(WP/RC14/Min/3 Rev.l)
MINUTES OF THE THIRD MEETmG
Legislative Council Chambers Friday, 6 September 1963 at 9.00 a.m. CHAIRMAN: later Dr Dr
R. F. R. Scragg J.C. Thieme (Vice-Chairman)
CONTENTS 1. 2.
Address by incoming Chairman •••••••••••••••••••••••••••••• Kuru in the Territory of Papua and New Guinea .............
120 12.2
3. 4.
Facilities for education and training of health personnel in the Western Pacific Region •••.••••••.••••.••• Studies on cholera E1 Tor ••••.•••.•••••••••••••••••••••••• Resolutions of regional interest adopted by the thirty-first and thirty-second sessions of the Executive Board and the .Sixteenth World Health Assembly ...........•..•........•................•....•....
124
126
5.
1.32
6.
Selection of topic for the Technical Discussions during the fifteenth session of the Regional CoDlJllj.ttee •••••••• If ••••••
If
••••••••••••••••••••••••
If
•
•
•
•
•
•
•
•
133
7.
Consideration of draft resolution on the Annual Report of the Regional Director •••••••••••••••••••••••••••
137
-117-
llB
REGIONAL COMMITTEE: FOURTEENTH SESSION
Third !eeting Friday, 6 September 1963 at 9.00 a. m. PRESENT
I.
Representatives of !ember States
AUSTRALIA
Dr Dr Dr Dr Dr
R.F.R. Scragg C. Raszler H1mson Mllas H.E. Downes C.J. Ross-Smith
.....
Dr C.K. Chang Dr T.C. Hsu
FRANCE JAPAN
Dr A. Ferron Dr E. Dr J. Mr Y. Dr K.
Wak.a.ma.tsu Ohmura Matsuda Ha.ma.no
KOREA MALAYA
Dr Suk Woo Y\m Dato Dr M1~d Din bin Ahmad Dr Haji Abbas bin RaJi Alias
NEW ZEALAND PHILIPPINES
Dr D.P. Kennedy
Dr L. Uyguanco Dr F.T. Diy Dr E.L. Villegas Dr Antonio Rosario Pinto Dr C.H. Gurd Dr R. Dickie
PORTUGAL
UNrrED KINGDOM
Dr C.H. James
UNITED STATES OF AMERICA
Dr J. Watt Dr R.K.C. lee
Dr Saipele Matagi VIEn'-NAM Dr Le-Cuu-Truong
WESTERN SAMOA
Dr J. C. Thieme
•
MINUTES OF THE THIRD MEETmG
119
II.
Representatives of other inter-governmental organizations and of non-governmental organizations
INTERNATIONAL ASSOCIATION FOR THE PREVENTION OF BLINDNESS INTERNATIONAL COUNCIL OF NURSES INTERNATIONAL DmTAL FEDERATION LEAGUE OF RED CROSS SOClm'IES SOUTH PACIFIC COMMISSION WORLD MEDICAL ASSOCIATION
Dr J. J. Loschdorfer
Miss V. Bignold Mt' T.E. Hubble MI' H. Buchanan
Dr R.A. Chappel Dr C.J. Ross-Smith
III.
WHO Secretariat Dr I.C. Fang Regional Director
SECRETARY
120
REGICliAL COMMITTEE: FOURTEENTH SESSION
1.
ADDRESS BY INCOMING CHAIRMAN: the first meeting l section 4)
Item 5 of the Agenda (continued from
The CHAIRMAN welcomed Dr Pinto (Portugal) who had only arrived
that m::>rning. He then expressed his thanks to the Committee for electing him as Chairman l this was a great honour to the Australian Government and to the Territory of Papua. and New Guinea.
He particularly regretted
that it was not possible for the Director-General to be present as he felt it would have been of advantage to the Region to have him see some of the southern Pacific area and some of its peculiar problems.
