>:~~ ,
I
0' R L D H EA LTH ORGANIZATION
ORGANISATION MONOIALE
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
•
DE LA SANTE
REGIONAL COMMITTEE Seventh Session Manila 7-13 September 1956
wp/RC7/ p&B/Mln/l Rev.l 7 September 1956 ORIGINAL: ENGLISH
" MINUrES OF THE MEEl'ING OF THE SUB-COMM:rr:rEE ON THE
PROGRAMME AND BUDGEr
mstitute of HY~iene Friday, 7 September 195 z at 2: 30 p.m." CHAIRMAN: Dr. J. Bierdrager
CONTENTS 1
~
Adoption of the agenda
2
2.1
... ........ • • .. • • • • Regular funds . . . . . . . . . . . . . . . . . . . . . . . MOdifications in the Basic and Supplementary Programmes and Budget for 1957 • • • • • • • • • • • • • • • • • • . . Supplementary List of Projects •
2 2 2,
"'-
..-;,
2.2
Basic "and Supplemental Programme end Budget Estimates for
1958 • • • • • • • • • • • • • • • • • • • • • • • • • • • • 3
5 20 21
4 5
.. ...... .. ·... Technical Assistance Programme • . . . . . . . . . . . . • Procedure for consideration of Programme and estimates at future meetings • • • • • • • • • • • • · . . . • Budget
, wp/RC7/P&B/Min/l Rev.l Page 2 The Sub-committee on the Programme and Budget, composed of representatives from Australia, France, Korea, Laos, Portugal and the United States, met at 2:30 p.m. on Friday, 7 September 1956 under the chairmanship of
Dr. J. Bierdrager (Netherlands). 1 ADOPTION OF THE AGENDA The CHAIRMAN proposed the adoption of the agenda before opening the discussions on the programme and budget. group the agenda was adopted. 2 REGULAR FUNDS
There being no comments from the
2.1
MOdifications in the Basic and Supplementary Programmes and Budget for 1957 (WP/RC7/4) The SECRETARY stated that in view of the reduction in the amount of
the effective working budget established by the Ninth World Health Assembly it had been necessary to reduce the basic 1957 regional field allocation by $151 330. Document WP/RC7/4 described the modifications of the Regular
Programme, which had taken place since the last meeting. This document showed that it had been possible to award a certain number of fellowships originally entered in the 1957 programme and budget out of savings in 1955 Gnd 1956. Apart from thiS, however, the reduction
/
in the basic 1957 allocation had meant that a certain number of projects had had to be transferred to the Supplemental Programme or the Supplementary List. The Supplemental Programme had been established by the Director-General \ with the approval of the Ninth World Health Assembly, in anticipation that ,'~. all
or some of the inactive
M~mbers
would resume active participation in the The maximum amount allocated to this
work of the Organization in 1957. region was $157 577.
wp/RC7/P&B/Min/l Rev.l Page :3 The Supplementary List contained projects Which could not be accommodated either in the 1957 Basic Programme or in the Supplemental Programme. The amount of Technical Assistance funds for 1957 would depend on decisions to be taken by the Technical Assistance Board in liaison with governments. A supplementary document covering modifications of the
Technical Assistance Programme had been submitted for information of the Cornmi ttee, taking into account all information to hand. Dr. H. E. DOWNES (Australia) requested clarification on the difference
between the Supplemental Programme determined by the Director-General at the World Health Assembly in anticipation that all or some of the inactive Members would resume active participation, and that which the Sub-committee last year had regarded as the Supplementary Programme, i. e., additional programmes for which governments had requested aid and Which were assigned lower priority. The SECRETARY explained that the Supplemental Programme had some chance of being implemented provided that some, or all of the inactive Members resume active participation. a third category. The Supplementary List was in effect
No funds were available to finance those projects, ex-
cept such savings as might become available. Dr. R. K. C. LEE (USA) expressed the wish that the Sub-committee would
be informal. in its delibjrations rather than formal, as the purpose of the Sub-committee meeting was to enable the group to learn something about the budget. One of the difficulties being faced by the Sub-COmmittee
was that there had been a complete change in membership, so that there was no one in the present group who had the benefit of a continuous experience in dealing with the budget, so that he himself was finding it
•
wp/RC7/p&D/Mln/l Rev.l Page 4 difficult to evaluate the present document. evaluation of wp/RC7/4. The CHAIRMAN agreed that the group should not make the discussions very formal and said that he had had the pleasure of attending the discussions on the Programme and Budget last year, during 'Which time many questions had been asked of the Secretary. The SECRETARY referred to the fact that the Sub-committee 'Which met in Singapore last year approved the 1957 Programme and Budget, and also approved its submission to the Director-General for inclusion in the overall WHO budget. Unfortunately, the budget proposal of the DirectorHe requested further
General had not been accepted entirely by the Ninth World Health Assembly. Instead of the additional $1 239 000 requested, the Assembly had authorized an increase of only $741 660. The effects of this reduction 'Which amounted However,
to more than $150 000 had been felt by the Western Pacific Region.
