of the Global Management System (GSM) for implementation, monitoring and evaluation of WHO's collaborative programmes in the Region through the Programme Budget. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Papua New Guinea Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 942 000 942 000 314 000 56 000 828 000 1 198 000 2 140 000 Voluntary contributions 1 101 000 1 101 000 0 0 0 0 1 101 000 Total 2 043 000 2 043 000 314 000 56 000 828 000 1 198 000 3 241 000

125

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 13.002.WP01 Sound financial practices and efficient management of financial resources is facilitated in the Region through timely and accurate guidance and the provision of relevant management reports. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Korea, Republic of Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 806 000 806 000 13 000 207 000 182 000 2 000 0 245 000 1 000 16 000 7 000 10 000 2 000 3 000 2 000 7 000 16 000 713 000 1 519 000 Voluntary contributions 1 567 000 1 567 000 26 000 3 000 10 000 13 000 1 000 38 000 10 000 22 000 20 000 17 000 21 000 11 000 7 000 9 000 76 000 284 000 1 851 000 Total 2 373 000 2 373 000 39 000 210 000 192 000 15 000 1 000 283 000 11 000 38 000 27 000 27 000 23 000 14 000 9 000 16 000 92 000 997 000 3 370 000

126

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 13.003.WP01 Human resources policies and practices in place to attract and retain top talent, promote learning and professional development, manage performance and foster ethical behaviour. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Korea, Republic of Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 13 000 13 000 3 000 4 000 4 000 1 000 0 2 000 2 000 3 000 3 000 2 000 2 000 2 000 1 000 1 000 18 000 48 000 61 000 Voluntary contributions 36 000 36 000 6 000 9 000 8 000 2 000 5 000 5 000 2 000 2 000 0 2 000 3 000 0 0 0 3 000 47 000 83 000 Total 49 000 49 000 9 000 13 000 12 000 3 000 5 000 7 000 4 000 5 000 3 000 4 000 5 000 2 000 1 000 1 000 21 000 95 000 144 000

127

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 13.004.WP01 Country-level ongoing support and development of secure and cost-effective solutions that meet the changing needs of the Organization. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Korea, Republic of Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 1 037 000 1 037 000 32 000 211 000 41 000 11 000 0 23 000 17 000 25 000 26 000 28 000 17 000 5 000 2 000 12 000 2 000 452 000 1 489 000 Voluntary contributions 2 097 000 2 097 000 140 000 83 000 71 000 16 000 5 000 15 000 6 000 7 000 1 000 9 000 28 000 20 000 6 000 4 000 32 000 443,000 2 540 000 Total 3 134 000 3 134 000 172 000 294 000 112 000 27 000 5 000 38 000 23 000 32 000 27 000 37 000 45 000 25 000 8 000 16 000 34 000 895,000 4 029 000

REGIONAL EXPECTED RESULT 13.004.WP02 Development of secure and cost-effective solutions that meets the changing needs of the Organization. Ongoing support to regional, country, and global information systems and their users. Information products and their effective use is supported within a Knowledge Management System (KMS). 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Samoa Vietnam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 289 000 289 000 1 000 1 000 2 000 291 000 Voluntary contributions 157 000 157 000 0 0 0 157 000 Total 446 000 446 000 1 000 1 000 2 000 448 000

128

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 13.005.WP01 Provision of management and administrative support at both regional and country level through service level agreements (SLAs). 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Korea, Republic of Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 3 235 000 3 235 000 379 000 343 000 221 000 2 000 0 91 000 122 000 120 000 162 000 62 000 94 000 16 000 34 000 4 000 137 000 1 787 000 5 022 000 Voluntary contributions 4 589 000 4 589 000 29 000 806 000 84 000 45 000 402 000 15 000 15 000 2 000 81 000 2 000 37 000 5 000 28 000 4 000 188 000 1 743 000 6 332 000 Total 7 824 000 7 824 000 408 000 1 149 000 305 000 47 000 402 000 106 000 137 000 122 000 243 000 64 000 131 000 21 000 62 000 8 000 325 000 3 530 000 11 354 000

129

2008–2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

REGIONAL EXPECTED RESULT 13.006.WP01 A safe environment in the Regional Office and country offices for all staff. 2008–2009 costs Budget centres Regional and intercountry RO/ICP subtotal Cambodia China Fiji Kiribati Korea, Republic of Lao People's Democratic Republic Malaysia Mongolia Papua New Guinea Philippines Samoa Solomon Islands Tonga Vanuatu Viet Nam Countries and areas subtotal Total - Regional and countries and areas Assessed contributions 1 426 000 1 426 000 153 000 215 000 84 000 6 000 0 68 000 78 000 3 000 64 000 50 000 18 000 52 000 21 000 23 000 97 000 932 000 2 358 000 Voluntary contributions 2 882 000 2 882 000 15 000 412 000 204 000 32 000 5 000 24 000 20 000 54 000 0 12 000 36 000 1 000 26 000 39 000 34 000 914 000 3 796 000 Total 4 308 000 4 308 000 168 000 627 000 288 000 38 000 5 000 92 000 98 000 57 000 64 000 62 000 54 000 53 000 47 000 62 000 131 000 1 846 000 6 154 000

SUMMARY STRATEGIC OBJECTIVE 13 2008–2009 costs Organizational level Regional and intercountry Countries and areas Total Assessed contributions 8 295 000 6 495 000 14 790 000 Voluntary contributions 13 656 000 4 768 000 18 424 000 Total 21 951 000 11 263 000 33 214 000

OVERALL SUMMARY OF STRATEGIC OBJECTIVES 2008–2009 costs Organizational level Regional and intercountry Countries and areas Grand Total Assessed contributions 34 782 000 45 377 000 80 159 000 Voluntary contributions 105 912 000 161 767 000 267 679 000 Total 140 694 000 207 144 000 347 838 000

130

COUNTRIES AND AREAS

2008–2009 PROGRAMME BUDGET BY COUNTRIES AND AREAS The Western Pacific Region, one of the six regions of the World Health Organization, is home to approximately 1.7 billion people, nearly one third of the world's population. It stretches over a vast area, from China in the north and west, to New Zealand in the south, and French Polynesia in the east. One of the most diverse of the WHO regions, the Western Pacific constitutes some of the world's least developed countries and areas as well as the most rapidly emerging economies. There are 37 countries and areas in the Western Pacific Region, 31 of which will receive WHO-funded technical cooperation in 2008–2009. Of the remaining six, two are overseas territories—Pitcairn Islands (United Kingdom); and Wallis and Futuna (France) and four have foregone WHO funding for 2008–2009—Australia, Hong Kong (China), New Caledonia and New Zealand. Country and area overviews of expected WHO technical cooperation in 2008–2009 are provided in the following pages. The costs of WHO's presence in countries that were included as part of the Regional Office budget in previous bienniums are now shown under strategic objectives 12 and 13 for each country hosting a WHO country office.