The Chairman then drew attention to the fact that during the year
El Tor cholera had entered the island of New Guinea for the first time, but fortunately the disease had been controlled. He felt this pointed
to a greater problem which should engage the attention of the World Health Organization and of the Committee. There were certain disease~
free areas in the world and, as this was a Regional Committee meeting, there should be concern for the keeping of new diseases out of regions and out of countries within that region. If there was consistent
progress and disease-eradication measures were successful in anyone country, then the adjoining countries, regions and areas, should be requested to devote their attention to the eradication of these diseases within their own areas. The Chairman then referred to the recent resolutions of the
Executive Board and the Sixteenth World Health Assembly, particularly those relating to malaria eradication which pointed to the need for
MINUTES OF THE THIRD MEETING
l2l
further development of medical services and the importance of these services in the maintenance of malaria control and malaria eradication and whatever might be developed in this field. This was particularly
relevant to papua and New Guinea which had very few roads and the majority of the villages and areas where malaria occurred could only . be reached on foot or by canoe. The need for an infrastructure, a
rural health unit or health activity to maintain a health state in the local area was not, however, restricted to malaria. equally to tuberculosis, yaws or leprosy programmes. This applied In all areas a
unit was required to fit the particular needs of a particular country to maintain and consolidate the health activity undertaken by special units in special programmes. Reference was then made to the comments of the Representative of the League of Red Cross Societies on the need for community participation and the assistance of voluntary agencies in all health programmes. In developed countries there was a large number of
voluntary agencies designed to reduce the burden on the government of the cost of health services and to bring the community as fully as possible into the role of disease prevention and care of the infirm. In Papua and New Guinea, in particular, the community within the village
had taken care of the social problems arising within that village. Organization, however, disturbed this community participation as also did every benevolent health administration by taking such persons from the village into institutions. Health education and health propaganda
worked through the press and health education councils designed to bring the community into such programme s. But wi thin the community
122
REGIONAL COMMITT.EE: FOURrEENTH SESSION
there were many who could help and take their part in the developm:!nt of health services, thus helping to reduce their cost and. making the programmes that were established more effective. This was a way to
provide the basis for the development and effective use of the infrastructure. Turning to the programme for the meeting, the Chairman corur.ented on its wide scope, which covered the developed as well as the developing countries, and emphasized WHO's breadth of activity in its aim to bring good health to the peoples of the Western Pacific. In conclusion, he referred to the exhibits and documents presented to representatives which gave an indication of both the problems and progress of the Territory. He expressed the sincere
wish that repre sentative s would take the opportunity of participa.ting in the government tours in order to gain a greater knowledge of the Territory. He hoped that many would find it possible to return some
day to see the further progress in the health field which would have been made.
2.
KURU m THE TERRITORY OF PAPUA AND NEW GUINEA: Agenda. (Document WP/RC14/5)
Item 12 of the
With the consent of the Committee, the CHAIRMAN invited Dr F.D. Schofield, Assistant Director of M3dical Research of Papua.
and New Guinea, to in the Territory.
spea..~
on Kuru which is a. new disease found only
MINUTES OF THE THIRD MEEI'ING
123
Dr SCHOFIELD explained that Kuru occurred only in the Fore area of the Highlands and the epidemiology was peculiar,because among children, boys and girls were equally affected whereas among adults women suffered much more frequently than men. There was progressive degeneration of
the central nervous system, leading to ataxia, involuntary movements, muscular inco-ordination, paralysis and death usually in less than a year. The social effects were extremely serious, personal tragedies
being frequent and adult men greatly outnumbering adult women because so many of the latter died of Kuru. The people themselves attributed
the disease to sorcery and until recently suspected sorcerers were brutally murdered, thus adding to social tension. There was no
effective treatment and the disease was always, or almost always, fatal. As regards aetiology, a genetic factor had been demonstrated by Professor Bennett of Adelaide University but the disease closely resembled scrapie of sheep which is a virus disease. It also somewhat resembled
amyotrophic lateral sclerosis from which a virus had been reportedly isolated in Guam. Anthropologists believed that the disease had. existed
for le ss than 100 years, the primary focus had been identified and the disease was still spreading and its incidence increasing. Genetics
alone could not explain these facts and some environmental factor, at present unkno'WIl, must also be involved. He then described the intense
scientific interest which this unique disease had caused since it was first described by Dr Zigas six years ago and the international research taking place in many countries to investigate all aspects of it. It was
hoped that this work would throw light on other degenerative diseases of
124
REGIONAL COMMITTEE: FOURTEENTH SESSION
human beings at present incurable, such as amyotrophic lateral sclerosis, disseminated sclerosis, etc. He also described the measures being taken
by the Administration and the missions to alleviate the situation pending the results of further research. Dr KENNEDY (New Zealand) tb.a.n.tced Dr Schofield for his interesting presentation which he had listened to with fascination.
(For adoption of resolution, see minutes of the fourth meeting, section 3.2.)
