(wpR/RC26/SR/5 )
SUMMARY RECORD OF THE FIFTH MEETING
WHO Conference Hall, Manila Thursday, 4 September 1975 at 9.20 a.m. CHAIRMAN: Dr T.M. McKendrick (Western Samoa)
CON'IENTS
1 2
Consideration of draft resolutions ••••••••••••••••••• Consideration of the report presented by the Sub~Comml ttee on Programme and Budget
159 165
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REGIONAL COMMIT'lEE:
'IWENTY-SIXTH SESSION
Fifth Meeting Thursday, 4 September 1975 at 9.20 a.m. PRESENT 1.
Representatives of Member States AUSTRALIA
Dr C.P. Evans Mrs A.E. Broinowski Dr Dr Dr Mr Chen Chih-ming Chen Wen Chieh Wang Lien Sheng Li Ching Hsiu
CHINA
,
FRANCE
Dr Yves Couturier Dr A. Tanaka Mr S. Kaneda Dr Phouy Phoutthasak Dr Keo Phimphachanh Tan Sri Datuk (Dr) Abdul Majid bin Ismail Mr Onn bin Kayat Dr Lim Ewe Seng Dr R. Dickie Dr J. Sumpaico Dr A.N. Acosta Dr J. Dizon Dr A. Galvez Dr F. Aguilar Dr R. Villasis Dr E. Fernando Dr T. Elicano, Jr. Mrs L.J. Zamora Dr Kyong Shik Chang Mr Se Lin Huh Mr Sun Dong Yin
JAPAN LAOS
MALAYSIA
NEW ZEALAND
PHILIPPINES
REPUBLIC OF KOREA
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157
REPUBLIC OF SOUTH VIET-NAM
Dr Tran Cuu Kien Dr Le Van Loc Dr Oon Beng Bee Dr S. Tapa Dr J.A.B. Nicholson Dr J .C. King Mr E. Noziglia Dr M. Kumangai Dr T.M. McKendrick
SINGAPORE TONGA
UNITED KINGDOM UNITED STATES OF AMERICA
WES'lERN SAMOA II. Representative of Associate Member PAPUA NEW GUINEA III • Observer DEMOCRATIC REPUBLIC OF VIET-NAM
Dr Ako Toua
Professeur Hoang Dinh Cau M. Nguyen Van Trong Dr Doan Xuan Muou
IV.
Representatives of the United Nations and Related Organizations
UNITED NATIONS CHIIDREN'S FUND V.
Mr Wah Wong
Representatives of Other Intergovernmental Organizations IN'lERNATIONAL COMMIT'lEE OF MILITARY MEDICINE AND PHARMACY Captain J .E. Batoon.
r«::
VI.
Representatives of Non-governmental Organizations IN'lERNATIONAL UNION OF ARCHImc'lS IN'lERNA'l![ ONAL SOCIETY OF BLOOD TRANSFUSION WORID FEDERATION FOR MEDICAL EDUCATION THE IN'lERNATIONAL IEPROSY ASSOCIATION Mr O. A. Arellano
Dr G.C. Caridad
Dr J. Cuyegkeng
Dr J.N. Rodriguez
SlMtfARY RECORD OF THE FIFTH MEETING
MEDICAL WOMEN'S IN'IERNATIONAL ASSOCIATION WORlD FEDERATION OF NUCIEAR MEDICINE AND BIOLOGY IN'IERNATIONAL COMMITIEE OF CATHOIJ:C NURSES IN'lERNATIONAL PLANNED PARENTHOOD FEDERATION WORlD PSYCHIATRIC ASSOCIATION IN'lERNATIONAL RADIATION PRO'IECTION ASSOCIATION IN'lERNATIONAL SOCIETY OF RADIOLOGY IEAGUE OF RED CROSS SOCIETIES COUI«::IL FOR IN'lERNATIONAL ORGANIZATIONS OF MEDICAL SCIEJlCES IN'lERNATIONAL COLIEGE OF SURGEONS WORlD FEDERATION OF UNI'lED NATIONS ASSOCIATIONS VII. WHO Secretariat SECRETARY
Dr C. Asuncion Dr 1. Y. Zalamea Dr L.S. Villadolid \,
Mrs M.R. Ordonez
Dr J. llano
Dr A. Umali Dr T. Elicafio, Jr.