131

2008–2009 PROGRAMME BUDGET – AMERICAN SAMOA

AMERICAN SAMOA American Samoa lies roughly on a line between Hawaii and New Zealand, about 1430 km from Honolulu and 990 km from Auckland. The independent state of Samoa lies about 80 km to the west. American Samoa is a territory of the United States of America, and its population (65 500) is predominantly native Samoans who are United States nationals. The territory is comprised of the main island of Tutuila and its small neighbouring island of Aunu'u, the three islands of the Manu'a group, Swain's Island, and uninhabited Rose Atoll. WHO programmes of technical cooperation are managed through the country office in Apia, which is responsible for American Samoa, Cook Islands, Niue, Samoa, and Tokelau. Technical cooperation between the Government and WHO focuses mainly on human resources development (fellowships), noncommunicable diseases and health promotion. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 84 000 Voluntary contributions 0 Total

SO10

84 000

132

2008–2009 PROGRAMME BUDGET – BRUNEI DARUSSALAM

BRUNEI DARUSSALAM Brunei Darussalam is situated in north-west Borneo with an estimated population of 359 700, around 32% below 15 years of age and around 2.3% above 65 years of age. Brunei Darussalam is an independent sovereign Sultanate. This small, wealthy economy encompasses a mixture of foreign and domestic entrepreneurship, government regulation, welfare measures, and village tradition. Crude oil and natural gas production account for nearly half of the gross domestic product (GDP). Per capita GDP is far above most other developing countries and areas (US$ 15 241 in 2004), and substantial income from overseas investment supplements income from domestic production. The Government provides for all medical services and subsidizes rice and housing. Brunei Darussalam has a record in being almost entirely free of major communicable diseases. The leading causes of mortality in 2004 were: cancer; heart disease; diabetes mellitus; cerebrovascular disease; and bronchitis, chronic and unspecified emphysema and asthma. The most common type of heart disease is ischaemic heart disease while the common types of cancers are trachea, lung and bronchus; colon and rectum; and stomach. WHO collaborative programmes are managed by a country office located in Kuala Lumpur which also covers Malaysia and Singapore. Currently, the WHO country programme for Brunei Darussalam is very small. Technical collaboration in selective priority areas is provided through WHO intercountry programmes. In recent years the collaboration mainly focuses on training and development of infant and child feeding, epidemiological research of noncommunicable diseases including diabetes. However, communicable diseases are still the concerns of the Government. Although Brunei Darussalam is a wealthy country and has achieved good health status, due to its small size and lack of human resources, the core capacity in health has to be further developed. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. Country/area programmes total Assessed contributions 42 000 Voluntary contributions 0 Total

SO3

42 000

SO4

3 000

45 000

133

CAMBODIA – 2008–2009 PROGRAMME BUDGET

CAMBODIA Cambodia is one of the poorest countries and areas in South-East Asia with a population of around 14 million people, of which 85% live in rural areas. Agriculture accounts for 40% of the gross domestic product (GDP) and employs more than 70% of the workforce. Recovery from 30 years of conflict is reflected in GDP growth of close to 10% during recent years and its graduation from the low to medium human development category. Communicable diseases are predominant, but the burden from noncommunicable diseases and accidents is increasing. WHO’s technical cooperation is managed through the WHO country office with professional staff in a range of areas, including support to health sector development; the control, surveillance of and response to communicable and noncommunicable diseases; child and maternal health; nutrition and environmental health, as well as emergency and humanitarian assistance. WHO is centrally engaged in the sector as lead donor facilitator, including efforts to increase the harmonization and alignment of external support and improved Sector-Wide Management. A new WHO Country Cooperation Strategy will support the new Government’s Health Strategic Plan for 2008–2015. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 207 000 75 000 28 000 Voluntary contributions 7 880 000 8 579 000 1 013 000 Total 8 087 000 8 654 000 1 041 000

SO4

462 000

2 439 000

2 901 000

SO5

338 000

44 000

382 000

SO6

194 000

1 263 000

1 457 000

SO7

5 000

43 000

48 000

SO8

59 000

2 624 000

2 683 000

SO9

489 000

4 562 000

5 051 000

SO10

484 000

1 216 000

1 700 000

SO11

15 000 2 356 000

957 000 30 620 000

972 000 32 976 000

SO12*

558 000

204 000

762 000

SO13*

672 000 3 586 000

293 000 31 117 000

965 000 34 703 000

134

CHINA – 2008–2009 PROGRAMME BUDGET

CHINA In recent years, China’s successful economic reform has produced annual economic growth rates averaging over 9% and has lifted over 300 million people from poverty. By 2005, GDP per capita was US$ 1700. Nevertheless, sharp variations in levels of development and access to basic services persist among and within provinces. At present, China is exploring options for significantly reforming the health system to ensure that all of the population has access to affordable essential health services. During and following the SARS outbreaks, China strengthened its systems for infectious disease surveillance, prevention and response. Important progress has also been made in controlling TB and HIV/AIDS. As part of the current Country Cooperation Strategy, WHO provides technical expertise on immunizations, control of communicable and chronic noncommunicable diseases and on maternal and child health. There is general agreement that the WHO-China partnership should pay added attention to strengthening the health system and to environmental issues affecting human health. Besides assisting government partners, WHO works closely with United Nations agencies, bilateral organizations and national and international nongovernmental organizations. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 406 000 640 000 1 050 000 Voluntary contributions 8 855 000 7 160 000 4 641 000 Total 9 261 000 7 800 000 5 691 000

SO4

567 000

2 147 000

2 714 000

SO5

85 000

SO6

559 000

4 191 000

4 750 000

SO7

5 000

SO8

393 000

1 384 000

1 777 000

SO9

94 000

492 000

586 000

SO10 SO11

2 861 000 510 000 7 080 000

1 097 000 823 000 30 880 000

3 958 000 1 333 000 37 960 000

SO12*

559 000

213 000

772 000

SO13*

1 089 000 8 728 000

1 655 000 32 748 000

2 744 000 41 476 000

135

COOK ISLANDS – 2008–2009 PROGRAMME BUDGET

COOK ISLANDS The Cook Islands are located in the Pacific, about 3500 km north-east of New Zealand. The country is made up of 15 islands, 13 of which are inhabited. In 2005, the population was estimated at 20 200. Of these, 9000 inhabitants live on the main island, Rarotonga. More than 50 000 Cook Islanders live in Australia and New Zealand. In early 2005, four cyclones hit Cook Islands. WHO programmes of technical cooperation are managed through the country office in Apia, which is responsible for American Samoa, Cook Islands, Niue, Samoa, and Tokelau. Technical cooperation between the Government and WHO focuses mainly on human resources development (fellowships), noncommunicable diseases, health promotion, nutrition and tobacco control. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 73 000 Voluntary contributions 0 Total