some of the programmes proposed for 1957 had already been implemented in 1956 in view of the fact that there had been some savings available. In view of this and other modifications, although there was a cut of $150 000, the reduction had not actually been as high. Dr. R. K. C. LEE asked if the Secretary could supply 1:h e correct
figure and was referred to Appendix 1 of document WP /RC7/4, 'Where the activities implemented out of savings for 1957 had been indicated. Dr. H. E. DOWNES referred to the cut mentioned and pointed out the
follOwing facts:
the figure for the Regional Office rose from $253 000 to
$302 000; the amount for malaria, instead of being reduced, was increased
wp/RC7/P&B/Mln/l Rev.l Page
5
from about $18 000 to $21 000; that of venereal disease was cut from
$96 000 to $91 000; tuberculosis remained at $46 000; nursing remained at $81 000; health education of the public moved up from $23 000 to $25 000; maternal and child health and mental health were cut ; nutrition was out; for "other Projects ", the increase was from $26 000 to $42 000; environmental sanitation went up"from $41 000 to $64 000; the figure for public health administration went down to $136 000. supplied could not be argued. The SECRETARY replied that the figures given were correct and mentioned that it was normal for governments to make changes before the year of implementation of projects. the request of governments. Dr. H. E. DOWNES expressed his satisfaction with the explanation given. Dr. R. K. C. LEE referred to the previous statement of the Secretary Dr. DOWNES supposed that the figures
The modifications had therefore, been made at
that some of the 1957 projects would be implemented out of 1956 savings and asked if information could be given as to the approximate economies that could be foreseen. The SECRETARY agreed to obtain this information.
2.2
The SECRETARY explained that the proposed Programme and Budget Estimates for the financial year 1 January - 31 December 1958 had been established in two parts: Part I, relating to projects to be financed
from Regular funds, and Part II, relating to projects to be financed from Technical Assistance funds. Within Part I, activities had been
indicated under two effective working budgets:
wp/RC7/P&B/Mln/l Rev.l Page 6 (1) (2) a basic effective working budget of $669 099, and a supplemental effective working budget not to exceed $157 577 and to be implemented only to the extent to Which inactive Members notify the Director-General that they will resume active participation in the work of the Organization as from 1957. Dr. R. K. C. LEE (USA) asked Whether there were any inactive Members
in this region and was informed there were none. Dr. H. E. DOWNES (Australia) referred to the transfer to the Western
Pacific Region of the cost of the Singapore Epidemiological Intelligence Station and asked if this was reflected in the Regional Office figures. so the Regional Office figures were pretty low and he wondered how this was done. The SECRETARY stated that in order to assist the SUb-connnittee in its deliberations on the programme and budget proposals, some working papers had been prepared showing the analyses of the diBtri but ion of funds by amounts and percentages among various activities planned to be carried out by WHO in the Western Pacific Region: wp/RC7/P&B Working Paper 2 If
Analysis of the Besic Programme and Budget Estimates; WP/RC7/P&B Working Paper 3 - Analysis of the Supplemental Programme and Budget Estimates. Both these working papers pertained to Item 3.2 of the provisional agenda of the Sub-committee. wp/RC7/P&B Working Papers 4 and 5 were analyses
of the Technical Assistance Estimates and were related to Agenda Item wp/RC7/P&B Working Paper 6 was a summary of activities under all funds expected to be available in the Region.
4.
