World Health Organization (WHO) · Technical Documents

Brief reports received from governments on the progress of their health activities

December 31, 1965 World Health Organization

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,I WO:ItLD ,HEALTH ORGANliZATION

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MANILA. PHILIPPINES . P.O. BOI< 2932

MANtLLE. PHILIPPINES TELE~.

, UNIs.>.NTE. MANIlA

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RID' REPCB'l'S RECIIft3) ROIl CJOVJlJUDIDlS ONTD lROG1tESS OF THE III HEAL'l'IlAcrIVI'fI18

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.AMlmICAN SAMOA

Report on the Progress of Health and M:!dical Services* The Department of M:!dical Services of the Government of American Samoa provides, at nominal cost, the only medical and dental care in American samoa. The staff of the Department of Medical Services consists of a medical director, qualified general physicians and specialists, a public health officer, and a dental surgeon. They are assisted by Samoan medical and dental practitioners, who are graduates of the Central Medical School in Fiji. The Department operates a l54-bed general hospital and dispensaries on the main islands of Tutuila, as 'Well as two dispensaries in the Manu' a Group. The nursing staff is drawn from graduates of the Nurses Training School of American Samoa, which has been in operation since 1912. The major health problems of the Samoan people are filariasis, tuberculosis, intestinal paraSitism, and infant maJ.nutrition, which demand increasing efforts at sanitation, mosquito control, and health education. Replacement of the hospital, public health facilities, and nurses' quarters in the near future is contellq)lated. Funds have been approvec for the design of a new 200-bed medical facility with new nurses' quarters, and the Samoan Government has contracted with a stateside architectural firm which is at present cOllq)iling necessary basic data for hospital construction.

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*Submitted by the Office of International Health, Department of Health, Education,and Welfare, Washington D.C., 20 July 1965.

HEALTH ACTIVITIES IN 1964/65 IN AUSTRALIA The past year in Aust I' h b progress i~ healt~ and welfare ~~tf~it~:s ~f~hf~et~; ~~~i;;cant and of an lncreaslng awareness of the value of international co-operation in dealing with world-wide health problems. Australia recently agreed to jOin the proposed international agency for cancer research. The Australian Government will contribute from £45,000 to £68,000 annually towards the cost of the agency, which is to operate as a semi-autonomous body to the World Health Organisation. It is understood that the agency will work by sponsorship and co-ordination of research work in established national laboratories rather than by setting up its own laboratories and Australia feels it can make a worthwhile contribution to the work of the agency. In the field of quarantine Australia has agreed to implement two World Health Organisation recommendations. The proposal that the period of validity of yellow fever vaccination certificates should be increased from six to ten years is acceptable to Australia, The proposal that vaccine used for smallpox vaccinations should be of a type certified to fulfil standards set by W.H.O. and that vaccination certificates should indicate the source and batch number of the vaccine is also acceptable to Australia. The calf lymph vaccine produced by the Commonwealth Serum Laboratories in Melbourne and used throughout Australia meets the potency and safety standards set by W.H.O. During the past year new links were established between the Commonwealth Department of Health with other countries interested in improvinr- the flow of international information about adverse drUg reactions. A comprehensive warning scheme is now operating in Australia by which doctors and hospitals throughout the country report any incidents involving adverse drug reactions to the Department of Health. The Au~tra~ian Drug Evaluation Committee, set up in 1963 after the thalldomlde tragedy, now meets regularly to review all of the information gathered by the Department both from"within,Austral~a and fr?m overseas. Where necessary the Drug Evaluatlon Commlttee advlses the Commonwealth Government on action which might be necessary against any drug. In the past year there have been several instances where warnings have been issued against the use of certain drugs or where particular drugs have been withdrawn from sale as a result of the operation of this drug control system. Great progress has been made in the past year within Australia in the compilation of a National Poisons Register. This register, the first edition of which is expected to be completed later this year, will be distributed to Poison Information Centres to be set up in more than 100 major hospi tals throughout the country, Whenever cases of' poisoning occur doctors will be able to telephone the Poisons Information Centres for urgent advice to assist them in diagnosis and treatment. The register will be one of the most comprehensive of its kind and will need continual revision and additions to keep it up to date. (When it has been brought to an appropriate stage of readiness the Poisons Register could be made available to other countries which might find it of value). , Ano~h?r major work of medical compilation has been a Natlonal Morbl~lty Survey carried out on behalf of the National Health and Me'Hcal Recc2.:c'C'!c. CouncdJ. '1;he data collected in this survey has now been tabulated and an outline of the survey and

On May 1st of this yea . in t~e field of medical measuri r ~n lmporta~t step Was taken metrle measuring of '" ng 1n Australla. On that date meulclnes prescribed und th Ph · Beneflts SCheme replaced t' Id I ' er e armaceutical £ 11 d t , n~ 0 mpenal System. This change 0, ow~ he sW1tch to metrlc measuring in the British Pharmacopoeia WhlCh lS, the st~ndard r~ference in Australia for pharmaceutical ' formulatIons. The metrlc system of weights a..'1d measures has been used exclusively in several Australian hospitals for some time and in the training of most medical graduates and pharmacists. The figures for notifiable diseases in Australia and over the past year highlight the success of the nation-wide vaccination campaign against poliomyelitis. In the past year there were only two confirmed cases of poliomyelitis in Australia and no deaths. Since the vaccination campaign against this disease was started in 1956 there has been a steady decline in its incidence with the exception of the epidemic years 1961/62. A significant feature of this epidemic, however, was the protection given to people who had been vaccinated and the high incidence among people who had not been vaccinated. Among people who had been vaccinated the incidence rate was 3.05 per 100,000 compared with 85.6 per 100,000 for people who had not been vaccinated. In 1955 in Australia there were 874 cases of poliomyelitis and 30 deaths and in 1956 there were 1144 cases and 57 deaths. Salk vaccine was first introduced into Australia in 1956 and large scale vaccinations began in June of that year. After 1956 there was a sharp decline in the incidence of the disease until 1961 when there were 450 cases and 21 deaths and 1962 when there were 259 cases and 25 deaths. Since 1962 there had been a total of only 54 cases and one death. Until 1964 all anti~poliomye~itis vaccination programmes in l.ustralia had been carrled out ~th Salk vaccine. In 1964 the Tasmanian State Governme~t carrl~d out a pilot vaccination programme us~ng Sabi~ oral vaCClne and 1S now about to begin a large scale Sabln campalgn • event of particular interest to health authorities in Australia was the conference in Canberra in A~gust ~f the .i~ustralian Postgraduate Federation in Medicine which revlewed .. \.U~tra~la' s potential contribution to postgra~uat~ med~c~l educatlon,ln South and South East Asia. The Federatlon ldentlfled sOI?e baS1C concepts concerning medical aid to overseas countr~es and, listed suggestions for future programmes. In summlng.u~ ~ts, findings, the Federation stressed the point that. the lnltlatlve for requests for aid must remain with the countrles concerned. "Our responsibility is to be prepared to meet these requests to the best of our ability", the Federation's report on the conference said. •\11

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This conference was followed later in the month by the fourth congress, held in Perth, Western Australia, of the Confederatio,' of Medical Associations in .\sia and Oceania. This congress, held in conjunction with the Second Australian Medical Congress, was attended by delegates from most of the ten national medical associations which are members of the Confederation.

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.. , Such conferences and congresses are just one more lndlcatlon of the desire for international co-operation which exists in the medical field. In our own part of the world it is good to know that fruitful co-operation is going on in two complementary fields of mediCine - through the governmental medical agencies in W.H.O. and through the practising medical profession in such organisations as tr~

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NATIONAL HEALTH ,

AND MEDICAL RESEARCH COUNCIL

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Fifty-Eighth Session

COMMONWEALTH OF AUSTRALIA

National Health and Medical Research Council Fifty-Eighth Session , ,

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CANBERRA 29TH-30TH OCTOBER 1964

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BY AlITHOIllTY: A. J. ARTHUR, COMMONWEALTH GOVERNMENT PRINTER, CANBBIlRA

15172/64.

CONTENTS Pagt General .. Medical Research Advisory Committee Grants for Medical ResearchUniversity of Adelaide .. University of Melbourne Monash University University of New South Wales .. University of Queensland University of Sydney .. University of Western Australia .. New South Wales, Institutes and Hospitals Queensland, Institutes, Hospitals and Miscellaneous South Australia, Institutes and Miscellaneous Victoria, Institutes and Hospitals Medicine Advisory Conunittee Antibiotics Conunittee .. Nursing Committee Nutrition Conunittee .. Radio-Isotopes Conunittee Public Health Advisory Conunittee Dental Health Conunittee Epidemiology Conunittee Food Additives Conunittee Food Standards Committee Maternal and Child Health Committee Medical Statistics Conunittee Occupational Health Committee Traffic Injury Conunittee Veterinary Public Health Conunittee Conunittee Membership and Procedure 5 7 9 11 15 16 17 18 20 22 23

24 24 27

29 30 30 30 31 35 36 36 37 39 39 39 40 40

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ApPENDICES I

Recommendations on the Collection and Recording of Dental Health Data

44 46 47 49 50

II Recommended Standards for Food Additives .. III Code of Principles Concerning Milk and Milk Products IV Standard for Coconut

V Standard for Fish and Fish Products VI Standard for Canned Fish Products .. VII Standard for Lemon Butter, Fruit Flavoured Spread and Fruit Flavoured Filling VIII Standard for Margarine IX Standard for Metals in Food X Prescribed Methods of Analysis

51 53 54 55 56 57 59 60

XI Standard for Coffee XII Standard for Sugar and Glucose XIII National Health and Medical Research Council Members for 1964-65 XIV The Inter-relationship of Council, its Committees and Sub-committees

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REPORT OF THE NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL

Fifty-Eighth Session, 29-30th October 1964 GENERAL The fifty-eighth Session of the National Health and Medical Research Council was held at University House, Canberra, on Thursday 29th October and Friday 30th October, 1964. The following members were presentMajor-General W. D. Refshauge, the Commonwealth Director-General of Health, (Chairman); ProfiJes. sBorMSirtEh~.ward Ford "-rrepresenting the Commonwealth Department of Health; D r. . . a leson Dr. R. W. Greville, representing the Commonwealth Serum Laboratories Commission; Dr. C. J. Cummins, the Director-General of Public Health, New South Wales; Dr. R. J. Farnbach, for the Chief Health Officer, Victoria; Dr. A. Fryberg, the Director-General of Health and Medical Services, Queensland; Dr. P. S. Woodruff, the Director-General of Public Health, South Australia; Dr. W. S. Davidson, the Commissioner of Public Health, Western AUiitralia; Dr. J. Edis, the Director-General of Health Services, Tasmania; Dr. T. K. Abbott, for the Director-General of Public Health, Territory of Papua and New Guinea; Dr. T. G. Swinburne, representing the Federal Council of the Australian Medical Association; Mr. K. W. Starr, representing the Royal Australasian College of Surgeons; Dr. J. J. Billings, representing the Royal Australasian College of Physicians; Professor S. Sunderland, representing the Australian Universities having medical schools; Professor S. L. Townsend, representing the Australian Regional Council of the Royal College of Obstetricians and Gynaecologists; Dr. J. G. Radford, representing the Australian College of General Practitioners; Dr. A. V. Jackson, representing the College of Pathologists of Australia; Dr. J. M. Wack, representing the Australian Dental Association; Dr. H. J. Ham, representing the College of Radiologists of Australia; Sir Norman Nock, an eminent layman appointed by the Commonwealth Government; Miss M. C. Nelson, an eminent laywoman appointed by the Commonwealth Government; Dr. R. H. C. Wells (Secretary of the Council). Dr. W. F. Simmons, Chairman of the Medical Research Advisory Committee, attended part of the meeting at the invitation of the Chairman of Council. An apology was received from Professor V. L. Collins, representative of the Australian Paediatric Association, who was unable to attend.

The Chairman welcomed Dr. T. K. Abbott, Acting Director of Public Health of the Territory of Papua and New Guinea and Dr. R. J. Farnbach. Deputy Chief Health Officer, Victoria.

The Chairman presented the following message from the Acting Commonwealth Minister of Health.. I sincerely regret that the pressure of other Government business does not allow me to-day to personally meet you all at the opening of your Council's 58th session. 1 understand that one of the main items on your agenda for this meeting is to make recommendations on the grants to be made for medical research in 1965. The applications for these grants have been received and I know from Dr. Refshauge that they have already been carefully examined by the Medical Research Advisory Committee and its subcommittees. The valuable work performed by the members of the Medical Research Advisory Committee, most of whom are heads of busy university or clinical departments, is much appreciated by my Government. I am told that on average each member of the Committee has to spend about 14 days each year assessing grant applications for the Council. I hope that they feel that their efforts have been made more valuable this year by the decision of the Government to increase the annual allocation to the Medical Research Endowment Fund from £318,500 to £400,000. Unfortunately this session marks the retirement of Dr. W. F. Simmons from the chairmanship of the Medical Research Advisory Committee after some 18 years' service to that particular committee. I think the most appropriate tribute that I can make to Dr. Simmons is simply to reflect on the achievements of the Medical Research Advisory Committee. Under Dr. Simmons' guidance the Committee has changed with the times and has served to make the National Health and Medical Research Council the leading authority in this country for the promotion of medical research. We are a small country in terms of population and must use a major part of our national income to develop our national resources, but medical research and education flourish throughout all States; This is evidenced by the award of two Nobel Prizes in Medicine to Australian research workers in recent years. It goes without saying that both of these were supported for part of their careers by National Health and Medical Research Council grants. We do not, of course, measure our success in this field only by the big and maybe spectacular discoveries. I think it would be correct to say that from now on most of the big breakthroughs in medical science will be based on pyramids of knowledge built up by the work of numerous individuals and teams of research workers. In a situation like this each block of the pyramid of knowledge is just as important as the peak. One project of which I have recently been informed and which seems to me to illustrate the value of such basic research is the hepatitis virus study being carried out at Fairfield Hospital. The isolation of a virus andifinding a means of culturing it which can become a routine rather than, as at present, a difficult achievement might not be as dramatic as the. final production and use of a vaccine which can eliminate a disease as a public health hazard. It is, however, only from the broad base of medical knowledge provided by basic research projects that discoveries can be made which are immediately and perhaps spectacularly useful. Such projects as the hepatitis study at Fairfield, and all the other basic research being done in the medical field, ultimately return wonderful dividends in human health and happiness. It is for this reason that my Government is happy to support the multiplicity of research projects recommended by this Council.

We in the Government, in our tum, need the help of the Council by way of advice about which projects are necessary to the complete structure of medical knowledge. In a building of this sort, as in any other type of building, it is important to know what is necessary to the structure and what are the priorities. I wish the Council every success in its deliberations at this 58th session. I trust that your deliberations will prove personally satisfying to you and I am sure that they will be beneficial to the community generally."

MEDICAL RESEARCH ADVISORY COMMITIEE The Medical Research Advisory Committee met in Canberra on 26th and 27th October, 1964, and also had a joint meeting with the Public Health Advisory Committee during the afternoon of 26th October. The Report of the Committee was presented by its Chairman, Dr. W. F. Simmons, and Council approved the following recommendations arising from the report.

Approved Research Institutions

The Council recommended that the Department of Biology, University of Queensland, which is no longer in existence, be deleted from the current list of" Approved Research Institutions".

Grant Variations by Chairman of Council

The Council recommended that the following variations in grants approved by the Chairman of Council be confirmed. The total amount involved is £785 4s. lId. .r

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April, 1964

PROF. M. LEMBERG, Institute of Medical Research, Royal North Shore Hospital. £80 lis. 8d.-Travel expenses in connection with attendances at meetings of ANZAAS and the Australian Biochemical Society. Dr. D. B. Morell (£16 2s. 4d.). Mr. W. H. Lockwood (£16 2s. 4d.). Miss J. Davies (£16 2s. 4d.). Miss L. Clarke (£16 2s. 4d.). Mr. P. Sinclair (£16 2s. 4d.). DR. H. M. WHYTE, Kanematsu Memorial Institute, Sydney Hospital. £28 4s.-Travel expenses for Dr. J. A. Young to attend Australian Physiological Society meeting. May, 1964

PROF. A. W. STEINBECK, School of Medicine, University of New South Wales. £7 4s.-Additional grant to provide a salary increase for Laboratory Assistant (Miss Dash) in accordance with State award. MR. B. S. GOW, Department of Physiology, University of Sydney. £24 7s. 3d.-Travel expenses to attend Australian Physiological Society meeting. June, 1964

DR. K. W. KNOX, Institute of Dental Research, Sydney. £18 lOs.-Cancellation of previous grant of £39 travel expenses for Mrs. Hall to attend Biochemistry Congress, and approval of additional grant to send Mrs. Hall to Melbourne for consultations with leading biochemists. July, 1964 DR. D. A. DENTON, Department of Physiology, University of Melbourne.

£63-Travel expenses in connection with attendances at meetings of the Australian Endocrine Society. Dr. J. P. Coghlan (£19). Dr. C. Boyd (£22). Mr. J. Blair-West (£22). 7

DR. K. D. MUIRDEN, Department of Medicine (Royal Melbourne Hospital) University of Melbourne. £190-Additional grant to enable Dr. G. Harris to be employed at a salary of £1,610 per annum for the period 3rd August, 1964 to 31st December, 1964 replacing Technical Officer Mrs. J. McCall. DR. K. G. RIENlTS, Department of Biochemistry, University of New South Wales. £43-Additional grant, in addition to £496 already approved by Council, to purchase an ultraviolet absorptimeter and chart recorder. DR. J. D. FEWINGS, Department of Human Physiology and Pharmacology, University of Adelaide. £23 Ss.-Travel expenses to attend Australian Physiological Society meeting. August, 1964

DR. M. E. HOLMAN, Department of Physiology, Monash University. £S9-Ad4itional Grant to provide a salary increase for Technical Assistant Miss J. R. Hughes in accordance with local award. PROF. R. C. NAIRN, Department of Pathology, Monash University. £52-Additional grant to provide a salary increase for Technical Assistant Mr. AskeyDoran in accordance with local award. September, 1964

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SIR MACFARLANE BURNET, Walter & Eliza Hall Institute, Melbourne. fIll-Travel expe!1Ses in connection with attendances at scientific meetings. Mr. J. Pye (£IS). Miss B. Cook (£IS). Dr. G. J. V. Nossal (£24 7s. 2d.). Dr. J. Marshall (£25 6s. 5d.). Dr. I. R. Mackay (£25 6s. 5d.). PROF. S. D. RUBBO, Department of Bacteriology, University of Melbourne. £5S-Additional grant to provide correct salary for Research Assistant Miss D. Paarman for period 1st January, 1964, to 31st December, 1964, in accordance with N.H. & M.R.C. salary scales. Her salary as from 1st July, 1964, would then be £1,470 per lPlllum.

GRANTS FOR MEDICAL RESEARCH The Council noted that the Commonwealth Government allocation to the Medical Research Endowment Fund was increased from £318,500 in 1963-64 to £400,000 per annum as from 1st July, 1964. For some years the Council has been recommending grants for periods up to five years according to the condition associated with N.H. & M.R.C. grants which states that the primary award of grants for the salaries of Research Fellows, Senior Research Fellows and Principal Research Fellows shall normally be for five years. In recommending other grants for periods of two years or longer, the Council intended to review all grants for periods of two or three years one year prior to the indicated termination of the grants, and to review all grants for periods of four or five years two years before the indicated termination of the grants. The Council considered that in making grants for periods of longer than one year, no more than 60 per cent. of the funds estimated to be available should be committed longer than one year ahead, including the commitment for salaries of Research Fellows, Senior Research Fellows and Principal Research Fellows. The Council recommended grants for 1965 totalling £394,364 and (subject to funds being available) commitments for 1966 totalling £157,978, as listed below. ,

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Name and Project

Nature of Gront

Gront

Commitment

1965 £

1966 £

1967 £

UNIVERSITY OF ADELAIDE Department 0/ Dental Science

r . .,

MR. T. GOTJAMANOS (New Grant) Cell renewal in the dental pulp of the rat.

Maintenance expenses.

250

Department 0/ Medicine

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PROF. B. S. HETZEL (Renewal) The nature and control of thyroid secretion.

Salary, Research Officer, Mr. B. f. Good. Maintenance expenses and pay-roll tax. Travel expenses, Mr. Good (for study with Dr. K. Ferguson, C.S.I.R.O.). Beckman spectrophotometer. Deep freeze.

1,950 400 40

1,950 400

1,700 300 4,390 2,350 2,350

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DR. I. J. FORBES (New Grant) Studies of human lymphocyte function.

Salary, Postgraduate Scholar, Mr. J. L. Smith. Maintenance expenses, minor equipment and pay-roll tax. Automatic C14 counting equipment.

900

300 1,660 2,860

Name and Project

Nature of Grant

Grant 1965

COmmitmelll 1966 1967 £

£ Department of Microbiology

PROF. G. B. MACKANESS Dr. F. M. Collins (Renewal) (i) Mechanism of acquired resistance to intracellular parasites. (ii) The functional and anatomical changes in immunologically activated macrophages.

Salary, Senior Research Officer, Mr. R. V. Blanden. Salary, Research Assistant (to be appointed). Technical assistance, maintenance expenses, minor equipment and pay-roll tax.

2,080 1,415 1,100 4,595

2,180

2,280

1,100 3,280 2,280

PROF. E. ROWLEY Dr. K. J. Turner Dr. C. R. Jenkin (New Grant) (i) Serum proteins, particularly antibody proteins in mammals. (il) The synthesis of antibody proteins by embryos. (iii) Antibody-like substances in invertebrates. DR. P. C. READE (Renewal) The production of immuno-globulins by foetal rats and chicks.

Salary, Research Fellow, Dr. K. J. Turner. Technical assistance, maintenance expenses and pay-roll tax.

2,750 1,000 3,750

2,860 1,000 3,860

2,970 1,000 3,970

Salary, Senior Research Officer, Dr. P. C. Reade Technical assistance, maintenance expenses and pay-roll tax

2,680

600 3,280

Department of Obstetrics and Gynaecology

DR.R. I. COX (Renewal) The development and use of gas chromatography in steroid analysis.

Technical assistance, maintenance expenses and pay-roll tax.

1,000

Department of Human Physiology and Pharmacology

PROF. R. F. WHELAN (Renewal) Nervous and humoral control of blood vessels in man.

Salary, Senior Research Officer, Dr. J. D. Fewings. Technical assistance, maintenance expenses and pay-roll tax.

2,480 1,000 3,480

DR. C. J. COOPER (Renewal) The initiation and control of voluntary movements.

Salary, Senior Research Officer, Dr. C. J. Cooper. Maintenance expenses and pay-roll tax.

2,580 250 2,830

DR. I. S. DE LA LANDE (New Grant) Pharmacological analysis of venom of bull dog ant (Myrmecia spp.).

Salary, Research Assistant, Miss J. Lewis. Consumable supplies and pay-roll tax.

1,415 200 1,615

DR. S. L. SKINNER (Renewal) Analysis of factors influencing renin secretion.

Salary, Senior Research Officer. Dr. S. L. Skinner. Technical assistance, maintenance expenses and pay-roll tax. Sanborn +Channel recorder and accessories (N.H. & M.R.C. ownership).

2,680 1,000 2,500 6,180

Name and Project

Nature o/Grant

Grant

Commitment

1965 £ DR. R. N. SPEDEN (New Grant) Electrophysiology of vascular smooth muscle. Department of Surgery DR. J. S. CHARNOCK Dr. L. J. Opit (Renewal) Further studies of the mechanism of cation transport. Laboratory assistance, maintenance expenses and pay-roll tax. 1,000

1966 £

1967 £

Salary, Postgraduate scholar (to be approved by Chairman of Council). Maintenance expenses, minor equipment and pay-roll tax.

900 640 640 640 640 640

1,540 Medical School Training Grant. Australian Journal of Experimental Biology and Medical Science Publication expenses. 2,000 1,500

UNIVERSITY OF MELBOURNE Department of Anatomy DR. A. F. ROCHE (Renewal) The physical growth of normal and abnormal children. Grant-in-aid. 3,500 3,500 3,500

Department of Bacteriology PROF. S. D. RUBBO Dr. J. Gardner (Renewal) Sporocidal activity of glutaraldehyde and related compounds.

Salary, Research Assistant, Miss D. Paarman. Maintenance expenses and payroll tax.

1,470

350 1,820

DR. F. W. E. GmSON (Renewal) (i) The biosynthesis of vitamin K and ubiquinal in bacterial cells. (ii) The pathway of degradation of naphthoquinones and other pathways of aromatic biosynthesis.

Salary, Research Assistant, Mr. G. B. Cox. Technical assistance, maintenance expenses and pay-roll tax.

1,580

1,200 2,780

DR. B. W. HOLLOWAY DR. A. J. PITTARD (Renewal) (i) Chromosome mapping in Pseudomonas aeruginosa. (ii) Genetic studies on P. aeruginosa phage B3. (iii) Genetic and biochemical investigation of aromatic biosynthesis in E. coli K-12.

Salary, Postgraduate scholar, Mr. B. Rolfe. * Technical assistance, maintenance expenses and pay-roll tax. * Research assistance, maintenance expenses and pay-roll tax. t

950 1,500 750

3,200 t For project (iii).

• For projects (i) and (ii).

N_ and Project

Nature of Grant

1965 £ DR. D. O. WHITE DR. I. H. HOLMES (New Grant) (i) Delay in initiation of viral infection. (ii) Purification and structure of Rabbit Oral Papilloma Virus. (iii) Tail structure and function in Pseudomonas bacteriophages. Salary, Postgraduate Scholar,

1966 £

1967 £

Miss B. Wansborougb. Maintenance expenses. Ultrasonic disintegrator.

950 400

450 1,800

Department of Biochemistry

PROF. V. M. TRlKOJUS Dr. M. T. McQuillan Dr. P. E. E. Todd (Renewal) (i) The specificity of intra-cellular proteinases and peptidases. (ii) The action of human thyroid enzymes in human thyroid and the structure of human thyroid. (iii) Culturing of thyroid follicular cells for enzyme studies. (iv) A study in rats of iodinated amino acids.

Salary, Research Assistant, Miss P. Jablonski. Salary, 5 months, Research Assistant, Mr. T. Dopheide. Salary, Postgraduate Scholar, Mr. G. G. Smith. Consumable supplies and pay-roll tax. Travel expenses, Research Assistants (Australian Biochemical Society Meeting).

1,635

1,690

705 950 750 48

1,000 750

4,088 DR. F. D. COLUNS (Renewal) The study of the chemical structure of phospholipids, the development of analytical methods, and the relationship between phospholipid metabolism and the essential fatty acids. Salary, Senior Research Fellow, Dr. F. D. Collins. Salary, Research Assistant, Mr. G. de Pury. Travel expenses, Dr. Collins and Mr. de Fury (Australian Biochemical Society Meeting). Technical assistance, maintenance expenses and pay-roll tax. Gas chromatogram (N.H. & M.R.C. ownership).

3,440

3,600 1,690

3,600

48 2,250 2,300

9,888 DR. L. R. FINCH Mr. J. W. Legge (Renewal) (i) Nucleic acid metabolism in relation to growth and differentiation. (ii) Transformation in Bacillus subtilis. (iii) Amino acid activation in mutants of Pseudomonas.

3,600

Technical assistance, maintenance expenses and pay-roll tax.

1,250

Department of Conservative Dentistry

PROF. E. STOREY Mr. A. Malcolm Dr. H. A. McIntosh (Renewal) (i) Investigation of the development of natura1ly occurring and experimentally induoed osteoporoses. (ii) The effect of tetracycline antibiotics on teeth and bone in man and animal. (iii) The effect of mechanical force on bones and bone structure. (iv) The effect of high levels of fluoride adtninistration on bones and teeth.

Technical assistance, maintenance expenses and pay-roll tax.

2,630

NII11/e and Pndect

Nature 0/ Grant

Grtllft

Ctlmmitment

DepartWlnt 0/ Dental Prosthetics PROF. H. F. ATKINSON Dr. R. W. Shepherd

1965 £

1966 £

1967 £

:0.-. C. G. Dennis Dr. A. A. Grant Mr. H. I. Gill Dr. E. Marks (Renewal) (i) Muscle activity during mastication

and speech. (il) Position of mandible and

Technical assistance, equipment, maintenance expenses and pay-roll tax.

2,500

teeth

during speech and mastication. (iii) Variations in the frequency of speech in the normal, cleft palate and operated patient. (iv) Muscle spindles in the masticatory muscles of man, cat and goat. (v) Tetracyclines in developing teeth and bone. (vi) Microradiographic study of dentine and bone. (vii) Bone resorption after tooth removal. Department 0/ Medicine (Royal Melbourne Hospital) DR. P. KINCAID-SMITH (Renewal) (i) The etiology and treatment of renal infection. (ii) The correlation of structure and function in renal disease. (iii) Analgesic abuse and renal disease. DR. J. R. E. FRASER DR. K. D. MUlRDEN (Renewal) Study of synovial cells.