SO3

73 000

SO4

70 000

SO6

196 000

SO9

30 000

SO10

114 000

483 000

136

FIJI – 2008–2009 PROGRAMME BUDGET

FIJI Fiji is the second largest Pacific island country. The estimated multiethnic population for 2005 was 846 085. It is growing slowly due to a moderately low level of fertility and a high level of emigration. The population occupies around two thirds of the 322 Fiji islands and is concentrated on the two largest islands, Viti Levu (10 429 sq km) and Vanua Levu (5556 sq km), with the nation's capital of Suva located on Viti Levu. Life expectancy at birth is high for both women (72.1 years) and men (67.0 years). Fiji’s economy and especially the income from the tourism industry have been affected by political developments in late 2006. The Pacific Islands Forum electoral assessment mission is anticipated to assist the interim Government to draw a time line for the next elections. Fiji falls under the responsibility of the WHO Representative Office of the South Pacific, together with 14 other countries and areas. The Ministry of Health has articulated its strategic development priorities in the “Strategic Health Plan 2004–2008: Shaping Fiji's Health”. The draft Subregional Cooperation Strategy (SRCS), which covers all 15 countries and areas under the responsibility of the office of the WHO Representative to the South Pacific, was prepared in early 2005, and has been used as a medium-term strategic tool for collaboration with the respective governments. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Assessed contributions 195 000 66 000 312 000 Voluntary contributions 254 000 506 000 0 Total 449 000 572 000 312 000

SO4

42 000

SO5

3 000

SO6

245 000

27 000

272 000

SO7

5 000

SO8

66 000

186 000

252 000

SO9

32 000

10 000

42 000

SO10

156 000

SO11

48 000 1 162 000

0 991 000

48 000 2 153 000

SO12*

649 000

184 000

833 000

SO13*

956 000 2 767 000

427 000 1 602 000

1 383 000 4 369 000

Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums.

137

FRENCH POLYNESIA – 2008–2009 PROGRAMME BUDGET

FRENCH POLYNESIA French Polynesia comprises 3521 sq km of land on 120 islands in the South Pacific, of which 25 are inhabited. The principal and most populated island is Tahiti. In 2005, French Polynesia had an estimated population of 254 600. French Polynesia has reached a high level of health and socioeconomic development with about 10% of the gross national product being spent on health. This favourable situation may be attributed to significant socioeconomic development and to the gradual implementation of an efficient health care system. Like many other countries, French Polynesia is experiencing an epidemiological transition, where communicable diseases are decreasing while noncommunicable diseases are increasing. Nearly all of the population have ready access to quality health care, resulting in immunization coverage levels of over 90%, low infant mortality rates (6.3 infant deaths per 1000 live births), a low maternal morality ratio, and a high life expectancy at birth of 71.7 years for men and 76.8 years for women. While morbidity due to acute respiratory infections remains fairly high, especially in rural and poor urban districts, improvements in medical care have resulted in very low mortality for these conditions. The leading causes of mortality are noncommunicable diseases, especially cardiovascular diseases and cancers. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 To reduce the health, social and economic burden of communicable diseases. Country/area programmes total Assessed contributions 45 000 45 000 Voluntary contributions 0 0 Total 45 000 45 000

138

GUAM – 2008–2009 PROGRAMME BUDGET

GUAM Guam is an island of 549 sq km in the North Pacific Ocean, about three quarters of the way from Hawaii to the Philippines. The population of Guam was estimated to be 168 564 in 2005. Guam is faced with the challenge of maintaining a health care system that will adequately meet the needs of a predominantly young and growing population. At the same time, it is also faced with the added challenge of addressing the problems of the rapidly increasing number of older people, forecast to increase from 3.9% of the total population in 1990 to 7.5% in 2010. In 2005, total life expectancy for both sexes was 78.4 years. Men are expected to live up to 75.3 years and women up to 81.6 years. Although the health status of Guam’s population continues to improve, the five leading causes of death in 2002 remain as follows: diseases of the heart, malignant neoplasms, cerebrovascular diseases, accidents and suicides. A reduction in human and financial resources has severely impacted the health system with health post vacancies having reduced the overall amount of services available to the uninsured and underinsured population. The vacancies have also affected progress in strengthening other health service priority areas, such as disposal of hazardous and toxic materials, environmental protection, vector control, and drug and alcohol abuse services. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 45 000 Voluntary contributions 0 Total

SO10

45 000

139

JAPAN – 2008–2009 PROGRAMME BUDGET

JAPAN Japan has the second largest economy in the world in terms of gross domestic product, after the United States of America. The health situation in Japan remains one of the best in the Region and the majority of health-related statistics, such as life expectancy and the under-5 mortality rate, continue to improve. The health disparities within the country are also relatively small compared with those in other industrialized nations. The average life expectancy remains the highest in the world. In 2004, it was 85.6 years for women and 78.6 years for men. The infant mortality rate fell from 3.0 per 1000 live births in 2003 to 2.8 per 1000 live births in 2004. Malignant neoplasms have been the leading cause of death since 1981 and have continued to increase. They accounted for 31.1% of all deaths in 2004. Other major causes of death are lifestyle-related diseases, such as diseases of the circulatory system in which daily diet and behaviour play a significant role. Due to the increasingly complex social environment created by a high-tech and competition-oriented society, it is said that stress levels felt by all age groups are rising. There were 30 247 suicides in 2004; the number has remained stable at approximately 30 000 since 1998. The suicide rate is relatively high for men aged from their midtwenties to forties. Tuberculosis, infectious and difficult-to-treat diseases, such as HIV infection, and new types of influenza are becoming serious threats to public health in Japan. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 35 000 35 000 Voluntary contributions 0 0 Total

SO10

35 000 35 000

140

KIRIBATI – 2008–2009 PROGRAMME BUDGET

KIRIBATI The Republic of Kiribati, located in the Central and Western Pacific, consists of 33 low lying atoll islands spread over 3.5 million sq km of ocean. It is vulnerable to climate change and rises in sea level. Kiribati had a population of 92 533 in 2005. 47% of the population live in “urban” settlements, 31% on only 10% of the total land area of 811 sq km. This density of population is putting stress on the environment. The annual budget is derived from marine products, copra, fishing licenses, grants and loans and substantial external financial reserves derived from past phosphate revenues. WHO’s programme of technical collaboration is managed through a country liaison office supported by professional staff from the South Pacific Office in Fiji. It is guided by the South Pacific Country Cooperation Strategy for the South Pacific and focuses on: (1) strengthening health systems and health service management; (2) improving health service delivery; and (3) strengthening public health functions. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Assessed contributions 10 000 0 85 000 Voluntary contributions 0 20 000 0 Total 10 000 20 000 85 000

SO4

8 000

SO5

10 000

SO6

91 000

3 000

94 000

SO7

5 000

SO8

57 000

SO9

10 000

SO10 SO11

38 000 171 000 460 000

1 000 81 000 130 000

39 000 252 000 590 000

SO12*

39 000

183 000

222 000

SO13*

55 000 554 000

137 000 450 000

192 000 1 004 000

Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums.