Dr. H. E. DOWNES said that if the Sub -commi ttee looked at the budget for 1957 as determined by the Ninth World Health Assembly and at the budget
wp/RC7/P&B/Mln/l Rev.l Page 7 for 1958 as given in the document, the fact was that, with three exceptions, there had been an increase in the Basic Budget: with the Regional Office,
there was an increase of approximately 4-1/'2$; malaria, an increase of about 7%, Which he thought was not enough; tuberculosis, as proposed last year, had. gone up by 28%; venereal disease, increased by about 1"')%; public-health administration had gone up by approximately 16%; maternal and child health had gone up; mental health had increased by about 67%. He explained that
his government had always taken the view that mental health was more a national problem than an international one and that first priority in expending WHO funds should be on the chain reaction - communicable diseases. There was a total increase of approximately 20% for field activities, compared with the increase of approximately 4% for Regional Office activities. Activities for Which there had been a ftchop" were: endemo-epidecic
diseases; nurSing, having a high proportion of the budget each year, had been cut this year; environmental sanitation, was reduced by 9%. Medecin-Colonel ARETAS (France) expressed the opinion that the importance of malaria eradication had been sufficiently emphasized in Geneva at the Ninth World Health Assembly and he was rather surprised with the small allocation for this activity in the Western Pacific. also asked Why nutrition was in th~
He
SUpplemental Programme.
The SECRErARY explained that in the budget it appeared that the amount allocated for malaria had been less than 'What appeared in the 1957 budget. However, the Eighth World Health Assembly in Mexico had established a Malaria Eradication Special Account and many of the activities in malaria would have to be financed from that Account. If the amount to be draw
from the Special Account was added to the figure given in the budget, it
WP /RC7 /P&B/Min/l Rev.l Page 8 would be f'ound that the total allocation f'or malaria would be higher than that f'or 1957. Regarding the question on nutrition, this was included in
the Supplemental Programme because it was the opinion of' this of'f'ice that this should be a lower priority. It was hoped that, When the inactive
Members resumed participation in the Organization, money wculd be available to implement this and other projects. Dr. R. K. C. LEE ref'erred to page
4 of' the document (wp/RC7/5) _
Cost of' living adjustment, duty travel, statutory staf'f' costs, etc., and asked Whether these were unif'orm allocations f'or WHO personnel and applied to all regions. The SECRETARY replied that apart f'rom the COL adjustment, Which 'WaS
special f'or the Regional Of'f'ice f'or the Western Pacif'ic and the Regional Of'f'ice f'or Africa, the rest were normal entitlements.
Dr. R. K. C. LEE then asked if' the COL adjustment was controlled through the Headquarters Of'f'ice or was there a standard COL adjustment. The SECRErARY replied that this was based on surveys made by the United Nations. M~~ecin-Colonel
ARETAS said that after having studied the various
parts of' the budget submitted by the Regional Director f'or the Western Pacif'ic Region, he had no comments to make but thought that the document had been very well prepared.
Dr. H. E. DOWNES ref'erred to the control of' yaws, treponematoses and venereal diseases and remarked that there were quite a number of' these projects running and that he was very pleased that they were operating so well. He noticed, however, that administrative control of' these activi-
ties varied f'rom place to place and drew attention to the Philippines Where
wp!RC7!P&B!Min!1 ~ev.l Page
9
supplies were being provided by UNICEF and nothing from WHO; for Cambodia and China, a venereologist ahd been supplied by WHO, actual supplies coming from UNICEF; "While the South Pacific yaws team lRd a venereologist, a scientist and an administrative officer. He was of the opinion that "Where
there was a high yaws prevalence there should be no need to have a scientiest and an administrative officer, "When the beneficial results could be obtained by giving injections to all people in the area. were concerned, unless the country 'W'8.S
As far as these diseases
underdeveloped and had a dearth of
medical staff, all that was needed for the activities were supplies. The CHAIRMAN was of the opinion that the differences in the various countries were in the first place due to the state of development and in the second, due to staffing. Further, there was some scientific work to
be done in this field too, such as studies on serological reactions. The SECRETARY explained that the administrative officer was also a male nurse "Who had had a good deal of administrative experience in field campaigns in Nigeria. This project was an inter-country project which After completing the campaign in one WHO's experiences in
required a great deal of planning.
area, the team needed to do some follow-up later.
Fiji and Western Samoa had proved the necessity of adequate follow-up. Aside from his normal duties, the administrative officer would do followup work in areas "Where the campaigns had been completed. In the yaws
campaign, WHO had to follow certain technical policies "Which had been established by the Expert Committee on Treponematoses and Venereal Diseases and accepted by the Executive Board and the Assembly. Campaigns had to These
be carried out, therefore, in accordance with such policies.
policies also necessitated serological study cf the previous and later
wp/RC7/P&B/Mln/l Rev.l Page 10 cases in order that the results of the campaigns would be long and enduring. He pointed out that the health aClministrations in the South Pacific
were not fully staffed. Dr. R. K. C. LEE asked for further details on the conference and study
tour.