60 per cent. part-time salary, Senior Research Fellow, Dr. P. Kincaid-Smith. Technical assistance, maintenance expenses and pay-roll tax.

2,160

2,750 4,910

Salary, Research Assistant. Equipment, maintenance expenses and pay-roll tax.

1,415 800 2,215

Department 0/ Medicine (St. Vincents Hospital) PROF. G. C. DE GRUCHY (Renewal) Red cell metabolism in congenital and acquired haemolytic anaemia. Part salary, Research Officer, Miss B. Esmonde. Maintenance expenses and pay-roll tax.

750 500 1,250

Department 0/ Obstetrics and Gynaecology DR. J. B. BROWN Dr. N. A. Beischer Dr. J. W. Johnstone Dr. H. P. Taft (Renewal) Development of oestrogen, pregnanectiol and gonadotrophin a&$lYS and study of ovarian and placental function in gynaecological and obstetrical disorders.

Technical assistance, maintenance expenses and pay-roll tax. Part-cost, gas chromatogram.

3,500 1,000

3,500 3,500

3,500 3,5M

4,500

Department 0/ PhysiQ(o¥y PROF. R.D. WRIGHT (Renewal) Histological studies ofsaIivary glands and other histological projects. Part salary, Histology Technician, and pay-roll tax.

550

Name and Project

Nature 0/ Grant 1965 £

Commitment

1966 £ 4,600 3,080 3,080

1967 £ -~.

DR. D. A. DENTON (Renewal) (i) Continuation of studies on ablation of kidneys in hypophysectomized animals in relation to site of origin of ASH. (ii) Study of hypophysectomized sheep with adrenal transplant. (iii) Effect of large or discrete ablations in the central nervous system on aldosterone secretion (iv) Effect of induction of emotional states in trained animals on the corticosteroid secretion (v) Effect of local haemodynamic changes in splanchnic and renal circulation on corticosteroid secretion. (vi) Effect of changes of plasma and extracellular volume of corticosteroid secretion and renal haemodyuamics. (vii) Effects ofNa deficiency and physiological response of secretory tissues. (viii) Continuation of studies on the biosynthesis of aldosterone. (ix) Study of aldosterone of sheep immunized to give high titre of antirenin in the circu1ation. (x) Investigation of neural mechanisms involved in selective appetite for Na shown by Na-deficient sheep-the influence of hypertension on this mechanism. DR. D. J. DEWHURST (Renewal) Precise control of human muscular movements. DR. A. SHULMAN (Renewal) (i) The use of metal chelates in the investigation of biological mechanisms. (ii) The mode of action of central nervous system stimulant and depressant drugs on the intact animal.

Salary, Principal Research Fellow, Dr. D. A. Denton Salary, Research Fellow, Dr. J. P. Coghlan Salary, Research Fellow, Dr. J. R. Blair-West. Salary, Senior Research Officer, Dr. G. W. Boyd Non-graduate technical assistance, equipment, maintenance expenses and pay-roll tax. Beckman D. U. spectrophotometer.

4,600 2,970 2,970 2,580 7,500 1,870 22,490

4,600 3;190 3,190

7,500

18,260

18,480

~--

Technical assistance, maintenance expenses and pay-roll tax

1,750

Salary, Senior Research Fellow, Dr. A. Shulman Salary, Research Officer, Miss G. M. Laycock. Technical assistance, equipment, maintenance expenses and pay-roll tax.

3,600 1,850 1,500 6,950

3,600

Department 0/ Zoology DR. G. BURNSTOCK Dr. M. Greenberg Dr. M. J. Rand Dr. R. Bagby Dr. M. E. Holman Dr. N. Merrillees (Renewal) Automomic nerve-smooth muscle transmission.

Salary, Postgraduate Scholar, Mr. C. Bell. Technical assistance, equipment, maintenance expenses and pay-roll tax.

1,100 2,000 3,100

Medical School

Trainins grant 14

2,SOO

Name and Project

Nature of Grant

Grant

Commitment

1965 Department of Anatomy

1966 £

1967 £

MONASH UNIVERSITY

PROF.G.C.SCHOAELD (Renewal) The ultrastructure, cultural characteristics and secretory properties of intestinal cells.

Research assistance, maintenance expenses and pay-roll tax.

2,200

Department of Biochemistry PROF. J. BORNSTEIN (Renewal) Investigations into the structure and mechanism of action of insulin antagonists and synergists. Two postgraduate scholarships at £900 per annum (Holders to be approved by Chairman of Council). Maintenance expenses and pay-roll tax.

1,800 1,000 2,800 1,000 1,000

DR. A. W. LINNANE Dr. H. B. Lukins (Renewal) The origin of mitochondria and the synthesis and organization of mitochondrial enzymes

Salary, Postgraduate Scholar, Miss R. Bishop. Research assistance, maintenance expenses and pay-roll tax

900 3,000 3,900 3,000 3,000 3,000 3,000

DR. D. A. LOWTHER (Renewal) (i) The macro-molecular structure of cartilage. (u) The biosynthesis of the mucoprotein complex in vitro.

Postgraduate scholarship (Holder to be approved by Chairman of Council). Maintenance expenses and pay-roll tax.

900 350 1,250

Department of Medicine, Medical Research Centre (Prince Henry's Hospital) PROF. B. HUDSON Dr. J. B. Brown Dr. J. Coghlan Dr. H. P. Taft (Renewal) The secretion and metabolism of androgens.

Salary, Research Assistant, Miss A. Dulmanis. Technical assistance, equipment, maintenance expenses and pay-roll tax.

1,800 3,000 4,800

Department of Microbiology PROF. B. P. MARMION Mr. G. Cross (Renewal) Study of the properties of infective hepatitis virus.

Technical assistance, maintenance expenses and pay-roll tax

1,900

Department of Pathology PROF. R. C. NAIRN Dr. W. G. R. M. De Boer Dr. A. R. McGiven Dr. P. Ironside Dr. S. P. Datta (Renewal) (i) Study of organ-specific antigens and autoantigens in man and experimental animals. (ii) Investigation of autoimmune diseases.

Salary, Senior Research Officer (to be appointed subject to approval by Chairman of Council) Technical assistance, maintenance expenses and pay-roll tax Densitometer Crystostat.

1,980 2,000 1,260 1,000

2,080

2,180 2,000

2,000

6,240

4,080

4,180

Name and Prt>Ject

NatUTe of Grant

C;rlllJt

Commitment

1965 £ Departm ent of Physiology

1966

1,l

1967 £

PROF. A. K. McINT YRE

Dr. A. R. Martin Dr. M. B. Holman Dr. J. W. Phillis Dr. J. L. Veale Mr. I. McCan ce Dr. A. Knights Dr. R. A. Westerm an

(Renew al) . (i) Afferent signalling and averagm g of cell-pop ulation responses. (ii) Synapti c transmi ssion in cerebellum and hypotha lamus. (iii) Inverteb rate recepto rs and synaptic mechanisms. (iv) Nerve tract regener ation, and olfactory synaptic mechanisms.

Salary, Electronics Technician. . Other technical assistance, eqwpDlent, mainten ance expenses and pay-roll t!lX. Beckma n infra-re d CO~ analyser and accessories. Hewlett -Packar d digital recorder. Tektron ix oscilloscope and accessories. Microm anipula tor and accessories. Hewlett -Packar d counter .

1,590

1,590 1,500

1,590

1,500 950 880

1,500

1,100 580 737

• 3,090

DR. M. B. HOLMAN Mr. J. Tille (Renew al) The electro-physiology of autonom ic effector mechanisms, cardiac muscle, and excitation-contractioD couplin g of mammalian smooth muscle. Departm ent of Surgery

7.337 Technical assistance, mainten ance expenses, equipm ent and pay-roll

tax. Special equipm ent.

1,500 1,000 2,500

1,500 1,500

PROF. H. A. F. DUDL EY (Renew al) Energy exchange studies of surgical patients , particul arly following severe injury; work studies with particul ar reference to the post-op erative and uraemic state. Medica l School

Salary, Senior Research Officer (appoin tee to be approve d by Chairm an of Council).

2,280

Trainina Grant. UNIVERSITY OF NEW SOUTH WALES School of Anatom y PROF. M. J. BLUNT Prof. C. P. Wendel l-smith (Renew al) (i) Ultra-st ructure of glial elements. (ii) Myelini sation in the central nervous system. (iii) The histochemistry of macrog lia.

Labora tory

tenance expenses and pay-roll tall.

assistance,

main-

1,100

DR. G. S. MOLY NEAUX (Renewal) The structur e and significance of dermal arterio- venous anastom oses. School of Biological Sciences Laborat ory assistance, equipm ent and pay-roll tax.

900

DR.C. H.DOY (Renew al) (i) Studies of the metabo lism and control mechanisms in micro-organisms. (ii) The biosynthesis and structur e of the cell envelope of Gram negative bacteria. Salary, Postgraduate Scholar, Mr. Y. K. Cha. Technic al assistalK1e. mainten ance expenses ami pay-roll tax. 950

1,500

2,450

N@leand Project

~N._a_tll1'_e_Of_G_rQ1l_t

_____

~_9_6_S £

__ 1_:£_:_mmi __ tme_1_9£:_'7- -

~D.~ (New Grant) The investigation of lipid metabolism of anaerobic bacteria.

Part-cost, fraction collector.

SIS

DR. K. G. RIENITS (Renewal) Biosynthesis of chondroitin sulphate. Department of Medicine

Grant-in-aid.

850

PROF. A. W. STEINBECK (Renewal) (i) Adrenal dyshormonogenesis. (ii) Blood and rogenic substances. School of Physiology

Research assistance, maintenance expenses and pay-roll tax.

1,600

PROF. I. DARIAN-SMITH (Renewal) (i) Neuronal inhibitory interaction in somatic afferent projections to the cerebral cortex by intracellular recording and unitary analysis. (ii) Interactions between parallel afferent projections via the rostral and caudal components of the trigeminal brainstem nuclei. Medical School

Technical assistance, maintenance Ilxpenses and pay-rol! tax.

1,300

Training Grant.

1,500

UNIVERSITY OF QUEENSLAND Department of Biochemistry

PROF. E. C. WEBB

Dr. M. D. Doherty Mr. C. J. Masters Dr. M. A. McDowall (Renewal) (i) Study of liver esterases. (ii) Isoenzymes of animal tissues. (iii) Comparative enzymology of creatine Salary, Research Assistant, Mr. D. 1. Horgan. Salary, Postgraduate Scholar, Mr. E. Bennett. Technical assistance, maintenance expenses and pay-roll tax. Multiple sample absorbance tecorder. Other equipment.

kmase. (iv) Aminoacid sequence of biologically active proteins. (v) Enzymes in animal tissues acting on urea.

1,000 2,000 2,400 1,000 2,000

2,000

7,9.25 Department of Dentistry

2,000

PROF. G. N. DAVIE.S Mr. P. B. Cadell (New Grant) The epidemiology of dental disease in Queensland. DR. B. J. KRUGER (Renewal) The effect of trace elements on the rat molar. DR. W. A. McDOUGALL Mr. K. F. Adkins (New Grant) Studies of outer enamel, gingival epithelium, and irradiation effects on hard tissues of the jaws.

Grant-in-aid.

1,500

Technical assistance, maintenance expenses and pay-roll tax.

675

TeclWcal tax.

~t.anQe

and pay-roll 675

17 15112/64.-1

Name and Project

Natur, of Grant

Grant 1965 £

CommitiMtII 1966 £ 1967 £ -~

Department of Medicine DR. A. M. PARFIIT (Renewal) The renal excretion and conservation of calcium. Department of Parasitology PROF. J. F. A. SPRENT (New Grant) Development of fluorescence diagnostic test for human Toxicara canis infection.

Technical assistance, maintenance expenses and pay-roll tax.

1,754

Salary, Postgraduate Scholar, Mr. G. Warren. Technical assistance, maintenance expenses and pay-roll tax.

900 1,100 2,000

Departmetll of Physiology PROF. R. W. HAWKER Dr. M. Booth Mr. G. H. Klemm (Renewal) Oxytocin and oxytoxic substance.

-r Technical assistance, maintenance expenses and pay-roll tax. Salary, Research Assistant, Mr. R. Smythe. Maintenance expenses and pay-roll tax.

1,000

DR. C. C. KRATZING (Renewal) Studies of manganese and calcium in liver fractions of animals on varying diets.

1,470 300 1,770

DR. A. LIPTON (New Grant) Investigation of isolated uterine muscle from pregnant and non-pregnant animals in various environments. Medical School

Laboratory assistance, (Miss Cook), maintenance expenses and pay-roll tax.

650

Training Grant.

1,500

UNIVERSITY OF SYDNEY Department of Bacteriology. PROF. S. FAINE Dr. R. Yanagama (Renewal) Initiation of microbial infection, including pathogenic mechanisms and virulence in leptospirosis. Department of Biochemistry DR.J.DONE (New Grant) The formation of isoenzyme of alkaline phosphotase by E. Coli.

Animals, apparatus and reagents.

400

Equipment and consumable supplies.

150

DR. A. L. HUNT (Renewal) Mechanism in induced synthesis of nicotinic acid hydroxylase respiratory complex in Ps. /luorescens. DR. R. G. WAKE (Renewal) D.N.A. replication in synchronously germinating B. subtilis spores.

Consumable supplies.

150

ISO

150

Salary, Postgraduate Scholar, Miss E. S. Davies. Shaking incubator bath. Consumable supplies and small equipment.

900 200

150 1,250

Name and Project

Nature 0/ Grant

Grant

Commitment

DR. V. K. L. WHITTAKER (New Grant) Biosynthesis of riboflavin and related compounds.

1965 £ Fraction collector and accessories. Equipment and consumable supplies. 460 250 710

1966 £

1967 £

Department 0/ Histology and Embryology

DR. J. K. POLLAK (Renewal) The characterization of a new cellular component, the reticulosome. t."':'

Contribution to cost, Spinco L2 Centrifuge.

1,000

Department 0/ Medicine

... ..

PROF. C. R.B. BLACKBURN Dr. L. Lazarus Prof. J. McRae Dr. M. Ma Dr. W. Arter Dr. J. Morris (Renewal) Liver disease studies.

Salary, Technician, (Miss G. Mitchell). Pay-roll tax.

1,371 35 1,406

PROF. B. G. FIRKIN Dr. M. Rosenburg Dr. R. Penny Dr. J. R. Turtle (Renewal) (i) Platelet function and physiology. (ii) Mechanisms of anaemia.

Salary, Senior Research Officer, Dr. L. Harvey. Salary, Technician (Miss B. Dunstan). Pay-roll tax.

1,980 1,250 81 3,311

2,080 1,250 81 3,411

2,180 1,250 81 3,511

,"t

"--<:.

Department 0/ Pathology

PROF. D. A. CAMERON (Renewal) (i) Pattern of synthesis of collagen in bone cell. (ii) Fine structure of synovial cells. (iii) Origin and function of osteoclasts.

Salary, 4/5ths. full-time, Senior Research Officer, Dr. H. Tyer. Laboratory assistance, equipment, maintenance expenses and pay-roll tax.

2,145 2,000 4,145

Department 0/ Pharmacy

PROF. S. E. WRIGHT Dr. A. J. Ryan (Renewal) Metabolism and excretion of food dyes, antioxidants and selected insecticides.

Technical assistance. Radio-isotopes, maintenance expenses and pay-roll tax.

3,000 650 3,650

- >."

DR. J. THOMAS (Renewal) Studies of the mechanism of the potentiation of acetylcholinesterase by certain quaternary compounds.

Salary, Postgraduate Scholar, Mr. B. D. Roufogalis. Technical assistance, maintenance expeoses and pay-roll tax.

950 1,700 2,650

Name and Pr9ject

Nature 0/ Grant

(;r(lIIJ

Commitment

1965 £ Department 0/ Physiology

1966 £

1967 £ :->~

PROF. P. O. BISHOP DR. W. BURKE DR. C. W. DUNLOP Dr. W. R. Hayhow Mr. R. W. Rodieck Dr. A. J. Sefton Mr. W. R. Webster (Renewal) (i) Neurophysiology of vision and neurohistological studies. (ii) Electrophysiolosical correlates of acoustic habituation in cats.

Salary, Research Assistant, Mr. P. S. Smith. Salary, Electronic Technician (Mr. R. Brailey). Salary, Electronic Technician (Mr. A. Knight). Salary, Histology Technician Miss J. Haverstock). Salary, Histology Technician (Miss G. Taylor). Technical assistance, maintenance expenses and pay-roll tax. Optical, histological and electronic equipment.

1,470 1,620 1,650 1,200 900

1,620 1,650 1,200

1,6ZO 1,650 1,200 900

900 1,800

1,800 3,800 12,440

1,800

7,170

7,170 -t'

DR. A. V. EVERITT . (Renewal) The ageing process in rats. PROF. M. G. TAYLOR Mr. B. S. Gow (Renewal) Measurements, in vivo, of dynamic elastic properties of the arterial wall.

Technical 8iSis~, maintenance expenses and pay-roll tax.

1,400

Salary, Senior Research Officer, Mr. B. S. Gow. Maintenance expenses and pay roll tax

2,480 200 308 2,988

High pm:i$ion lathe

/)epaI'ttnellt of Surgery

MR. J. A. MYHILL (New Grant) Experimental tests of some predictions of tracer dynamic theory and some consequences in medicine and biolOJY.

Part-cost, special X-ray generating equipment Laboratory assistance and pay-roll tax

".4;_,

3,SOO

794 4,294

flileJical Sdwal

Training Grant

2,500

UNIVERSITY OF WESTERN AUSTRALIA Department of Biochemistry :DR. R. LOGAN (New Grant) A ,study of lAe biochmnical changes in the .cell <luring the mitotic ~e.

Gnnt-m.-aid..

2".S00

DR. f. T. OLiVER Dr. W. F. C. Blumer (Renewal) Biochemical aspects of development in neo-natal rat liver.

Technical assistance, maintenance expensca and pay-roll tax. Muhipie sample absorbance 'recorder, fitting for spectrophotometer (N.H. &: M.It.C. ownership).

2.000 2;600 4,600

2.000

2.'000

2,000

Name and Project

Nature of Grant 1965 £

COmmitment 1966 £

1967

Department of Microbiology

PROF. N. F. STANLEY (Renewal) Epidemiology of arbovirus infection in Western Australia.

Research assistance, travel and maintenance expenses, and pay-roll tax

1,250

DeptJTtment of Pathology

> .;(..

J. M. PAPADIMITRIOU (New Grant) Virus transfer to target organs, a mainly electron microscopical study.

D~.

Salary, Senior Research Officer, Dr. J. M. Papadimitriou. Maintenance expenses and pay-roll tax

2,180 478 2,658

Department of Phormacology

PROF. MARY F. LOCKETT Dr. D. Curnow (Renewal) The growth hormone molecule-fragmentation studies relating to oxytocin and vasopressin.

Laboratory assistance, maintenance expenses and pay-roll tax.

1,366

Department of Physiology

PROF. W. J. SIMMONDS (Renewal) Fat absorption studies

Salary, Senior Research Officer,

'iZ

Dr. R. G. H. Morgan Salary, Senior Research Officer, Dr. J. Maserei. Laboratory assistance, maintenance expenses, minor equipment and pay-roll tax.

2,680 2,080 2,000 6,760 2,080 2,000 4,080 2,000 2,000

DR. B. M. JOHNSTONE (Renewal) Gensis of endocochlear potentials.

Equipment

700

DR. I. KALDOR Dr. E. H. Morgan (New Grant) (i) Kinetics of secretion and absorption of iron across epithelial membranes. (ii) Plasma protein metabolism and transmission to foetus, milk and suckling young during pregnancy and lactation.

Laboratory assistance, equipment, maintenance expenses and pay-roll tax. Beckman fraction c;ollector, and part c;ost isotope c;ounting equipment.

1,250

1,200 2,450 1,250 1,250

DR. T. G. REDGRAVE (New Grant) The effect of antimitotic agents on fat absorption and gastrointestinal motility. M,dtcal School

Minor equipntent and consumable supplies.

300

Training Grant.

1,500

2.1

,Name and Project

Nature of Grant

Grant

Commitment

1965 £

1966 £

1967 £

NEW SOUTH WALES, INSTITUTES AND HOSPITALS Il1Stitute of Delllal Research

DR. G. J. WALKER (Renewal) The enzymic mechanisms for the synthesis and degradation of polysaccharides in oral streptococci.

Salary, Research Assistant (to be appointed). Zeiss polarimeter.

1,415 683 2,098

1,415 1,415

DR. K. W. KNOX (Renewal) Studies on the cell wall of L. casei.

Salary, 1st January, 1965-30th June, 1965, Research Assistant, Mrs. E. A. Hall. Travel expenses, Mrs. Hall (Australian Biochemistry Society Meeting).

-!';

845 41 886

Il1Stitute of Medical Research, Royal North Shore Hospital

DR. DOROTHY FREY (Renewal) Reference work in mycology.

Salary, Senior Research Officer, Dr. D. Frey. Maintenance expenses and pay-roll tax.

2,480 150 2,630

DR. I. B. HALES (New Grant) Endemic goitre in West Wyalong.

Grant-in-aid.

2,000

DR. M. R. LEMBERG (Renewal) Haemoproteins and tetrapyrrolle chemistry.

Part salary, Principal Research Fellow, Dr. M. R. Lemberg. Salary, Senior Research Fellow, Dr. D. B. Morell. Salary, Research Fellow, Mr. W. H. Lockwood. Salary, Research Fellow, Mr. J. Barrett. Salary, Research Assistant, Miss J. Davies. Salary, Research Assistant, Mr. P. Sinclair. Salary, Research Assistant, Miss V. Chang. Salary, Research Assistant (to be appointed). Part salary, Secretary. Consumable supplies and pay-roll tax. Linear recorder. Fares and travel expenses, sabbatical leave, Mr. Lockwood. Fares and travel expenses, sabbatical leave, Mr. Barrett.

1,600 3,600 3,300 2,860 1,800 1,690 1,470 1,470 350 1,100 400 310

1,600 3,600 3,300 2,970 1,800 1,745 1,525 1,525 350 1,100

1,600 3,600 3,300 3,080 1,800 1,800 1,580 1,580 350 1,100 :4'

700 20,650 19,515 19,790

Name and Project

Nature of Grant

Grant 1965 £

Commitment 1966 £

1967 £

Kanematsu Memoria/Institute 0/ Pathology, Sydney Hospital DR. H. M. WHYTE Dr. A. A. Palmer Dr. K. D. G. Edwards Dr. R. B. Goldrick (Renewal) (i) Metabolic studies in undernutrition and related conditions. (ii) Cellular transport studies. (iii) Calcium and magnesium metabolism in bone and kidney.

Salary, Senior Research Officer, Dr. N. W. Alcock. Salary, mechanic. Technical assistance and main tenance expenses. Gas chromatograph.

2,680 1,395 2,600 2,750 9,425

2,680 2,600 5,280

Institute of Clinical Pathology and Medical Research, Lidcombe, Department of Public Health DR. E. GARNER (New Grant) Grant-in-aid. 3,000 Establishment of Syphilis Reference Laboratory.

Fairfax Institute of Pathology, Royal Prince Alfred Hospital

DR. PHYLLIS M. ROUNTREE (Renewal) (i) The epidemiology of staphylococcal infection with special reference to surgical wound infection. (ii) The phage-bacterium relationships in staphylococci with special reference to transduction phenomena. (iii) Staphylococcal reference work.

Salary, Senior Research Officer, Miss M. A. Beard. Maintenance expenses and pay-roll tax

1,980 350 2,330

QUEENSLAND INSTITUTES, HOSPITALS AND MISCELLANEOUS Brisbane Hospital

DR. K. G. JAMIESON (Renewal) The medical aspects of traffic accident injury in the Brisbane metropolitan area. Cairns

Grant-in-aid.

6,000

DR. J. H. BARNES (i) Taxonomy of cubomedusae. (ii) Ecology of Chironex /leckeri and Chiropsalmus quadrigatus. (iii) Correlation between marine stings and causative medusae. Queensland Institute of Medical Research

Salary, part-time, Research Assistant, Mrs. M. Hayes. Personal remuneration, consumable supplies and pay-roll tax.

600 900 1,500

DR. R. L. DOHERTY Mr. J. G. Carley Mr. H. A. Standfast Mr. E. G. Westaway Mr. B. M. Gorman (Renewal) The epidemiology of arbovirus diseases in Queensland with particular reference to Murray Valley encephalitis and epidemic polyarthritis.

Grant-in-aid.

2,500

,, NlIture qf GrlJllt 1965 £

(4l1J1\itment 1966 £

1967 £

SOUTH AUSTRALIA, INSTITUTES AND MISCELLANEOUS Institute of Medical and Veterinary Science

DR. K. F. ANDERSON (Renewal) Salmonella reference work for Australia.

Grant-in-aid.

2,500

DR. W. H. HOWARTH Prof. G. B. Mackaness Dr. D. Hardy (New Grant) Development of a fluorescent staining technique for TrIC virus identificatlofi in smears.

Salary, Research Assistant, Mr. P. G. Surman Maintenafice expenses and payroll tax.

1,470 300 1,770

South Australian Museum

DR. R. V. SOUTHCOTT (Renewal) Medical effects of marine invertebrates and other marine and terrestrial al'lililils harmful to man.

Grant-in-aid.

100

VICTORIA, INSTITUTES AND HOSPITALS Fairfield HospitQ], EpidemiDlogical Re6earch Unit

MRS. RUTH A. COLE (Renewal) Tissue culture studies with hepatic viruses.

Salary, Senior Research Officer, Mrs. R. A. Cole Technical assistance, maintenance expenses and pay-toll tax.

1,980 750 2,730

Royal Children's Hospital, Gastroenterological Research Unit

DR. CHARLOTTE M. ANDERSON (Renewal) Digestion and absorption of sugars, particularly the disturbances of disaccharidase enzyme function.

Research assiStance, malntanance expenses and pay-roll tax.

1,104

St. Vincent's Hospital, School of Medical Research

DR. P. EDMAN (Renewal) (i) Improving the performance of the new automatic aminoacid sequence analyser. (ii) Search for heterogeneity in the aminoacid sequence of a certain protein

Technical assistance, maintenance expenses and pay-roll tax.

1,500

r '!

"'" '" Na~

:z, ,

and ]>rojllet

Nature of Grant

Grant 1965 £

Commitment 1966 £ 1967 £

:'>

Walter and Eliza Hall Institute of Medical Research

,I -<,.

.,;;..

PROF. SIR. F. MACFARLANE BURNET (Renewal) Salary, Principal Research Fellow, Cellular immuniology and related topics. Dr. I. R. Mackay Salary, Principal Research Fellow, Dr. G. J. V. Nossal Salary, Principal Research Fellow, Dr.G. L.Ada Salary, Research Fellow, Dr. A. Szenberg Salary, Research Fellow, Dr. J. Pye Salary, Research Fellow, Dr. K. Shortman. Salary, Senior Research Officer, Dr. P. Lind Salary, Senior Research Officer, Dr. W. H. Marshall. Salary, Senior Research Officer, Dr. G. Goldstein. Salary, Senior Research Officer, Dr. S. Whittingham. Salary, Research Assistant, Mrs. J. Mitchell. Salary, Research Assistant, Miss P. Giltinan. Salary, Research Assistant, Miss G. Lang. Salary, Research Assistant, Miss L. Sibthorp. Salary, Research Assistant, Miss Smalley. Salary, 3 months, Research Assistant, Miss B. Cook. Salary, Postgraduate Scholar, Mr. N. Kraft. Salary, Senior Technical Officer, Mr. A. Abbot. Salary, Technical Officer, Mr. K. Clarke. Salary, Technical Assistant, Mr. H. Altenof. Other technical assistance, minor equipment, maintenance expenses and pay-roll tax. CoUlter Counter.

4,600 4,600 4,600 3,300 3,080 2,750 2,580 2,580 2,480 2,280 1,690 1,635 1,415 1,415 1,415

2,300 4,600 4,600 3,300 3,190 2,860 4,600 4,600 3,300 3,300 2,970

409 1,000 2,095 1,605 1,479

26,000 3,808 76,816 20,850 18,770

Clinical Research Unit, Walter and Eliza Hall Institute

The Council approved the report of the Medical Research Advisory Committee regarding the Clinical Research Unit of the Walter and Eliza Hall Institute that the time limit dated 31st December, 196: placed on the support of the Clinical Research Unit at the 55th Session be amended to allow provision of the salary of Dr. I. R. Mackay until 30th June, 1966. Appreciation The Council placed on record its grateful acknowledgement of the outstanding service rendered to the Medical Research Advisory Committee, over a long period of time, by Dr. William Foster Simmons.