141

KOREA, REPUBLIC OF – 2008–2009 PROGRAMME BUDGET

KOREA, REPUBLIC OF The Korean Peninsula and its associated islands extend about 1000 kilometres southward from the north-east Asian continental landmass. The population of the Republic of Korea was 48.2 million in 2005. A notable trend in Korea's demographic situation is that the population is growing older with each passing year. The Republic of Korea has experienced rapid socioeconomic change during the past three decades. Rapid economic growth and industrialization have accelerated urbanization and, by 2003, about 80% of the population was urbanized. In the Human Development Index prepared by the United Nations Development Programme (Human Development Report 2005), the Republic of Korea ranks 28th out of 177 nations. The recent socioeconomic development has transformed the Republic of Korea from a recipient country into a donor country. As a result, WHO and other development partners have gradually changed their roles within the country, moving chiefly to liaison and resource mobilization. In recent years, the health and quality of life of citizens in the Republic of Korea has improved steadily. There has been a significant rise in life expectancy, in part due to progress in medical services and increases in the number of medical facilities and medical staff. These improvements have also greatly contributed to reductions in the infant mortality rate and the maternal mortality ratio. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO 10 To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total Assessed contributions 45 000 45 000 Voluntary contributions 0 0 Total 45 000 45 000

SO12

15 000

SO13

0 45 000

419 000 434 000

419 000 479 000

142

LAO PEOPLE'S DEMOCRATIC REPUBLIC – 2008–2009 PROGRAMME BUDGET

LAO PEOPLE'S DEMOCRATIC REPUBLIC Landlocked along the Mekong River, the Lao People's Democratic Republic is a least developed country. The population is 5.6 million, (2005), with a growth rate of 2.0%, a sparse population density and large interprovincial variations, 47 ethnic groups and an average household size of 5.9. Health indicators, despite improvements in past decades, remain below the international standards. WHO’s programme of technical cooperation is managed through a country office with professional staff in several technical areas. The Ministry of Health and WHO, based on the National Socioeconomic Development Plan, 2006–2011, has identified the following priority areas for future intensified technical support: communicable diseases including immunization, newly emerging diseases and HIV/AIDS, maternal and child health, health sector development and financing, and primary health care. Technical support remains a major focus and efforts continue for more effective donor coordination and policy development. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 947 000 442 000 86 000 Voluntary contributions 3 741 000 1 193 000 670 000 Total 4 688 000 1 635 000 756 000

SO4

89 000

1 688 000

1 777 000

SO5

11 000

SO6

26 000

714 000

740 000

SO7

9 000

41 000

50 000

SO8

77 000

579 000

656 000

SO9

145 000

77 000

222 000

SO10 SO11

272 000 12 000 2 105 000

1 752 000 75 000 10 541 000

2 024 000 87 000 12 646 000

SO12*

25 000

528 000

553 000

SO13*

641 000 2 771 000

174 000 11 243 000

815 000 14 014 000

143

MACAO, CHINA – 2008–2009 PROGRAMME BUDGET

MACAO (CHINA) Macao, China on 20 December 1999, entered a new era in its development, with the return of its administration to China. Under its “one country, two systems” formula, China has promised Macao a high degree of autonomy with its present political, judicial, social, cultural and economic systems for the next 50 years. Based on the results of the 2001 census and the data on population changes since then, the resident population of Macao, China was estimated at 465 333 as of 31 December 2004. The natural increase of the population and population migration are important factors in population growth. Having gone through the process of a demographic and epidemiological transition, the population of Macao, China enjoys a fairly low mortality rate and a long life expectancy. They also enjoy a high standard of health, as reflected in the general decline in the incidence of communicable diseases and the increase in life expectancy, as well as the improvement in health indices. Noncommunicable diseases are the main causes of morbidity and mortality. However, as in other developed areas, the threat from re-emerging and newly emerging infectious diseases continues. Tuberculosis is one of the top communicable diseases. Morbidity and mortality of most vaccine-preventable communicable diseases have remained very low for many years. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 45 000 45 000 Voluntary contributions 0 0 Total

SO10

45 000 45 000

144

MALAYSIA – 2008–2009 PROGRAMME BUDGET

MALAYSIA Malaysia is composed of Peninsular Malaysia and the states of Sabah and Sarawak on the island of Borneo with a population of 26.6 million in 2006. Life expectancy at birth is 72 years for males and 76 years for females in 2006. The population is comprised of 58% Malay, 25% Chinese, and 7% Indian. Since 1990, Malaysia has been a middleincome and emerging multisector economy transformed from a producer of raw materials. Malaysia has achieved good health indicators with a primary care led and generally accessible health system. The top five main notifiable diseases in 2006 were: tuberculosis; food poisoning; dengue fever; hand, foot and mouth disease; and malaria. Cardiovascular disease, diabetes and cancer are the major causes of admissions and death. WHO collaborative programmes, managed by a small country office, have focused on selective priority areas. The WHO country office also coordinates Malaysia's increasing contribution to the work of WHO through its hosting of a large number of WHO regional and global meetings, providing expert support to WHO programmes and receiving a large number of foreign fellows. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Assessed contributions 43 000 125 000 93 000 Voluntary contributions 4 000 202 000 0 Total 47 000 327 000 93 000

SO4

20 000

SO5

40 000

SO6

40 000

18 000

58 000

SO7

9 000

634 000

643 000

SO8

62 000

SO9

71 000

20 000

91 000

SO10 SO11

491 000 23 000 997 000

3 536 000 33 000 4 467 000

4 027 000 56 000 5 464 000

SO12*

127 000

559 000

686 000

SO13*

339 000 1 463 000

75 000 5 101 000

414 000 6 564 000

Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums.