3.
FACILITIES FOR EDUCATION AND TRAINING OF HEALTH PERSONNEL IN THE WESTERN PACIFIC REGION: Item 13 of the Agenda (Document WP/RC14/6, Add.l and 2) The REGIONAL DIRECTOR referred to the resolution adopted at the
thirteenth
sessio~
urging governments to submit full information on
training programmes suitable for foreign students, so that it could be distributed to Member governments in the Region. Following the
meeting, a circular letter had been sent to governments and the report before the Committee s~ized
the information received to date.
Dr KENUED"J: (New Zeeland) reported that a course leading tl'l a diploma in dental. public health (D.D.P.H.) would be introduced in the University of Otago beginning next year. Dr WATT (United states of A..'1lerica) stated that the training of personnel was a key to the development of health throughout the world.
MINUTES OF THE THIRD. MEErING
125
There was no question as to the need for additional trained manpower to carry out the results of the research effort being made all over the world in medicine. The very speed with which research was turning up
new and more effective methods of treatment was a point to which he wished to speak. All persons concerned with the training of people
recognized that far more thought and attention than ever in the past must be given to the development of mechanisms, whereby graduates could continue their education effectively in the places where they worked. It was no longer sufficient for a physician to receive refresher courses at intervals of five to ten years. This had been enough in the days He considered that it was
when possibly one new drug appeared a year.
of tremendous importance for the physician, once graduated, to be able to continue to educate himself while at the same time carrying out his duties. This was a point to which educators of today had given relatively He did not mean to downgrade their efforts,
little thought and attention.
but he did not consider the mechanisms of the universities or the teaching institutions had expanded at a rate commensurate with the pace of research. He felt, therefore, that it was of some importance for
the Committee to give thought and attention to this situation.
He
believed that an organization such as WHO could assist in this aspect of education and training. The REGIONAL DIRECTOR stated that Dr Watt had raised a very important pOint. During his visit to the South Pacific some years ago
he had noticed that the medical services were often completely isolated and out of conto.ct with the modern VIOrld. For this reason various
seminars had been organized, such as the tuberculosis refresher course
126
REGIONAL C9MMI:r1EEi FOURTEFmH SESSION
in Fiji and the refresher course on integrated rural health in Apia. A nursing education seminar would take place in Fiji in December and another tuberculosis refresher course would be organized in NOl.Ulea in 1964. It had been originally planned to have one seminar every other ~ortance
year, but because of the
attached to this type of activity,
seminars and/or refresher courses were now being held each year with the assistance of the South Pacific COmmission. (For adoption of
resolution, see minutes of the fourth meeting, section
3.4.)
'
...
4.
STUDIES ON CHOLERA EL TOR: WP/RC14/7)
Item 14 of the Agenda (Docl.Ulent
The REGIONAL DIRECTOR stated that in accordance with the request
of the Regional Committee, governments had been asked to provide information on the cholera studies in operation in the Region and on any future developments in this field. The doc'UIlent presented to the Since
Committee contained a summary of the replies received to date.
the report had been written, Sarawak had indicated that no research studies were being undertaken. Japan had provided information on the
activities of the "Research Committee on El Tor Cholera", which had been established in July 1962. During the past ten months, efforts
had been concentrated on the differentiation between the El Tor cholera
vibrio and classical cholera vibrio by a study of:
(1) the antigenic
structure, (2) the haemolysin test, (3) the phage sensitivity test and
(4) cultural methods.