Dr. Simmons was elected to the National Health and Medical Research Council in 1943 and has been a member of the Medical Research Advisory Committee since its creation in 1946. He was elected Chairman of this Committee in 1957 and has held that office with distinction, and with the unreserved confidence of his colleagues, ever since. During his long period of service the Committee has benefited greatly from his wisdom and guidance. He has acquired an intimate knowledge of its affairs, has conducted its meetings with impartiality and ability and has always represented the Committee in a most effective manner on Council where his standing and reputation have been of considerable benefit to the Committee. Over the years all have been impressed by his devotion to duty, his integrity, his unfailing common sense and courtesy and his kind tolerance of diverse opinions. The Council expressed its most grateful thanks to Dr. Simmons for his long and distinguished service both to the Committee and to the Council and in acknowledging his services in this way wished him the greatest happiness and continued good health for the future. The Council also recorded its tribute to Professor E. S. J. King for the outstanding contribution he has made to medical research in Australia and for the wise council he has given during his seven years on the Medical Research Advisory Committee.

MEDICINE ADVISORY COMMITTEE The Medicine Advisory Committee met in Canberra on Wednesday, 28th October, 1964. Dr. J. G. Radford presented the report of the Committee to Council. Recommendations arising from the reports of the Antibiotics, Nursing, Nutrition and Radio-Isotopes Committees, which report to Council through the Medicine Advisory Committee, are recorded under the individual Committee headings. Definition of "Antibiotic" The term" antibiotic" is used in connection with many Council recommendations, and in the past there has been some doubt as to what it was intended to include. Council decided that the term "antibiotic" as used in Council reports and recommendations means substances derived from micro-organisms, derivatives of such substances and allied drugs which may be used for the specific treatment of human or animal infections by bacteria, fungi or viruses. The term does not include non-specific disinfectants. Diabetes Mellitus and Driving Council considered that special measures should be taken to ensure that persons are not licensed to drive motor vehicles who are liable to sudden periods of unconsciousness due to diabetes and hypoglycaernia. As a guide to the licensing authorities Council recommended(a) That every person applying for a driving test should be required to state whether (b)

(c)

(d)

(e)

they have suffered from diabetes. That every person applying for a driving licence who has had diabetes should be required to apply annually upon a special form stating whether he or she has during the preceding year(i) had any attacks of faintness, giddiness or unconsciousness; (ii) been under treatment for diabetes; and (iii) if under treatment, whether the treatment has been altered. This form should be signed by the applicant's usual medical attendant and be sent direct to the appropriate authority of the licensing department. Upon first application and every three years thereafter, the applicant should produce a medical certificate which should include a statement on whether the patient is under treatment, whether the treatment is being changed, whether the patient is co-operative and whether the patient is known to have had hypoglycaernic attacks in the previous two years. A driving licence should not be issued to a person with a history of diabetes who is liable to hypoglycaernic attacks. A licence to drive a public vehicle for the transport of passengers should not be issued to any person with diabetes under treatment with insulin or other hypoglycaemic drugs. That the use of oral hypoglycaernic drugs or insulin should not debar issue of a driving licence, and insulin dosage bears no relation to suitability for a driving licence.

Epilepsy and Driving Council considered that special measures should be taken to ensure that persons are not licensed to drive motor vehicles who are liable to sudden periods of disordered consciousness due to epilepsy (including petit mal). As a guide to the licensing authorities Council recommended(a) That every person applying for a driving licence should be required to state whether

they have suffered from epilepsy, fits, petit mal or sudden periods of confusion or unconsciousness (abbreviated hereafter as " epilepsy"). (b) That every person applying for a driving licence who has suffered from epilepsy should be required to apply annually upon a special form stating whether he or she has during the preceding year(i) had any attacks; (ii) been under treatment for epilepsy; and (iii) if under treatment, whether the treatment has been altered. This form should be signed by the applicant's usual medical attendant and be sent direct to the appropriate authority of the licensing department.

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(c)

(d) (6)

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Upon first application and every three years thereaftelr. the applicant should produce a medical certificate which should include a statement on whether the patient is under treatment. whether treatment is being changed, whether the patient is co-operative and Whether the patient is known to consume excessive alcohol Or to have had attacks in the previous two years. A driving licence should not be issued to a person with a history of epilepsy after the age of ten years unless the person(i) has had no manifestations of epilepsy during the preceding two years; and (ii) is under regular medical supervision if he or she has had an attack within the previous five years. A licence to drive a public vehicle for the transport of passengers should not be issued to any person with a history of epilepsy. Anticonvulsive treatment in itself need not debar issue of a driving licence. Any person who is granted a driving licence should undertake to notify the licenSing authority if he or she has an epileptic attack, or treatment for epilepsy is discontinued with or without medical advice.

Handbook on Treatment of Poisoning The Council received a request from the New South Wales Branch of the Australian Medical Association that consideration be given to the preparation of a handbook on the treatment of poisoning. Several excellent handbooks on this subject are currently available, and these will be supplemented by the Commonwealth Poisons Register containing up-to-date information on drug poisoning, domestic and industrial poisoning and the first aid treatment of poisoning. The Council therefore considered that no further handbooks on this subject were required at present. Human Anti-Tetanus Globulin The Council received a letter from the Tasmanian Branch of the Australian Medical Association requesting an opinion on the use of human immune globulin (anti-tetanus) in wounded persons who are not adequately immunised by previous injections of tetanus toxoid.

The Council had previously emphasised that the only fully effective method of preventing deaths due to tetanus is to actively immunise the whole population with tetanus toxoid and give everyone booster doses at least once every five years or after injury (Report of 56th Session, p. 42). At the same time, the Council advised that passive prophylaxis with tetanus antitoxin (equine or bovine) should only be given to injured patients who(i) have probably not been actively immunised (with toxoid); (ii) have no history indicative of a definite allergic diathesis; (iii) have no clinical reaction to a O. 5 ml. subcutaneous trial dose of 1 in 50 diluted antitoxin; and (iv) in whom there is reason to believe that cleaning and dressing of the wounds may not eliminate tetanus bacilli or spores. Human hyper-immune anti-tetanus globulin (human A.T.G.) is in very short supply, and its use should only be considered when there are strong indications for passive prophylaxis against tetanus, as defined above, and strong contra-indications to the use of equine and bovine anti-tetanus sera. Thus, if a patient requiring passive anti-tetanus prophylaxis has a history of specific allergy to equine serum or reacts to a subcutaneous test dose of equine tetanus antitoxin, bovine antitoxin should normally be used as the first alternative. Human A. T.G. should normally be reserved for use in patients requiring passive anti-tetanus prophylaxis who(i) have had anaphylactic or serum sickness types of reaction following the administration of equine or bovine sera previously; or (ii) have reacted to subcutaneous test doses of both equine and bovine anti-tetanus sera; or (iii) are unable to develop effective active immunity to tetanus. This group includes patients with hypogammaglobulinaemia and patients receiving high dosage glucocorticoid therapy. Council recommended that depots be established to maintain readily available supplies of bovine anti-tetanus serum. Labelling of Therapeutic Substances The Council urged early implementation oflegislation to ensure that all medicines, when received by the patient, are labelled to indicate clearly the active ingredients in the product unless the prescribing doctor desires otherwise.

M14lti-dose Containers for Intravenous Drugs The use of multi·dose containers for intravenous drugs carries a risk that partially used containers may become contaminated and give rise to serious effects when the remaining contents are given intravenously. The Council considered that the convenience of multi-dose containers for intravenous drugs is outweighed by the dangers, and recommends that as soon as practicable all drugs for intravenous use be dispensed in single-dose containers. Oral Contraceptive Agents The Council considered a request from the Australian Medical Association requesting an authoritative opinion in regard to drugs for ovulatory control. It was decided to seek the opinions of the Australian Regional Council of the Royal College of Obstetricians and Gynaecologists, the Royal Australasian College of Physicians, the Australian College of General Practitioners and the Australian Drug Evaluation Committoe, and to reconsider the matter at the next meeting.

ANTIBIOTICS COMMITTEE The following recommendations arising from the report of the Antibiotics Committee were approved. Antibiotic Sensitivity Tests in General Practice At its previous meeting Council was concerned about the use of antibiotic sensitivity kits in general practice and considered that" the use of these kits may often be unreliable as a guide to the prescribing of antibiotics". To draw further attention to this matter Council requested the Chairman to send the following letter to the Editor of the Medical Journal of Australia. .. Dear Sir, DRUG SENSITIVITY TESTS IN GENERAL PRACTICE

The National Health and Medical Research Council wishes to draw attention to the limitations associated with the use of drug sensitivity kits in general practice. The errors inherent in this technique have already been clearly defined. It is possible to envisage circumstances in which the kit might be useful to the practitioner, such as the investigation of an acute infective lesion which it may be anticipated will yield the causative organism in pure culture. But if cultures are taken from sites colonised by normal fiora, the findings can only mislead and result in the unnecessary administration of antibiotics for a nonexistent pathology. Negative findings can be equally dangerous for the patient, as many infections of medical importance rely for early diagnosis upon the examination of a stained film of pus, sputum or exudate. Cultures taken from a purulent urethritis might show no growth on the medium used in these kits and thus lead to a diagnosis of non-specific urethritis, while a Gram stained film might show numerous intracellular, Gram negative diplococci. Similarly, many vaginal exudates are due to trichomonas infection, which will certainly be overlooked by cultures made on solid media. A specimen of sputum may yield a growth of normal respiratory flora leading to the administration of a broad-spectrum antibiotic, while the unsuspected tuberculous disease remains undiagnosed. These are but a few examples of diagnostic problems which are encountered daily in every bacteriology laboratory and which the staff are trained to handle as part of a routine investigation. No patient should be required to accept standards less than those provided by competent and adequately equipped personnel working in their appropriate speciality. Even when these kits can be employed to produce some useful information, the interpretation of zones of inhibition produced by various antibiotics carries with it an added risk for the patient. The zone diameter produced by each drug bears no relationship to its therapeutic usefulness, but is governed by the molecular size of the antibiotic and consequently its speed of diffusion through the agar medium. If one substance is chosen because it produces a larger inhibitory zone than another, those antibiotics of small molecular size will be preferentially selected. Unfortunately, chloramphenicol is one such drug which, because of its small molecular size, invariably gives large zones of inhibition with sensitive strains. The danger inherent in the frequent prescription of this potentially toxic substance for trivial (or non-existent infections) needs no further emphasis. The Council feels that these diagnostic kits are of dubious value to the general practitioner, while the hazards associated with their use far outweigh their limited applications in the solution of common diagnostic problems. Yours faithfully, W. D. Refshauge, Chairman, National Health and Medical Research Council"

Penicillin Anaphylaxis and Skin Tests Although 7-10 per cent. of patients in Australia may say they are "penicillin sensitive ", practical experience indicates that the true figure is probably nearer 1 per cent. Council considered that the current methods of skin testing for penicillin were unreliable and seemed to be of little value in detecting the rare patient who will develop severe or fatal anaphylaxis after penicillin administration. Preparation of 3rd Edition of National Health and Medical Research Council Report " Chemotherapy with Antibiotics and Allied Drugs" Council had previously recommended that another edition of this successful publication be prepared and now further recommended(i) that Dr. Jean Tolhurst, Mr. Glen Buckle and Dr. Stanley Williams be requested to prepare the third edition with a view to publication before the end of 1965; (ii) that 20,000 copies be printed initially, of which 10,000 should be reserved for free distribution to medical students and medical practitioners in Australia, 500 should be reserved for free distribution to organisations and individuals in other countries, and the remainder should be available at a price to be determined by Council to partially defray printing costs; and (iii) that the sum of £4,000 be allocated from the Medical Research Endowment Fund for publication expenses. Reporting of Antibiotic Sensitivity Tests Antibiotic sensitivity tests are commonly carried out using small discs impregnated with specific antibiotics which diffuse out from the discs into the culture medium. Antibiotics, such as chloramphenicol, with smaller molecules di:.'fuse out more readily than those with larger molecules, and methods of recording the sensitivity results in accordance with the size of the inhibitory zones may therefore be misleading and encourage the unnecessary use of chloramphenicol in preference to safer antibiotics. Council therefore recommended that the results of antibiotic sensitivity tests should be routinely be reported as .. sensitive" or " insensitive", and should not be reported as +, + +, + + + or + + + + because this may be misleading.

NURSING COMMITTEE The following recommendation was approved following receipt of the Nursing Committee report. DomiCiliary Nursing Council recommended to State Health and appropriate Nursing Authorities that the recommendations of the 53rd Session of Council on domiciliary nursing be implemented by establishing a pilot training scheme in each State.

NUTRITION COMMITTEE The Nutrition Committee is mainly working on a revision of the recommended dietary allowances for consideration by Council in 1965. The following statement from the Nutrition Committee report was approved. Vitamin Preparations and Athletic Performance The addition of vitamins to food or the taking of vitamin preparations may improve health and performance when a faulty diet is consumed. However, a few vitamin components do not correct any fundamental defects in the overall pattern of the diet, and there is no value in adding vitamins to an already adequate diet.

The Council considered that when vitamin preparations improve athletic performance this is a reflection of the inadequacy of the diet. The concept that any well balanced diet is all that athletes actually require for peak performance has not been superseded. RADIO-ISOTOPES COMMITTEE A report from the Radio-Isotopes Committee was received. 30

PUBLIC HEALTH ADVISORY

COMMITTEE

Sir Edward Ford presented the report of the Public Health Advisory Committee, which met in Canberra on the 26~, 2?th and 28th Octo~r. Recommendations arising from the reports of the Dental Health, EpidemiOlogy, Food AddItIves, Food Standards, Maternal and Child Health Medical Statistics, Occupational Health, Traffic Injury and Veterinary Public Health Committees, which report through the Public Health Advisory Committee are recorded under the individual Committee headings. Commonwealth Poisons Register The Council was addressed by Dr. A. J. P. Proust, the Medical Officer in charge of the Commonwealth Poisons Register. Dr. Proust described the operation of the Register and explained that it is now being compiled in the form of(i) An introductory and explanatory booklet with sections on(a) case reporting-emphasising the importance of case reports in helping to keep the register up to date and providing information on morbidity from poisoning; (b) prevention of poisoning, especially in children.

L . _"" ~ -

(ii) A card index file divided in six sections. Section I includes advice on how to use the Register and on first-aid measures suitable for transmission over the telephone. Section II contains details of therapeutic procedures commonly encountered in poisoning and also detailed treatment of symptoms and complications as well as indications for specialised procedures. The latest therapeutic agents, antidotes and drugs used in the treatment of poisoning will be listed. Section III contains detailed information on important compounds or groups of compounds-known as reference congeners. Forty out of a total of 120 of these have been completed. Section IV contains all compounds and substances used as ingredients in toxic and potentially toxic preparations in the home, factory and around the farm. 750 cardsout of a total of 4,000 have been completed. Section V-The Trade Name Index-will contain perhaps 30,000 entries. 500 of these have been completed. It may be possible over the next. six months .to ~omple~e another 3,000 of these cards which would then enable the Register to be distrIbuted III a useful but incomplete form. Section VI is a last resort to which the enquirer turns when he has no trade name or knowledge of the register to guide him. As yet no work has been done on this section. Dr. Proust also mentioned that some thought has to be given to the following(i) The best system of notification of poisoning. Unless this system works well, the Register will largely fail. (ii) The number of Poison Information Centres which can be set up and be well and enthusiastically staffed. On the staff will depend the poisons notification system. (iii) Whether a booklet containing information about the more commonly encountered

poisons should be prepared for much wider distribution than the Register itself. Identification Marking o/Tablets and Capsules As a general rule, manufacturers issue charts which enable their own particular tablets and capsules to be identified according to colour. However, if the name of the manufacturer is unknown, it is almost impossible to positively identify the product. T~e Council ~ecommen~ed. that. an approach be made to the Drug and Allied Trades CouncIl of Australia, requestmg It to ll1vestigate the possibility of manufacturers marking their tablets an~ capsules with an id~ntifYing symbol or mark. The Council felt that this symbol together With each manufacturer s colour chart would materially assist in the identification of unknown products.

Poliomyelitis Report Apl?roval ~as. given for the Poliomyelitis Sub-Committee to prepare for p bli t' poliomyelitis m Australia in 1963-64. u ca Ion a report on

Public Health Travelling P(!IIDwshlp t

Council recommended the award of a Public Health Travelling Fellowship to Dr. J. F. Woolcott, Department of Public Health, Western Australia. Sabin Vaccine

At the previous meeting Council recommended different types of Sabin vaccine for the first and second doses to be given in the face of an epidemic. In the light of further knowledge Council amended this recommendation and advised that a single uniform trivalent vaccine should be used in dealing with a poliomyelitis epidemic. Scheduling of Poisons It was agreed that the State Directors-General and Directors of Health in the A.C.T. and Northern Territory should inform the Public Health Advisory Committee prior to its October meeting each year whether their particular States or Territories intended implementing the poisons schedule recommendations made at the previous two Council meetings. This procedure will assist all States and Territories to implement the same amendments at the same time.

The following amendments and additions to the Uniform Poisons Schedules, as listed in Appendix II to the Report of the 56th Session of Council and amended on pages 21-22 pf the Report of the 57th Session of Council, were approved. Ametryne Ametryne should be listed in Schedule 6. Antibiotics for Veterinary Purposes

The Proviso at the end of Schedule 4 should be amended to read as follows". Notwiths~nding anythin~ contained elsewhere in this schedule. a person may sell by retaIl for.vetennaI?': therapeutIc and prophylactic purposes, without a written prescription of a medIcal practltroner, dental practitioner or veterinary surgeon, the folIowingPreparations of(a) Sulphanilamide, its salts, its derivatives, their salts Dapsone, its salts, its derivatives, their salts Testosterone propionate and testosterone dipropionate when such preparations are contained in the original unopened container as supplied by the manufacturer and clearly and distinctly labelled with the words" Warning unsafe for use in human beings" and with the statement that the contents are to be used only for veterinary purposes; (b) Antibiotic substances approved by the Minister by notice in the Gazette which

are(i) Penicillin, streptomycin, tetracycline, their salts, their derivatives, their salts when suitably coloured with Brilliant Blue PCF or other approved colour as a marker and when specially packed in applicator devices designed for intra-mammary infusion in the treatment of animals; or (ii) Chloramphenicol, penicillin, streptomycin, tetracycline, their salts, their derivatives, their salts prepared for topical application, and which are contained in the original unopened container as supplied by the manufacturer and clearly and distinctly labelled with the words, " Warning unsafe for use in human beings ", and with the statement that the contents are to be used on~y for veterinary purposes. These substances which have been exempted from the necesSIty of a prescription when specially prepared, packed and labelled as stated above, shall be labelled in accordance with Schedule 6." An additional warning notice should be added to the labelling requirements of Schedule 6 all follows" (e) Warning-milk from animals treated with this preparation is ~t for hu~an consumption and must be discarded for (to be stated) ?ours foll()W1ng the cessatron ... ...J.._.

",:

of treatment to ensure that the milk is free from residues.,. 32

Antibiotic preparations for intra-mammary treatment of ani~." f~

Anticho/inergics A new entry should be made in Schedule 4 to read" Diphemanil methylsulphate except in preparations for topical use." ~

-'f.

A new entry should be made in Schedule 3 to read" Dipheinanil methylsulphate in preparations for topical use."

Arsenical Preparations The following entry should be made in Schedule 7" Arsenical substances being ant poisons or recommended for use as liquid weedkillers or as liquid preparations for the destruction of termites." The following consequential amendments should also be made. Schedule I: the entry under arsenic should have added thereto" and except when included in Schedule 7 ". Schedule 2: the entry under arsenic should have added thereto" and except when included in Schedule 7 ".

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Ii -

Brucine The entry under brucine in Schedule 2 should be amended to read" Brucine and substances containing 0 _2 per cent. or less brucine except when used in 02 per cent. or less for the denaturation of alcohol." concentrations of 0 _

Chloropropylate .y;

Chloropropylate should be listed in Schedule 5 in the following manner" Chloropropylate except when labelled and packed in accordance with Appendix A to these Schedules."

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Dextropropoxyphene A request was received for the re-scheduling of dextropropoxyphene, but it was decided that it should be scheduled as previously recommended, namely, that dextropropoxyphene in substances containing I per cent. or less of dextropropoxyphene be placed in Schedule 2 and that dextropropoxyphene and its salts except in preparations containing I per cent. or less should be placed in Schedule 4.

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Diamines A request was received for the re-scheduling of diarnines. It was decided that phenylene and toluene diarnines should be scheduled as previously recommended, namely, that diarnlnes, phenylene toluene and all other alkylated benzene diamine derivati-ves should be scheduled in Schedule 2 except when included in Schedule 5 for use in hair dyeing preparations.

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Diphenoxylate Preparations Diphenoxylate in preparations containing 2. 5 mgm. or less of diphenoxylate and not less than 25 microgrames of atropine (sulphate) per dosage unit should be scheduled in Schedule 2.

Diquat and Paraquat Diquat and Paraquat should be included in Schedule 6 as follows" Diquat and Paraquat except in preparations containing 5 per cent. or less of the sum of the two which are labelled and packed in accordance with Appendix A to these Schedules. "

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Emetine

The entry in Schedule 4 under " emetine" should be amended to read" Emetine and its salts except in preparations containing 0.2 per cent. or less."

loxynil

loxynil should be scheduled in Schedule 6. 33 I

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Labelling of Schedules 5 and 6 The labelling requirements of Schedules 5 and 6 should be amended to read as follows-

POISON

NOT TO BE TAKEN KEEP OUT OF REACH OF CHILDREN Approved Name. Quantity, percentage, strength or proportion. Manufacturer's or supplier's name and address. Antidote and directions for first aid (when indicated). Where the substance is sold for a specific purpose the purpose is to be stated with concise directions for its use and the label shall bear the words" Not to be used for any other purpose".

(See also Antibiotics for Veterinary Purposes above.)

Lysergic Acid Lysergic acid diethylamide and its derivatives should be scheduled in Schedule 7 and State and Territory Health Departments should prepare appropriate distribution controls.

Methoxychlor The following entry should be included in Schedule 5" Methoxychlor except in preparations containing 10 per cent. or less which are labelled and packed in accordance with Appendix A to these schedules."

Methyl Polysiloxane For Therapeutical Use The entry under activated methyl polysiloxane in Schedule 4 should be deleted.

Organic Phosphate Compounds and Anticholine Esterases The entry in Schedule 4 under anticholine esterases should be amended to read" Anticholine esterases such as Dyflos, neostigmine and its salts and other organophosphorus compounds with anticholine esterase activity when used for therapeutic purposes except when included in Schedule 6 for veterinary purposes." The entry in Schedule 6 under organo-phosphorus compounds should be amended to read" Organo-phosphorus compounds, organic fiuorophosphates, organic pyrophosphates, organic thiophosphates and any other organo-phosphorus compound used as a pesticide except when included in Schedule 7."

Pituitary Hormones In Schedule 4 the entry under corticotrophin should be deleted and the following entry should be inserted in its place" Pituitary, its extracts, its active principles, natural or synthetic and its derivatives."

Schedule 8 Amendments The following entries should be deleted from Schedule 8. " acetyl dihydrocodeine, diacetyl nalorphine, dihydrocodeine." The following new entries should be inserted"Fentanyl (l-phenethyl 4-N-propionylanilino piperidine) and norpipanone (4, 4diphenyl-6-piperidine-3-hexanone)." The entry under morphine derivatives to read as follows.. Morp~ne d.erivatiyes (except ~cetyldihydrocodeine, codeine, dihydrocodeine, ethyl morphme, mcocodme, pholcodine) not specifically included in this schedule."

The following consequential amendments should be made: Schedule 2 (new entries)" Acetyl dihydrocodeine, in substances containing 1 per cent. or less of acetyldihydrocodeine. Dihydrocodeine, in substances containing 1 per cent. or less of dihydrocodeine. Nicodine in substances containing 1 per cent. or less nicodine." Schedule 4 (newentries)" Acetyldhydrocodeine in substances containing more than 1 per cent. of acetyldihydrocodeine. Dihydrocodeine in substances containing more than 1 per cent. of dihydrocodeine. Nicodine in substances containing more than 1 per cent. of nicodine." Sex Hormones The use of sex hormones in cosmetics was discussed. It was agreed that sex hormones, natural or synthetic, their derivatives and their substitutes, in all preparations including cosmetics, should remain in Schedule 4. Slow Release Strips Containing DDVP A request was received for the exemption from the labelling requirements of Schedule 6 in respect of" Slow Release Strips" containing 20 per cent. DDVP. The Council recommended that such an exemption should not be made. Staphisagria In Schedule 2 the name" Staphisagria" should be changed to " Stavesacre". Zinc Sulphocarbolate The entry zinc sulphocarbolate in Schedule 5 should be amended to read" Zinc phenolsulphonate " .

Uniform Standards for Surgical Dressings, Sutures, Plasters, &c. Council recommended that favourable consideration be given to the National Biological Standards Laboratory undertaking the preparation of standards for therapeutic substances, which, at present, are not covered by the Therapeutic Substances Act, with the object of achieving uniformity between the States and Territories for this group. Appreciation The Council accepted a proposal of the Public Health Advisory Committee to record its appreciation ofthe work done by Dr. A. Johnson until his recent retirement as Deputy Chairman and Convernor of the Public Health Advisory Committee.

DENTAL HEALTH COMMITTEE The following recommendations arising from the report of the Dental Health Committee were approved: Cadmium in Dental Castings The use of cadmium in dental castings may lead to the production of very poisonous cadmium oxide fumes when the cadmium and wax are burned out. Council recommended that a warning be issued against the use of cadmium pre-formed patterns in dental castings unless the burningout furnace is associated with an adequate exhaust fan. Fluoride Dentrifices In so far as the manufacturers of fluoride dentrifices are claiming therapeutic properties for their products, Council recommended that radio and television advertisements for such substances should be subject to the routine scrutiny of the Commonwealth Department of Health. Standardisation of Dental Data Recording A special Sub-Committe~ has been studying means of standardising the collection and recording of data on dental conditions to facilitate comparison of data from different sources and dental health surveys. Council recommended(a) the general adoption of the recommendations on collection and recording of dental data as summarised in Appendix I;

;

(b) that facilities be made ~vailable for selected representatives of State and Territory

instrumentalities and of branches of the Armed Forces to attend a course of training to provide standardization of examining techniques and recording procedures; (c) that advantage be taken of the facilities of the Institute of Dental Research in Sydney in the training of such personnel; and (d) that all State and Territory instrumentalities be encouraged to conduct surveys of the dental health of their regions. Trace Elements of Soils and Waters with Relation to Dental Caries This appears to be a wide and fertile avenue for research and while field work in this subject has been carried out in New Zealand and the United States nothing of this nature has been attempted in this country. Council considered that there is a need for adequately prepared epidemiological studies in Australia designed to test whether or not there are significant associations between regional variations in the prevalence of dental caries and soil types, geological formations, and potable waters.

EPIDEMIOLOGY COMMITTEE The following recommendation arising from the report of the Epidemiology Committee was approved: Measles Vaccine Council considered that none of the measles vaccines currently available has proved to be entirely satisfactory, and recommended that(a) their use in Australia should be for investigational purposes only in selected groups; and (b) their further use in Australia should be postponed for the present.

FOOD ADDITIVES COMMITTEE Council approved the following recommendations arising from the report of the Food Additives Committee : Food Additives Ascorbic Acid in Frozen Fish Asorbic acid should be permitted as an antioxidant on frozen fish fillets and frozen prawns in an amount not exceeding 400 p.p.m. Diphenylamine Diphenylamine should be permitted for use as a dip or spray for the prevention of superficial scald on apples and pears with a residue tolerance of 7 p.p.m. Essences Triacetin and brominated vegetable oils should be permitted for use in the preparation of essences. Glucono Delta Lactone GIucono delta lactone should be permitted as a leavening agent in pre-packaged dry cake and pastry mixes in an amount not exceeding 5 per cent. of the weight of the flour in the mixture. Imitation Smoke Essence Imitation smoke essence prepared from oil of cade should be permitted as a flavouring essence provided that any product so flavoured may not be labelled as a smoked product. Food Additives Standard There were no amendments to this Standard until the present meeting. The Food Additives Standard previously recommended by Council (Report of 52nd Session, page 28) and as now amended is shown in Appendix II. Fumaric Acid Fumaric acid should be added to Group III of the approved modifying agents in the Standard for Food Additives. 36

Lecithin

In Group IV of the Standard for Food Additives the name " Phospolipids derived from natural sources" should be substituted for the name lecithin. Propylene Glycol Alginate

In the Standard for Food Additives the words" excluding propylene glycol derivatives " in Group I should be deleted. Codex Alimentarius Commission The Council considered that Australia's comments for consideration by the joint Codex Alimentarius Commission of FAO and WHO could only be presented and supported effectively by a person intimately concerned with the working of the Food Additives and Food Standards Committees and with an intimate knowledge of the working of food legislation throughout the Commonwealth.