145

MARSHALL ISLANDS – 2008–2009 PROGRAMME BUDGET

MARSHALL ISLANDS The Republic of the Marshall Islands covers an area of 181 sq km and comprises 29 atolls and five major islands that form two parallel groups—the Ratak (sunrise) chain and the Rali (sunset) chain. The last census took place in 1999; the next is scheduled for 2009. The estimated population in 2004 was 61 218. The Marshall Islands is a parliamentary democracy, constitutionally in free association with the United States of America. The gross domestic product is derived mainly from payments made by the United States under the terms of the Compact of Free Association. It has a developing agrarian and service-oriented economy. Both Marshallese and English are official languages. The Marshall Islands falls under the responsibility of the WHO Representative Office of the South Pacific, together with 14 other countries and areas. The strategic development priorities have been articulated in the “Strategic Plan for the Delivery of Health Services, 2001–2015”. The main focus of the WHO collaborative programme is on human resources development, including the distance education system (POLHN). Some Government priorities are not covered by the WHO regular budget, as funds from “other sources” are available. Nonetheless, WHO technical support is strong for all public health programmes, including those without WHO funding. It is envisaged that a WHO epidemiologist will recruited in the second half of 2007 and based in Pohnpei, supporting the communicable diseases prevention and control programmes in the Federated States of Micronesia, as well as in the Marshall Islands. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 35 000 18 000 Voluntary contributions 0 0 Total 35 000 18 000

SO3

7 000

SO6

194 000

4 000

198 000

SO9

3 000

SO10

79 000 336 000

0 4 000

79 000 340 000

146

MICRONESIA, FEDERATED STATES OF – 2008–2009 PROGRAMME BUDGET

MICRONESIA, FEDERATED STATES OF The Federated States of Micronesia consists of four major island groups forming the states of Chuuk, Kosrae, Pohnpei, and Yap. The total land area is only 701 sq km, and only about 65 of the 607 islands are inhabited. Pohnpei island constitutes about one half of the total land area and is home to about one third of the population, while more than half of the population lives in Chuuk State, which consists of many small atolls and lagoon islands. The estimated population of the Federated States of Micronesia was 114 100 in 2005, 41.6% of which were below 15 years old while 3.5% were 65 years or over. The Federated States of Micronesia is an independent country in Compact of Free Association with the United States. The Federated States of Micronesia falls under the responsibility of the WHO Representative Office of the South Pacific, together with 14 other countries and areas. It is envisaged that a WHO epidemiologist will recruited in the second half of 2007 to be based in Pohnpei, supporting the communicable diseases prevention and control programmes in Micronesia as well as in the Marshall Islands. The strategic development priorities have been articulated in the “Federated States of Micronesia's Strategic Development Plan, 2004–2023, The Next 20 Years. Achieving Economic Growth and Self-reliance”. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 293 000 71 000 10 000 Voluntary contributions 0 0 0 Total 293 000 71 000 10 000

SO4

12 000

SO6

29 000

SO8

62 000

SO9

5 000

SO10

90 000 572 000

0 0

90 000 572 000

147

2008–2009 PROGRAMME BUDGET – NAURU

MONGOLIA Landlocked between the Russian Federation and China, Mongolia had an estimated population of 2.6 million in 2006, with 60.9% classified as urban and 39.1% as rural. Mongolia is included in a group of countries and areas with midlevel human development and average life expectancy. The main pillar of the economy continues to be the agriculture sector. Mongolia has a severe continental climate and large numbers of people continue to migrate to urban centres. WHO's programme of technical collaboration is managed through a country office with professional staff in the areas of programme management and communicable diseases surveillance and response. A Country Cooperation Strategy was developed in 2002 that focused on four principal components: (1) policy analysis and institutional strengthening in the health sector; (2) facilitation of donor coordination; (3) controlling communicable and noncommunicable diseases; and (4) environment and healthy lifestyles. These areas of collaboration have been reflected in the country programme budgets over the last two bienniums. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 403 000 111 000 354 000 Voluntary contributions 245 000 97 000 398 000 Total 648 000 208 000 752 000

SO4

172 000

1 227 000

1 399 000

SO5

35 000

292 000

327 000

SO6

218 000

154 000

372 000

SO7

3 000

45 000

48 000

SO8

296 000

206 000

502 000

SO9

73 000

20 000

93 000

SO10 SO11

549 000 85 000 2 299 000

540 000 329 000 3 553 000

1 089 000 414 000 5 852 000

SO12*

543 000

16 000

559 000

SO13*

224 000 3 066 000

153 000 3 722 000

377 000 6 788 000

148

NAURU – 2008–2009 PROGRAMME BUDGET

NAURU Nauru, the world’s smallest republic, is a small oval shaped coral island (21 sq km), located 40 km south of the equator. The projected population size of Nauru for 2005 was 13 839, 35.1% of which were below 15 years old, while around 4.9% were 65 and above. It is estimated that there are 107 men for every 100 women. For more than 80 years, Nauru revenues have come from exports of phosphates, but phosphate reserves are expected to be exhausted within five years. Today, only the coastal strip is inhabitable, with the central phosphate plateau left covered with coral pinnacles after the phosphate extraction. With the near exhaustion of phosphate, alternative forms of economic activity are being sought and promoted, such as fisheries. Coconut, banana, papaya, and small quantities of vegetables are grown around the coastal belt. Nauru falls under the responsibility of the WHO Representative Office of the South Pacific, together with 14 other countries and areas. Four areas of work were chosen in a consultative process that are focused on and reflect national health priorities. The areas are: communicable diseases prevention and control; human resources development, including the distance education system (POLHN); surveillance, prevention, and management of noncommunicable diseases; and environmental health, including food safety. Government priorities that are not covered by the WHO regular budget, still receive strong WHO technical support from the South Pacific and regional offices of WHO. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 5 000 10 000 4 000 Voluntary contributions 0 0 0 Total 5 000 10 000 4 000

SO4

1 000

SO8

76 000

SO10

16 000 112 000

0 0

16 000 112 000

149

2008–2009 PROGRAMME BUDGET – NORTHERN MARIANA ISLANDS, COMMONWEALTH OF THE

NIUE Niue is a small, isolated island in the South Pacific Ocean, situated between Tonga and Rarotonga, Cook Islands. This large raised coral atoll, with a land area of 259 sq km, is home to around 1730 inhabitants in 2005. Since 1966, the population has dropped significantly in size from more than 5000 inhabitants. A lack of natural resources, isolation, insufficient social and economic development, coupled with Niuans being New Zealand citizens, has prompted migration. In 2001, more than 20 000 Niuans lived in New Zealand. In general, health indicators are good. Infant mortality is low and no maternal death has been recorded from 1999 to 2005. The average life expectancy in 2001 was 69.8 years for men and 71.2 years for women. Cyclone Heta devastated Niue, including its health facilities, in January 2004. WHO programmes of technical cooperation are managed through the country office in Apia, which is responsible for American Samoa, Cook Islands, Niue, Samoa and Tokelau. Technical cooperation between the Government and WHO focuses mainly on human resources development (fellowships), communicable and noncommunicable diseases, health promotion and nutrition. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 To reduce the health, social and economic burden of communicable diseases. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 3 000 Voluntary contributions 0 Total 3 000