Dr H. Zialcita
Dr G.C. Caridad Dr A.M. Dalisay
Dr L. Martinez
Dr M.M. Alimurung
'\
Dr Francisco J. Dy
SUMMARY RECORD OF THE FIFTH MEETING
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1
CONSIDERATION OF DRAFT RESOWTIONS The Committee considered the following draft resolutions:
1.1
International programme for the improvement of water supply and sanitation in rural areas of developing countries (Document WPR/RC26/WP17) in reading out the list of countries Potable water Supply expressed interest
Dr SUMPAICO (Philippines), Rapporteur, noted resolution that Malaysia had been included in the to take part in the Ad Hoc Working Group on Rural and Sanitation, in conformity with that country's and desire.
Decision: The draft resolution was adopted without comment (see resolution WPR/RC26.R8). 1.2 Infant nutrition and breast-feeding (Document WPR/RC26/WP/8) Decision: The draft resolution was adopted without comment (see resolution WPR/RC26.R9). 1.3 WHO's role in the development and coordination of biomedical research: greater involvement of the Regions in research (Document WPR/RC26/WP/9)
Dr DICKIE (New Zealand) supported by Dr KING (United States of America) expressed the view that the word "implementing" in paragraph two did not reflect the intention of the resolution. WHO could be expected to promote and coordinate research programmes, but not to implement them. Dr TOUA (Papua New Guinea) favoured replacement of "implementing" by "promoting and coordinating". "Implementing" suggested that WHO would play an active role in research as opposed to encouraging it. The CHAIRMAN said that if the Regional Office was involved in research programmes, that would imply promotion and coordination. Did Dr Toua nevertheless want the word "implementing" to be removed? Dr TOUA (Papua New Guinea) said that he merely wished to emphasize that WHO should if possible assist countries to develop research, through promotion and encouragement. Dr MAJID (Malaysia) noted that the resolution as it stood made no mention of applied research which had been emphasized in the discussions. Such reference could be made in paragraph 2, which would thus read " •.• biomedical research, with emphasis on applied research".
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REGIONAL COMMITlEE:
'lWENTY-SIXTH SESSION
Dr TOUA (Papua New Guinea) said that there was no referenoe to the availability of national resouroes in paragraph three. Also, would the researoh be oentralized in, or oonduoted outside, the Regional Offioe? That point required olarifioation. The REGIONAL DIRECTOR said that a further clause might be added as sub-paragraph 3(0), reading: "the availability of adequate national resources and facilities". Dr NICHOlSON (United Kingdom) asked whether the WHO regional oentre for researoh and training in tropioal diseases, mentioned in paragraph 5, would award a diploma to physicians trained there. There was a sohool of tropioal medioine in Bangkok. Was it to be designated a WHO collaborating centre? Dr KAPLAN (Director, Division of Researoh Promotion and Development) said that the sohool in Bangkok would be a collaborating oentre. It was not, however. the intention that it should award a diploma: it would provide training in researoh on tropical diseases and field techniques in areas suoh as epidemiology. The preoise arrangements would depend on the outcome of a feasibility study on the subject. Mr KANEDA (Japan) mentioned that the word "and" would have to be placed at the end of sub-paragraph 3(b) if a sub-paragraph 3(0) were included.
The Committee agreed that the proposed amendments should be included in the draft resolution. Decision: The draft resolution, as amended, was adopted (see resolution WPR/RC26.Rlo). 1.4 Drug dependence and alooholism (Document wpR/RC26/wp/10) Dr KING (United states of America) noted that Item 16 of the Agenda referred to drug dependence only while the draft resolution before the Committee mentioned drug dependence and alcoholism. While the two fields were similar, they were nevertheless distinct. As indioated at the twenty-fifth session, alcoholism warranted consideration as a separate topio. It should be studied not only by the Regional Committee but also by the Region as a whole. The intention was not to eliminate the reference to alcoholism in the resolution, but merely to highlight the problem. Mention should also be made in the present context of the important role played by the United Nations Fund for Drug Abuse Control.
,
-SUMMARY RECORD OF THE FIFTH MEETING 161
A sub-paragraph 5(c) might be added to the draft resolution, which would thus read: "CALIS the attention of the Members to the assistance that may be available to them from UNFDAC". A sixth paragraph might also be added, reading: "REQUESTS the Regional Director to include the topic of alcoholism as a separate agenda item at the next meeting of the Regional Committee and to prepare a report on this subject in collaboration with the governments of the Region prior to that meeting." Dr EVAN:! (Australia) supported the Representative of the United states of America and referred to the emphasis he had placed upon this point during the discussion on Item 16 of the Agenda when he had said that alcoholism was the greatest problem faced by many countries or areas in the Region and it should be studied separately from drug dependence. The two treaties controlling international trade in drugs of dependency should also be kept in mind. He supported the amendment regarding the United Nations Fund for Drug Abuse Control.