FOOD STANDARDS COMMITTEE Council approved the following recommendations from the report of the Committee: FAO/WHO Code of Principles concerning Milk and Milk Products

Council considered that the F AOjWHO Code of Principles (Appendix III) concerning milk and milk products should be endorsed. Food Standards Canned Foods Council considered a request that consideration be given to the preparation of a Standard governing the manufacture and processing of canned foods in general, but concluded that such a Standard was not warranted. Cocoa and Chocolate (" Hollow Moulded Goods") Clause 7(b) " Hollow Moulded Goods" in the Standard for Cocoa and Chocolate (Report of 54th Session, page 41) was reviewed in the light of the definition ofmilk chocolate as proposed by the Expert Committee on Cocoa Products and Chocolate of the Codex Alimentarius Commission. Council considered that as the definition in the Codex proposal was not complete and as several States have already adopted clause 7(b), no alteration should bemade at present. It was also recommended that the Codex Alimentarius Commission should be requested to prepare a standard for hollow moulded goods and that the request should be accompanied by the arguments advanced for and against clause 7(b). Coconut and Confectionery Council recommended that the Standard for Coconut and Confectionery as set out in Appendix IV be forwarded to the States and Territories for adoption. Fish and Fish Products Council recommended that the Standard for Fish and Fish Products should be amended by the addition of a recommendation on Fishmarinades or Fish Semipreserves and that the amended Standard, as set out in Appendix V, be forwarded to the States and Territories for adoption. Fish Paste Council considered a request that provision for a fish paste of lower fish. content than presently allowed be made in the currently recommended Standard for Canned Fish Products (Appendix VI) but recommended that the present Standard should not be altered. Ice Cream and Related Products Council recommended that clause l(c) of the Standard for Ice Cream and Related Products, as set out on page 51 of the Report of the 55th Session, be amended to read" The use of farinaceous matter, except as permitted in clause 6, in the preparation of ice cream is prohibited."

Lemon Butter, Fruit Flavoured Spread and Fruit Flavoured Filling Council recommended that the Standard for Lemon Butter, Fruit Flavoured Spread and Fruit Flavoured Filling, as set out on page 51 of the Report of the 55th Session, be replaced by the Standard set out in Appendix VII, and be forwarded to the States and Territories for adoption. Margarine It was recommended that, in clause 2 of paragraph 1 of the Standard for Margarine, the words" mono or diglyceride emulsifiers" be amended to read" mono or diglycerides of fatforming fatty acids". The amended Standard is set out in Appendix VIII. Metals in Food Council recommended that the Standard for Metals in Food be amended by(i) the insertion immediately after the entry" Copper in beverages" of the entry"Copper in Ghee--O.15 p.p.m. calculated as the metal ". (ii) the replacement of the final paragraph by the paragraph" The proportions here specified refer to the total contents of the container and, for the purposes of analysis, a representative proportion of the sample shall be taken ".

The amended Standard is set out in Appendix IX. Prescribed Methods of AnalysiS for the Determination of Crude Fibre in Chocolate and Crude Fibre in Cocoa Paste and Cocoa It was recommended that the prescribed methods of analysis as received from the Royal Australian Chemical Institute and listed in Appendix X be forwarded to the States for inclusion in the appropriate Standards. Prescribed Methods-Deletion from Certain Standards Council recommended that the words " when determined by the prescribed method" be deleted from the following Standards currently approved by CouncilStandard for Canned Fish Products-clause 5(b), see Appendix VI. Standard for Cocoa and Chocolate-clause 7(b), Report of 54th Session, see p. 41. Standard for Coffee-clauses 8 and 9, see Appendix XI. Standard for Skim Milk-Clause 1, Report of 54th Session, see p. 38. Standard for Sugar and Glucose-clause 4, see Appendix XII. Sour or Cultured Cream Council considered a request that sour or cultured cream, with an 18 per cent. fat standard, should be permitted to be sold under that name, but recommended that the applicant be informed that sour or cultured cream containing 18 per cent. fat should be labelled Sour (or Cultured) Light (or Coffee) Cream. Vitamins and Minerals Council recommended that the Standard for Vitamins and Minerals approved by Council in 1962 (Report of 54th Session, Pages 42, 43) be amended by the addition of the following to Table 1 Part 1Substances To be calculated as A verage daily allowances Micrograms of ·Vitamin B12 2 micrograms Cyanocobalamin cyanocobalamin • Umited to milk substances of vegetable origin.

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and the following to Table 2. Foodstuff Reference Quantity Invalid foods .. 2 oz. Milk substitutes of vegetable origin (diluted according to label) 1 pint.

Terms of Reference The Council was firmly of the opinion that labelling is a necessary corollary of food standards and quality and it is essential that it shall be on a uniform basis throughout Australia. Council therefore recommended that confirmation be requested from the appropriate authorities that the functions of the Council include the making of recommendations on all aspects of food legislation, including standards, labelling and packaging.

.. MATERNAL AND CHILD HEALTH COMMITTEE The Council received a report of the Maternal and Child Health Committee on abortion in Australia, an noted that the members of the Public Health Advisory Committee were interested in the possibility of further work on this subject.

MEDICAL STATISTICS COMMITTEE Council made the following recommendations arising from the report of the Medical Statistics Committee: International Classification of Diseases The Council endorsed the comments on the Eight Revision of the International Classification of Diseases (ICD), as contained in the report of the Medical Statistics Committee, and recommended that when the final proposals for consideration by the Revision Conference in July, 1965 are received these be sent to all State and Territory Departments responsible for public health, hospital services and mental health services requesting their final comments. Hospital Morbidity Statistics Council was informed that in some hospitals comprehensive records are kept only in respect of public patients, and considered that similar recording should be extended to include all patients as hospital statistics will continue to be deficient until this is done. To promote this extension of hospital recording Council recommended that discussions be initiated between the interested bodies (e.g. Australian Medical Association, Hospital Commissions, &c.).

Australia, as a signatory to the WHO Nomenclative Regulations, is committed to the use of the ICD for the coding and presentation of official statistics on morbidity and mortality. The Council was firmly of the opinion that a uniform system of classification should be adopted by all hospitals in Australia for the indexing of hospital medical records, and considers the International Classification of Diseases (ICD) prepared by WHO is the most desirable classification to be adopted. Council requested that this recommendation be forwarded to the State Ministers for Health requesting their assistance in its implementation.

OCCUPATIONAL HEALTH COMMITTEE The following recommendations concerning occupational health were approved: Licensing of Certain Devices Containing Radioactive Material Recognising the expanding use in Australia of devices containing small activities of radioactive substances and believing that certain of these devices can be designed and used so as to be without any significant hazard to health, the Council considered that it is appropriate to consider the relaxation of the present control exercised through the licensing of the user of such devices under Radioactive Substances Acts and Regulations provided the devices are considered acceptable for exemption after a scientific assessment has been made by a central assessing authority. Safe Handling of Cyanides on the Waterfront

Further consideration was given to the current Council recommendations published as Appendix III to the Report of the 56th Session of Council, pages 64-67. It was recommended(a) that the following addendum be made to paragraph 15, page 65, Respiratory Protective Devices.. Persons who wish to enter atmospheres containing hydrogen cyanide are reminded that, because of absorption of the gas through the intact skin, prolonged exposures in an atmosphere containing more than 1 per cent. by volume of the gas, even with suitable respiratory protection, must be considered as a serious risk, and in certain circumstances as dangerous to life. Complete skin protection impermeable to hydrogen cyanide, should be worn in such circumstances."

(b) That the following amendments be made in paragraph 16, page 66, Recommended Procedures for Guidance of Stevedoring Companies Handling Cyanides, under the sub-heading Gaseous Cyanides; insert the words" and skin" between" respiratory" and" protection" in line (a) of clause (ii) and in line (a) of clause (iii).

TRAFFIC INJURY COMMITTEE CQuncil approved the foUowing recommendations arising from the report of the Traffic Injury Commit~.

Door Latches As a contributing cause of injury in traffic accidents is the unintentional opening of doors, Council recommended for the consideration of Commonwealth and State Governments that door latches, effective in resisting forces tending to pull the door from the door posts,' should be required in all new cars. The Council considered that the attention of the Standards Association of Australia and the automotive industry should be drawn to this recommendation. Motor Cyclists' Helmets In Victoria the wearing of safety helmets by motor cyclists and motor scooterists is compulsory, and there is evidence that this has halved the risk of fatality in motor cycle accidents. Because of its ready enforcibility, high effectiveness, moderate total cost and very low cost per life saved, Council recommended to Commonwealth and State Governments the compulsory wearing of helmets by motor cycle riders as is done in Victoria. Seat Belts Previous Council recommendations on seat belts were reviewed and confirmed and the following additional reconunendations were made(i) Council recommended the use of the three point belt (or harness), as it is the type which combines ease of use with effectiveness to a higher degree than the other types. (ii) Council emphasised the desirability of all members of the medical profession setting an example to the public by installing seat belts in their own cars and by wearing them.

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VETERINARY PUBLIC HEALTH COMMITIEE The following recommendations derived from the report of the Veterinary Public Health Committee were approved by Council. Antibiotics in Agriculture and Food Preservation It was considered that the previous Council recommendations (Report of 54th Session, p. 32; Report of 56th Session, p. 44) should be cancelled, and that the following Council recommendation (Report of 55th Session, p. 32) should be reaffirmed.. (i) That the problem of the use of antibiotics as preservatives in the fishing industry be examined carefully, and information should be sought from all available sources regarding the treatment offish by ice with an antibiotic content of 5 p.p.m. (including whether antibiotic is incorporated in the ice or added after the ice has been manufactured) ; - ' . (ii) That in the meantime the current recommendation of the Antibiotics Committee' that approval of the use of antibiotics for food preservation should be withheld until there is an adequate body of evidence to show that the potential hazards visualised are not important' should be reaffirmed." Bovine Tuberculosis in Beef Cattle as a Public Health Problem There is still a high incidence of tuberculosis in beef cattle in some parts of the Commonwealth and in the overall drive against tuberculosis in Australia Council recommended that it is desirable to eradicate the disease in cattle. Brilliant Blue and Detection of Antibiotics in Milk It was considered that the previous Council recommendations (Report of 54th Session, p. 30; Report of 55th Session, p. 32) should be replaced by the following statement" Council strongly reaffirms that there should be a zero tolerance for penicillin in milk as detected by the most sensitive method available; and recommends that all States and Territories should require all antibiotic preparations for intra mammary infusion to be marked with an approved dye, and as long as it is an approved food additive, Brilliant Blue F.C.F. can be used for this purpose." Chloramphenicol for Bovine Intramarnrnary Infusion Council noted the WHO recommendation that the use of chloramphenicol for the treatment of bovine mastitis should be strongly discouraged (WHO Technical Report Series No. 260, 1963), and considered that this drug is valuable but not indispensable for that purpose. (See amendments to Scheduling of Poisons, p. 32.)

Chloramphenicol Toxicity It was considered that the previous Council recommendation (Report of 57th Session p. 18) might be misinterpreted and should be reworded as follows' "The incidence of aplastic anaemia induced by chloramphenicol, though small, represents a grave hazard, and Council considered that the use of chloramphenicol in human medical practice should be restricted to cases of life-threatening infection or other serious infections sensitive only to chloramphenicol. Disposal of Animals Treated with Radio-Active Substances It was considered that the previous Council recommendation on this matter (Report of 56th Session, p. 38) was open to misinterpretation and should be reworded as follows" That whilst recognising that there are circumstances under which it can be demonstrated that there are no hazards to human health, but recognising there may be implications of local and overseas trade, no animal to which a radio-active isotope has been deliberately administered for experimental, diagnostic or therapeutic purposes should be slaughtered for human consumption." Hormones in Animal Production and in the Poultry Industry It was considered that the previous Council recommendation (Report of 53rd Session, p. 32) should be reworded as follows" Having in mind that no definite assurance can be given of the absence of a public health risk from the consumption of treated meat, and in view of the fact that certain countries will not, on public health grounds, accept carcasses if the animals, including poultry, have been given oestrogens as an adjunct to fattening, the administration of oestrogens to livestock for other than therapeutic purposes, should be prohibited." Veterinary Use of Antibiotics It was considered that the previous Council recommendation (Report of 50th Session, p. 28) should be reworded as follows" That antibiotic preparations for intramammary treatment of mastitis in cows should be labelled to the effect that milk from cows so treated must be discarded for such length of time following cessation of treatment as is sufficient to ensure that the milk is free from antibiotic residues. The period necessary after the use of a particular preparation is to be stated on the label of that product."

COMMITTEE MEMBERSHIP AND PROCEDURE Resignations and Retirements The following resignations and retirements were noted(i) Dr. J. G. Radford resigned from membership of the Poisons Schedule Sub-Committee. (ii) Dr. A. P. Miller resigned from membership of the Preventive Medicine in General Practice Sub-Committee. (iii) Dr. W. F. Simmons would be retiring from membership and chairmanship of the Medical Research Advisory Committee on 31st December, 1964. (iv) Professor E. S. J. King would be retiring from membership of the Medical Research Advisory Committee on 31st December, 1964. Appointments to Current Committees and Sub-Committees The following appointments were approved by Council(i) Professor S. Sunderland, Department of Neuroanatomy, University of Melbourne, as Chairman of the Medical Research Advisory Committee from 1st January 1965 to 31st December 1968. (ii) Professor R. J. Walsh, Director, N.S.W. Blood Transfusion Service, as Deputy Chairman of the Medical Research Advisory Committee from 1st January 1965 to 31st December 1965. (iii) Professor J. S. Robertson, Department of Pathology, University of Adelaide, as Chairman of the Traffic Injury Committee until 31st December 1966, and as a member of the Medical Research Advisory Committee until 31st December 1971. (iv) Professor R. F. Whelan, Department of Human Physiology and Pharmacology, University of Adelaide, as a member of the Medical Research Advisory Committee until 31st December 1971. (v) Mr. B. K. Rank, C.M.G., 29 Royal Parade Parkville, Victoria, as a member of the Antibiotics Committee until 31st December 1966. (vi) Dr. Joan Woodhill, Nutritionist, Prince Henry Hospital, Sydney, as a member of the Nutrition Committee until 31st December 1966. (vii) Mr. L. N. Thornton, Chief Veterinary Officer, Commonwealth Department of Primary Industry; Dr. W. J. Stevenson, Department of Public Health, Victoria; and Mr. W. S. Smith, Stock Medicine Board, South Australia, as members of the Veterinary Public Health Committee until 31st December 1966. (viii) Mr. V. E. Pickering, Bureau of Census <'nd Statistics, as a member of the National Morbidity Survey Sub-Committee until 31st December 1965. (ix) Dr. P. J. d' Arbon, 74 King George's Road, Wiley Park, N.S.W., as a member of the Preventive Medicine in General Practice Sub-Committee until 31st December 1966. Commonwealth Health Department Personnel on N.H. & M.R.C. Committees

In accordance with the principle approved at the 57th Session of Council, the Chairman (Commonwealth Director-General of Health) made a number of changes in the appointments of Commonwealth Health Department staff to Council Committees and Sub-Committees. The current membership of all Council Committees and Sub-Committees is summarised in Appendix

XIII. Formation of New Sub-Committees The formation of the following two new Sub-Committees was approvedad hoc Notification of Diseases Sub-Committee. " To investigate the purposes and methods of disease notification and periods of exclusion of present notifiable infectious and/or communicable disease contacts from school in Australia, and to make recommendations to the Epidemiology Committee before June 1965." Membership until 30th May, 1965Dr. J. B. Mathieson, Commonwealth Department of Health, Chairman and Convener. Dr. A. Douglas, Metropolitan Medical Officer of Health, Sydney. Dr. J. A. Forbes, Medical Superintendent, Fairfield Hospital, Victoria. Dr. W. J. Stevenson, Department of Public Health, Victoria.

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with the following additional members to attend the final meetingDr. G. H. McQueen, Department of Public Health, South Australia. Dr. H. M. L. Murray, Director of Public Health, Tasmania. Dr. P. R. Patrick, Department of Health and Medical Services, Queensland. Dr. D. Snow, Department of Public Health, Western Australia. Food Analysts Reference Sub-Committee. "To consider matters concerning methods of analysis of foods and food additives referred to the Sub-Committee by the Public Health Advisory Committee and to make recommendations to the Public Health Advisory Committee."

Membership until 31st December 1966Dr. D. B. Travers, Commonwealth Department of Health, Chairman. Mr. J. Warry, Commonwealth Department of Health, Convener, and Food Analysts from each State to be nominated by the State Director-General of Health. Other Committee Changes and Procedure It was agreed that the name of the " Radiation Technical and Policy Sub-Committee" was misleading, and that it be changed to " Radiation Technical Sub-Committee".

TIME AND PLACE OF NEXT MEETING It was agreed that the 59th Session of Council would meet in Sydney on the 28th May, 1965, to be preceded by meetings of the Medical Research Advisory Committee on the 24th and 25th May, Public Health Advisory Committee on 25th and 26th May, and Medicine Advisory Committee on 26th and 27th May.

R. H. C. WELLS, Secretary

W. D. REFSHAUGE, Chairman

APPENDIX I - _-J

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RECOMMENDATIONS ON THE COLLECTION AND RECORDING OF DENTAL HEALTH DATA 1. Data 1.1 On the dental health of the Australian community should be obtained on(i) Dental caries; (ii) Dental traumatic Injuries; (iii) Periodontal diseases; (iv) Dento-facial anomalies; (v) Oral neoplasia; and

1.2 On the amount of treatment 1lICeived in(I) Restorations; (ii) Extractions; (iii) Orthodontics; and (iv) Prosthetics. 2. Indices Indices used for measm:ing the extent of the diseases and treatment should follow the World Health Organisation Technical Report Series No. 242. 2.1 Dental Caries (i) DMF Index-the average number of permanent teeth per person which are decayed (D), missing because of caries (M) or filled (F). In the calculation of the DMF Index, the numerator is the total number of DMF teeth and the denominator is the total number of persons examined. (ii) df Index-Number of primary teeth which are decayed (d) or filled (f). In the calculation of the df Index, the numerator is the total number of primary teeth which have clinical caries or which have been filled. The denominator is the total number of persons examined. 2.2 Periodontal Diseases (Russell's Index) The index should be based on the mean score per tooth per individual, the score for each individual being obtained by assessing the degree of disease from the followingScore 0 NEGATIVE.

Criteria There is neither overt inflammation in the investing tissues nor loss of function due to destruction of supporting tissues.

MILD GINGIVITIS.

There is an overt area of inflammation in the free gingivae, but this area does not circumscribe the tooth. Inflammation completely circumscribes the tooth, but there is no apparent break in the epithelial attachment. The epithelial attachment has been broken and there is a pocket (not merely a deepened gingival crevice due to swelling of the free gingivae). There is no interference with normal masticatory function. The tooth is firm in its socket and has not drifted. The tooth may be loose; may have drifted; may sound dull to percussion with a metallic instrument; may be depressible in its socket.

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GINGIVITIS.

GINGIVITIS WITH POCKET FORMATION

ADVANCED DESTRUCTION WITH LOSS OF MASTICATORY FUNCTION

From the Periodontal Indices of each individual, an index can be obtained for the group on an age specific percentage basis. 2.3 Dento-facial Anomalies Dento-facial anomalies which cause disfigurement or which impede function. No attempt is made to classify the anomalies other than on the basis of whether or not they require treatment. An anomaly should be regarded as requiring treatment if the disfigurement or functional difficulty is particularly likely to be an obstacle to the patient's physical or emotional well-being. The anomalies to be regarded are:

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Oeft palate; Oeft lip; Prognathiam (Mandibular protrusion); Retrognathism (Maxillary protrusion);

Deep overbite; Open bite; Crowding; and Spacing. 1bey should be expressed as the age specific percentage of persons who in the judgment of the examiner have a handicapping dento-facial anomaly which requires treatment.

2.4 Prosthetic Needs (i) For Full Dentures-expressed as the percentage of persons who require extraction of their remaining natural teeth, the percentage of persons who have lost all their natural teeth and the percentage of persons who are wearing artificial dentures. (ii) For Partial Dentures---expressed as the petQe1ttage of petsoDS· who requite elttrllction or some remaining natural teeth, the percentage of persons who have lost some of their natural teeth lind the percentage of persons who are wearing partial dentures. The rates in (I) and (ii) should be referred as age specific percentages.

2.5 Oral Neoplasia Index to be determined on the age specific pel"CeDtages of persons, who as a ",suIt of biopSY of the lesiOll, are proved by tonfirtnatory tests to have some form of oral neoplasia.

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APPENDIX II RECOMMENDED STANDARD FOR FOOD ADDITIVES (As amended at 58th Session of Council, October, 1964) Food Additives Prohibition No person shall add any colouring, flavouring, preservative, anti-oxidant, emulsifier, stabiliser, modifying agent as prescribed in Regulation . • • or other additive to any food or sell any food containing any such substance unless the addition or presence of such substance is specifically permitted by the Regulations. Nothing in this regulation shall preclude the addition of wholesome food in its natural state or as standardised by these Regulations to produce a food not specifically standardised by these Regulations. Prescribed Modifying Agents Prescribed modifying agents as listed below may be added to foods where permitted in the Regulations and as set out in the Schedule hereto, provided that where a specific regulation limits the maximum proportion of a particular prescribed modifying agent, such modifying agent shall not exceed that maximum. Group I Agar agar Alginates Gum acacia Gum benzoin Gumguar Gum karaya Gum locust bean Gum tragacanth Irish moss Pectin Group III Acetic acid Citric acid Fumaric acid Lactic acid Malic acid Tartaric acid Group V Group II Ammonium, sodium and potassium carbonates and bicarbonates Calcium and maguesium carbonate Calcium chloride and oxide Potassium hydrogen tartrate Sodium and calcium ortbophosphates Sodium and potassium polyphosphates Sodium polymetaphosphate Sodium pyrophosphates

Group IV Ammonium salt of phosphatidic acid Mono and di glycerides of fat forming fatty acids Phospholipids derived from natural sources

Group VI

~~;=l }when used as humectants .. Dextranised or pregelatinised starches Gelatine Starch Schedule of Permitted Additives Permitted Additives Food Dessert Mixtures I, II, mand VI. Mayonnaise, Salad Dressings I, II, m, IV and VI. Soups (including Canned and Dried) I, II, III, IV and VI. Spreads and Extracts I, II, m, IV, V and VI.

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APPENDIX III CODE OF PRINCIPLES CONCERNING MILK AND MILK PRODUCTS (Drawn up by a Committee of Government Experts under the Joint FAOfWHO Program on Food Standards) Application of the Code Governments are requested to inform the Director-General of FAO whether they intend to apply the provisions of the Code of Principles as set out below. Governments which so declare their willingness to apply the Code are further requested to state whether they can indicate the date by which they will be able to bring their national requirements into conformity with its provisions, as well as the steps they will require to take in order to achieve this position.

PREAMBLE The purpose of this Code of Principles is to protect the consumer of milk and milk products and to assist the dairy industry on both the national and international levels byEnsuring the precise use of the term" milk" and the terms used for the different milk products; AVOiding confusion arising from the mixing of milk and/or milk products with non-milk fats and/or non-milk proteins; Prohibiting the use of misleading names and information for products which are not milk or milk products and which might thereby be confused with milk or milk products; and Establishing (a) definitions and designations; (b) minimum standards of composition; and (c) standard methods of sampling and analysis for milk and milk products.

ARTICLE I Milk 1.1 The term" milk" shall mean exclusively the normal mammary secretion obtained from one or more milkings without either addition thereto or extraction therefrom. 1.2 Notwithstanding the provisions of Article 1.1 the term" milk" may be used for milk treated without altering its composition, or for milk the fat content of which has been standardized under domestic legislation. 1.3 The term" milk .. may also be used in association with a word or words to designate the type, grade, origin and/or intended use of such milk or to describe the physical treatment or the modification in composition to which it has been subjected, provided that the modification is restricted to an addition and/or withdrawal of natural milk constituents. 1.4 In international trade, the origin of the milk shall be stated if it is not bovine. ARTICLE 2 Milk Products 2.1 The terms used to designate milk products shaH only be employed for those products which are exclusively derived from milk as defined in Article 1. 2.2 Notwithstanding Article 2.1, the terms used for each milk product may be employed when substances necessary for the manufacturing process are added, provided that these substances are not intended to take the place in part or in whole of any milk constituent. 2.3 The terms used to designate milk products may also be used in association with a word or words to designate the type, grade, origin and/or intended use of such milk products or to describe the physical treatment or the modification in composition to which they have been subjected in accordance with Articles 1.3 and 2.2.

ARTICLE 3 Composite Products 3. The term .. milk .. and the terms used for milk products may also be employed together with a word or words to designate composite products of which no part takes or is intended to take the place of any milk constituent and of which milk or a milk product as referred to in Articles I and 2 is an essential part either by quantity or for characterization. If such composite products are designated in terms which are suggestive of milk or milk products or the dairy industry, the label shall indicate the milk or milk product used as well as the other essential constituents.

ARTICLE 4

4.1 A product which is neither milk, nor a milk product nor a composite product as referred to in Articles

I, 2 and 3, whatever its origin, source or composition, shall not be described or designated in any label, commercial document or publicity material by words or pictorial devices, or be presented in such manner as to refer to or be suggestive of milk or milk products or other dairy term, if likely to lead the purchaser and/or consumer to suppose that the product is milk, a milk product or a composite product as referred to in Articles 1,2 and 3.

4.2 Without restricting the scope of Article 4.1 whenever products foraeen by that Article are of such nature as to be likely to lead the purchaser and/or consumer to suppose that they are products as referred to in Articles 1, 2 and 3, the designation of such products shall be presumed to meet the requirements of Article 4.1 if carried out in the following manner(a) by the name of the product referred to in Articles 1, 2 and 3 preceded by the word" imitation" in clear type; or (b) by a distinct name and/or description indicating the true nature of the principle raw materials used. In countries where the mixing of milk products with products foreseen by Article 4. t is not forbidden, wherever the label of such a mixed product or any publicity referring to it declares the presence of the milk or milk product, the percentage dry matter by weight of the milk ingredients to the total product sbal1 also be indicated, except that where butter is present in a mixture of fats its percentage by weight shall be stated. ARTICLE 5 Labelling, Presentation and Publicity 5. No label declarations, methods of presentation and publicity concerning products referred to in Articles 1, 2, 3, 4.2 and 4.3 shall be made in a manner likely to mislead the purchaser and/or consumer as to the true nature of the composition of the product as a whole. )

ARTICLE 6 Extent of Application 6.1 Unless otherwise stated, the provisions of this Code shall apply to all products therein considered whether imported, exported or produced and offered for sale upon the home market. 6.2 In view of the relationship between a Federal Government and its constituent States or Provincial Governments, wherever some or all of the provisions of this Code are not regarded as appropriate for Federal action, Federal Governments undertake to make effective arrangements for the reference of such provisions to the appropriate authorities with the request that they give active consideration to the amendment of their State or Provincial requirements in conformity therewith. 6.3 In adapting their practices to this Code, GOvernments undertake to give earnest and Iympathetic consideration as appropriate to the individual standards established in association with the Code aCCOrding to Resolution No. 16/57 of the FAO Conference. 6.4 This Code and the individual standards established in association with it are not intended to affect the adoption and use of more rigorous requirements or standards under domestic legislation.

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APPENDIX VI STANDARD FOR CANNED FISH PRODUCTS (As amended at 58th Session of Council, October 1964) 1. Canned Fish Products are the products prepared in accordance with good commercial practice from fish properly prepared and fit for human consumption. They may contain salt, sugar, acetic acid or vinegar, saltpetre (potassium or sodium nitrate), potassium or sodium nitrite, seasoning, water, any substance added by the process of smoking or any other wholesome foodstuff. Canned Fish Products shall be packed in clean containers, hermetically sealed and processed by heat to ensure preservation. 2. The total fat and oil content of canned fish products shall not exceed 25 parts per centum. 3. Canned fish products shall not contain a proportion of nitrites greater than one grain per pound of canned product when calculated as potassium nitrite. The proportion of total nitrates and nitrites when calculated as potassium nitrate shall not exceed fourteen grains per pound of canned product. 4. The addition without declaration of sodium hexametaphosphate, in proportion not exceeding half or one part per centum, to canned fish or canned fish products shall not be a contravention of those regulations.