Studies had. also been carried out on the
differentiation of the El Tor cholera vibrios into the Celebes and the other type s •
MINUTES OF T:H:E THIRD MEETING
127
The attention of the Committee was also drawn to a paper received
from the Government of China on "The epidemic of El Tor vibrio paracholera in Taiwan". On the invitation of the CHAIRMAN, Dr SCHOFIELD, Assistant Director
of M3dical Research, Papua and New Guinea, stated that Dr Lang of the Commonwealth Serum Laboratories had under preparation a vaccine against cholera El Tor which had been introduced to animals and had shown very minor toxic or side-effects. Double blind trials of the vaccine had
been arranged with the Department of Public Health as to its acceptability for immunizing human beings in the villages, particularly in the Sepik District of the Territory, within the next few weeks. This
would provide information whether or not the cholera El Tor vaccine could be used as a routine method of immunizing indigenous populations in this part of the world. The possibility of using the vaccine on a controlled
field trial, should there be an epidemiC of cholera El Tor, had also been discussed with the public health authorities. Since this activity was
considered to be a rather big proposition, with limited resources, he thought that it might be wise to inform WHO of what was being planned. There was, of course, the ethical situation as regards the controls of such a trial and at present, in v'j.ew of HHO' s recommendations during the Manila Conference that Asiatic cholera vaccines should always be given, Dr Lang proposed to use these as a control with a cholera El Tor plus Asiatic cholera vaccine as an experimental unknown. He considered
that the Asiatic cholera vaccine had not been clearly demonstrated in cholera El Tor. Some authorities, including those present at the
Manila Conference, had recommended that where adequate therapeutic
128
REGIONAL CCMocr'J.1lIEE: FOURTEENTH SESSION
services were available, an immunized control group would be justified. If this trial were undertaken in the Territory" official guidance from
WHO would be required. Dr Dm (MaJ..aya) stated that no studies on cholera El Tor had been
undertaken in his country. been seventeen years ago.
The last time choJ.era occurred in MaJ.aya had
In early May this year, however, there had
been several cases of gastro-enteritis in the State of Ma.lacca.
El Tor
cholera had been identified during the middle of the second week of May and investigations had shown that the water supply in the cities had not been properly and adequately treated with ,chlorine. It had,
therefore, been thought that the water supply had caused this recent outbreak. Control measures had been immedUtely enforced and after
treatment of the water supply no new cases had been reported up to the end of May. The preventive measures had included the following:
(1) more effective chlorination of the water supply which had had a dramatic effect; (2) mass vaccination which had covered 90 per cent of the population; (3) restricted movement of the population from one state to the other; (4) ban on exports of perishable foodstuffs. It
was felt, howver, that the treatment of the water supply had probably been responsible for the control of the outbreak. No new cases had been
reported during June, although a fe-w isolated cases had been found in It&1.acca during the early part of July. cholera-free at the end of July. Dr CHANG (China) reported that cholera El Tor had occurred in Taiwan during the middle part of JUly last year and had lasted for fifty-seven days, with a total of 384 cases. It had been observed The country had been declared
MINUTES OF THE THIRD MEErING t
129
that the duration of the convale scent carrier state lasted from four to
..
seventeen days.
Cases of cholera had been found among the crew members
and a passenger aboard a ship that had sailed from Hong Kong.
It had
been noted that everyone in the ship had a valid immunization certificate against cholera. It was therefore feared that the present International
Sanitary Regulations were not adequate to prevent the introduction of the disease, and it was strongly felt that further studies on the problem of carriers should be continued under the leadership of WHO. This new
knowledge might result in amendments being made to the present International Sanitary Regulations. Dr HASZLER (Australia) drew attention to the fact that the crews
of some ships that called casually at Papua and New Guinea ports did not have international certificates of vaccination. Originally, these
ships had not intended to call Got foreign ports but weather conditions, breakdowns or illness had forced them to do so. This situation posed
a potential danger and he suggested that the Regional Committee should ask ~mber
governments to ensure that the crews of such ships should
be provided with valid international certificates of vaccination. Dr VILLEGAS (Philippines) said. that in his country there had been serious outbreaks of cholera El Tor in the late summer of 1961 and sporadic cases had continued to appear in many places. There had been
a slight resurgence of the disease d.uring the middle of 1963, but fortunately its spread had. been kept under control and the number of deaths reduced. Studies of cholera El Tor were being undertaken, Initial findings The use
particularly on its epidemiological characteristics,.
stressed the role of carriers in the spread of the d.isease.
130
of mixed vaccine for immunization was also being studied and laboratory findings had revealed that a mixture of cholera El Tor vibrio and the Ogawa strain was useful for immunization purposes. full reports on these studies would soon be available. Dr WATI' (united states of America) recalled that the Regional
He hoped that
Director's report summarized some of the projects which had been cOIqpleted in the past year, one of which was the pilot study of bUharziasis in the Philippines. The sl.ll!mlB.ry pointed out that
bilharziasis constituted an extremely cOIqplex bio-social problem,
and the actual control of the disease required collaboration between health authoritiea and those who dealt with social and economic development. This situation was analogous to that of cholera. The importance
of considering the bio-social factors involved in a planned attack on cholera should be eIqphasized. Each of the countries threatened by this
disease had. its own protective devices and, to some degree, there was collaboration in the prevention of spread from one to another.