Dr TOUA (Papua New Guinea) said he wished to support the amendment proposed by the Representative of the United States of America because alcoholism was a more important problem in the Pacific area, whereas drugs were a more important problem in Asia. The REGIONAL DIRECTOR suggested that the amendment regarding the Uni ted Nations Fund for Drug Abuse Control might be better treated as a separate paragraph. There would then be a paragraph 6 which would read: "CALIS the attention of the Member states to the assistance that may be available to them from the United Nations Fund for Drug Abuse Control". The Committee agreed that the proposed amendments should be included in the draft resolution. Decision: The draft resolution, as amended, was adopted {see resolution WPR/RC26.Rll}. 1.5 Preparation of the Sixth General Programme of Work covering a Specific Period (1978-1983 inclusive) (Document WPR/RC26/wp/ll) Dr SUMPAICO (Philippines), Rapporteur, drew the attention of the Committee to an amendment to document WPR/RC26/wp/ll, paragraph 3 of which now read: "DECIDES to consider at its twenty-seventh session whether it will be advantageous to prepare a regional programme of work, as has been done in the past, or if the Sixth General Programme of Work will be a sufficient guide".
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'IWENTY-SIXTH SESSION
In reply to a query from the Representative of Malaysia, the REGIONAL DIRECTOR explained that the Executive Board would sul:xn1 t the proposed Sixth General Programme of Work to the World Health Assembly in May 1976. The Regional Committee for the Western Pacific would decide in September 1976 whether it wished to prepare a separate Programme of Work for a specific period as in the past or if the Sixth General Programme of Work, which was expected to be adopted by the Assembly, would be sufficient as a guide for the programme of the Region. The Committee agreed that the proposed amendments should be included in the draft resolution. Decision: The draft resolution, as amended, was adopted (see resolution WPR/RC26.R12). 1.6 Topic of Technical Presentation in 1976 (Document WPR/RC26/wp/12) Decision: The draft resolution was adopted without comment (see resolution WPR/RC26.Rl3). 1.7 TWenty-seventh and twenty-eighth sessions of the Regional Committee (Document WPR/RC26/WP/13) Decision: The draft resolution was adopted without comment (see resolution WPR/RC26.R14).
1.8
of the Re 14)
onal Committee
Dr EVANS (Australia) agreed with the substance of the draft resolution but thought it did not go far enough. He considered the reasons leading up to the resolution should be included. He had prepared a suggested re-draft of the resolution for the consideration of the Committee. The REGIONAL DIRECTOR drew attention to the fact that the reasons leading up to the resolution were available in the Summary Record and could be referred to there. Dr EVANS (Australia) then read out the following draft resolution: The Regional Colllllli ttee, Having heard the statement of the Representative of Australia in regard to:
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163
1. Changes towards a biennial oyole generally in WHO affairs as evidenced by (a) (b) a biennial programme and budget; a reoent deoision by the Director-General to publish his full report every second year, wi th only an interim statement in the alternate year; and
2. The savings of costs in manpower and financial resouroes in both the Regional Office and for Member states which would acorue if the meetings of the Regional Committee were held every other year instead of annually;
DECIDES to include as an agenda item for the twenty-seventh session of the Regional Committee a possible change in frequency of the meetings of that Committee to every second year. Dr NICHOLSON (United Kingdom), supported by the Representative of Malaysia, said that although the draft resolution stated the full case in support of the proposal of the Representative of Australia he recalled that there had been some opposition to the proposal. Reference to this should also be included. Dr DICKIE (New Zealand) stated that he agreed with the proposal of the Representative of Australia, and also with the comments of the Representative of the United Kingdom. Dr KING (United States of America) suggested that the Representatives of Australia, Malaysia, New Zealand and the United Kingdom should meet with the Rapporteurs to draft a resolution which would include both sides of the issue. It was so agreed. After the meeting with the Rapporteurs a revision of the draft resolution was submitted to the Committee. The REGIONAL DIRECTOR drew the attention of the Committee to paragraph lea) of the draft resolution and said the biennial programme budget had not been implemented, as the amendments to Artioles 34 and 55 of the Constitution had not yet been ratified. Two-thirds of the Members of the Organization must first signify their acceptance of the amendments before there oould be any changes in the Articles of the Constitution. He suggested that the following phrase be added to paragraph lea) "which will come into being at suoh a time as the amendments to Articles 34 and 55 of the Constitution have been ratified".