5. (a) Canned fish (other than fish paste) with starch, cereal, water or other foodstuff shaH not contain more than six parts per centum of starch nor less than 51 parts per centum of fish. (b) Canned fish balls or canned fish rissoles are fish mixed with cereal, with or without condiments and/or vegetables, and the mixture formed into balls or pats. Each ball or pat shall contain not less than 51 parts per centum of fish of the kind or kinds designated in the label. When fish balls or fish rissoles are first named in the label the contents of the container shall contain not less than 66 parts per centum of balls or pats. Labelling 6. lbere shall be written in the label on or attached to every container of canned fish products in bold-faced,

sans serif capital letters of not less than 10 points face measurement a statement giving a true description of the fish contents of such containers as in the following examplesBARRACOUTA or TUNA Where the article is prepared from two kinds of fish, the fish first mentioned in the label shall be in greater proportion than any other. The label shall contain in bold-faced, sans serif capital letters of not less than 6 points face measurement a statement of the approximate proportion of each kind of fish present as in the following example: CONTAINS 80% BARRACOUTA AND 20% SALMON 7. Where the article is prepared from more than two kinds of fish there shall be written in the label on or attached to the container in bold-faced, sans serif capital letters of not less than eighteen points face measurement the words" MIXED FISH". The label shall also contain in bold-faced, sans serif capital letters of not less than six points face measurement a statement of the approximate proportion of each fish contained as in the following example: CONTAINS SALMON 50% BARRACOUTA 30% TUNA 20% Provided that when a particular kind of fish is present in the proportion of not less than 75 parts per centum of the fish contained in the package, the statement of the approximate proportion of each of the fish present may be made in the following example: CONTAINS BARRACOUTA 75% AND OTHER FISH 25%, WHICH MAY INCLUDE SALMON, TUNA, MULLET, HERRING (insert the names of any other kinds of fish which may be present) 8. There shall be written in the label on or attached to every container which contains a mixture of canned fish with cereal, water, starch, or other foodstuffs, with the exception of edible oil or tomato sauce where the tomato sauce does not exceed 10 parts per centum of the contents in bold-faced, sans serif capital letters of not less than 10 points face measurement a true description of the contents of the container as in the following examples: SALMON WITH CEREAL or BARRACOUTA WITH TOMATO SAUCE AND CEREAL The label shaH also contain in bold-faced, sans serif capital letters of not less than 6 points face measurement a statement of the approximate proportion of each ingredient as in the following example: CONTAINS 60% SALMON and 10% CEREAL

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APPENDIX V STANDARD FOR FISH AND FISH PRODUCTS (As amended at 58th Session of Council, October 1964)

1. Fish .. Fish" means any wholesome fish or the wholesome part of any fish ordinarily used for human consumption and includes crustaceans and molluscs. 2. Fresh or Chilled Fish Fresh or chilled fish is fish which has been maintained in a wholesome condition and the temperature of which has not been reduced below 300 P. 3. Frozen Fish Frozen fish is fish which has been maintained in a wholesome condition and the temperature of which has been reduced below 300 P. 4. Smoked Fish Smoked fish is fish which has been maintained in a wholesome condition and treated with salt and subjected to the action of wood smoke. It may be coloured with annatto and may contain formaldehyde incidentally absorbed in the processing in proportion not exceeding one third of one grain to the pound. 5. Salted Fish Salted fish is fish which has been maintained in a wholesome condition and treated with salt. Salted fish may be dried and/or coloured with annatto. 6. Oysters and Other Shell Fish (a) No person shall pack or sell oysters or other shell fish which have been procured from any area prohibited under provisions of any Act. (b) No person shall sell any oysters in containers unless there is attached thereto a label in which is written in bold-faced, sans serif capital letters of not less than eight points face measurement the following particularsName and address of Vendor, Trade description of contents, The date of packing or bottling, Particulars of source of supply, and From whom and where obtained. Provided that Clause (b) shall not apply to oysters sold in the shell, or served for a meal, or processed and packed in hermetically sealed containers, or frozen in bulk as raw material for further processing.

7. (a) All fish, smoked fish and fish products when sold under a name descriptive of kind, composition or origin, shall correspond thereto. (b) Provided that where a fish product is made from two or more kinds of fish and the kinds of fish are named on the label, the kind first named shall be in greater proportion than any other. 8. Fishmarinades or Fish Semipreserves (a) Fishmarinades or fish semipreserves are fish products not processed by heat to ensure preservation in which the fish has been marinated with acetic acid and/or vinegar with or without salt and/or spices and/or other wholesome foodstuffs. (b) They may contain benzoic acid or sorbic acid either singly or in combination in total proportion not exceeding 1,000 parts per million. (c) Labelling

Fishmarinades, when sold in a package, shall bear a label on which the word .. Marinated" or .. Marinade" shall precede or follow the name of the product in letters of the same size. There shall also appear on the label the words" KEEP UNDER REFRIGERATION BETWEEN 30° AND 50°F", or words of similar import in letters with a face depth of not less than 4/32 of an inch. Such words shall be printed in such colour as to afford a distinct colour contrast to the ground, and no other words shall appear in the same line.

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APPENDIX VI STANDARD FOR CANNED FISH PRODUCTS (As amended at 58th Session of Council, October 1964)

1. Canned Fish Products are the products prepared in accordance with good commercial practice from fish properly prepared and fit for human consumption. They may contain salt, sugar, acetic acid or vinegar, saltpetre (potassium or sodium nitrate), potassium or sodium nitrite, seasoning, water, any substance added by the process of smoking or any other wholesome foodstuff. Canned Fish Products shall be packed in clean containers, hermetically sealed and processed by heat to ensure preservation. 2. The total fat and oil content of canned fish products shall not exceed 25 parts per centum.

3. Canned fish products shall not contain a proportion of nitrites greater than one grain per pound of canned product when calculated as potassium nitrite. The proportion of total nitrates and nitrites when calculated as potassium nitrate shall not exceed fourteen grains per pound of canned product. 4. The addition without declaration of sodium hexametaphosphate, in proportion not exceeding half or one part per centum, to canned fish or canned fish products shall not be a contravention of those regulations.

5. (a) Canned fish (other than fish paste) with starch, cereal, water or other foodstuff shall not contain more than six parts per centum of starch nor less than 51 parts per centum of fish. (b) Canned fish balls or canned fish rissoles are fish mixed with cereal, with or without condiments and/or vegetables, and the mixture formed into balls or pats. Each ball or pat shall contain not less than 51 parts per centum of fish of the kind or kinds designated in the label. When fish baIls or fish rissoles are first named in the label the contents of the container shall contain not less than 66 parts per centum of balls or pats. Labelling 6. Tllere shall be written in the label on or attached to every container of canned fish products in bold-faced, sans serif capital letters of not less than 10 points face measurement a statement giving a true description of the fish contents of such containers as in the following examplesBARRACOUTA or TUNA Where the article is prepared from two kinds of fish, the fish first mentioned in the label shall be in greater proportion than any other. The label shall contain in bold-faced, sans serif capital letters of not less than 6 points face measurement a statement of the approximate proportion of each kind of fish present as in the following example: CONTAINS 80% BARRACOUTA AND 20% SALMON 7. Where the article is prepared from more than two kinds of fish there shall be written in the label on or attached to the container in bold-faced, sans serif capital letters of not less than eighteen points face measurement the words" MIXED FISH". The label shall also contain in bold-faced, sans serif capital letters of not less than six points face measurement a statement of the approximate proportion of each fish contained as in the following example: CONTAINS SALMON 50% BARRACOUTA 30% TUNA 20% Provided that when a particular kind offish is present in the proportion of not less than 75 parts per centum of the fish contained in the package, the statement of the approximate proportion of each of the fish present may be made in the following example: CONTAINS BARRACOUTA 75 % AND OTHER FISH 25 %, WHICH MAY INCLUDE SALMON, TUNA, MULLET, HERRING (insert the names of any other kinds of fish which may be present) 8. There shall be written in the label on or attached to every container which contains a mixture of canned fish with cereal, water, starch, or other foodstuffs, with the exception of edible oil or tomato sauce where the tomato sauce does not exceed 10 parts per centum of the contents in bold-faced, sans serif capital letters of not less than 10 points face measurement a true description of the contents of the container as in the following examples: SALMON WITH CEREAL or BARRACO UTA WITH TOMATO SAUCE AND CEREAL The label shall also contain in bold-faced, sans serif capital letters of not less than 6 points face measurement a statement of the approximate proportion of each ingredient as in the following example: CONTAINS 60% SALMON and 10% CEREAL

9. No pictorial desiJn of fish shall appear on the label on or attached to any container of fish products excepting where the contents are entirely fish, with or without the addition of salt, sugar, saltpetre, acetic acid or vinegar, seasonings, edible oil or tomato sauce. Such pictorial design shall be characteristic of the variety of fish present in greatest proportion.

10. Permitted Addition Canned fish and canned fish products may be coloured with annatto. 11. FIsh Paste (a) Fish paste is a paste prepared from one or more kinds of fish with or without other wholesome foodstuffs, condiments and permitted colouring. It shall contain not less than 70 parts per centum of fish. (b) Labelling: Every person who sells any package of fish paste shall attach thereto a label in which shall be written In letters of not less than 8 points: (i) (Where the paste contains only one variety of fish) the words .. Fish Paste .. with or without the name of the fish contained therein; or (ii) (Where the paste contains two or more varieties of fish), the words .. Fish Paste" with or without the name of the variety of fish, provided that where the fish are named, the variety first named shall be in greater ptoportion than any other: or (iii) (Where the paste contains two or more varieties of fish, one or more of which impart a flavour to the paste), the words" Fish Paste" followed or preceded by the words" Fish Paste" followed or preceded by the words .. ........................................................ (name of flavouring fish or fishes) flavour"; or (iv) (When the paste contains and derives its flavour from one or more varieties of fish and a vegetable) the words" Fish Paste", followed by the words, .......................................................... (name offtavowing lith and name of vegetable) flavour ".

APPENDIX VII STANDARD FOR LEMON BUTTER, FRUIT FLAVOURED SPREAD AND FRUIT FLAVOURED FILLING 1. Lemon Butter Lemon Butter is a preparation of butter, egg, sugar, citric acid, water, and flavouring substances derived solely from lemons, with or without glucose. It shall contain not less than 4 per cent. butter fat, and not less than 1.5 per cent. of egg solids. It may contain permitted colouring. It shall not contain any other subStance. 2. Fruit Flavoured Spreads and Fillings (a) Fruit Flavoured Spread and Fruit Flavoured Filling are preparations of sugar, edible oils and fats, and flavouring wholly derived from lemons, passion fruit and/or bananas, with or without starch. They may contain permitted yellow colouring and not more than 2 per cent. of prescribed modifying agents. (b) Labelling: There shall be written in the label, attached to any package containing fruit flavoured spread or fruit flavoured fillipg, in bold-faced sans, serif capital letters with a face depth of not less than 5/64 of an inch the words " ........................................ (here insert the name of the ftavour) FLAVOURED SPREAD (or FILLING)".

3. PrBhibitions The words .. butter" .. cheese" "curd" and any pictorial representation of butter, fruits or eggs chall not appear on the label attached to any package containing fruit flavoured spread (or fllIillg).

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APPENDIX VIII STANDARD FOR MARGARINE (As amended at 58th Session of Council, October 1964)

1. Margari1U! Margarine shall be a mixture of edible fats, oils and water prepared in the form of a solid or semisolid emulsion. It includes all substances made in imitation or semblance of butter and all preparations resembling butter the fat contents of which are not derived exclusively from milk. Margarine may contain salt, skim milk, permitted anti-oxidants, mono-or di-glycerides of fat forming fatty acids, flavouring, harmless vegetable colouring and added vitamins A & D. 2. The fat contained in margarine shall conform to the general standards for edible fats and oils and shall have a Kirschner value not greater than the figure obtained by using the formula. Polenske value of fat 0 5 8 + . <

3. Margarine shall contain not more than 16 parts per centum of water and not more than 4 parts per centum of salt. 4. Margarine sold as table margarine, shall contain not less than 800 International Units Vitamin A per ounce and not less than 60 International Units Vitamin D per ounce. When vitamins A & D are added to any margarine other than table margarine the proportions of such vitamins shall be as prescribed for table margarine.

5. Labelling: (a) There shall be written in the label attached to every package which contains Margarine in boldfaced, sans serif capital letters not less than 18 points face measurement, the words:

TABLE MARGARINE or COOKING MARGARINE (as the case may be) (b) The word" Butter" or any expressions or devices which include, resemble, or suggest butter shall not be written in the statement or label written on or attached to any package which contains Margarine. (e) There shall be written on the label attached to every package containing Margarine sold as table margarine, or containing any other margarine to which vitamins A and D have been added in bold-faced, sans serif capital letters of not less than 8 points face measurement the words:

CONTAINS VITAMIN A & D In accordance With The Prescribed Standard (d) No other reference to vitamins shall appear on the label.

APPENDIX IX STANDARD FOR METALS IN FOOD (As amended at 58th Session of Council, October 1964) No food substance shall be in contact with any antimony, arsenic or lead, nor shall it contain any antimony. arsenic, lead, tin or other poisonous metal or compound of any of them. It shall not be a contravention of this Regulation if the food specified in the following list contains not more than the quantities of the metals or their compounds specified in each case; provided that such metals or compounds are unavoidably present in the food.

Parts per million

IArsenic calculated I Lead calculated"

--------------------------------------Phosphates for use in food

ias Arsenious Oxide; 1.5 0.15 1.5 1.5 1.5 1.5 4.0 4.0 1.5 5.0 1.5 0.15 1.5 0.15 1.0 0.15 1.5 1.0 1.5 1.5 1.5

as Metal

Ales and Beer I Baking Powder : Cheese and other foods wrapped in tinfoil Cream of Tartar Fruit and Fruit Products other than dried fruit Dried Fruit Gelatine Glucose Lactic Acid Meat in tinplate containers Milk Milk and Milk Products in tinplate containers Non excisable fermented drinks Sauces Summer drinks and aerated waters Vegetables Vinegar Fish in tinplate containers Prescribed Colouring Matters (relative to lOOper cent. dry active dye) .. All other foods

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10.0 0.2 10.0 4.0 20.0 5.5 15.0 10.0 10.0 10.0 5.5 0.2 2.0 0.2 10.0 0.2 4.0 10.0 5.5 10.0 2.0

Antimony in beverages Antimony in other foods Copper in beverages Copper in ghee Copper in other foods Heavy Metals other than Lead in Prescribed Colouring Matter relative to 100 per cent. dry active dye Selenium in any food Tin in any food packed in tinfoil or tinplate containers .. Tin in other foods .. Zinc in beverages .. Zinc in gelatine Zinc in other foods

Parts per million calculated as the metal 0.15 1.5 5.0 0.15 30.0

100.0 2.0 250.0 40.0 5.0 100.0 40.0

In any food any metal other than aluminium, arsenic, antimony, calcium, copper, iron, lead, lithium, magnesium, manganese, potassium, selenium, tin or zinc 5.5 parts per million in solid foods and 0.15 parts per million in beverages, calculated as the metal in both cases. The proportions here specified refer to the total contents of the container and, for the purpose of analysis, a representative proportion of the sample shall be taken.

APPENDIX X PRESCRIBED METHODS OF ANALYSIS Determination of Crude Fibre in Chocolate

1. Treat 508. of the chocolate in a centrifuge bottle with two or three 100 mi. portions of ether, centrifuging and decanting the supernatant liquid after each addition. 2. Dry the residue in an oven at approximately 100°C, and then pulverize it in the bottle with a flat-end glass rod. If milk chocolate, shake with 100 mi. of 1 per cent. sodium oxalate solution, let stand 30 minutes, centrifuge and decant supernatant liquid. 3. Wash the residue in the bottle with three 100 ml. portions of water at room temperature, shaking well each time to remove particles adhering to the sides. 4. Centrifuge for 10--15 minutes after each washing, and decant the aqueous layer. 5. Wash the residue in the same manner with two 100 mi. portions of alcohol and one 100 ml. portion of ether. Transfer the residue to a suitable dish, dry to constant weight, and grind in a mortar. 6. Weigh 2g. of the dried material and proceed as for crude fibre in cocoa paste. 7. Calculate the percentage of crude fibre in the water-free, fat-free sugar-free chocolate by taking the percentage of crude fibre as determined and multiplying by 0.7 (as in A.O.A.C. (1960) 12.014(a».

Determination of Crude Fibre in Cocoa Paste and Cocoa Note: The crude fibre is expressed as a percentage of the dried, ether-extracted cocoa paste or cocoa.

1. Reagents (a) Sulphuric acid solution----{).25N. 1.25g. of concentrated sulphuric acid per 100 ml. (b) Sodium hydroxide solution----{).31N. 1.25g. of sodium hydroxide per 100 ml. free, or nearly so, from sodium carbonate. The concentration of these solutions must be checked by titration. (c) Asbestos. Gooch grade, medium fibre, acid-washed, and ignited is usually satisfactory, but it should be tested for chemical stability and filtering speed before use. Digest on a steam bath, or at equivalent temperature, at least 8 hours with 5 per cent. sodium hydroxide solution, and wash thoroughly with hot water, then digest in similar manner 8 hours with dilute hydrochloric acid (1 + 3) and again wash thoroughly with hot water. Dry, and ignite at bright red heat. 2. Apparatus (a) Condenser-Use condenser that maintains a constant volume of solution throughout digestion. (b) Digestion Vessels-Use digestion vessels of such size and shape that solution is not less than 1" nor greater than 1.5" in depth. A 700--750 ml. erlenmeyer flask is suitable. (c) Filtering cloth-Use filtering cloth of such character that no solid matter passes through when filtering is rapid. 3. Determination (a) Dry a sufficient quantity of the sample and extract with ether. (b) Weigh 2g. of the residue and transfer, together with about 0.5g. of asbestos, to the digestion vessel. If the material is difficult to wet, add 3 drops of a diluted (I + 3) silicone anti-foaming agent. Add 200 ml. of the boiling sulphuric acid solution, immediately connect the digestion vessel with the condenser, and heat under reflux. (Contents of vessel must come to boiling within I minute and brisk boiling must continue for exactly 30 minutes). Rotate vessel frequently until sample is thoroughly wet. Take care to prevent material remaining on sides of vessel out of contact with the solution. A blast of air conducted into the vessel services to reduce frothing of the liquid. After 30 minutes remove the vessel, immediately filter through the filtering cloth and wash with boiling water until the washings are no longer acid. Wash the charge and asbestos back into the vessel with 200 ml. of the boiling sodium hydroxide solution, using a wash bottle marked to deliver 200 ml. Connect the vessel with reflux condenser and boil exactly 30 minutes.

After 30 minutes, remove the vessel and immediately filter as before. For materials difficult to filter in this procedure, use a vacuum and wash with hot 10 per cent. potassium sulphate solution. This solution may be added during filtering whenever filtration becomes difficult. (c) Transfer the residue to the Gooch crucible prepared with a thin but close layer of ignited asbestos, thoroughly washing all adhered material from the cloth with hot water. Thoroughly wash contents of Gooch crucible with boiling water, then with 15 mi. alcohol. Dry the Gooch crucible and contents at 110°C to constant weight, cool in a desiccator, and weigh. (d) Ignite the contents of the crucible in an electric muffle furnace at dull red heat until carbonaceous matter is consumed (approximately 20 minutes). Cool in a desiccator and weigh, reporting loss in weight as crude fibre calculated as a percentage.

APPENDIX XI STANDARD FOR COFFEE (As amended at the 58th Session of Council, October 1964)

1. Coffee bean Coffee bean is the seed of one or more of the species of Coffee. 2. Coffee Coffee is the coffee bean roasted and ground.

3. Coffee shall(a) not contain any fat other than that natural to coffee; (b) not contain more than one part per centum of sugar calculated as invert sugar; (c) not yield more than six parts per centum of ash of which not less than seventy-five parts per centum shall be soluble in water; (d) not contain any foreign substance. 4. Chicory Chicory is the dried root of Cichorium intybus, roasted and ground. 5. Coffee and Chicory Coffee and chicory is a mixture of coffee and chicory. It shall contain not less than fifty parts per centum by weight of coffee. It shall not contain any foreign substance. 6. Labelling (a) There shall be written in the label attached to every package which contains coffee mixed with chicory the words" Coffee and Chicory" in larger letters than those of any word on the label immediately followed by a statement of the percentage proportion in which the ingredients of the mixture are present, written in bold-faced, sans serif capital letters of not less than twelve points face measurement, in the fonowing form: CONTAINING NOT LESS THAN (here insert the number of parts per centum) PARTS PER CENT. OF COFFEE. (b) The word .. coffee" and expressions which include the word .. coffee" shall not appear in any statement or label written on or attached to any package which contains a mixture of coffee and chicory, unless it be conjOined with the words" and chicory .. uniformly written in the same size of type.

7. Soluble Coffee Soluble coffee is a preparation consisting of dried soluble solids obtained from a water extract of coffee. It shall contain not less than three parts per centum of anhydrous caffeine (CaH 1oN 40.) derived from the coffee. It shall not contain any foreign substance. It shall contain not more than 0.3 parts per centum of residue insoluble in boiling water. 8. Soluble Coffee and Chicory Extract Soluble coffee and chicory extract is a preparation consisting of dried soluble solids obtained from a water extract or extracts of coffee and chicory, where the proportion of coffee used is not less than that of the chicory admixed with sugar, dextrins, mono and di saccharides. It shall not contain less than 0.5 parts per centum by weight of anhydrous caffeine (C S H 10N,02) derived from the coffee. It shall contain not more than 0.3 parts per centum of residue insoluble in boiling water. 9. Liquid Coffee Essence or Extract Liquid coffee essence or extract shall be prepared from coffee with or without the addition of sugar and/or glycerine and/or glucose. It shall contain not less than one half of one part per centum by weight of anhydrous caffeine (CaHlON,O.) derived from the coffee. 10. Liquid Coffee and Chicory Essence or Extract Liquid coffee and chicory essence or extract shall be prepared from a mixture of coffee and chicory of which not less than fifty parts per centum by weight shan be coffee, with or without the addition of sugar and/or glycerine and/or glucose. It shall contain not less than one fourth of one part per centum by weight of anhydrous caffeine (CSHlON,O.) derived from the coffee.

11. Labelling (0) There shall be written in the label attached to every package which contains Liquid Coffee and Chicory Essence or Extract in larger letters than those of any other word on the label the words-

COFFEE AND CHICORY ESSENCE or COFFEE AND CmCORY EXTRACf (b) The word" coffee .. and expressions which include the word" coffee" shall not appear in any statement or label written or attached to any package which contains Coffee and Chicory Extract unless it be conjoined with the word" and chicory" uniformly written in the same size type.

12. Coffee and Milk Coffee and milk shall be prepared from milk or milk products sugar and coffee extract. It shalt contain not less than twelve one-hundredths of one part per centum of anhydrous caffeine (CSHlON,Oz) derived from the coffee and not less than nine parts per centum of milk fat.

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APPENDIX XII STANDARD FOR SUGAR AND GLUCOSE (As amended at 58th Session of Council, October 1964) 1. Sugar is the substance which is chemically known as sucrose. 2. Crystal, granulated, loaf, cut, milled, icing and powdered sugar shall contain at least ninety-nine and fivetenths parts per centum of sucrose. 3. Icing Mixture Icing mixture is a mixture of icing sugar with or without permitted flavouring and colouring, with or without farinaceous substances not exceeding 5 per cent., and with or without tricalcium phosphate and/or basic calcium phosphate not exceeding 1 per cent. calculated as P 205' It shall contain no other added substance and not less than ninety-five parts per centum of sucrose.

4. Glucose Syrup Glucose syrup is the viscous product resulting from the partial hydrolysis of wholesome starch, and consists of a mixture of dextrin, reducing sugars and water. Glucose syrup may contain sulphur dioxide not exceeding two grains to the pound. Its reaction value shall be between pH 4.5 and pH 7. O. If sold in containers of 4 lb. net weight or less it shall contain not more than 21 per cent. of water, and it shall yield not more than one part per centum of ash. S. Solid Glucose (Starch Sugar) Solid glucose is the solid product obtained from the hydrolysis of wholesome starch. It shall contain not less than seventy parts per centum of reducing sugars calculated as dextrose. It may contain sulphur dioxide not exceeding two grains to the pound. It shall yield not more than one part per centum of ash. 6. Labelling (a) In the label attached to every package of Glucose Syrup there shall be written in letters of not less than twelve points face the wordsGLUCOSE SYRUP followed by a statement of the water content of such syrup. (b) Every package of solid glucose shall bear a label in which shall be written in letters of not less than twelve points face measurement the wordsSOLID GLUCOSE followed by a statement of the percentage proportion of reducing sugars calculated as dextrose contained therein.

, APPENDIX XIn NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL MEMBERS FOR 1964-65 Major-General W. D. Refshauge, the Director-General of Health, Commonwealth (Chairman);

Pro~JessoBrMSirtbiE~ward Ford}representing the Department of Health of the Commonwealth; . . . a eson Dr. R. W. Greville, representing the Commonwealth Serum Laboratories Commission; Dr. C. J. Cummins, the Director-General of Public Health, New South Wales; Dr. K. Brennan, the Chief Health Officer, Victoria; Dr. A. Fryberg, the Director-General of Health and Medical Services, Queensland; Dr. P. S. Woodruff, the Director-General of Public Health, South Australia; Dr. W. S. Davidson, the Commissioner of Public Health, Western Australia; Dr. J. Edis, the Director-General of Health Services, Tasmania; Dr. R. F. R. Scragg, the Director of Public Health of the Territory of Papua and New Guinea; Dr. T. G. Swinburne, representing the Federal Council of the Australian Medical Association; Mr. K. W. Starr, representing the Royal Australasian College of Surgeons; Dr. J. J. Billings, representing the Royal Australasian College of Physicians; Professor S. Sunderland, representing the Australian Universities having Medical Schools; Professor S. L. Townsend, representing the Australian Regional Council of the Royal College of ObstetrlciaDil and Gynaecologists; Dr. J. G. Radford, representing the Australian College of General Practitioners; Dr. A. V. Jackson, representing the College of Pathologists of Australia; Dr. J. M. Wark, representing the Australian Dental Association; Professor V. L. Collins, representing the Australian Paediatric Association; Dr. H. J. Ham, representing the College of Radiologists of Australasia; Sir Norman Nock, an eminent layman appointed by the Commonwealth Government; Miss M. C. Nelson, an eminent laywoman appointed by the Commonwealth Government; Dr. R. H. C. Wells (Secretary of the Council).