The SEC:RE:rARY stated that the plan was: (1) for a short-term con-
sultant to visit Japan, China (Taiwan) and Vietnam; and (2) after making arrangements with these governments, he would proceed to Hongkong where the Regional Committee Meeting would be held next year. After the Regional
COmmittee, the consultant would re-visit Japan for a period of ten days to two weeks, then Taiwan for a week or ten days, and to Vietnam for a week. He would be accompanied by two staff members from the Regional Office. The
group would then return to Hongkong where they would complete the report. Dr. R. K. C. LEE asked whether the countries to be visited were will-
ing to have the group and discuss health problems with them and whether arrangements had been worked out with the Member Countries. The SECRETARY
replied in the negative but presumed that there would be no difficulty in the governments' acceptance of the request for such visits. Dr. R. K. C. LEE thought that if a country was not quite prepared to
receive the group, it was possible that some misunderstanding would arise a member of the group might say the wrong thing at the wrong time, thus jeopardizing good relations. The SECRETARY felt that between now and then there would be sufficient time to negotiate with the governments concerned. Preliminary
negotiations between the WHO staff and the government representatives concerned would start while the Regional Committee was in session. This
wp/RC7/P&B/Min/l Rev.l Page 11 would be followed by formal arrangements later. All negotiations wuld
have been completed before sending the group to the countries. As far as organization of the tour was concerned, the group, comprising fourteen people, would appoint a leader and there would also be rapporteurs. After each visit, discussions would be held and a record of As
these would be kept - all these to be compiled into a report later. to people saying the ~ng
thing at the wrong time, the SECRETARY believed
that the people representing governments were quite responsible and experienced, both in their technical fields and in inter-personal relations, so that they would have to rely on their discretion. Dr. R. K. C. LEE asked if this kind of tour was also being conducted in other regions and was informed that this had been successfully arranged in Europe and South-East Asia. The SECRETARY stated that the situation as far as Dr. Lee's question on 1956 savings was as follows: of the $151 330 there was a reduction of
$77 000 because projects were not implemented owing to governments having withdrawn their requests. Of this $77 000, $41 000 were not required
because an area representative had been appointed who would perform the duties of the public-health administrators originally planned for two countries. $67 000 had been relegated to the Supplemental Budget. As far
as the 1957 programme was concerned, $4500 were financed from Regular 1956 savings; $9000 from Technical Assistance savings. roughly about $13 000 were financed from savings. Dr. R. K. C. LEE asked if only $13 000 of the $151 000 1957 budget had been implemented from 1956 savings, and was informed that this was the case. So, out of the $151 000,
wp/RC7/P&B/Min/l Rev.l Page 12
Dr. R. K. C. LEE thought that an amount should be added to the
$13 000.
If Member Governments were not using in 1957 the $77 000 plus, The SECRETARY said that the
then this represented savings in 1957.
$77 000 were taken from the $151 000 for 1957 because governments had amended some requests for 1957. Dr. R. K. C. LEE said that he had
brought up this question in order that the Sub-committee could follow the discussions on savings. The SECRETARY said that, as already mentioned, the budget for 1957 for the Western Pacific had been reduced by $151 000. be asked: The question might
how had it been possible to cut it by $151 OOO? and the reply
would be: $77 000 worth of projects were withdrawn by governments, from the remaining $80 000, $67 000 had been relegated to the Supplemental Programme and Supplementary List. Approximately $13 000 worth of projects
had been implemented from 1956 savings. Dr. H. E. DOWNES asked how much had been transferred to the Sup-
plemental Programme and the Supplementary List and was informed $67 000. Dr. H. E. DOWNES then stated that with regard to the 1958 budget, he
agreed that the Regional Office or the Organization allocated funds on the request of governments. It was known, however, that requests could be Referring to environmental sani-
stimulated by experts in the Organization.