SO6

89 000

39 000

128 000

SO9

1 000

26 000

27 000

SO10

21 000 114 000

0 65 000

21 000 179 000

150

NORTHERN MARIANA ISLANDS, COMMONWEALTH OF THE

NORTHERN MARIANA ISLANDS, COMMONWEALTH OF THE The Commonwealth of the Northern Mariana Islands are under the administration of the United States of America as part of the United States Trust Territory of the Pacific. Negotiations for territorial status began in 1972 and a covenant to establish a commonwealth in political union with the United States of America was approved in 1975. A new government and constitution went into effect in 1978. The Commonwealth of the Northern Mariana Islands comprises 15 islands (471 sq km) in the western Pacific Ocean about three quarters of the way from Hawaii to the Philippines. Only three of these islands were inhabited in 2000, Saipan, Rota, and Tinian. The estimated multi-ethnic population was 80 362 in 2005. The economy benefits substantially from financial assistance from the United States of America, but funding has declined as locally generated government revenues have grown, notably from tourism. As the economy of the Commonwealth continues to grow and develop, the overall health status of the population is moving away from the health profile of a developing nation towards that of a more industrialized one. Infectious diseases are once again emerging as a major public health concern. Of particular concern are tuberculosis, hepatitis B, hepatitis A, enteric foodborne illnesses, vaccine-preventable diseases, HIV infection and other sexually transmitted infections. Obesity, diabetes, hypertension and atherosclerotic vascular disease are increasing concerns facing the ageing population. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 45 000 45 000 Voluntary contributions 0 0 Total

SO10

45 000 45 000

151

PALAU – 2008–2009 PROGRAMME BUDGET

PALAU Palau (Belau) is a democratic republic, which consists of eight principal and 252 smaller islands in a chain about 650 kilometres long. The estimated multi-ethnic population of Palau was 19 907 in 2005, with a natural per annum increase of 5.7%. The population consists of 70% Palauans, 28% Asians and 2% Caucasians (2000 estimate). Over 70% of this population resides in the capital Koror. The economy of Palau consists primarily of tourism, subsistence agriculture, and fishing. The Government is the major employer of the workforce, relying heavily on financial assistance from the United States of America. The Palau National Congress has two houses: the Senate with nine members and the House of Delegates with 16 members. The Council of Chiefs is an advisory body to the President that contains the highest traditional chiefs from each of the 16 states. Palau falls under the responsibility of the WHO Representative Office of the South Pacific, together with 14 other countries and areas. There were two areas of collaboration chosen in a consultative process for the 2006–2007 biennium. The WHO collaborative programmes focus on human resources for health development and on health education through the Palau Community College. This reflects the Government's aim to provide enough trained and qualified staff for provision of quality services in all the outlying dispensaries, including the more remote areas and islands, as well as at the main hospital in Koror. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 135 000 135 000 Voluntary contributions 0 0 Total

SO10

135 000 135 000

152

PAPUA NEW GUINEA – 2008–2009 PROGRAMME BUDGET

PAPUA NEW GUINEA Papua New Guinea, the largest developing country in the Pacific, is classified as a low-income country. The country has more than 600 islands with a population of approximately 6 million people (2005). Close to 87% of the population lives in rural areas. Access to widely scattered rural communities is often difficult, slow and expensive. Health services in Papua New Guinea are provided by the Government and church medical services and are primarily financed by public funds, but also with considerable contribution from development partners, in particular AusAID. In recent years, rural health services have deteriorated significantly because of the closing down of many rural health facilities. The shortage and skewed distribution of human resources is a critical issue in Papua New Guinea. Communicable diseases, including malaria and tuberculosis, remain the major cause of morbidity and mortality in all age groups. Papua New Guinea now has a generalized epidemic of HIV/AIDS. Maternal and child morbidity and mortality are still high. The strategic directions for WHO’s work in Papua New Guinea is outlined in the Country Cooperation Strategy 2005–2009. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 192 000 554 000 144 000 Voluntary contributions 1 330 000 4 069 000 621 000 Total 1 522 000 4 623 000 765 000

SO4

128 000

2 370 000

2 498 000

SO5

295 000

1 796 000

2 091 000

SO6

198 000

1 296 000

1 494 000

SO7

9 000

SO8

47 000

118 000

165 000

SO9

123 000

20 000

143 000

SO10 SO11

615 000 404 000 2 709 000

3 584 000 0 15 204 000

4 199 000 404 000 17 913 000

SO12*

572 000

25 000

597 000

SO13*

696 000 3 977 000

161 000 15 390 000

857 000 19 367 000

153

PHILIPPINES – 2008–2009 PROGRAMME BUDGET

PHILIPPINES The Philippines is a middle-income country, but economic growth and productive resources in the country are distributed unequally. Economic growth has been at a respectable pace in recent years, but is modest compared with other Asian countries and areas. Poverty is predominant in rural areas as well as urban settlements. The country is prone to natural disasters brought about by floods, typhoons, volcanic eruptions and earthquakes. Improvement of health status in the country has remained unsatisfactory compared to other middle-income countries and areas in the Region. In addition to the slow reduction in infant mortality and the stagnant high maternal mortality rates in the last eight years, there is an increasing burden of chronic and degenerative diseases. WHO’s programme of collaboration in the Philippines focuses on national health priorities of the Government, which aim to achieve health system goals namely: better health outcomes, responsiveness of the health system and equitable health financing. The Country Cooperation Strategy identified four strategic areas of intervention which are consistent with country needs: (1) control of disease risks; (2) reaching the unreached; (3) health sector development; and (4) advocacy and partnerships for health. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Assessed contributions 747 000 163 000 122 000 Voluntary contributions 860 000 7 099 000 729 000 Total 1 607 000 7 262 000 851 000

SO4

152 000

1 887 000

2 039 000

SO5

74 000

5 656 000

5 730 000

SO6

48 000

1 314 000

1 362 000

SO7

6 000

SO8

152 000

102 000

254 000

SO9

73 000

836 000

909 000

SO10 SO11

272 000 79 000 1 888 000

225 000 534 000 19 242 000

497 000 613 000 21 130 000

SO12*

560 000

112 000

672 000

SO13*

198 000 2 646 000

110 000 19 464 000

308 000 22 110 000

Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums.