"
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REGIONAL COMMITIEE:
'IWENTY-SIXTH SESSION
Committee agreed that the proposed amendments should be included in the draft resolution. The
Decision: The draft resolution, as amended, was adopted (see resolution WPR/RC26.R15). 1.9 Development of the antimalaria programme (Document WPR/RC26/wp/15) It was noted that this draft resolution should be considered as the report of the Working Group on Malaria.
Dr roUA (Papua New Guinea) suggested that the words "Member States" in paragraph 4 (d) should be replaced by "member countries or areas". Mrs BROINOWSKI (Australia) asked whether paragraph 3(iv) should be modified to take account of the fact that there were some reservations regarding the effectiveness of DDT. The use of DDT also had environmental implications which were now considered to be significant. Mrs Broinowski read out a suggested wording. The REGIONAL DIRECTOR said that DDT in the malaria eradication programme was not used in the same way as it was in agriculture. Its use had been approved by the World Health Assembly and the Executive Board. Since DDT was the insecticide needed, he strongly recOllllDended that the present wording of the resolution remain. Dr MAJID (Malaysia) endorsed the views expressed by the Regional Director. Experience in Malaysia had shown that DDT was the ideal insecticide. There was no danger to the environment from the way it was used. If it was applied to specific areas such as the walls of houses and not used widely in agriculture there was no danger to the environment. Dr roUA (Papua New Guinea) said that although he supported the remarks of the Regional Director the point raised by the Representative of Australia was that there were problems which arose from the use of DDT. There were some areas were DDT was not fully accepted. It might be that another insecticide should be mentioned in the resolution in case DDT could not be used. Professor HOANG DINHCAU (Democratic Republic of Viet-Nam) said that his country's malaria control activities had been based on the use of DDT. Experienoe had shown that it had practically no adverse effect on the environment of Viet-Nam, which could not be said of other chemicals that had been used in nature for quite different purposes.
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Dr NICHOlSON (United Kingdom) suggested paragraph 3(iv) be left as it was. He questioned what other insecticides were available. Malathion was regarded as a reserve when there was resistance to DDT on the part of the vector. Dr Nioholson considered referenoe to DDT should be kept in the resolution and that no other insectioides should be mentioned unless DDT was failing in its antimalaria function. The REGIONAL DIRECTOR suggested the addition of the following words to paragraph 3(iv) "or such other inseotioides as may be required". Dr MAJID (Malaysia) said that paragraph 3 was meant to contain an indication of areas where improvements were needed. Sinoe the problem was the shortage of DDT, thereoolllDendation was simply an endeavour to improve the lSupply of it in the Region. Dr THAN CUU KIEN (Republic of South Viet-Nam) supported the suggestion that other insecticides should be referred to in the resolution. In the areas of Viet-Nam that for some time had been under the control of the Provisional Government, DDT had proved effeotive against Anopheles, but it had had practically no effect in the neighbourhood of newly liberated towns and cities. The CHAIRMAN recommended that the Committee aooept the amendment proposed by the Regional Director. Referring to the proposed amendment to paragraph 3(iv), Mrs BROINOWSKI (Australia) asked if a similar amendment should not made to paragraph 4(e), whioh requested the Regional Direotor to explore the possibility of producing additional DDT in the Region. In reply the REGIONAL DIRECTOR assured the Chairman that there was no problem regarding the produotion of other inseoticides. The Committee agreed that the proposed amendments should included in the draft resolution. be be
Deoision: The draft resolution, as amended, was adopted (see resolution WPRjRC26.Rl6). 2 CONSIDERA'J!J:ON OF THE REPORT PRESEN'IED BY THE SUB-COMMITmE ON PROGRAMME AND BUDGET: Item 7.2 of the Agenda (Document WPR/RC26/l6)
The Committee considered and adopted this report without comment. It also considered the following draft resolutions submitted by the Sub-Committee on Programme and Budget.
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2.1 Budget performanoe 1974 - Direot services to governments (Document wpR/Rc26/P&B/wp/l) Deoision: The draft resolution was adopted without comment (see resolution WPR/RC26.R17). 2.2 Decision: The draft resolution was adopted without comment (see resolution wpR/RC26.R18). for Decision: The draft resolution was adopted without oomment (see resolution WPR/RC26.R19).
The meeting rose at 11.30 a.m.