tation and health education of the public, he said that the experts in these fields were estimable and excellent men and because of this they might branch out and cause unbalance in their own spheres. Organization was now interested in composting. For example, the
He expressed the view that
this was also a question of economics and that excreta disposal was not the pri.mB.ry concern of the Organization, as it was purely an economic matter
lilP/RC7/P&B/Min/l Rev.l Page 13 As far as WPRO 53 - seminar on veterinary health was concerned, it was agreed that zoonoses were important but there were a lot of things Which were more important. As indicated before, he felt that the Committee
had not yet given sufficient guidance to the Regional Office in the matter of priorities. Dr. R. K. C. LEE asked if it was not true that the Committee had adopted guiding principles in planning the use of funds available to governments from WHO and the Technical Assistance Board. Director followed these principles? tive. Dr. H. E. DOWNES was of the opinion that the guiding principles were too general. Dr. R. K. C. LEE then raised the question of the effectiveness of the area representatives in helping Member Countries follow the guiding principles. If the principles were too general as claimed by Dr. Downes, Had the Regional
The SECRETARY replied in the affirma-
it would be very difficult for the WHO representatives to assist the governments. carefully into The He suggested, therefore, that the Sub-committee look more thes~. /
CHAIR}~
recalled that last year a resolution had been adopted
urging governments to include estimates representing governments' contributions to projects and asked if the Secretary could clarify this pOint. The SECRETARY stated that the government estimated expenditure in respect of field activities, including fellowships, whether individual or as part of projects, in the following year or two years would of course be subject to revision for a number of reasons such as
/
wp/RC7/P&B/Min/l Rev.l Page 14 delayed implementation of the project, revised programming, etc. Con-
sequently, any estimates submitted by governments were for information purposes only and were at no time binding on the governments concerned. Referring to the statement of Dr. Downes on composting projects, he explained that a more sanitary disposal of garbage and night-soil was distinctly a health problem and was within the prerogatives of WHO. to the economic phase of this, the improvement of general health had its economic value. In most of the countries compo sting was important As
because of the fact that they lacked sanitary facilities on account of the low economic status. For that reason, compo sting in the under-developed
countries would continue to be a very important project for some time to come. The composting projects started by WHO were mostly pilot projects
but it was hoped that from this experience, ways could be learned as to how to turn garbage and night-soil into some useful purpose, as in most of the countries in the Western Pacific, this represented a serious publichealth problem. He also made reference to resolution wp/Rc6.R8 'Which
recommended the according of priority to environmental sanitation activities. Regarding zoonoses, this was quite a debatable question. He mention-
ed his conversations with Dr. Hammon, of the University of Pittsburg, 'Who was doing some research work in the Philippines at the present time. It
seemed that virus diseases carried by animals were becoming an important public-health problem. the efforts made. Very fortunately, very little was known despite
During the last few years, information had been col-
lected from research centres in this region - Melbourne, Kuala Lumpur, Tokyo, etc. At one time it was felt that WHO should call an inter-regional
wp/RC7/p&B/Mln/l Rev.l Page 15 conference to study insect-borne virus diseases, however, after the DirectorGeneral's budget was cut it was not possible to carry this out on a 'WOrld-wide basis. In view of the importance of these diseases, it was
thouo1t that a small conference could be held in 1957 where it might be possible to gather all important 'WOrkers in this field and the results of their deliberations 'WOuld be made available not only to Member Governments in this region, but also to other regions. study group had been included in the budget. The CHAIRMAN invited the Secretary to read the following dra:rt resolution on the 1957 Regular Programme and Budget which 'WOuld be circulated later: I~e
For this reason, the
Regional Committee,
Having considered the modifications made in the regular programme for 1957, which became necessary as a result of the decision of the Ninth World Health Assembly to establish an effective 'WOrking budget for that year at an amount less than that requested by the Director-General, Having considered the report of the Regional Director on the action taken in regard to the Supplementary List of Projects approved by the Regional Committee at its sixth seSSion, NarES the action taken to accommodate as many of the approved activities as possible within the resources made available to the Western Pacific Region." Dr. R. K. C. LEE did not think the Sub-committee was quite prepared
to consider the resolution yet.