154

SAMOA – 2008–2009 PROGRAMME BUDGET

SAMOA Samoa consists of a small group of islands in the South Pacific Ocean, situated about half way between Hawaii and New Zealand, and measuring about 2935 sq km. Most of the population lives on the two main islands, Upolu and Savaii. Based on the 2001 census, the population of Samoa is 176 710. There is a high rate of overseas migration (some 3500 people per annum) which is expected to continue unless the Government can ensure employment opportunities and at the same time implement an effective retention policy. More than half of the population (51%) is below 20 years, with adolescents comprising 21%, youth, 18%, and women of childbearing age, 22%. The proportion of elderly people (65+ years) is about 4.4% of the population. WHO programmes of technical cooperation are managed through the country office in Apia, which is responsible for American Samoa, Cook Islands, Niue, Samoa, and Tokelau. A Country Cooperation Strategy was developed in 2002 for the period from 2003 to 2007. It focuses on three principal components: building healthy communities and populations, developing a strong health sector, and combating communicable diseases. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 8 000 269 000 250 000 Voluntary contributions 3 000 29 000 0 Total 11 000 298 000 250 000

SO4

16 000

SO5

5 000

SO6

110 000

105 000

215 000

SO7

5 000

SO8

190 000

SO9

171 000

20 000

191 000

SO10 SO11

191 000 0 1 205 000

0 10 000 177 000

191 000 10 000 1 382 000

SO12*

557 000

204 000

761 000

SO13*

190 000 1 952 000

153 000 534 000

343 000 2 486 000

155

SINGAPORE – 2008–2009 PROGRAMME BUDGET

SINGAPORE Singapore is a small country with total population of about 4.3 million, with a resident population of 3.5 million in 2005 and a relatively young population, with only 8% of the resident population above age 65. Singapore is a parliamentary republic and the legal system is based on English common law. Singapore is characterized by a highly developed and successful free-market economy. The Singapore economy grew by a healthy 6.4% in 2005. Per capita gross national income amounted to US$ 26 700 in 2005. Health status in Singapore is good by international standards. The infant mortality rate in 2005 stood at 2.1 per 1000 resident live births, while the average life expectancy was 79.7 years. The leading causes of morbidity and mortality are currently the major noncommunicable diseases such as cancer, coronary heart disease, pneumonia, strokes, accidents and injuries. The WHO collaborative programme, being managed by a small country office based in Kuala Lumpur, is very small and mainly focuses on training in emergency preparedness, laboratory response to infectious respiratory viruses, vectors and parasite control, and health promotion and disease prevention. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 45 000 45 000 Voluntary contributions 0 0 Total

SO10

45 000 45 000

156

SOLOMON ISLANDS – 2008–2009 PROGRAMME BUDGET

SOLOMON ISLANDS The Solomon Islands form a Pacific archipelago of 922 islands—347 inhabited. Its land area of 28 900 sq km is widely scattered over 1.3 million sq km. The population was estimated as 478 000 in 2005. Social disturbances in recent years have challenged economic and health improvements. An estimated population increase of 59 000 persons during 2000–2005 supports a demographic trend creating increasing pressure on infrastructure and employment, as well as raising growing environmental issues. WHO’s programme is managed through a country office. Expected outcomes of the 2003–2007 United Nations Development Assistance Framework include: health sector reformed and staff trained to promote equitable distribution of health services; improvement in health settings; reduced morbidity and mortality from communicable and noncommunicable diseases; reproductive/maternal health improved through delivery of cost-effective reproductive health strategies; and national multisectoral HIV/AIDS strategy developed and implemented. These areas of collaboration have been reflected in the country programme budgets over the last three bienniums. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 146 000 578 000 312 000 Voluntary contributions 32 000 581 000 0 Total 178 000 1 159 000 312 000

SO4

190 000

408 000

598 000

SO5

44 000

195 000

239 000

SO6

70 000

121 000

191 000

SO7

2 000

25 000

27 000

SO8

18 000

195 000

213 000

SO9

7 000

22 000

29 000

SO10 SO11

110 000 14 000 1 491 000

0 0 1 579 000

110 000 14 000 3 070 000

SO12*

384 000

12 000

396 000

SO13*

85 000 1 960 000

122 000 1 713 000

207 000 3 673 000

157

TOKELAU – 2008–2009 PROGRAMME BUDGET

TOKELAU Tokelau is a self-governing territory administered by New Zealand. It consists of three small atolls (Fakaofo, Nukunonu, and Atafu), with a total area of approximately 12.2 sq km. Each atoll is approximately 200 metres wide and no more than five metres above sea level, which makes the territory highly vulnerable to cyclones and to any climatic changes. A cyclone devastated Tokelau in early 2005. Tokelau has a population of around 1530 (2005). The constraints of atoll life and limited opportunities have led some 6000 Tokelauans to settle in New Zealand and a few hundred more in Samoa, the island’s nearest neighbour. Families, both immediate and extended, constitute the core of social organization, with the village (nuku) being the foundation of Tokelauan society. Community welfare is paramount in what has been traditionally a subsistence environment. WHO programmes of technical cooperation are managed through the country office in Apia, which is responsible for American Samoa, Cook Islands, Niue, Samoa, and Tokelau. Technical cooperation between the Government and WHO focuses mainly on human resources development (fellowships), communicable and noncommunicable diseases, and tobacco control. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 To reduce the health, social and economic burden of communicable diseases. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes total Assessed contributions 3 000 Voluntary contributions 0 Total 3 000

SO3

75 000

SO6

5 000

SO10

29 000 112 000

0 0

29 000 112 000

158

TONGA – 2008–2009 PROGRAMME BUDGET

TONGA A lower middle-income country, Tonga is an island nation in the Pacific Ocean with an estimated population of 102 371 (2005), of which 68% live on the main island Tongatapu and 32% are distributed on outer islands. The economy is based on agriculture, tourism and fishing and many families are dependent on remittances from relatives living abroad. The publicly funded health system provides services free of charge and the formal private sector remains small. WHO's programme of technical collaboration is managed by a Country Liaison Officer based in the Ministry of Health. The dominant health problem is the rapidly growing burden of noncommunicable diseases, of which diabetes and complications of diabetes are most prominent, and WHO's technical assistance focuses on noncommunicable diseases prevention and control, health promotion, human resources for health and health systems development. New mechanisms for health care financing, including the introduction of social health insurance, is a key area of health development for the future. Important international partners in health include the World Bank, AusAID and NZAID. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 133 000 0 31 000 Voluntary contributions 44 000 1 000 0 Total 177 000 1 000 31 000