The
history of cholera showed that cholera did not, and could not, maintain itself effectively in any population except under some very unique conditions. It had been :repeatedly introduced into the western world
and population groups in the east without maintaining itself for a long period of time. It was a disease found in a:c-eas where there were maIlY Even
people living in extraordinarily primitive sanitary conditions.
a minimum amount of sanitation introduced into a large population group could prevent the disease from becoming endemic. The existing endemic
foci served as a threat to the rest of the countries whose population l1ved under conditions- susceptible to its reception. Ways to solve
'-
MINUTES OF THE THIRD MEETING
131
some of the bio-social problems leading to the actual eradication of this disease from the world should be found. It was clear that the
repeated introduction, with eventual disappearance in a relatively short time, meant that this organism did not effectively surviv~
and in places
where it was "at home " it was not in a state of stable relationship with the human population. Therefore, assistance directed towards the bio-
social factors would go a long way towards eliminating the disease as a threat to the human race in a short period of time. In areas where
cholera was "at home", collaboration with other regions was de sirable. He believed that the Directors of the WHO Regional Offices for the Western Pacific and south-East Asia should work out some means whereby the actual eradication of cholera could be achieved.
The REGIONAL DIRECTOR believed that the point raised by Dr Watt was very relevant and important. The Organization considered that In his
immunization alone was not sufficient to control cholera.
Annual Report he had stressed the very vital role played by environmental sanitation in the control of this disease. Unfortunately in
many countries environmental sanitation was not the direct responsibility
of the ministry or department of health but that of the public works or public utilities department. bodies was very essential. Close co-operation between these government The ministry or department of health must
take leadership in this aspect of public health, for unless this was done, the programme would be ineffective and inadequate. (For consideration of draft resolution, see minutes of the fourth meeting, section 3.3.)
132
REGIONAL COMMITTEE: FOURTEENTH SESSION
5.
RESOLUTIONS OF REGIONAL INTEREST ADOPTED BY THE THIRTY-FIRST AND THIRTY...SECOND SESSIONS OF THE EXECUTIVE BOARD AND THE SIXTEENTH WORLD HEALTH ASSEMBLY: Item 15 of the Agenda (Document WP/RC14/8) The REGIONAL DIRECTOR stated that the document before the Committee
contained resolutions of regional interest adopted by the
thirty~first
and thirty-second sessions of the Executive Board and the Sixteenth World Health Assembly. A note had been added in connection with some
of these resolutions as it was felt that the attention of the Committee should be specifically drawn to certain parts. Mt- BUCHANAN (League of Red Cross SOcieties) noted that some of
the resolutions mentioned called for special contributions and asked what results had so far been gained in these efforts. The REGIONAL DIRECTOR stated that the appeals to governments for voluntary contributions to the special accounts for some of the activities mentioned had not been very successful. There being no other comments, the CHAIRMAN proposed that the Committee take note of the resolutions given in document WP/RC14/8. It was so agreed.
At this pOint, Dr THIEME (Western Samoa), Vice-Chairman, took over the Chair. Before proceeding to the next item on the agenda, he expressed
his sincere thanks for the honour accorded him and his country by his election as Vice-Chairman.
MINUrES OF THE THIRD MEETING
133
6. f
SELECTION OF TOPIC FOR THE TECHNICAL DISCUSSIONS DURING THE FIFTEENTH SESSION OF THE REGIONAL COMMITTEE: Item 16 of the Agenda (Document WP/RC14/9) The REGIONAL DIRECTOR stated that document WP/RC14/9 contained
suggestions of the Secretariat for the Technical Discussions in 1964. It was for the Committee to decide which topic should be selected. Dr HASZLER (Australia) suggested four other topics for the consideration of the COmmittee, namely: 1.
Urbanization in rural areas and its effects on health Planning the infrastructure of the health department in the organization of rural health services
2.
3. 4.
The changing disease patterns of modern life
Community participation in health programmes especially in the financing of health programmes.
Dr KILA WARI (Australia) referred to the subject of community participation in health programmes and stated that in the Territory of Papua and New Guinea, health programmes with community participation had been introduced and financed by the Government of Australia. In some
districts of New Guinea where there was little public health activity, problems -were dealt with by community participation. He believed that
the participation of communities would be of great help in any health programme introduced in the Territory. Dr KENNEDY (New Zealand) asked for a definition of the word "infrastructure" • Dr HASZLER stated that the health department's infrastructure did the specialized work required by the different health campaigns
REDIONAL COMlgTTEE: FOURTEENTH SESSION
such as antimaJ.aria, anti-tuberculosis.