wp/RC7/P&B/Min/l Rev.l Page 16 llie SECRErARY drew the attention of the Sub-connnittee to the working papers WhiCh gave an analysis of the 1958 Regular Programme and Budget and suggested that if the Sub-committee were satisfied with the analysis as presented, it might like to consider recommending to the Regional Committee the adoption of the following resolution: 'The Regional Committee, Recalling that the Director-General has requested the Regional Director to prepare detailed programme and budget estimates for work to be done in the Region and to obtain the recommendations thereon of the Regional COmmittee, in order that he preparing h:is proposed programme and budget, Considering that the Regional Director has developed the programme for 1958 in consultation with the governments concerned and in contonni ty with the:ir requests, Having reviewed the Regular Programme for the Western Pacific Region as presented by the Regional Director, 1. CONSIDERS that the programme proposed for the Western Pacific ~
use those plans in
Region for 1958 is well conceived and the cost estimates carefully established; 2. REQUESTS the Regional Director to transmit the proposals to
the Director-General for his consideration and inclusion in his Proposed Programme and Budget Estimates for 1958." Dr. R. K. C. LEE asked Whether this meant that the Sub .. dommi ttee did not have to meet tOI:lDrI'OW a.fternoon for the study of the ·budBet.• The SECRE!M.RY stated that if all the i terns on the agenda were considered there was no need to meet tomorrow afternoon. The only remaining
wp/RC7/p&B/Min/l Rev.l page 17 items for discussion were
3.3, which was simple, 4, 4.1 and 4.2 Which were
actually for information as the Sub-committee had no control over these matters, and 5 which covered the establishment of the Sub-committee on Programme and Budget as a perraanent Sub-committee of the Regional Committee and not of an ad hoc character as had previously been the case. A report could then be prepared for discussion on Monday morning during a short meeting. Dr. R. K. C. LEE asked for information on the relationship between the area representatives and the public-health administrators. The SECRETARY stated that in the Regional Office there were two branches of administration, one the Administration and Finance and the other the Bureau of Health Services. The Bureau of Health Services had
a Director assisted by two public-health administrators who were liaison officers for governments Where there were no area representatives. as area representatives~
As far
concerned, because of the vast area covered
by the Western Pacific, contacts with governments were very difficult to maintain, supervision over teams working in different countries also presented a problem. In other regions such as the Americas, there were
zonal offices and in the African Region, there were four sub-offices headed by area representatives. In the South-East Asia Region, there In this region, the
were resident representatives in each country.
system of area representative had been adopted for econorllc reasons. There were at present three area representatives, one stationed in Sydney covering the South Pacific territories, Australia and New Zealand, one
wp/RC1/P&B/Mln/l Rev.l Page 18 stationed in Singapore covering Brunei, Sa.rawak, North Borneo, Mal.a.ya and Singapore, and one in Saigon covering Cambodia, Laos and Vietnam. It was hoped in 1958 to have one stationed to cover Korea, Ja.pan and
China. Dr. R. K. C. LEE a.sked 'Who ws the immediate supervisor of the area
representatives and was informed by the SECRETARY that as the title denoted they were really the Regional Director's representatives but were technically under the Bureau of Health Services. Dr. R. K. C. LEE then asked whether the public-health ailministrators
in the Regional Office still divided the Region in two.
The SECRETARY
replied in the affirmative but stated that with the establishment of area representatives, public-health ailministrators were now able to devote more of their time to co-ordination of health level. Dr. R. K. C. LEE felt that the Sub-committee should take cognizance activ~ties
at the regional
of the merger of the Epidemiological Intelligence station in Singapore With the Regional Office, and asked the Secretary to describe the use of the medical officer in charge of the Station as area representative and at the same time explain the future of the statistical and epidemiological services given by the Station. The SECRETARY replied that the status of the station remained the saz::J.e except that the medical officer in charge had the added duty of area representative and that the Singapore EPidemiological Intelligence Station WS DOW
under the administrative supervision of the Regional Office.
Dr. R. K. C. LEE asked 'Whether with this merger the services would
be the same as formerly rendered.
WP/RC1/p&B/Mln/l Rev.l Page 19 The SECREI'ARY replied that this was correct as it would be a very bad move to transfer the Station from Singapore to Manila. Further, it
would mean.that an area representative vould still have to be appointed for that area. Dr. R. K. C. LEE felt that cognizance should be taken of the fact that the Singapore office had been merged with the Regional Office and services had been obtained with very little additional cost to the Region. He sug-
gested this Should be recorded and due recognition given to this merger. He asked how the South-East Asia Region and the other regions felt about the transfer. The SECREI'ARY stated that this had come abuut as a result of a Joint visit by the Director-General, the Regional Director of South-East Asia Regional Office and himself a.:Nier a tuur of inspection. had the agreement of Dr. Mani and Dr. Candau. The ClmIRMAN suggested that if nobody else wished to raise questions of a general nature the Sub-c)mmittee might proceed to consider the dra.:Ni resolution on the 1957 programme and budget (wp/RC7.R3). Dr. R. K. C. LEE proposed that the resolution be submitted to the
The transfer
main Committee for adoption, this was seconded by M6decin-Colonel ARETAS and unanimously agreed. The CHAIRMAN then presented the draft resolution on the 1958 programme and budget estimates (wp/RC7.R4) for reconsideration. Modecin-Colonel ARETAS moved that this be submitted 1D the main Committee. This was seconded by Dr. R. K. C. LEE who reserved the right to
suggest modification of the resolution after consideration of the draft report of the Sub-committee.