SO4

209 000

SO5

5 000

SO6

54 000

2 919 000

2 973 000

SO7

77 000

SO10

494 000 921 000

148 000 3 194 000

642 000 4 115 000

SO12*

385 000

12 000

397 000

SO13*

62 000 1 368 000

88 000 3 294 000

150 000 4 662 000

159

TUVALU – 2008–2009 PROGRAMME BUDGET

TUVALU Tuvalu is one of the smallest independent countries in the world, comprising nine low-lying atolls with a total land area of only 25.6 sq km. With an estimated population of 10 885 in 2005, the country has a very high population density. Tuvalu's main potential resource is its ocean. With its large exclusive economic zone, Tuvalu would need vast financial resources, technology, and human resources to fully tap into this resource. The extremely arid and sandy non-agricultural soil does not allow growing of any vegetable or fruit, and there is no industry, including tourism. The major sources of income for the people of Tuvalu are the sale of copra and fishing rights, wages paid for employment, remittances from relatives living overseas, and seamen’s wages sent home to their families. Tuvalu falls under the responsibility of the WHO Representative Office of the South Pacific, together with 14 other countries and areas. Three areas of work have been chosen in a consultative process for the 2006–2007 biennium. These areas of work reflect the national health priorities, as well as the health agenda formulated by the Pacific islands’ ministers of health during meetings organized by WHO and the Secretariat of the Pacific Community. These areas are human resources development; surveillance, prevention, and management of noncommunicable diseases; and environmental health, including food safety. The main focus has been on human resources development, including the distance education system (POLHN). In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 To reduce the health, social and economic burden of communicable diseases. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes total Assessed contributions 53 000 Voluntary contributions 0 Total 53 000

SO6

16 000

298 000

314 000

SO8

22 000

SO10

48 000

SO11

3 000 142 000

0 298 000

3 000 440 000

160

VANUATU – 2008–2009 PROGRAMME BUDGET

VANUATU Vanuatu, a Melanesian archipelago of 83 islands and more than 100 languages, has a land mass of 12 189 sq km and a population of 221 852 (2005) with 41% under age 15. Almost 12% (1996) of children under 5 are underweight and infant mortality remains significant with 27% (1999). Vanuatu is in a geographic zone at high risk for natural disasters. “Priorities and Action Agenda for 2006–2015” defines the main agendas for Vanuatu as follows: expanding the productive sector (agriculture, tourism); maintaining a macroeconomic balance; raising public service performance; cutting costs associated with transport and utilities; and improving access to basic services for health and education. WHO's programme of technical cooperation supports the Government's commitment to provide equitable and affordable health care, through a country office with professional staff in the areas of health systems development, epidemiology, communicable diseases surveillance and response. WHO supports many components of the health sector as reflected in the country programme budgets over the last bienniums, including health systems development and financing, control of communicable and noncommunicable diseases, and human resources for health. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total * Included as part of the Regional Office budget in previous bienniums. Assessed contributions 7 000 386 000 12 000 Voluntary contributions 24 000 114 000 0 Total 31 000 500 000 12 000

SO4

11 000

332 000

343 000

SO5

159 000

79 000

238 000

SO6

477 000

1 345 000

1 822 000

SO7

11 000

22 000

33 000

SO8

7 000

SO9

13 000

20 000

33 000

SO10 SO11

44 000 6 000 1 133 000

387 000 0 2 323 000

431 000 6 000 3 456 000

SO12*

426 000

SO13*

122 000 1 681 000

85 000 2 408 000

207 000 4 089 000

161

2008–2009 PROGRAMME BUDGET – VIET NAM

VIET NAM Situated some 3260 km along the eastern coast of the Indochina peninsula, Viet Nam forms an area of 332 600 sq km, with an estimated population of 83.1 million (2005) in 54 ethnic groups, with the Kinh representing 87% of the nation’s population. While literacy is high, Viet Nam remains a low income country. With rapid economic growth, however, the percentage of poor households continues to decline drastically. Meanwhile, Viet Nam’s social and health achievements have placed it ahead of many countries and areas with similar and higher levels of income. WHO’s programme of technical collaboration is managed through a country office. The Country Cooperation Strategy, developed in 2007 and built on the principles of equity, fairness and good governance, represents the medium term WHO strategy for strengthening the health sector. It focuses on six priority areas: (1) health policy, legislation and systems development; (2) communicable disease surveillance, prevention and control; (3) promoting healthy environment and healthy lifestyles and prevention of noncommunicable diseases; (4) family and community health and nutrition; (5) HIV/AIDS, tuberculosis and blood safety; and (6) partnerships and coordination. In 2008–2009, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives**: Strategic objective SO1 SO2 SO3 To reduce the health, social and economic burden of communicable diseases. To combat HIV/AIDS, tuberculosis and malaria. To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches. To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. To ensure improved access, quality and use of medical products and technologies. Country/area programmes subtotal To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work. To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively. Country/area programmes and country office total Assessed contributions 744 000 104 000 480 000 Voluntary contributions 5 563 000 4 053 000 1 988 000 Total** 6 307 000 4 157 000 2 468 000

SO4

361 000

889 000

1 250 000

SO5

8 000

779 000

787 000

SO6

802 000

2 486 000

3 288 000

SO7

10 000

610 000

620 000

SO8

210 000

436 000

646 000

SO9

381 000

4 315 000

4 696 000

SO10

1 541 000

8 440 000

9 981 000

SO11

20 000 4 661 000

1 630 000 31 189 000

1 650 000 35 850 000

SO12*

591 000

275 000

866 000

SO13*

1 166 000 6 418 000

716 000 32 180 000

1 882 000 38 598 000

162

2008-2009 PROGRAMME BUDGET BY REGIONAL EXPECTED RESULTS

* Included as part of the Regional Office budget in previous bienniums. ** The High Level Panel on United Nations system-wide Coherence in the areas of Development, Humanitarian Assistance, and the Environment (HLP) was presented on 9 November 2006 (http://www.un.org/events/panel/). One of the recommendations concerning United Nations reform at country level was to "recommend the establishment of One United Nations at country level, with one leader, one programme, one budget and, where appropriate, one office." It was proposed that the one leader be an "empowered Resident Coordinator". There were many other recommendations related to achieving greater coherence in the United Nations system but the Secretary General, in his letter of 22 November 2006 to Mr Kemal Devis, Chairman of the UNDG, singled out only those on reform at country level and called for their implementation at country level in pilot countries. Subsequently, in early January 2007, it was confirmed that there would be eight pilot countries which includes Viet Nam. In the interest of alignment in the context of the Viet Nam One United Nations pilot, the WHO two-year programme may undergo possible changes in order to adapt to the "one plan" currently under development to cover the five-year framework of the Government of Viet Nam and United Nations' planning cycle.

163

Informations clés

Organisation Organisation mondiale de la santé (OMS)

Type de document Technical Documents

Date d'adoption 31 décembre 2007

Source Organisation mondiale de la santé