To allow work to be done by
one organization instead of parallel teams working along in the same area, it was necessary to reorganize the general health department's structure. The REGIONAL DIRECTOR believed that infrastructure actually referred to the peripheral health structure of the local health services. Dr WATT (United states of America) asked what staff worked in the infrastructure. Dr HASZLER replied that it. was c0Ili>0sed of the workers in the field hospitals, the aid-posts, the health centres, who did the actual work in the field and had been trained at headquarters. Dr VILLEGAS (Philippines) stated that according to his understanding
,
the word meant the other services such as public works, waterworks, electricity, etc., that "Were supposed to support any health activity but were not services 'Within the health activity. He felt that the
Australian delegation should define the word more precisely as otherwise the Comm1ttee members might be thinking of it in different terms. Dr HASZLER called attention to resolution EB31.R3l, paragraph 2,
'Where the term. had been used 'With reference to malaria eradication. It could also, hO"Wever, be applied to other subjects. The Australian
delegation wished to recommend that ''planning the infrastructure of health departments in the organization of rural health services" should be considered as the subject of the Technical Discussions.
tGNU'l'ES ---------------------
OF TI-m THIRD NEETING
135
Dr DICKIE (United Kingdom) believed that in choosing a subject for
the Technical Discussions, more concrete topics should be considered. He appreciated the suggestion made by the Australian delegation but from the discussions it was apparent that the meeting was at a loss as regards the meaning of the term infrastructure. Of the three subjects
presented in document 'WP/RC14/9, t.opic No.3, "The role of statistics in public health administration" would seem to be the most interesting one. The value of having basic statistics of diseases was well known.
In Sarawak, and in many countries in the Region, there was a great lack
of proper statistics and a discussion on the best methods of collecting valid statistics would appear to l1e the most appropriate topic for the Technical Discussions in 1964. Dr YUN (Korea) supported the proposal of the representative of the United Kingdom. Dr WATT stated. that for many years in the Public Health Reports,
which
cont~ined
the official reports of the United states Public Health
Service on the occurrence of communicable diseases, there was a small quotation along the following lines: that any health officer in order to be able to do his job must know where, when, and under what circumstances, disease was occurring. In many cases, with the develop-
ment of associated personnel, i.e. statisticians, etc., the importance of statistics to the medical officer himself was commonly overlooked.
The statisticians had developed. their own world and were doing a fine job but the health officers frequently lost intimate contact with statistics as a working tool, as a means of planning and evaluating their work. He would, therefore, like to vote for topic No. 3 with
REGIONAL COOITTTEE: FOURTEENTH SESSION
a slight roodification, that the word "use" should be sUbstituted for "role ", thus amending the topic as follows: in public health a.d.m:I.nistration".
"The use of statistics
This would make the subject roore
concrete rather than simply delineating the role, which did not convey the seriousness of the task of improving the work which the people were charged to do. This 'WOuld be a very valuable approach, especially in
an area such as the Pacific, where the population groups were widely scattered, the distances between people were great, and the means of communicating what was going on between the different areas was not well developed. It 'WOuld be very useful for the Committee to look into
the actual use of living statistics, not just for documentary and historical purposes, but as a prospective tool for evaluating and carrying out one's 'WOrk. The REGIONAL DIRECTOR explained that the three topics suggested by the Secretariat had been chosen after a review of the subjects of the previous Technical Discussions. The question of health education always came to the front no
matter what kind of programme was being implemented.
The Regional
Office now had an adviser on health education and during the last year there had been developments in this particular field. It had, therefore,
been thought that the subject "Health education leadership, organization and administration" might be a good one. The second topic, "Basis and methods for the evaluation of health progr~s ",
had been chosen because it was felt that the Regional
Office had reached a stage where a regular assessment should be made of the 'WOrk that had been done.
MINUTES OF THE THIRD MEETING
137
Regarding the third topic, the statistical unit, section or department in many countries in the Region had not been very well developed. It was difficult to get statistics, particularly reliable ~ortant
ones, and it was realized that they were very administration.
in public health
Although there had been seminars and training courses
and there were some projects in this field in the Region, it had. never as yet been the subject of the Technical Discussions. The VICE-CHAIRMAN fltated that four subjects had been submitted and suggested that the Committee might wish to take a vote on them.