wp/RC7/P&B/Min/l Rev.l Page 20
3
SUPPLEMENTARY LIST OF PROJECTS (wp/RC7/5 Add. 1) Dr. H. E. DOWNES (Australia) stated that it was his understanding
that the projects on this list became operative if the Assembly gave more mcney than expected or there were savings. He asked clarification of
priorities between regional and country projects. The SECRETARY replied that in a resolution adopted during a previous Regional Committee meeting, there had been a mandate from the Regional Committee to iIlI.l?lement as many inter-country or regional projects as P08-
sible because they were sometimes more profitable than individual country projects on the same subject. As savings became available consideration
would be given to each project before the decision was taken as to whiCh activity would be iIlI.I?lemented. Dr. R. K. C. LEE (USA) referred to the proposed study groups and
inter-country visits Which he believed worthwhile but hoped the Secretariat recognized the danger of too many inter-country Visits and study tours and asked that they should be closely scrutinized. Dr. H. E. DOWNES endorsed this statement and said that 'When the Secretariat worked out an inter-country project, the Regional Committee always agreed to these projects. In a previous meeting, however, it had
been suggested that study tours could easily develop into Cookls tours. He gave as an example the project for medical librarians ($36 000). When
a decision was taken with regard to jOint projects and country projects, priority was always given to Joint projects. worthy projects. In his opinion there were more
wp/RC1/P&B/M1n/l Rev.l Page 21 Dr. R. K. C. LEE referred to page 15 (Philippines 49) 'Where reference
i
i
was mode to
0.
fellow spending six months eo.ch in Australia and India and
asked 'Whether the leprosy situution in Australia justified this tour. Dr. H. E. DOWNES referred to the leprosy situation in Australia and
the changes 'Which had taken place in the past few years.
However, there
were actually only a few hundred cases of leprosy in Australia a&d little plastic surgery was being undertaken; a study tour for this purpose was not therefore warranted. M6decin-Colonel ARETAS (France) referred to the change of attitude towards lepers in general, and the fact that complete segregation was now no longer considered necessary. He cited as example the work being done
in French-Equatorial Africa and also in South America and pointed out that it might be useful to contact Dr. Rodriguez 'Whom he had met at a leprosy conference in Rome for further advice on the matter. The SECFErARY apologized for the mistake in the document, which had led to unnecessary discussion. The study tour was worked out on the basis
of six months to Australia to study general surgery and six months in India to study plastic surgery. The CHAIRMAN then asked the Sub-committee for comments on the draft resolution on page 1 of document WP/RC1/5. Dr. H. E. DOWNES tlOved that the adoption of this resolution (wp/RC1.R6)
be recommended to the main Committee. ARETAS and agreed.
This was seconded by M6decin-Colonel
4
TECHNICAL ASSISTANCE PROGFAMME (wp /RC1/5 Part II) Dr. H. E. DOWNES (Australia) asked the Secretary to inform the Sub.com-
mittee on hoy liaison was established between the governments and the Regional
' . wp/RC1/P&B/Min/l Rev.l Page 22 Office with regard to the preparation of the Technical Assistance Programme. The SECRETARY stated that early in 1956 representatives from the Regional Office visited Member Governments and discussed with the health authorities the possible request that they would make to the Technical Assistance Board. Following these discussions, projects were costed and
f
justifications prepared by the governments with the assistance of the Secretariat. ning board. Each health department then submitted its list to the planFor instance, in the Philippines the National Economic Council
co-ordinated all requests for assistance under the Technical Assistance Programme. This council made the final decision as to how much each de'rhe
partment received and 'Which requests were to be accepted or cancelled.
Council then submitted the request for approval to the President prior to submittal to the Technical Assistance Board through the Regional Technical Assistance Representative. formal request. The Regional Office received a copy of the
This was a long process and it was for this reason that
it was not possible to present the document earlier. Dr. H. E. DOWNES asked 'Who decided the ceiling for category I and
category II programmes and was informed by the Secretary that the figures were arbitrary, merely planning figures, and there was no guarantee that the sum stated would be forthcoming. Dr. R. K. C. LEE (USA) referred to the study group on quarantine and
asked whether this was not rather a Headquarters acti vi ty.