ADVISORY COMMITTEES OF THE COUNCIL Medical Research Advisory Committee Professor S. Sunderland (Chairman) Professor R. J. Walsh (Deputy Chairman) Professor H. N. Robson Professor P. O. Bishop Professor F. J. Fenner Professor W. J. Simmonds Dr. H. M. Whyte Dr. I. J. Wood Professor H. F. Atkinson Professor J. Loewenthal Professor V. L. Collins Professor E. C. Webb Professor J. S. Robertson Professor R. F. Whelan Dr. R. H. C. Wells (Convener) Medicine Advisory Committee Dr. J. G. Radford (Chairman) Dr. J. J. Billings Professor V. L. Collins Dr. H.J. Ham Dr. A. V. Jackson Miss M. Nelson Mr. K. W. Starr Dr. T. G. Swinburne Professor S. L. Townsend Dr. J. M. Wark Dr. R. H. C. Wells (Convener)

Public Health Advisory Committee Dr. K. Brennan Dr. C. J. CUmmins Dr. W. S. Davidson Professor Sir Edward Ford (Chairman) Dr. A. Fryberg Dr. A. Green Dr. J. B. Mathieson (Deputy Chairman and Convener) Dr. H. M. L. Murray Dr. R. F. R. Scragg Dr. P. S. Woodruff

COMMIlTEES OF THE COUNCIL Antihroficg

COmmittee Professor T. J. Rendle-Short Professor T. Stapleton Professor S. L. Townsend

Dr. E. F. Thomson (Chairman) Dr. K. F. Anderson Sir William Morrow Mr. B. K. Rank Professor H. N. Robson Dr. Phyllis Rountree Dr. B. Royall (Convener) Dr. S. W. Williams

Medical Statistics COmmittee Dr. R. H. C. Wells (Chainnan and Convener) Mr. R. Dibley Mr. E. K. Foreman Dr. J. G. Graydon Miss E. James Dr. A. Johnson Dr. D. L. Jones Professor P. Moran Mr. V. E. Pickering Mr. R. Spencer

Dental Health Committee Dr. J. M. Wark (Chairman) Professor Sir Arthur Amies Professor J. F. Atkinson Professor G. N. Davies Mr. A. R. Docking (Convener) Mr. R. Harris Professor A. M. Horsnell Professor N. D. Martin Professor E. Storey Professor K. J. Sutherland Epidemiology Committee Sir Edward Ford (Chairman) Dr. J. B. Mathieson (Deputy Chairman and Convener) Sir Macfarlane Burnet Dr. C. E. A. Cook Professor F. J. Fenner Dr. A. A. Ferris Dr. E. L. French Dr. R. W. Greville Dr. H. McLorinan Food Additives Committee Dr. D. B. Travers (Chairman and Convener) Dr. R. A. Bottomley Dr. C. E. A. Cook Dr. I. S. de la Lande Dr. K. T. H. Farrer Dr. P. E. Hughes Mr. W. R. Jewell Mr. E. S. Ogg Professor F. H. Reuter Dr. J. R. Vickery Mr. J. P. Warry Professor S. E. Wright Food Standards Committee Professor F. H. Reuter (Chairman) Dr. D. B. Travers (Deputy Chairman and Convener) Mr. W. R. Jewell Mr. K. F. Kelford Mr. W. H. Kelly Mr. J. G. Krigsman Mr. D. Kruger Dr. V. M. Lewis Dr. R. C. McCarthy Mr. W. Madwick Mr. E. S. Ogg Mr. I. H. Smith Mr. L. N. Thornton Mr. J. P. Warry Maternal and Child Health Committee Professor W. B. Macdonald (Chainnan) Dr. A. Green (Deputy Chairman and Convener) Dr. Grace Cuthbert Browne Dr. H. N. Chesterman Professor V. L. Collins Professor L. W. Cox Dr. B. P. McCloskey Professor G. M. Maxwell

Nursing Committee Miss F. M. Peterson (Chairman and Convener) Miss C. S. Kirk Miss P. F. Lee Miss C. A. E. Michelmore Miss M. Nelson Mrs. E. W. Sullivan

Nutrition Committee Dr. F. W. Clements (Chairman) Professor V. L. Collins Dr. E. Hipsley (Convener) Sir Norman Nock Professor E. J. Underwood Dr. D. M. Walker Dr. J. Woodhill Occupational Health Committee Dr. H. E. Downes (Chairman) Dr. A. Bell Dr. A. J. Christophers Mr. A. W. Findley Professor D. Gordon Dr. D. D. Letham Dr. G. H. McQueen Dr. H. M. L. Murray Dr. E. M. Rathus Dr. G. C. Smith (Convener) Mr. D. J. Stevens Radiation Health Committee Mr. D. J. Stevens (Chairman) Professor M. Clarke Dr. A. G. S. Cooper Dr. E. R. Crisp Dr. M. G. S. Donnan Dr. H.J. Ham Dr. B. S. Hanson Dr. W. P. Holman Dr. J. McRae Dr. R. Motteram Mr. J. F. Richardson Mr. R. W. Stanford Radio Isotopes Committee Mr. D. J. Stevens (Chairman) Dr. A. G. Baikie Professor V. L. Collins Dr. W. P. Holman Mr. D. W. Kearn Dr. W. E. King Professor E. S. J. King Professor R. Nairn Dr. D. P. Pearce

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Traffic Injury Committee Professor J. S. Robertson (Chairman) Dr. J. H. W. Birrell Dr. K. G. Jamieson Dr. J. C. Lane Mr. R. A. Money Dr. D. B. Travers (Convener) Dr. J. I. Tonge Tropical Medicine and Health Committee Dr. R. H. C. Wells (Chairman and Convener) Professor R. H. Black Dr. C. E. A. Cook Dr. R. L. Doherty Professor Sir Edward Ford

.Dr. W. A. Langstord Professor W. V. Macfarland Dr. R. K. Macpherson Dr. F. D. Schofield Veterinary Public Health Committee

Dr. A. McArthur (Chairman and Convener) Mr. J. L. Anderson Mr. A. L. Clay Dr. G. Edgar Dr. T. S. Gregory Mr. K. S. McIntosh Dr. D. T. Oller Mr. W. S. Smith Dr. W. J. Stevenson Mr. L. N. Thornton

SUB-COMMITTEES OF COUNCIL Food Analysts Sub-Committee Dr. D. B. Travers (Chairman) Mr. J. Warry (Convenor)

Mr. J. P. Warry Professor S. E. Wright Medical Research in Aborigines Sub-Committee Dr. R. H. C. Wells (Chairman and Convener) Professor R. H. Black Dr. W. S. Davidson Dr. A. Fryberg Dr. W. A. Langsford Dr. P. S. Woodruff National Morbidity Survey Sub·Committee Dr. A. Johnson (Chairman and Convener) Dr. W. Breinl Dr. D. L. Jones Mr. V. E. Pickering Dr. J. G. Radford Notification 0/ Diseases Sub-Committee Dr. J. B. Mathieson (Chairman and Convener) Dr. A. Douglas Dr. J. A. Forbes Dr. W. J. Stevenson Dr. G. H. McQueen Dr. H. M. L. Murray Dr. P. R. Patrick Dr. D.Snow Pesticides Sub·Committee Dr. G. C. Smith (Chairman) Dr. A. Bell Dr. J. S. BOllall Dr. A. J. Christophers Mr. J. P. Warry (Convener) Pesticides Residues in Food Sub-Committee Dr. J. R. Vickery (Chairman) Dr. J. S. BOllall (Convener) Mr. P. C. Hely Mr. H. Nardin Mr. J. P. Warry Professor S. E. Wright Poisons Scheduie Sub-Committee Dr. J. S. Boxall (Chairman) Mr. H. A. Braithewaite Dr. I. S. de la Lande Mr. W. H. Kelly Mr. R. C. McCarthy Dr. G. C. Smith Dr. E. Thompson Mr. J. P. Warry (Convener) Professor S. E. Wright

,•

Food and Cosmetics Colours Sub-Committee Dr. D. B. Travers (Chairman and Convener) Dr. R. A. Bottomley Mr. E. S. Ogg Dr. J. R. Vickery Mr. J. P. Warry Professor S. E. Wright Food Irradiation Sub· Committee Mr. D. J. Stevens (Chairman and Convenor) Mrs. Audrey Cahn Mr. D. W. Kearn Professor F. H. Reuter Dr. W. Scott Dr. D. B. Travers Frozen Foods Code Sub-Committee Dr. D. B. Travers (Chairman) Mr. S. L. Guilfoyle Mr. W. Madgvnck Mr. R. Pryse-James Mr. R. C. Stanhope Dr. J. Vickery Mr. J. Warry (Convener) Health Advertisements Sub· Committee Dr. 1. B. Mathieson (Chairman) Dr. R. J. Farnbach Mr. B. Holt Mr. W. Kelly Dr. E. S. A. Meyers Mr. J. Newton Mr. Osborne Dr. C. J. Ross-Smith Mr. K. Thomas Labelling 0/ Hazardous Substances Sub-Committee Dr. J. S. Boxall (Chairman and Convener) Dr. F. W. Clements Mr. W. H. Kelly Dr. G. C. Smith

Poliomyelitis Sub-Committee Dr. Dr. Dr. Dr. Dr. D. B. Travers (Chairman and Convener) A. A Ferris J. Graydon H. McLorinan S. W. Williams

Preventive Medicine in General Practice Sub-Committee Dr. A. J. P. Proust (Chairman and Convener) Dr. J. A. C. Bamford Dr. D. E. Craven Dr. P. J. D'Arbon Dr. C. C. Jungfer Dr. H. S. Patterson Dr. H. Shannon Senator Dr. R. J. D. Turnbull

Dr. 1. Ferris Mr. D. W. Kearn Dr. D. D. Letham Dr. A. McArthur Dr. G. H. McQueen Dr. H. M. L. Murray Dr. E. M. Rathus Dr. G. C. Smith Mr. B. W. Worthley Dr. A. R. W. Wilson

Virology Sub-Committee Dr. A. A. Ferris (Chairman) Dr. A. McArthur (Deputy Chairman and Convener) Dr. R. L. Doherty Dr. W. Howarth Dr. D. Howes Mr. I. Jack Mr. A. Murphy Dr. L. C. Rowan Professor N. F. Stanley Dr. F. Warburton

Radiation Technical Sub-Committee Mr. D. J. Stevens (Chairman) Dr. A. Bell Dr. A. J. Christophers

APPENDIX XIV THE INTER-RELATIONSHIP OF COUNCIL, ITS COMMITTEES AND SUB-COMMITTEES Advisory Committees Committees Sub-Committees

~ Adelaide Grants Brisbane Grants IMedical R e s e a r c h l - - - - - - - - - - - - - - i Melbourne Grants Perth Grants ~Ydney Grants

Antibiotics Nursing Medicine>------i Nutrition Radiation Health Radio Isotopes

r Food Analysts Health Advertisements Labelling of Hazardous Substances Medical Research in Aborigines Poisons Schedule Poliomyelitis Preventive Medicine in General Practice Dental Health Epidemiology------- Virology Irradiation Food Additive:s-s- - - - - - Food and Cosmetic Colours Pesticide Residues in Food Food Standards Maternal and Child Health Medical Statistics>------ National Morbidity Survey Occupational Health-----r-Pesticides Radiation Technical Traffic Injury Tropical Medicine and Health Veterinary Public Health

Council-

Public Health

FOOd

By Authority: A. 1. AB'IHVII, ~ ~ Printor, Canberra.

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FIJI Report on thG Progress of Health Activities* 1. 0

INTRODUCTION

Fiji lies between longitude 177 0 west and 1750 east and latitude 15 and 220 south. It is an archipelago of over three hundred islands. Suva, the capital, is situated on the main island of Viti levu. Lautoka, the second to~, is the main centre on the western side of Viti levu. Labasa is the main town on the second largest island - Vanua levu. The total estimated population of Fiji at the end of 1964 was 456 390 of 'Thom 189 169 ,.,ere Fijians and 220 176 Indians. 2. MEDICAL .ADMrNISTRATIVE STRUCTURE

The country is divided into four medical administrative divisions each under a senior medical officer. A division is further divided into three or four SUb-districts under the immediate su,pervision of a subdistrict med.ical officer. The Sub-District Headquarters Team consists of sub-district medical officer, a health sister &ld a sanitari~~. There are a total of 46 health centres and dispensaries scattered throughout the group in the charge of medical officers and also an additional 120 nursing stations under the charge of nurse-midwives. 3. CLINICAL STRUCTURE There are three types of hospital:

(1) (2) (3)

the four divisional hospitals organized on specialist lines;

six district hospitals situated at tlw main regional centres; eight rural hospitals.

In addition to these, there are three special hospitals, viz:

(1)

The Tuberculosis Hospital at Tam.avua, Suva; The st. Giles Hospital (Psychiatric) in Suva; The leprosy Hospital at Maltogai.

(2)

(3)

IMMUNIZATION CAMPAIGN

',.

A campaign to immUllize schoolchildren against poliomyelitis and tetanus was cOlll;pleted in 1903. This follo'led the BeG c~aign of 19581963 during ,{r;ich 21'5 SC'{ infants and young people below· the age of twenty werc vaccinateCi \Ii th 13CG.

jln 1964

*Submitted 1965.

by the Director of Medical Services, Fiji, 19 July

- 2 -

In 1964, attention ,TaS directed to the immunization of all preschool children with BCG, oral poliomyelitis vaccine (two doses) and DPT (three doses). This phase of the campaign is now proceeding and figures up to the end of June for this phase of the campaign are set out in Table 1.

Table 1.

I~~ization

Programme to June 1965 Pre-school Children DPT 2 10 7 5 9 038 857 BeG

Division 1 Central Eastern Northern Western Totals: 20 12 12 22

SABJN 2 14 447 10937 10 ($9 113 254 53 737 13 IJ 7 13 1 709 640 715 821

3 7 2 4 5 566 983 570 633 11 858

657 932 914 805

966

216

8931 13 182 18928 52 899

69 308

43 885

33 127

20752

Approximate total pre-school population: 80 000. The routine immunization of infants according to the following schedule has now been commenced:

Immunization Schedule Age of Child

Immunization BCG (1) DPT Sabin (1) r

At birth

4 months 5 months

DPT

( 2)

6 months 24 months (In urban areas only, viz.: Suva, Nausori, Lautoka, Nadi, Ba, Labasa, Levuka) School Entry

DPl' (3) Sabin (2) Smallpox

Tetanus Toxoid Sabin booster BCG i f Mantoux ne gat i ve BCG if Mantoux negative

School-Leavers

/5.

FAMILY •••

(

--~

... - 3 :J.

FAMILY PLANNING

The promotion of a family planning C&~aign is a declared instrument of government policy. Attendances at family planning clinics have increased rapidly over recent years and in 1964 totalled 18 084. The overall birth rate has fallen from 41.78 in 1959 to 37.82 in 1964.

ENVIRONMENTAL SANITATION

The development of the programme for environmental sanitation includes a water-seal latrine programme, and measures aimed at improvement of rural water supplies. The water-seal programme achieved some success during 1964 and it is hoped to step up the programme in 1965.

A schene for the improvement of village water supplies has recently been initiated with assistance from the British Government and UNICEF. 7. HousmG

A Committee is at present working on the design of a low cost rural house and it is intended to prepare a booklet on construction details and prepared plans .rhich will be available free of charge. A prototype of this house will be built for viewing on the environmental sanitation demonstration site at the Fiji School of Medicine. 8. TRAINmG

The Fiji School of Medicine provides courses in medicine, dentistry and ancillary subjects and the Central Nursing School provides nursing training to both the local and New Zealand curricula.

MLdwifery training to the New Zealand curriculum was introduced in June 1964. A School of Public Health Nursing has recently been opened to provide public health training for graduate nurses. STATISTICAL DATA Table 2. Incidence of Tuberculosis

Year 1960 1961 1962 1963 1964 *Note:

NewCases Registered

_ _--------- ----------Population 1 December 401 413 427 441 456 018 1327 351 301 390 ...

Rat

e per 1.62 1.36 1.31 1.19 1.13

1000

648 5G 4 50 0 529 516*

43.4% of this number 'Were sputum positive either on direct smear or on culture; /Tab1e 3 •••

- 4Table 3. Incidence of Leprosy 1960 Total number of admissions 39* AdtlJ.ts .....................................

1961 45 36 9 9) 5) 18 4) 4) 13) 18 1)

1962 40 35 5 11) 5) 22

1963 40 34 6 6) 4) 13 3) 2) -)

1964 44 42 2 8) 1) 17 8)

32 7 13) 7) 20

Children (under 14)

...........

Tuberculoid 1 •.•••••••..• Tuberculoid 2 •.•.••••.••• Tuberculoid 3 ....•.......

-) 3) 11) 17 3) 1

Lepromatous 1 •••••.••.••. Lepromatous 2 ••.......... lepromatous.3 ..••.....•..

2) 6) -)

1) 15 7 2

8) 14 6) 6 4 3

Dimorphous L(T ••••••••••• Dimorphous T/ L ••••••••••• "Burnt out n case s ................

7 3

One case unclassified Table 4. Notifiable Diseases 1960 1961 8 6 360 8 3 538 215 12 163 93 15 52 175 566 741 44 11

1962 5 4 494 5 3 347 191 56 282 2 40 1 415 560 2 041 36 16 316 13 39 II

1963 4 3 195 2 3 215 410 23 765 2 989 48 808 529 1 627 41 30 445 21 1

1964 26 1 129 4748 293 45 915 4 )86

Cerebro-spinal meningitis Diphtheria .••••••.••.•••• Dysentery (all types) Enteric group ••••••••••• Infantile diarrhoea ••••• Infective hepatitis •••.•

...

Inflllenza ............................ .. 1easles ................................

Poliomyelitis ••••••••••• Tetanus .................................. Trachoma ................................

9 203 5 3 295 206 13 030 465

Tuberculosis (all forms) Pertussis .............................. Leprosy ................................. Syphilis ................................

Gonorrhoea ••.•.....•••.• Yaws ....................... Dengue fever .......................

III ..............

172 648 509 39 2 380 26 5

227 30 19

48 380 516 893 29 25 455 37

GUAM

Report on the Progress of Health and Vedical. Services* The state of health in the territory of Guam is excellent and during the past year there were no epidemics. Prevention of diseases and curative medical. care are the primary functions and responsibilities of the Guam Department of Madical. Services and al.l efforts are exerted to give the most efficient and expeditious service possible to the patient and the general. public. The medical in-service training program seeks to recruit and retain the best professional. qual.ified personnel, and the workload is designed so that adequate provisions can be made for personnel to serve the public efficiently. An especially meaningful achievement is the recent accreditation for a three-year period of the Guam M2morial Hospital, which took many months of dedicated effort by the hospital. directors and professional and non-professional. employees to create the standards of operation and .patient care which the Joint Commission on Accreditation of Hospital.s demands. The Hospital. has been newly reconstructed and renovated as a result of typhoon damage in 1962, and public health programs are constantly being expanded. The Hospital. handles approximately 7000 admissions and 27 000 out-patients annually. M2dical services in Guam must cope with the complex problems and a steadily growing population. With its mounting workload, the Department of Madical. Services is utilizing new methods and equipment to facilitate operations. There are also sixteen health centers throughout the various villages of the territory which are staffed with competent professional. personnel.

, ')..

Office of International Health, Department of Health, Education, and Welfare, Washington D.C., 20 July 1965.

*Submitted by the

HONG KONG

Report on the 1 GENERAL HEALTH

PrOgreSS

of' Health Activities, 1964*

The general health of the population remained good and, whilst the background of severe overcrowding remained, the severe shortage of water was alleviated by heavy rainfall from M3.y onwards and a twenty-four-hour supply was possible from September. 2 VITAL STATISTICS

The estimated mid-year population of Hong Kong in 1964 was 3 692 200, approximately 4~ of the population being below 15 years of age and only 5% over the age of 60. Table 1 Estimated Mid-year Population Total Live Births Crude Live Birth Rate (per 1000) Crude Death Rate (per 1000 population) Infantile Mortality Rate (per 1000 live births) 48~3

Year

Maternal Mottality Rate (per 1000 total births) 0.73 0.40 0.45 0,48 0,29 0.3S

1959 1960 1961 1962 1963 1964

2 857 000 2981 000 3 177 700 3400300 3592100 3692200

104 579 110667 108 726 111 905 115263 lOB 519

36.6 37.1 34.2 32.8 32.1 29.4

7.1 6.4 5.9 5.9 5.5 4.9

41.5 37.7 36.9 32.9 26.4

During the year, live births showed a decrease from the figure recorded in 1963 and the 1ivet' birth rate fell from 32.1 to 29.4 per 1000 population.

The crude death rate at 4.9 per 1000 of population is now one of the lowest in the world and reflects the rapid improvement of medical and health services in a young and expanding population. The infant mortality dropped still further to 26.4 per 1000 live births. The marked decline in infantile mortality has been due to improved control of the preventible diseases of later infancy, particularly of broncho-pneumonia, gastro-enteritis, and tuberculosis.

3 3.1

COMMUNICABLE DISEASES Cholera

During the year, thirty-four cases of cholera with four deaths occurred. O£ great epidemiological interest was a short but severe outbreak which started on 13 M3.y. The infection, which was responsible

Ifor fourteen •••

*Submitted

10 August 1965

- 2 -

for fourteen cases,ano. a further three possible, was traced to a restaurant. The source o£ the infection was found to be a polluted well 'Which had in all probabil.ity been infected by an employee of the restaurant who bad experienced a very mild attack of gastro-enteritis and was subsequently found to be excreting vibrios. During the year, approximately 65~ of the Colony's population received anti-cholera inoculations.

3.2 Tuberculosis Tuberculosis remains the major health problem of Hong Kong although considerable progress is now being made. Prevalence of active tuberculosis is estimated to be between 1. 5 and ~ of the population. There continues to be a high degree of co-operation between the Government on one hand and voluntary agencies) particularly the Hong Kong AntiTubel"culosis Association, on the other. There are tw main lines of attack. (a) BCG at birth During the year, 86.4~ of babies born in the Colony received BeG vaccination within forty-eight hours of birth. This measure is believed to have been largely responsible for the very impressive reduction in the infantile IOOrtality rate from this disease. A figure of .07 deaths, from tuberculosis meningitis per 1000 live births was recorded, compared with 2.4 in 1950.

(b)

CheIOOther!py Once a diagnOSis of active tuberculosis has been made, a regime of ambulatory chemotherapy is instituted. The standard treatment consists of intensive dally

treatment for the first six IOOnths after 'Which each case is reviewed. Hospitalization is largely reserved for those whose organisms have become resistant to the first-line drugs and require treatment with the IOOre expensive and toxic second-J.iDe drugs. The total number of tuberculosis bed,s available 1s 1728. The numbers under treatment at government clinics during the year were 24 606. In

,culosis was to 49.05 in

1964, the death rate from all forms of tuber39.03 per 100 000 population as compared 1963 and 208 in 1951.

3.3 MU.a.ria

A·

The important vectors in Hong K:ong are A. minimus and jeyporiensis y!!:, candididiensis.' There Was a marted fall in the number of cases occurring during the year, the figure Of 180 cases comparing with 377 in 1963. This was probably due to

/ continued •••

continued routine control measures together with the prolonged drOught follo'Wed by very heavy rainfall factors which were most unfavourable to mosquito breeding.

3.4 Venereal Disease ..

The decline in latent syphilis and gonorrhoea continued.

The

inCidence of early ini'ectious syphilis, which had been riSing gradually since 1958, showed a slight but welcome fall.

Theincldence of this disease remained almost static at 7.3 per 100 000 of population; 271 new cases, mainly tuberculoid in type, were treated. The leprosy (Repeal) Ordinance is due to be enacted in 1965 with the object of legally controlling the disease in the same manner as other inf'ectious notifiable diseases.

3.6 Diphtheria The incidence has continued to decline and the mortality during this year at thirty--eight deaths ;ms less than halt: the number for

1963.

3.7

Enteric Fever

The pattern generally follo'Wed that of previous years; however, subsequent to the introduction of a dally ;mter supply in June, there ;ms a marked decrease in the number of cases. During Septelliber and October, a short but severe localized outbreak of the disease occurred within a small area of Northeast Kowloon.

3.8 PoliOmyelitis The incidence of acute poliomyelitis since the widespread campaign using oral vaccine early in 1963 remained low. Approximately half of all children born received the vaccine at maternal and child health centres and general campaigns .are· held in January and March each year in an attelll.Pt to i.mm.unize fully the remainder •. There ws a tendency for the number 01' cases to rise during the latter part of 1964 and the position is being ;mtched. with great care. Vi:rological investigation of the di,Sease is maintained on a routine and year-round basis. or the. thirty-seven cases reported during 1964, eighteen ·were due to type I virus, seventeen due to type III and the remaining two to type II. Two approaches to the problem of recrudescence 'Were under investigation: (a) (b) to increase the conc~ntration

of type I in the vaccine,

and to feed type I vaccine soon atter birth.

/3.9 Measles •••

- 4 3.9 ~asles

In Hong Kong, as elsewhere, this disease recurs every two years as a wave of infection spreading through very young children. Such a wave commenced in December, but the mortality which was mainly due to complicating advanced bronche-pneumonia remained low.

MATERNAL AND CHILD HEALTH

53.6% o~the children born attended a maternal and child health centre on at least one occasioD;th1s compares with a figure of 45.8~in 1963. Three new full-time centres 'Were opened during the year, two being in Kowloon and one in the east of' Hong Kong Island. Approximately 93% of' births took place in institutions and seventy-two new maternity beds 'Were provided in new government centres. 5 MElNTAL HEALTH SERVICES

The Castle Peak Hospital was originally designed f'or 1000 beds but pressure has been such that an average of' some 1250 patients had to be accommodated. Treatment facilities 'Were augDl'ilnted by the provision of portable f'aradic batteries for aversion therapy and these have been used with ef'fect in selected obsessional and phobic patients.

The Drug Addiction Treatment Centre situated in Castle Peak Hospital has provided treatment on a voluntary basis for male drug addicts since early 1961. Following the opening in 1963 of Shek Kwu Chau maintained by the SOCiety for the Aid of Rehabilitation of' Drug Addicts, patients remained in the Centre f'or one month during the iImDediate withdrawal period and thereafter transferred to Shek Kwu Chau for rehabilitation.

HOSPITALS

At the end of' 1964, there was a total of 11 831 beds available in all hospitals in Hong Kong, excluding those maintained by Her Majesty's Armed Forces; an additional 617 beds in private maternity and nursing homes 'Were also available. Owing to increased. demand for services at Queen Mary Hospital, the hospitals nominal capacity of' 632 beds was augmented considerably by the use of camp beds which averaged approximately. 120 each day. During the year, construction commenced on major extensions designed to redress these inadequacies. This will result in a further 180 beds being made available, and will provide expanded teaching facilities to enable an increased output of doctors. Queen Elizabeth Hospital with 1388 beds, the largest building in Hong Kong, serves as an emergency and specialist centre for Kowloon and the mainland portion of the New Territories, representing a population of some 2-1/2 million. By mid-1964, all parts of the hospital were fully functional. fA feature •••

•

.. 5 i

A feature of note was the increased number of attendances at the Casualty Department. Of these 47.6oj, 'Were due to trauma., the main causes being, in descending order of frequency, domestic, traffic and industrial accidents. A new infirmary is being bullt in the Wong Tai Sin area eyE under the auspices of the Tung Wah Group eyE Hospitals. The first phase to provide 2~O beds will be cOD!P1eted ear~y in 1965. Kow~oon

OUT..PATIENT FACILl'l'IES

Pressure remained heavy throughout the yea:r, a total of 5 893 199 out-patient attendances at government out-patient depa:rtments being recorded. Four new government clinics 'Were opened and the Government now maintains forty out-patient clinics as 'Well as mobile dispensaries, floating clinics and a flying doctor service •

•

.. .

JAPAN

Report on the Progress of Health Acu'vities' tor the ." Fiscal. Year 1964:~ '. (Jlpr11 1964 .- March 1965)* . 1 ORGANIZATION OF NATIONAL AID LOCAL HEALTH ADMINISTRATICD

On 1 .!\pr11 1964, the Environmental Pollution Control. Section was newlyestabl1shed in the Environmental Sanitation Bureau. There 'Were no other .changes in the organization of the M1nistry of ~.alth:,and Welfare during the period under reView as far as the hea.lth service Is concerned. The p~fectura.l and municipal health centres continUeQ. to carryout'j:;heir routine functions as local community health. service 'agenCies •. !l'bere 'Were 820 health centres throughout Japa.Il at 'the end of Mu-ch1965, an increase of· 8 centres over the previous year. ,.

VITAL STATISTICS

The est1matedpopUlati6n a.r;:Of 1 October 1964 was 97 186 000. The following table gives soma of' the Vital statistics data for 1964 with a .' " . couiparison with 1963. --_

,',

J:2§2. Births: Number Rate (per 1000 :population) Deaths: Number Rate (per 1000 population) Infant deaths: Number . Rate (per 10 000 total births) Maternal deaths: Number Rate' (per 10 000 total: birthS)' Still-births: Number Rate (per 1000 total births) 1659·52J. 17.3 670770 1.0· 38 442 23. 2 . 17m., 1.9. 2 175 424 . .

1964 1 714 7C1) 17.6 672 860 6.9

950 20.4 8~9

1 677 167 955 89.2 ..

9 .6 .5 .

The average life e~ctancy at .birth foor'the JapaneSe people,' .' prepared on the basis of' the 1964 data, indicates 67 ~ 7 years for males. and 72.9 years f'or femalesj the comparable figures for the previOUS. year being 67.2 years for males and 72.3 years for females.

MATERNAL'AND CHILD HEALTH

During'the calendar year 1964:, 881 376 ~i6its were made to the clinics by mothers, and 5 249 906 by children. Public health nurses /paid •••.

*Submitted

by the Ministry of Health and Welfare, 5 August 1965

.. 2 -

paid 234 687 home visits on mothers and 879 071 on children. At the end of M:l.rch 1965, there were 341 maternal. and child health centres in the rural areas (277 centres in 1964). During the calendar year 1964, 77 196 preJW::l,ture births were reported, indicating an increase of 346 compared '\; with 1963.

TUBERCULOSIS CONTROL

In the calendar year 1964, the number of deaths from tuberculosis decreased further, there being only 22 858 deaths, rate: 23.5 per 100 000 population (in 1963, 23 259 deaths, rate: 24.2). During 1964, 38 876 000 persons (42 631 000 persons for 1963) received health examinations for case-finding purposes. Among them, 33 678 000 (36 699 000 for 1963) were.examined by photofluorography. The case ..finding rate for 1964 was 0.2a'fo (0.23% for 1963). Among those tuberculin-negative, 4 605 000 were vaccinated with BCG.

The total number of registered tuberculous patients at the end of 1964 -was 1 527 657 (15.7 per 1000 population) I .64.1% of whom were active cases; 22.9% of the active cases were hospitalized, 57.7% were under dOmiciliary treatment; 16.a'fo did not receive complete medical treatment and the remaining 3.4% cannot be traced. During the same period, 345 470 cases were newly registered. In 1963, the total expenditure on tuberculosis treatment was estimated to be 95 blllion yen (85 billion yen for 1962). This is equivalent to 12.6% (13.1% for 1962) of the total eJq)enditure on medical care for all kinds 01' illness. At the end of 1964, there were 227 456 beds allocated to tuberculosis patients and the bed occupancy, rate -was 79.9%.