The REGIONAL DIRECTOR stated that the three subjects presented in the document were only suggestions of the Secretariat and the document did not represent a recommendation. If the Committee wished to vote on
the matter, he believed that there were two proposals on the floor, the first made by the Australian delegation and the second by the United Kingdom delegation, seconded by the United states of America delegation, which had proposed a slight modification. Decision: The proposal of the United Kingdom delegation as amended by the United states of An¥3rica delegation was chosen by a majority. The topic of the 1964 Technical Discussions would therefore be "The use of statistics in public health administration "•.
7.
CONSIDERATION OF DRAFT RESOLUTION ON THE ANNUAL REPORT OF THE REGIONAL DIRECTOR (Draft resolution WP/RC14/wp/l) (continued from the second meeting, section 1) Dr FERRON (France), Rapporteur, read. draft resolution WP/RC14/wp/l
to the Committee.
138
REGIONAL COOUTTEE: FOURTEENTH SESSION
Dr YON (Korea) stated that the draft resolution covered quite well
the discussions of the previous session. the inclusion of an additional point.
However, he wished to suggest
There was no need to explain the In
importance of statistics, particularly on birth and death rates.
Korea, statistics were available but these were sometimes not reliable due to the lack of organization, particularly at the local level. Sometimes statistics in official reports differed from those reported in other official d.ocuments. The amendment which he wished to propose
to the Committee was the addition of another paragraph, perhaps between paragraphs 7 and 8, requesting the Regional Director to collect reliable statistics of births and deaths during the last ten years from Member countries in the Region and to make this information available to them. Dr DICKIE (United Kingdom) stated that his delegation felt that too much emphasis had been placed on the first subject dealing with genetic factors. The importance of this subject was appreciated but
three paragraphs had been given to it in the resolution and it was a subject which perhaps was not widely significant in the Region. Dr WAKAMA,TSU (Japan) referred. to the question of population problems which had been raised during the discussion of the Regional Director's Annual on this. ~port.
He felt that more emphasis should be placed
A first step would perhaps be the collection of vital statistics.
Dr WATT (United States of America) agreed with the representative of the United Kingdom that the item on genetics was possibly out of focus with respect to the Regional Director's report. The item which
was of some importance,had been brought to the attention of the Secretariat
MDruTES OF THE THIRD MEETING
139
• but it might be preferable to cover it in a separate resolution. The amendment proposed by the representative of Korea also seemed to him an item somewhat different from the report itself. The actual collection
of statistics over a period of ten years was an item of technical magnitude and he was not prepared to decide on it at this particular moment untU he could see its possible utility. He would like to know
what this would mean to the work of the Secretariat, how much work it would entail for M=mber governments, the investment in time and money It seemed more appropriate to deal with it under
that would go into it.
another item and after more discussion and thought had been given to it.
He hoped that the representative of Korea might see fit to withdraw his proposed amendment and to present it under another agenda item. quite prepared to do the same on the subject of genetics. Dr YON stated that before proposing his amendment to the Committee he had considered 'Whether he should present it as a separate item or as a part of the draft resolution before the meeting. the latter for two reasons. He had decided on He was
The discussion on the subject had taken
place during the discussion on the Regional Director's Annual Report and the other reason was to save time. He had not thought that it would However, if the
be necessary to discuss the proposal which he had made.
M=mbers of the Committee wished to discuss it later as a separate topic, he would be happy to wi thdraw it at the moment. Dr VILLEGAS (Philippines) associated himself with the comments made
by the representatives of the United Kingdom and the United states of America with reference to the parts of the resolution on genetics.
He
suggested that the three paragraphs concerned should be deleted and that the Committee should proceed to discuss the amended text.
140
BEG1JNAL COMMITTEE: FOURXEENTH SESSION
• Dr DICKIE suggested that the resolution should be referred back to the rapporteurs for redrafting. Decision: The draft resolution was referred to the rapporteurs for redrafting. (For consideration of the revised resolution, see minutes of the fourth meeting, section 3.1.)
The REGIONAL DIRECTOR stated that an item "other Business" was provided in the agenda, and the subjects of genetics and statistics could be raised at that point. It was so agreed. (See minutes of the fourth meeting, section 2.)
The meeting was adjourned at 11.45 a.m.