The SECREI'ARY
replied that the Headquarters responsibility was really quarantine legislation while regional responsibility was connected more with techniques and special circumstances. Various health administrations had stated that
it would be desirable to have such a seminar.
wp/RC7/P&B/Min/l Rev.l Page 23 Dr. H. E. DOWNES asked on 'What the amount set aside for inter-
country projects was based and was informed that the amount set up by the Technical Assistance Board approximated lrJfo of the total allocation. M6decin-Colonel AREl'AS (France) then asked 'Whether the health education course mentioned in the third paragraph of the resolution was the one to be held in the French language in Noumea in
1957.
The SECREI'ARY replied
in the affirmative. Dr. R. K. C. LEE asked 'Whether the Secretariat was guided by
principles 'Which applied both to Technical Assistance and the Regular programmes, also by available funds and. by certain priorities in determining
'Which projects got help and 'Which were dropped.
The SECREI'ARY replied
that neither the Regional Committee nor the Regional Office determined this, it was done by the planning authority in the country in the first place and then by the Technical Assistance Board and Technical Assistance Committee. The document had been submitted for information only. The following draft resolution was then submitted for consideration by the Sub-committee: -rhe Regional COmmittee, Having reviewed the activities planned to be carried out in
1957
and
1958
under the Expanded Programme for Technical Assistance,
Considering that the country programming procedure established for the Technical Assistance Programme reduces the effective review 'Which the Regional Committee can make of the country projects proposed for financing from Technical Assistance funds, Noting that the amount of Technical ASSistance funds available from year to year for health work is not only dependent on the place in their total programmes 'Which governments give to health, but also
wP/RC 7/P&B/Min/l Page 24
Rev.l
may fluctuate from year to year as a result
of the voluntary nature
of the financial support for the programme, 1.
NarES the projects requested by governments in the Western
Pacific Regional Office for health work in 1957; 2. APPROVES the regional (and inter-country) projects proposed
to be financed by Technical Assistance funds, and requests that these projects be approved by the Technical Assistance Board and the Technical ASSistance Committee;
3.
NOTES the training course in health education requested by
the South Pacific Commission as a jOint WHO/SPC project, and adds its request to that of the Commission that the project be approved by the Technical Assistance Board and Technical AsSistance Committee and financed from Technical Assistance funds in 1957, considering the urgency of the project for the people of the territories concerned;
4.
RECOGNIZES that the projects and amounts shown for 1958
are for the purpose of original planning only, and that there is no assurance as to the amount of funds which may become available fJr health work in the Western Pacific Region in 1958;
5.
URGES governments"in the Region, in the development of the
country programmes, to give the emphasis to health projects necessary to support their economic developments, and particularly to assure that continuing projects are safeguarded. tI M6decin-Colonel ARETAS moved that this resolution be submitted to the main Committee for adoption. and approved. This was seconded by Dr. R. K. C. LEE
wp/RC7/P&B/Min/l Rev.l Page 25
5
PROCEDURE FOR CONSIDERA.'IlION OF PROGRAMME AND BUDGET ESTIMATES AT FUI'URE MEm'INGS
The SECRErARY referred to the rather ad hoc nature of the Subcommittee and suggested that as it was important that the Regional Committee should make a thorough study of the programmes and budgets each year a permanent committee might be established. The following draft resolution was
then submitted for consideration of the Sub-committee (wp/RC7.R7): -r.ue Regional Committee, Having established a Sub-committee on Programme and Budget during the last two sessions,to examine the proposed programme and budget prior to it being discussed by the COmmittee, Noting that such an arrangement has proved to be most usefUl in studying and asseSSing the proposed programme and budget, 1. DECIDES that the establishment of a Sub-committee on Programme
and Budget, consisting of six members plus the Chairman of the Regional COmmittee, should become a routine activity of the Regional Committee; 2. RECOMMENDS that the membership of this Sub-Committee be rotated.
among the representatives of various Members, subject to the provision that any representative desiring to be a member of the Sub-committee should be entitled to participate. 11 Dr. H. E. DOWNES (Australia) moved that adoption of the resolution be
recommended to the main Committee. .A:RErAS (France) and agreed.
This was seconded by M6decin-Colonel
Dr. R. K. C. LEE (USA) stated that he wished to put on record the
suggestion that the appointing body in selecting members for this Sub-commi ttee should ensure that a balance of members was maintained, as well as continuity. There being no further discussion, the meeting rose at 5:35 p.m.