COMM.lNICABLE DISEASE. CONTROL

The number of persons who receiVed :fronn m1 zation during the calendar year 1964 was as follows: 3 458 000 for smallpox; 17 8ll 000 for typhoid and paratyphoid fever; 2 129 000 for diphtheria; 1 080 000 for whooplog cough; 3 326 000 for diphtheria..whooping cough combined, 95 000 for epidemic typhus, and 1 688 000 for poliomyelitis (attenuated vaccine).

In 1964, there -was a marked decrease in most of the acute' communicable diseases. The incidence of poliom.Yeli tis was dramatically reduced after the successful oral administration of Sablo type polio vaccine. In 1964, only 86 cases were reported. The yearly decrease 10 the number of poliomyelitis cases for the past several years is as follows: 5606 for the year 1960, 2436 for 1961, 289 for 1962, 131 for 1963 and 86 for 1964.

Mass vaccination against influenza -was carried out during the autunm of 1964 for almost all children in the kindergartens, primary schools and junior high schOOls. A small influenza outbreak due to B type virus, Akishima and Amakusa strains occurred in the Kyushu district at the end of January 1964. In the summer of 1964, an outbreak of Japanese encephalitis occurred in almost all prefectures of Jal?an. The number of cases was jestimated at .•.

-<'

- 3 -

including 1300 deaths. Voluntary immunization aga1n8t Japanese encepbalitis has been carried out every year., In 1964, two cases of cholera were reported. One of them was a nonimported case which occurred on :5 August 1964 in OO.ba PrEifecture; the patient died due to Ogawa Type El Tor on 24 August. One of biscorit$Cts, was found to be a heal.thy carrier ofEl Tor by bacteriological. examina- . tion. Another one was an imported case which occurred on 11 October lQQ4 at Shizuoka Pref'ecture. There was no secondary infection, because of' ail extensive control programme carried out by national. and local. health ,_ authorities.

eat1ma.ted at 2700,

lmERNATIONAL QUARANTINE

During the cal.endar year 1964, 23 590 Vessels and 9400 aircraft' (in 1963, 21 505 vessels and 7412 aircraft) involving 1 102 OeB and 640 234 person.f>, respectively, were subjected to quarantine inspection; 124 130 persons received preventive vaccinations for quarantinable diseases, 988 vessels underwent deratting and 4647 vessels received deratting exemption certificates~ As in the past years we have strenthened the quarantine measures f'or preventing the introduction of cholera, smallpox, etc. from overseas. We had to take special precautions particularly because of the Olympic Games held in Tokyo. However, as referred to in the preceding paragraph 5, one lion-inIported El Tor cholera case was detected on 3 August 1964,. and ~'other was not found at the time of the patient' s entry into. port in .spite of our vigilant preparedness; It was fortunate that We had no secondary outbreak. . . ,

ENVIRONMENTAL SANITATION

As of the end of loW'ch 1964, a population of 61 206 574 (about 6:5.7% of the total population) was covered by some kind of public water su;pply. At the end of March 1965, there were 77 cities operating sewage. treatment plants and a population of 11 060 000 benefitted from these services. At the end of December 1964, there were 325 cities operating nightsoll disposal. plants. At the end of' ~ch 1963, a population of 24 352 000 was covered by the garbage disposal programme, either by incineration or composting methods. The insect and rodent control programme, su;pported by community organizations, has been continued, and routine sanitary inspections have been carried out continuously. In order to cope with the air pollution problem, so far seven large or newly industrial.ized cities have been designated as specific

smoke control areas under the Smoke Control Law. The study of the effect of polluted air on human health commenced in severalih.dustrial.izEid cities. Three rivers ,,/ere designated as control. 'ba!>,1ns under the Water Pollution Control Law. "

'-""

FOOD •••

- 48 FOOD SANITATION

During the year 1964, 4732 food inspectors were stationed in 820 health centres to deal with 2 184 502 food-handling establishments. For the same year, the food poisoning cases reported totalled 2037, involving 41 638 patients and 146 deaths. Chemical synthetics to be . used as food additives are fully controlled by the Government. At the end of 1964, a total of 346 chemical synthetic food additives had been included in the list of authorized synthetic food additives.

NUTRITION

During the calendar year 1964, 1 431 074 cases of personal guidance and 81 494 group sessions, including demonstrations at mobile kitchencars, were given by the nutritional staff in the health centres. At the end of March 1965, there were 150 authorized nutritionist training schools and about 84 000 licensed nutritionists. In.order to meet the necessity of producing more clear-cut information on the status of the nutrition intake of the people, the methods used in the national nutrition survey, which has been carried out every year for seventeen ~a.rs, rrere revised in 1964. 10 DmTAL HEALTH

One hundred and trrenty-four of the 820 health centres (as of the e~ of March 1965) are equipped with dental facilities and dentists,

and are p1E1¥ing an ill!POrtant role in the preventive dental health programme. During 1964, 218 605 dental health guidance consultations were

given to pregnant women and 1 309 533 consultations to children. 11 MENTAL HEALTH

continuous efforts rrere made to improve the mental health programme during 1964, including care of the mental cases. The number of mental hospitals, mental beds I etc. at the end of June 1964, compared with the same date in 1963 is shown below:

~ Mental hospitals Units in generllJ. hospitals .M!ntal beds :tn-patients Bed occupancy 616 310 128 849 142 440 111

1964 676 3 29 153 630 16 5 697 1 079

•

There are many governmental facilities supporting the progr&llQe for the promotion of mental health guidance tor the public, as well as for mentaJ.ly retarded children and adults.

/12

Ml!DlCAL •••

- 512 MEDICAL SERVICE

At the end of the calendar year 1964, there were 6831 hospitals (662l in 1963) 'With a total bed capacity of 833 6cX:> (794 434 in 1963) sho~ng an,increase of 210 hospitals and 39 172 beds compared 'With th~se available 10 1963. There were 63 296 general clinics (62 363 in 1963) and 28 150 dental clinics (27 869 in 1963), shOwing an increase of 933 general clinics and 281 dental clinics.

As of the same date, there \/ere 108 088 physicians (11.1 :per 10000 population), 35 C179 dentists (3.6:per 10 000 population), 66 599 pharmaCists (6.9 per 10 000 population) and 229 797 nurses (23.8 pe·r 10 000 population). This means an increase of 1576 physicians, 562 dentists, 1684 pharmacists and 11 434 nurses. In order to deal with the increase in trai'f1c aCcidents, the ambulance medical care system was revised in February 1964, and a network of ambulance medical care was established at about 2500 public and private medical facilities throughout the country. 13 MEDICAL REHABILITATION

The Rehabilitation occupational. therapists course in basic science produce the first batch eighteen-month physical

School for training physical therapists and established in 1963 finished the first-year at the end of March 1964, and is expected to of graduates next March. WHO is providing an therapy teacher.

PHARMACEUTICAL CONTROL

During the calendar year 1964, 1884 pharmaceutical inspectors visited 182 742 out of the estimated number of 270 000 establishments, such as drug and medical supply manufacturers, pharmacies and blood banks. The control of amphetamine preparations and narcotics was also maintained. 15 INTERNATIONAL CO-OPERATION

During the calendar year 1964, the Government extended its services and co-operation in connexion with the international health programme, and received and trained 23 WHO fellows, 2 AID and 35 CoJ.ombo Plan trainees. The Government also released four experts to work with the Colombo Plan and two to work with other schemes.

ORIGINAL. FRENCH LAOS

Report on the Progress of Health Activities* o.

The Royal Government of Laos is happy to report the progress made in various public health programmes.

1 ~

MATERNAL AND CHILD HEALTH

The Maternal and Child Health Service continually extends its activities both in the clinical field and as regards vocational training. First of all, thanks to the help of UNICEF, which has provided substantial fellowships, and of the Asia Foundation, which made possible the construction of four schools for resident stUdents. The first group of thirty-two rural midwives possessing the CEPCEL (certificate of additional primary studies in Laotian schools) has been trained. From now on, all rural midwives will be recruited from among the CEPCEL holders. A law establishing a cadre of rural midwives will soon be approved. Last April, the Maternal and Child Health Service organized a oneweek seminar on paediatrics for young Lao doctors serving in various prOvinces of the Kingdom. Eight doctors, including two women, attended this interesting seminar. Let us mention here that the activities above were mainly due to the vitality and competence of Dr. P. Fazzi, whose departure for another duty station we much regret.

NURSING SCHOOL

The School continues working with the entire WHO team of tutors and the national counterparts. Three groups of about twenty male and female nurses have been trained by the School. The possibility of bringing the enrollment up from 25 to 50 stUdents and constructing a new building is under consideration.

ENVIRONMENTAL HEALTH (RURAL HEALTH DEVELOPMENT)

The arrival of Dr. Christiansen has ccmpleted the WHO team for the rural. health development project. A few weeks a1'ter his arrival, the Ministry of Public Health decided, in agreement with the Secretariat for Rural Affairs, to undertake rural health development in the Thadeua area, some 30 kilometres away from Vientiane.

/The working programme

*SUbmitted by the

Director-General of Health, 25 August 1965

- 2 -

':rhe working programme is as follows: _ survey of the death rate and - medical care in the meantime _ hea~th education and obstetrical care for pregnant women and mothers

A. epidemiO~ogy

in the area.

- sanitation (construction of water-sealed latrines, digging .of we~ls, sewage disposal,. etc.) UNICllF, as it always does, has supported the imp~ementation of this project by providing the necessary sanitation equipment.

fUBLIC HEALTH LABORA':rORY

After the arrival of Dr. Parl:lentier, who rep~aced Dr. Modica, the has resUllled the ~tter' s activities. ':rhe possibUity of training a second group of ten assistant ~aboratory technicians to meet the needs of the country is under consideration. ~aboratory

••

MACAU

SANITATION

In the field of sanitation, we have to report that the installation of a new sewera~ network in the town of Macau is proceeding. 2 BUDGET

The appropriation of funds in the budget of the Province for the health and welfare services rose from $2 232 536.24 patacas (in 1964) to $2 993 416 (in 1965); this represents an increase of 34.2% over the 1964 aJ..10cation. The increase in relation to the total budget of the Province was from 7% to 7.6%.

INSTALLATIONS

Inaugurated in May 1964, the new pavilion for the treatment of tuberculosis patients, which is attached to the Hospital Central Cende de S • .Januario, the central hospital of the hospital network of this province, went into operation in the second-half of the same year. This pavilion has 98 beds.

STAFF

The total permanent staff of the Health and Welfare Services rose from 150 to 166 units, an increase of approximately 11i. This increase was mainly in the number of medical and nu.rsing staff. In fact, the number of government doctors, of whom there were 19 in 1964, rose in 1965 to 25 doctors. The new staff consists of three general health and medical officers, a school medical officer, a bacteriologist and an ear, nose and throat specialist. The total number of doctors in the Province is now 86. Since the present population of Ml,cau is estimated at 290 000, this represents one doctor for every 3372 persons. The nursing staff has been increased by three tutor nurses. In 1965, a pharmacist was added to the pharmaceutical staff.

STUDY AND TRAINING

A far-reaching improvement has been the local implementation of the Health .and Welfare Services Technical School. This was a logical sequence to the promulgation of the General Regulation covering overseas Health and Welfare Services Te::hnical Schools, which brought up to date and made uniform the teaching and training of paramedical officers in all Portuguese overseas territories.

/The first •••

*Submitted 1 July 1965.

by the Director of Health and Welfare Services,

_ 2 The first courses now in operation and wlllch follow the new regulations of the Heal.th and Welfare. Services Technical. School are the generaJ. nursing and auxiliary nursing courses. These two courses started in January of tbis year.

MATERNAL .AND CHILD CARE

Special. attention was devoted during the year to the intensification of maternal. and child health care, as well as to the in!provement of the school medical. service It is of interest to point out that the infant heal.th clinic attached to the Macau Heal.th Centre has been transformed into a cbild heal.th clinic. The purpose of tbis new clinic is to extend. mdical. care beyond the first two years of lite.

SCHOOL MEDICAL SERVICE

We tbink that the creation of the post of school medical. officer to work full tim represents :progress in the school medical. care service.

MENTAL HEALTH

Final.ly, we have to point out, as a measure of the inte::est shown in the field of public heal.th, the inauguration on 14 April 1965, of a village in the Island of Coloane for cured drug addicts. The new village represents an attempt and, as such, is a new experiment, to rehabilitate the ex-drug addicts, most of whom have been addicted for a long time to heroin,. with a view to readjusting them to a new social. life.

MALAYSIA

RePOrt on the Progress of Health Activities in MUaysia* 1

STATES OF MALAYA

The general health of the population of the States of Mal.aya is constantly improving from year to year and the gradual decrease in the general mortality rate and infant death rate has been maintained. The country is in the last year of its Second Five ..Year Development Plan and more than 90 per cent.· of the- projected plans are expected to be achieved. The follOwing vital statistics favourably reflect the improvements made in the general health of the population:

!22I Population

1263 or 1264 7 810 205 (1964) 39.4 (1963) 8.9 (196 3) 57 (1963) 2.24 (1963)

........................

6 278 763 46.2 12.4 75 2.8

Birth rate per thousand population ................................... ~

Death rate per thousand population .................................. Infant mortaJ.ity per thousand 11ve births

................

Maternal death rate per thousand live births •••••••••

Projects under the Second Five-Year Development Plan provide for a rapid expansion of the medical and health services not only to cope with the demands of an increasing population but also with the demands of a more enlightened population who are coming forward for modern medical treatment. 1.1 loEdical Care This involves modernization of existing hospital, the expansion and improvement of medical facilities at existing hospitals and the construction of new and replacement hospitals. The bed capacity of all hospitals in this country has been increasing from year to year; where in 1957 there were 20 337 beds and at the beginning of 1965, 25 575 beds, it works out XIOW to 3.275 beds per thousand population.

In addition to institutional care, there are 275 static outpatient clinics and 155 mobile dispensaries.

/The following •••

*Submitted

by the M1nistry of Health, MalaYSia, 25 August 1965

- 2 A_

The following figures illustrate the rapidly increasing demand for medical attention:

Hospital in-patient treatment ••••••• Ho.spital out-patient treatment

271 490

4O'3ll7 5 912 126

••••• 3 281 966

The Medical Faculty, University of l>t1J.aya was officially declared open in 1965 and the Teaching Hospital with a bed complement of 750 costing around $50 000 oool is nearing completion and w1l1 be ready for clinical teaching in 1966.

1.2

Rural Health Service

.Amongst the priorities under the Five-Year Development Plan, the e:x;pansion of the medical and health services into the rural. areas through a network of' main health centres, health sub-centres and midwives' clinics have been given the highest priority. At the beginning of 1957, there were only 4 rural main health centres but by the end of 1964, a total of 38 rural main health centres, ll2 health sub-centres and 557 midldves' clinics bad been completed and were functioning. This means that nearly 2 000 000 people living in the rural areas are now provided with medical and health facilities within easy range. By the end of this year, it is expected that the orig1nal. target of' 37 main health centres, 148 heaJ.th sub-centres and 652 midwives' clinics w1l1 be fully achieved. We would .like to record our appreciation of the assistance rendered by UNICEF and WHO in making this massive project a reality. Through this scheme a total of 62 561 deliveries were' condueted by the rural. health staff in 1964. In addition, 1 292 164 .home ;v1sits were made and the attendances at all the rural health cliniCS, static and mobile dispensaries totalled 6 721 261 for the same period. The· corresponding figures for1960 respectively were 44 759 deliveries, 843 C173 home visits and 5 136 336 clinic attendances.

Environmental sanitation in the rural areas is also gradually improving as more and more public health inspectors and public health overseers are being attached to the rural health services. The rural population is being systematically educated in the construction of proper domestic water supplies, house latrines and the disposal of refuse. 1.3 Dental. Services No change has been made in the dental policy of the country which provides systematic dental treatment of pre-school and schoolchildren, emergency dental treatment of adults and dental. treatment of pregnant and lactating mothers. /There are ••• 1 -·l

us$l.oo = M$3.03

,- 3.i'bere are now 287 dental clinics as cOll\Pared to 245 dental clinics in 1963. The total attendance at these clinics at the end ot 1964 was 928 U8 as compared to 635 140 in 1960.

1.4 Training Programme With the rapid expansion of the medical and health services, it ' was found necessary that the country should embark on a training programme of all categories of medical and p~dical staff on an unprecedented scale. In this mass1ve programme of training" every care has been taken to see that quality has not been sacrificed for quantity. This was achieved through the systematic expansion of available training facilities within the country and m8.king use of every available opportunity overseas. The three basic nurse training schools in the country are now producing anavera.ge of 200 trained nurses and 50 hospital assistants annually. In addition, Some 300 nurses are being trained in the united Kingdom, AustraJ.ia and Singapore. At local training schools the annual output of assistant nurses and midwives 1s 200 and 150 respectively. The Public Heal.th Institute in Kuala LUIl\Pur is now completed and ready for occupation. This will increase the intake of public health inspectors and public health visitors for training. The Rural Heal.th Train;l.ng' SchoOl at Rembau has al.so been completed and together with the Tre.1ning School at Jitra, the intake will be more than doubled. The new Dental. Nurses and Dental i'echnicians Training Schqol at Penang is nearing complet:i.onand will al.so double the present ,intake'. With the completion of the Pharmaceutical. Laboratory, the intake for dispenser training has been doubled. " 1. 5

Public Health Programmes smallpox

1. 5.1

No case of smallpox was reported during 1964. A total. of 281 030 primary vaccinations and 168 6c:J7 secondary vaccinations ~re carried out during 1964.

1.5.2 Tuberculosis The national tuberculosis control campaign 1s DOW fUllY developed. With the exception of laboratory technicians,aJ.l other categories of staff required for the execution of the campaign have been 'trained and are now operational. in the field. In 1964, a total. of 269 968 chlldren were given BeG.

em the completion of the malaria eradication pilot project, the country has now embarked on apre-eradication phase. Systematic surveys are being carried out by the existing malaria 'control programme and a report is being drawn up of how a national eradicatiot;l programme should be embarked upon taking into consideration the presentavaUable staff and facilities of the control programmes. /1.5.4 Yaws •••

- 4 1.5·4

l!!!

-, ..

This disease is being systematically and successfully attacked by trained teams in pocket areas of' the states of' Pahang, Kedah, Peralt and Kelantan. 1.5.5 FUariasis Like the yaws cam,pa.1gn, trained teams are now working in known

endemic areas of' the country. 1.5.6 Leprosy control --{ ..

With the return of our Leprosy Control Of'f'icer from his postgradW3-te studies, the recommendation of the WHO Leprosy Consultant, Dr J.N. Rodriguez, will soon be implemented through the formation of a National Leprosy Registry with skin clinics being established throughout the country.

1.5.1 lental health In addition to the two mental institutions which have a total bed com;plement of 6340 beds, a number of psychiatric clinics for out-patient treatment are being established in the general hospitals of the country. The number of these clinics will be progressively increased as more and more doctors trained in psychiatric medicine become available. 1.5.8 Diphtheria Immunization against this disease 1s now a routine measure carried out by the staff of the health services. In 1964, 13 119 children com;pleted their course of immunization of either diphtheria toxoid or triple antigen. 1.5.9 1965. Cholera

This country has been free of cholera El Tor since 26 January The last case reported was 30 December 1964.

1.5.10 Nutritional Services The Nutrition Division of the Institute for ledical Research is continuing its studies on local foods. Pregnant and lactating oothers where necessary, are given iron and vitamin pills as a routine during antenatal care. In addition, sk:1.mmed and whole milk powder are given to mothers and pre-school children who require supplemental feeding.

The Govermaent of ~1a would like to record its appreciation of the many and varied consultants made available for the various public health projects that have been undertaken in this country. SimUarly I we would like to record our appreciation for the invaluable assistance rendered by UNICEF to the rural health scbeme, tuberculosis national clm!Paign and other training programmes. /2 SABAH •••

- 5 2 2.1 General

It is onJ.y in the last tew years that increasing emphasis has been placed ~n the development ot a public health service. Prior to 1961 most-medical services oftered were based larsely on curative disciplines run trom seven hospital centres each statted by one or more medical. officers, tosether with nursing statt to run the hospital, curative service; etc. outside the hospital intake area being provided by hospital assistants (infirm1ers) trom simple dispensaries. In the beginning o~ 1961 our tvo major public health schemes 'Were started vi;. the tuberculosis control scheme and the malaria eradication scheme, at tbesame time a start was made to extend our rural health services, with particular emphasis on maternal and child health care. Up to the present t he health service -has concentrated on development of these four (curative, malaria eradication, tuberculosis control, maternal and child health serVices) disciplines. This year a start has been made on a school health service and attempts are being made in the health education field by way of dissemination of literature, co-operation with the Information Services in arranging to show fUms related to health especially in the rural areas, and working with the Agriculture Department and rural health nurses to hold health education talks and demonstrations at maternal and chUd health clinics. Another project which was started this year was the first area health unit in the state based in the Interior. This is statted by an area medical officer of health and the health visitor together with a _senior health inspector and a trained hospital asSistant with e:x:,perience -in the development of rural health services and rural environmental health, the idea of this unit being to bring together all the public health services in the area, to co-ordinate activities, to liaise with other departments in the development of health services in so far as they may be involved, and to mould the public health service into an integrated unit. Next year the headquarters of this unit' will be involved in the setting up of a training school tor rural health technicians who will be seneral public health field workers with special training in health, environmental sanitation and health education. OUtside this s1ngle area health unit, district medical officers, at present nine in, all, are responsible for co-ordinating health work in their ow districts. ' 2.2 Notes on Projects 2.2.1 Malaria eradication

'!'be plan of operation was first implemented in 1961, run by a more or less separate unit within the ~d1cal Department under the direction of the Deputy Director of ~dical Services, under the operational control and day to day running of the Government Malariologist together with a team of advisers provided by WHO. Aid for the programme is generous~ provided by UNICEF in the form of supplies and by WHO in the form of advisory staif - and felloWships.

/Since 1963 •••

_6Since 1963 , however, more and more attell\Pts have been made to integrate the maJ..aria. eradication project into the general public health structure. As the latter developed, the first step was to have closer touch between directorial staff, by now supplemented by the Principal ledical Officer (Health) and opera.tional activities a.s the scheme progressed. This 1Dtegration bas been put more and more into opera.tion especially now tbat surveillance has been set up in six of the eight sectors. Pa.ssive ca.se detection is ba.sed on travell1Dg clinics and curative institutiOns and the maternal and child health service run mainly by the rural health nurses under the direction of the Health Sister. 2.2.2 Tuberculosis control scheme

This was started with a.ssistance from Colombo Plan and UNICEF around 1961 under the operational control of the ledical O1':1'icer (Tuberculosis). Briefly, the campaign consists of ca.se finding by mass radiography, Heaf testing of schoolchildren and where appropriate BeG inoculation and the usual screening of contacts where such action is appropriate. A curative service is also prOvided, both domicil.iary and institutional for cases discovered. The service has always been closely integrated with the curative service of the state, and District ledical Officers run their local segment of the scheme. In 1964, a Principal. M!d1cal Officer (Tuberculosis) became the intermediate tiI01'ler between the Director of M!dical Services and the Tuberculosis Control Officer. 2.2.3 Maternal and child health services Ml.ternal and child health services have been developing since 1948 and more recently a formal course of two years training ha.s 'been 1D operation. At present the Rural Health Nurse Training School is capable

of qualifying thirty nurses per year. At the IOOmnt they are responsible for most maternal and child health clinics. They do domicil.iary midwifery and home visiting, problems encountered are ma:.tnly those of colllllUDication and the need for transport is pressing. It is considered that a mobile clinic based on a four-wheel drive vehicle will increase their scope. 2.2.4 Environcental health services

•

These are run by medical. oi'f'icers of heal.th (usually the District Medical Officer) aided by a district health inspector and varying numbers, depending on distribution, of village heal.th inspectors, a grade which will be replaced by rural health technicians in the future. It is considered especially urgent to expand and ilI!Prove this serrlce.

3 3.1

SARAWAK

General.

1964 was the first year of the new Five-Year Development Plan 1964-1968,due to be incorporated later into the first Ml,laysian ' Development Plan, 1966-1970. The new Plan bas its main ell\Pha.sis on / rural development •••

- 7 rural development, the one main exception being the new Sarawak General HospitaJ. for which $13-1/2 million has been provided to complete Phase I. Final plans and working drawings for this 57Q..bed general hospital were cOlllPleted during the year and tenders called tor, and construction is expected to start before the end of 1965. Extensions to the Nurses Home 'Were completed during the year.

3.2

Malaria Eradication Pilot Project

This project continued to make progress, though at a slower rate than in previous years due to the difficulties caused by Indonesian Confrontation and subsequent border troubles and curfew restrictions. A barrier zone has been set up along the border with Kalimantan, which will be maintained in the attack phase and kept sprayed, while eradication proceeds elsewbere. There were less than 1000 proved cases of malaria throughout the State during 1964, and the infection rate is about 0.2</0. The rate found in refugees from across the border varies bet'Ween 3cY/o and 6(J1j.. 3.3 Tuberculosis Control PrOject

The tuberculosis control project was extended during the year to cover four of the five Divisions of Sarawak and is shortly to move into the Fifth Division also, when the training of tuberculosis staff is completed. In the First and Third DiviSions, where the project has been operating for SO!1le time in the urban areas, work has now extended to the semiurban and rural areas.

3.4

Rural Health Im,provement Scheme

.:.-

The rural health iIIlProvement scheme started in 1963 as a pilot project, was expanded during the year, and trained supervisors are now working in two areas of the First Division where their work in iIIlProving the environmental sanitation, water supplies and general cleanlineSS, etc. have earned praise from visiting WHO personnel. Trainees are being recruited from other DiVisions, to extend the scheme to rural areas there also. 3.5 School Dental Service

The school dental service has expanded considerably during the year, and there are now fifteen clinics established in schools in four of the five divisions. The tra.in1ng of dental nurses in New Zealand has now been discontinued and all trainees are now being trained in the dental training schools in Penang and Singapore. New dental centres have been built at Simanggang and Limbang and the former is already cOlllPleted, and in use. The Limbang clinic is almost completed, and a third new centre in Sibu will be built in 1965/1966. 3.6 Rural Treatment Oentres

The rural treatment centres have been completed and brought into use at various places throughout the state during the year, and others are almost completed. They include two new 25-bedded local hospitals

fat Lundu •••

- 8 at Imldu (First Division) and MIn'ud1 (Fourth Division) and new static dispensaries at Skrang, Pantu, LongLinau, Nangga Medam1t and Tatau. Other new building wrks cOuqUeted, or under construction during the year, were a new DivisionaJ. Medical. Store at Simanggang, ward extensions to Limbeng Hospital. and a new extension to the maternity wards of the Lau King Howe Hospital., Sibu.

'.7

The training of statf, ,both locally and overseas, bas continued and increased. A new training school for local. authority midwives was set U.p in Sibu during the year, in addition to the school in Kuch1ng for nurse/midwives. Shortage of tutorial. staff has, however, prevented the establishment of a second Nurses' Training School in Sibu.

">-' "

ORIGINAL: FRENCH

NEW CA.LEDONIA . Report on the Progress of Health Activities in New Caledonia and its Dependencies* ~ progress made in the Health Service is satisfactory. be summarized in the following tables:

It can

l. I "...

BUDGET

1964 Budget of the Health Service(l)

......

~ 250 367 258 332 12.75<fo 2.98

232 346 240 201

~~c:~)d~~~~.~:.~~~.~~~~ ••••••• Ratio budget of the Health Service/ budget of the Territory Expenditure per inhabitant and

.............

12.72%'

per yea:r ( 1; ........................... . .

2.77

PERSONNEL

The ntunber of med.ical officers in the Department of Public Health rose from twenty-seven on 31 December 1963 to thirty-t';o on 31 December 1964. Since then, a new post has been established and soon another one will be set up.

The total ntunber of non-professiooo staff in the Health Service increased from 383 to 408 in .the same period.

EQUIPMENT During the

year 1964,'new developments

were as follows:

establishment ora medical sector reactivation of the MJoile ~dic8J. Team for Health and Preventive ~dicille creation of a service of neuropsychiatry at the Territorial Hospital '. . . important improvements in the eq,uipment of the electroradiology service and the biochemistry laboratory at the Territorial ,Hospital . construction 61' a diSpensary /- construction •••

Director of Public Health and in New Caledonia and dependencies, 21 July 196 5.

*Submitted by the

~dical

Assistance

(I)m thousands of C.F.P. Francs: us$l.OO = C.F.P. Francs 89.77

- 2 construction of an operating room in a :post far a~ from the chief town. This post is manned by a surgeon. the total number of beds in the Territorial Hospital and other units has risen from 1154 to 1293.

0Ul'PUl'

Number of patients in hospitals Bed days

10 395 240323 73 964

10 587 253 800

.... " ............ ,. ............ .

Consulta.n.ts .......................................................

Consultations •••..••••...•.•••••••.•.•• 16~ 135 Major surgical operations Minor surgical operations Deliveries Radiology: Number of radiodiagnostic units Number of fluoroscopies Number of radiographs Laboratorie s: Parasitological, cytological and microbiolog;:.cal analyses ••••.•••••••••• Serological and biological tests •••••••

168 794 1 643 2 451

........................ ...........................

1 462 2 301 1

..................................................... ...............

725

1 728

25 10 OOJ.

25 7460 23 380

..........................

.... " ....................... . 22 247

40 601 8 312

45 321 10 035

TB bacillus tests....................... Inoculation of, guinea-pigs ••••••••••••••

4 015

4 775 207

Chemistry .............................................. Preventive medicine:

31 6.35

35 741

To be noted is the increase in the number of BeG vaccinations (optional in the Territory), 'Which 'Went up from 1612 in 1963 to 3212 in 1964.

CONCLUSIONS

The activities of the Health Service of the Territory follow the population growth. Personnel and equipment have been steadily on the rise during the last year.

NEW ZEALAND

Significant Developments in Public Health in 1964/1965* PUBLIC HEALTH SERVICES

1.1 Environmental Health 1.1.1 Evaluation of food premises

The implementation of a system of inspecting and evaluating the hygienic standards of food premises mentioned in last year's report has been well received, and it is generally accepted that, provided the effort is sustained, it will provide the means of raising standards of hygiene in these premises considerably. The project has involved the training of experienced Departmental and Local Authority Inspectors in .a uniform.· method of inspection and the scoring of all types of food premises. The system is based on a score-card method providing for 30 checkpoints (27 common to all premises and 3 special features for particulax premises) aggregating 100 "demerits" (see forms attaChed). The assessment is made in a completely objective way and demerits are recorded for failure to reach satisfactory compliance with the minimum requirements of the Food Hygiene and Eatinghouse Regulations. The scores for "demerits" are graded according to the degree of hazard resulting and it is expected that correction will be made within 14 days, 3 months and 6 months as required.

Inspections of all food premises in every Local Aut.hority area are to be carried out at intervals of less than six months by Local Authority Inspectors. A periOdic check will be made by Departmental Inspectors at intervals of less than five years to determine the "Official" average score for food premises in all parts of the country. The Departmental check is made by random sampling, calculated by statistical methods to cover a representative number of food premises in every Local Authority area. Already there is a substantial number of premises without demerits and progress to date indicates that, with reasonably efficient inspection and firm. administration, the immediate target of 9C11o of the premises with fewer than 10 demerits is practicable of attainment •

1.1.2 Fluoridation Steady progress has been made with fluoridating public water supplies; Wellington, the Capital City, commencing on 1 April 1965. A dental study carried out in Hastings to determine the effectiveness of fluoridation in reducing tooth decay in the 10 years since the water was first treated there revealed that in the permanent teeth of children aged 6, 7, 8, 9 and 10 years caries rates had been reduced by 84%, 73%, 67%, 53% and 55% respectively.

/1.2

COmmunicable

*Submitted

by the Department of Health, 6 August 1965.

- 2 -

.. L.

1.2 Communicable Diseases 1.2.1 Poliomyelitis The policy of offering as routine procedure oral poliomyelitis vaccine to all babies and to all permanent arrivals in the country is maintaining a high standard of immunity in the cOlJlIlll.Ulity and there has been no confirmed case of polio~litis reported since 1 APril 1962. 1.2.2 Trichinosis A case of trichinosis in a middle-aged man was confirmed during October 1964, this being only the second reported case in New Zealand r s medical history. The disease has since been confirmed in four pigs on various farms, which 'Were subsequently placed under quarantine. As a result of this, legislation has been introduced to make trichinosis in humans a notifiable disease. New regulations, known as The Health (Diseases Communicated by Animals) Regulation 1965 have been drafted and are shortly to come into force. These regulations make it obligatory on every veterinary surgeon to notify the Medical Officer of Health if he has reason to believe an animal. is suffering from any one of the several diseases (including trichinosis) listed in the Regulations. The general public has been advised through the press that the best precaution against the disease is the thorough cooking of all pig meats.

It is not, hO'Wever, antiCipated that this disease will in any way prove a health hazard in this country. 1. 3

M:I.ori Health

The comprehensive health services provided in New Zealand are available free to all citizens, but surveys have revealed that many M:I.ori mothers and their infants are anaemic. In order to remedy this condition, supplies of an iron mixture have been made available to all M9.0ri mothers. M:I.ori children also have a high incidence of' discharging ears and special ear clinics have been arranged to alleViate this situation. MEDICAL CARE SERVICES

2.1

Pharmaceuticals

Increasing attention is being given to the possible dangers frOm pharmaceutical preparations. Two significant developments are: 2.1.1 Committee on Adverse Drug Reactions

In February 1965, a "Committee on Adverse Drug Reactions" was set up. Its objective is the establishment and maintenance of an agency in New Zealand for the collection of information from general. /practitioners •••

- 3/4 i

_-!-

practitioners in regard to the adverse effects of drugs used in treatment. The COIIlIIIittee, although financed by the Government is an independent group, its members representing various organizations. The basic feature of the scheme is the Early Warning Card. The card takes the form of a business reply card, the inside of which makes provision for essential data - i.e. Name of drug - length of time patient has been on drug - age, sex,. etc. This follows .the lines used by the United Kingdom Committee on the Safety of Drugs, with which. the New Zealand committee will wrk in close co-operation. Within three 'Weeks of the initial distribution of Early Warning Cards to public hospitals and general practitioners, fifty reports of adverse reactions had been received. The information so far available is only that provided by the cards and is therefore very much of a preliminary nature. The Committee will in due course be in a position to pass on their findings to general practitioners and so benefit the community at large. 2.1.2 "Proper Name" Labelling: Tablets and Capsules

From 1 A;pril, in accordance with the Social Security (Pharmaceutical Benefits) Regulations 1965 containers for tablets or capsules are labelled with the proper name unless the prescriber indicates: (a) (b) that he does not wish this to be done, or that he wishes the label to be marked with some other appropriate designation instead of the proper name.

The ''proper Name" means the name or abbreviated name stated in the prescription. If preparations other than tablets or capsules are marked with the proper name, this is clearly indicated in the labelling directions in the prescription.

A minority of doctors (about 10 per cent.) are strongly opposed to automatic labelling with the proper name. others may not wish the proper name to be used with particular prescriptions. In such cases the contraction "Not N. P." is ell!P10yed. 2.2 Hospitals Operational Research l-lith patient nurse of a series of planning hospital planning and

The Research and Planning Unit (formerly the Unit) has cOII!P1eted the series of reports dealing dependency by speciality and has issued the first guides designed to assist wrkers in the field of design.

- 5 -

INFORMAfiON FOR PROPRIETOR

A cross entered in the appropriate column indicates the item is unsatisfactory. The notice accompanying this report ex;plains in .detail tbe unsatisfactory items.

2. I.

The items with demerits of 4, 3, and 2 Jlilould be corrected within periods of 14 d~s, 3 months, and 6 months respectively from the date of service of the notice following the inspection.

3. ''<'

In the event of failure to comply, the relevant registration may be revoked and you will be required to cease using the premises for that particular purpose untU corrections have· been made and the premises re-registered.

1,200 bks./2/65-998J.5 WK

.-! '(

- 6 p •

INSPECTION SHDl'

Na.ne of Firm: Address: ___________________________________________________

a ...t

Class of Premises

Items

.p ...t

1-1

1. 2. 3. 4. 5· 6. 7·

9. 10. 11.

12. 13· 14. 15. 16. 17· lB. 19~

· . · . · . · . 2B. · . 29. Housekeepingf~ment .. 30. Miscellaneous ·. ·. ·. Total Demerits ·. Signature:

20. 21. 22. 23. 24. 25. 26. 27.

Floors Walls Ceilings Lighting ventilation Overcrowding Change rooms Privy accommodation Hand basin Hand basin maintenance •• Water supply Hot water service Plumbing Sewage disposal Yard Vermin control Refrigeration Food storage Food protection •••• Condition utensils/Equipment Clean utensils/Equipment •• Personal cleanliness MlU.ntenance of premises Required notices Cleanliness and tidiness

) ) Specials ) ••

·. ·. ·. ·. . · ·. . · .. ·. . · ·. ·. ·. ·. ·. ·. ·. . ·

·.

·. . · ·. · . · ·. . ·. · . · . ·. · . · . · . ·. ·.

·. · . · ·. . · . ·. ·. · . · . ·. ·. ·. · ... ·. · ·. . · . ·.

( ( (

2 2 2 3 3 3 2 3

4 4 4

4 4 4 3 4 2 4

4 4 4 4 4 4 2 3 4 3 3 100

------------------------ Date:

-7 .. ~

'. 4

,':

.... ",

; '

-"; .~. -

-. '. '

, "GENERAL REQlT.IRl!Mlm'S

:F'loor§;: Repair,. Cleanl:!.:ness IXIIpervious Graded and drained Repair C1eanl.iness IXIIpervious ' Paintwork ~;U;l.ngs

13 Handbasin

Ma.1ntenanc~

Soap, : Clean towel and nailbrush Cleanliness 14 Water Suppl...v Saf'ety Adequacy Cross connections 15 Hot Water Service Heating Unit Adequacy Temperature boosting Maintenance and temperature (check of temperature)

5 W!iYls .,;,

Repair Clean11ness Dust-proofing Paintwork 7 Lightin~

Adequacy Working surfaces (20 ft. candles) Cl.ean1iness Windows Skylights Fittings'

16 Plumbing Compliance with Hegul.a.tions Working order Good repair 17 Sewage ni~osal Adequacy outfall. Grease traps Yard Accessible Paving Clean11ness Tidiness Alternative. space refuse storage Adequacy Rat proofing Fly control Evidence of infestation 20 Refri~ra.tors

8 Ventil.ation ~

Adequacy Qiours? Hoods and fans Fumes removal

9 Overcrowding Adequate floor space

'. -. . ~

10 Change Rooms Clean1iness Adequacy Separate proVision Impervious 11 Pri!l Accommodation Location Adequacy Repair Clea.n1.ine ss

19 Vermin control

Adequacy Temperature ma.:lntenance (check temperature) Cleansing and defrosting

.'-

Handbasin Location Sufficiency Repair Hot and Cold water

• - 8 21 Food Stor~ Cleanliness Suitability Separate storage Perishable foods (5()O or belov) 22 26 MUntenance of Premises State and repair (excluding items aJ.ready assessed) Routine maintenance Exterior condition 27 Required Notices Special handwashing Dog notice Registration 28 Cleanliness and Tidiness General condition Used as an additional demerit vhen cleanliness and tidiness unsatisfactory in two or more items 29 Housekee12inW Ma.n.agement Cleansing routine Removal of refuse Supervision - staff and customers Knowledge of requirements and skills 30 Miscellaneous To be used for any item not specifically mentioned

•

lood

Protection ~asures suitable Protection - rodents, dust, flies, insects Use of tongs, scoops 'no touch" technique Protection from contamination

23 Condition of utensils, J\;ppliances z and Equi12Suitability Repair Design and construction Surface and material Ease of disassembling ~

24 Cleanliness of utensils J A,ppliancesz and Equi]2ment Cleanliness (sight and touch) CleanSing methods storage and protection after cleansing 25 Personal Cleanliness General appearance of operators Uniform and head-dress Hand and fingernails Use of tobacco Skin condition, infected wounds

.. ~

. ,'If

PHILIPPINES

Report on tho Provei3s of Health Activities, 1964* 1 STATISTICAL R&4LTH PICTlmE Population .............................. Crude birth rate ........................ Crude death rate ........................ Infant death Y'ate ...................... Maternal death rate .................. Neonatal death rate .................. 30 709 000 c..( .. { f)"~ r-t

7·0 rr. ,.. 2.1

1.J0.b

31.3

Leading Cause s of Death Pneumonia ..•.....•.•..•.•. Respiratory tuberculosis .•. Gastro-enteritis and colitis Bronchitis .............................. . Beriberi ..............•... 2 HEALTH SERVICES

11.2

15· 5\~

7·0 6.2

I ?

5. 2

Diseases of the heart •..•... Diseases of' vascular system. Accidents •...•.••.•.••....•. MalignUlfG neoplasms ••••••••• Nephritis and nephrosis ....•

4.1% 3.4 2.9 2.9 1. 7

Operational activities in the field of health are performed under the supervision and control of re&,ional health offices. However, the Bureau of Health Services exercises tcdmical supervision and consultative flmctions over the reGional offices. During the year under review, there ,'Tere 1383 rural health units operated by 1594 rural health physicians, 1636 public health nurses, 2371 midw'ives, and 1342 sanitary inspectors. There ,;ere 319 pul)lic health dentists and 321 dental aides giving dental care to the people.

-,..

ENVIRONMENTAL SAlUTATION

There ,;ere notable imp1"0vemel'!ts in the prov~s~on of community water supplies, drainage systems, rcfuse and garbage collection and disposal, and in sanitation and cleanliness of envi1"Onme:lt. An intensive and extensive campaign ,-las \-rageci to abate nuisances and to enforce rigid sanitary inspectionsaf public and private premises, public markets, hotels, restaurants, and eateries. With WHO and UNICEF' assistance, forty-seven health centers and nineteen schools "ere provided with water supply and sanitary facilities; seventy-four more health centers and t~~nty-eight schools are scheduled to. receive vlHO and Ul~ICEF' assistance. In line ,-lith the sanitary toilet campaign program, an intensified campaign for the construction of l;1ore tOilets, especially the ,rater-sealed type, has been launched. l~

HEALTH EDUCATION OF THE PUBLIC

As of 30 June 1964, there were a total of fift.y-one health educators ell'\Ployed in the Health Department, seven at national level and forty-four in the regional offices. Consulting services al'ld guide,nce in health

-;:.

Submitted by the Department of Health, Philippines, 6 August 1965.

- 2 education to field personnel are provided by the health education staff of the Office of Health Education and Personnel Training. Health education activities in connexion vith environmental sanitation, maternal and child health, and the prevention of cholera El Tor infection have been intensified.

MEDICAL SERVICES

During the year lli'lder revie\f, there were in operation 138 government operated hospitals \fith a total bed capacity of 15 400 and a total admission of 490 780 patients. A total of 2 403 496 out-patients attended and were treated in dispensaries; there ,Tere 38 0)9 major and 45 050 minor surgical operations, and 35 1~6': obstetrical delive:d.es, These hospitals are staffed by llEl3 physicians, 2414 nurses, 155 dentists and 6998 other employees.

rJEERCULOSIS CONTROL

Tuberculosis still continued to be a ma,jor disease problem of the country. Activities were directed towards the pl'evention and immunization, treatment and supervision of cases, rehabilitation and research. Services \fere rendered primarily by chest clinics, static units and mobile units. There are thirty-one chest clinics, twelve of which are static and nineteen mobile.

LEPROSY CONTROL

Activities along this line ,Tere direc;tec. tow·a:c0 the detection and treatment of leprosy in the d.ifferent lepros8.ria und stationary skin clinics; the discovery and treat!l1.ent of patients by the travelling skin clinics; the care and placement of non-leprous children, household contacts and schoolchildren; research, training and rehabilitation~ There were in operation four stationary skin clinics aEd ten traveJ.ling sl,in clinics which operatec: ,Ii.th UNICEF assistance in -I;l1e form of medical supplies and e~uipment.

MENTAL HYGIENE

Acti vi ties in this field vTere directed tovards service development, epidemiological survey::>} mental health education) demonstration, staff training, studies and research. Regular one-day-a-vree1i neuropsychiatric guidance and counselling services ,rere estai"llished in the provincial hospitals. The scope of service development has expanded to the point where mental hygiene clinics are being established in different parts of the country. This service development has opened the \"ray for hospitals to admit some classified ''psychiatric emergencies II and discharges were encouragingly nad.e early with the follow-up being done by the corresponding out-patient service.

.' ..

RESEARCH

Am) •••

- 3 -

RESEARCH AND LABORATORIES Vaccine Production

9.1

The task of supplying the needed vac:cine to maintain the immunity level of the population against cholera in Tor .'1.rlli other "~DidVlr,ic diseases kept the Production Laooratvries at f<~abanG at a sustained increased pace. One signal accomplishment is the dC'lelop1"ent of the ch01e2'8, El Tor vaccine "hich is fast gaining international recognition

and demand. I ..;,

,).2

Laboratory Hesearch

Two research projects are vTorthy of special mer!'t 5. x, for they ';.r'..:Jn a'vrc.rds in the l'hil::'ppine 1':,,5ic2.1/ Ab'bott Research CcnteL:'~',: First Aviard Antibody Survey as an Index of I1ilrnunity to Poliomyelitis among I'ilipir,oG Serological Stuclies in Cholera El Tor

Eecond Alfard Virology Center

The Virolcgy Center provides diagnostic serdces and serves as a reference virus laboratory ,There research is cO;1dlCcted and aid given in epidemiolo[1;ical studies relatec, to virus diseases and teclmic8,l supervision provided over public health laboratories engage;'l in virolo& '-fork. The most important '1irus diseases diagnosed by the Center are poliomyelitis, encephalitis, rabies, influenza, and smallpox.

10 10.1

SPECIAL PROJECTS Cholera El Tor Studies

~lhe Philippine/ Japan/miO research studies on chuJ_.3ra El Tor continue. The follOwing stu(,ies had becrl implemented:

(a)

Vaccine stUdies i!l Negl'os Ocddental - to evaluate the efC'ectivity of variou~; tYI)(~S of ,,]colera vaccines in the prevention of cholera El Tor infection. The study Has conducted on 600 000 j_nha\:dt:mtr: '. The l-rere immunized \Tith three types of' ctnJ.el'a vaccine. Carrier studies in Davao City - to deterrdl:e the pre'1alence of 'the can'ier st8,te in households and ccmrmu"lities and to demonstrate the possible role that the calTier may play in the transmission of the infection. Viability stUdies - on the vibrio El Tor \Thieh were performed by the BUT<.~au of Research 2.nd Laboratories in Manila and in Japanese laboratories. /10.2 Malaria ...

(b)

(c)

- 410.2 Malaria Eradication

Of the total population of the Philippines, 25.410 live in malarious areas. Out of these, 50.2% are in the attack anq. 1+9, t~); in the consolidation phases.

In the attack phase areas, ,.here DDT residual spraying is conducted twice a year, there are 800 790 houses; 613 747 ..rere sprayer, during the first cycle and 587 720 durinG the secone with a ~:overage of 76.6% and 73.Lf% respectively. A total of 464355 ·blood smears were col:'ected from active and passive detection activities ana. 533 245 s:rears ,le~'e examined from all sources with a total positivity of 22 142. In the consolidation phase areas, where spraying has been discontinued and surveillance operations instituted, a total of 259 260 blood smears were collected and 313 379 were examined from other sources with a total positivity of 4069. For the presumptive treatment of malaria suspects and radical treatment of confirmed cases, a total o~ 2 683 234 an1 1 9~8 562 tablets of camoCluine and primaCluine respectively were administered in both the attack and consolidation phase areas. 11

FllIANCING OPERATIONS

The Health DepaTtment I s General Fund Appropriation inche Fiscal Year 1964 amounted to -pno 903 109 as against the 19:::3 appropriation of f?95 256 094, representing an increase of ;l?15 647 095. 1 During the year under review, the Bt:dget Commission releasee, funC::s i~u ·the Department to ena1)le it to meet the Government 1 G commi ;~ments vith foreign assisting agencies. Among the activities supported by additional. funds are the cholera E1 Tor studies, in collaoora·tion ~..rith Japan and WHO, malaria eradication with combine(~ material support from the United States Agency for Intenlational Development ~~d ~mo, and the cost of distribution of aid commociities and equipment from UNICEF.

1 US$l,OO

= -P3.86

.. REPUBLIC CI' CHINA

Report on the Progress of Health Activities in Taiwan, 1964* At last year I s meeting, we reported on our ten-year health plan and' said that we should report this year on the progress in the first year of the ten. First of all, the crude death rate in Taiwan has dropped further from 6.1 per 1000 in 1963 to 5.1 1n 1964, a reduction of more than 6 per cent. During the past year, we were again able to keep cholera out of our borders. When the economic planners ask for an economic justification for the health programme, this helped to convince them that investment in health does pay high dividends. We have now reached the ma.intenance phase in maJ.aria eradica.tion. There were 21 cases discovere.l during the past year, none of which were indigenous. In view .f our increasing ties with African countries, a sound vigilance programme is the answer to keeping our land mal.aria-free.

...

39 per 100 000 in 1963 to 31 in 1964..

The lOOrtality rate from tuberculosis has further decreased from In 1964, 614 034 children were

BCG vaccinated. Five hundred twelve thousand, seven hundred and twenty-eight adults were chest X-rayed, and 111 320 persons were sputum examined for tubercle bacilli. A total of 5225 open cases were detected and given free treatment. The trachoma. control programme, the largest one of this kind, examined more than 4 million people and has given treatment to 1.4 million persons. In addition, blanket treatment was given to 110 000 persons. The incidence moong the primary schoolchildren has been brought down from 4~ in 1956 to 1~. Iodization of table salt for control of endemic gpitre has been started in forty townships in four counties; The total beneficiaries of the programme exceed one million, and the plan is to cover 6 million people in the Province. Polio~litis has become a health problem of higher priority. Ckle million children below three years were 1,",nl1n1 zed with Salk vaccine.

Japanese encephalitis is another u:enace to children in Taiwan, but so far no steps have been taken to tackle this problem. A pllot field trial programme was started this summer with the support of WHO in four endemic areas, and 240 000 children, aged three to seven years, have been 1rnrm m 1zed either with the Japanese-made mouse-brain encephalitis vaccine (or a placebo) to assess its efficacy. If the results are convincing, the plan is to produce the mouse-brain vaccine ourselves for ma.ss immunization.

Cornrn1ssioner, Department of Health, Taiwan Provincial Government, 6 August 1965

*SUbmitted by the

/San1tat1on •••

- 2 -

San:1tation still remains one of our JOOst important progr8DllJes. In 1.964, 3280 public wells, 208 urban 1.atrines, 2849 rural. 1.atrines, 1.2 simpl.e rural. water systems were constructed. :Before the end of this year, 54 more rural. water systems wi1.l be comp1.eted. Village clerks are being trained for the sanitation programme, which, with the help of WHO/UNICEF, has made a good start. The p1.an is to train 6566 such derks, one in every village, to inspect and maintain sanitary faci1.ities in the villages, and to assist the peop1.e to improve their own environment. The village heal.th education progr8llUle, which was started in 1.962 following the cho1.era El. Tor epidemic, is being intensive1.y pushed forward. There are now 1.00 publ.1c heal.th nurses who stay in a village for one month in groups of three to teach peop1.e home sanitation and personal. hygiene.

One of the most rapidl.y expanding programmes is that of family p1.ann1ng, 'Which started in January 1.964 in one county onl.y but which now reaches the entire Province. The heal.th authorities have assumed responsibility for the education and motivation of the people, and the actual. service is provided by the Maternal. and Child Heal.th Association, which is a vo1.untary organization. The main method used is the Lippes 1.001" By the end of June 1.965, 1.04 1.1.2 married women (against a target of 600 000 for six years) had al.ready accepted the device. This number is equival.ent to 8.1.~ of the total. married women in the age-group 2<>-39. The Taiwan Population Studies Center of the Provincial. Department of. Heal.th is conducting related demographic surveys and studies, and making eval.uations to ensure the wise use of money and manpower. Seminars in publ.ic health demography have been organized by the Center in three medical. colleges. The Center al.so provides training opportunities for students from home and abroad on the subject. M:>re than 200 visitors in fifty groups from fifteen countries 'Were received by the Center during the period under review.

.' ,

Bet;reen 1963 and 1964, there was a 5% reduction in the crude birth rate, from 36.3 to 34.5. The actual. number of births has al.so decreased from 424 250 to 41.6 609, a reduction of 7641. This has happened, for the first time in the past t'Welve years. The Industrial. Hygiene Division of the Provincial. Heal.th Department established last year has undertaken surveys of the working condition and heal.th status of workers. In!Provement in the areas of medical. care service includes raising the qual.ity of service of the government hospitals. The total. number of out-patient visits has increased from 862 228 in 1963 to 964 77l in 1964 and the number ofhospital.ization days from 385 88l to 415'000; the bed-occupancy rate has risen from 83% to 85%. The construction of a new building for the proposed Cormnunicab1.e Diseases Contro1. Bureau and Food and Drug Bureau is approaching compl.etion. Work in these fields will. be greatl.y strengthened when the bureaus are estab1.ished.

/One

wore •••

. ,,.

.,.. • - 3 ~ 'WOrd about the heaJ.th budget. The Oovertllllentfe contribution to the health progt'amme was slightly less than that of the previous

year. In addition, t.he united stat.es Agency for International. Development. (AID) has phased out of a number of programmes and it.s aid last . year decreased from us$ 1 million t.o less t.han a half m1lllon. In the next year, aid from this source will most. likely not exceed us$ m11l1on. Last year, accomplishments 'Were achieved mth less money than before.

0.,

The ten-year heaJ.th plan for Taiwan was generally 'Well received by related ox:ganizat.ions. AID Washington organized a team of speciaJ.1sts specifically to evaJ.uate the plan. The comments received from the group included t.he follomng major point.s:

(1)

M:mey, personnel, and organizational. st.ructure are the three basic fact.ors, Which have not. been given sufficient at.tention. Because of many restrictions, it. 1s unlikely that the Government can solve these basic problems in a short t.ime. The medical care programme should be given higber priority,

(2)

not because of its ~ortance from the preventive aspect, but because it w111 consume a disproportionat.ely .large part of t.he ava.11ab1e funds and personnel unless it is more realistically realighned to present and future needs and capability. In pa.rt.icular, the government hospitals should be opened so that privat.e' physicians may look after their pat.ients there.

(3) MOre nurses must be trained. (4) SaJ.e.ries must be raised or the standards of work w1ll decline.

Although ~rovement during the past. year has been significant, t.here is still much more to be done, and efforts must be made to:

(1) (2)

strengthen the quality of service of the local. health departments and health stat.ions; ~rove

'. .-'

the service of the government hospit.als;

(3) (4) (5)

rehabilit.ate t.he venereal disease progra.mme, which is faJ.t.ering badly; give more jmag1 n at.ive leadership t.o t.he mat.ernal and child heaJ.t.h service; expand t.he mental health programme, which up to now has been experimental, into a public health programme to benefit a greater proportion of' the population; speed up the diphtheria/pertussis 1mnDlDj zation

(6)

progt'amme.

Next year, 'We hO!Je to be able to report more progress.

•

.... '.~ :""('."..

REPUBLIC OF KOREA-

GENERAL SITUATION

In 1964 J the Govenurent made every possible effort to strengthen systematicaJ.ly the health network:, particul.ar attention ~ing given to local health problems, by making the most effective use of qualified health workers and available financial· resources;· as vrell as the assistance provided by WHO/UNICEF and other international agencies. A national health planning unit has been established in the Mi.nistry of Health and Social Affairs to prepare a long-term health plan which will fit into the overall national economic development plan.

1.1 Health Personnel and Medical Education The number of health and medical personnel and educational institutes registered is as follow: Health and Medical Personnel PhySicians Dentists

................................. ................................... III ..

10 035 1 722

Nurses ••••••••••••••••••••••••••••••••••• l4:ld'W1ve s ................................. Phm1Da.c1sts ............................... .

Herb·Mi!dical Practitioners Total

.................................................. Educational Institutes No. of .. Schools

•••••••••••••••

2 673 36 799

8 159 5 631 8 519

==-===

Schools

AnnuaJ. Graduates 627

Medical Schools. ••••••••••• Dental School ...... ~ ~ • ... ' Ph&rmaceutical Schools' • '. ~ ~' " Nursing Schools ..... ~ ~ ~ .. ~ ," Herb'Medical School .. ~ ~ ~ ~ .. Total .......................... 1.2

8' ' 1 "

13" 25"

'.',', '791

100 1 150

.:.! . 48

175 ====2 849

Health and Medical Facilities

In 1964, there 'Were· 32 general hospitals, each of which has ,100 beds or more,and 161 other hospitals. 'The health centre network, which consists of 189 health centres apread throughout the, country, has been extended at the ratiO of one centre for each Gtin(County) and Ku (District). The details are as follows: .. " /Hospitals and

...

*Submitted ' August

1965

by the Ministry of Health and Social Affairs, 23

- 2 Hoapitals and CJ.inics General Hospitals •••••••••••• Hospitals •••••.•.••.••••••..• Number

Beds

Tuberculosis Hospitals ••••••• repro saria .................................. . M:!ntal Hospitals ...................... Total. ............................. .

32 161 Heal.th Centre s .............................. .. 189 Clinics .......................................... .. 5 CJ73

3827 7 CJ74 1 715 10 500 640 23 756 ===--== ~

§ -2 ====

5469

MAJOR PUBLIC HEALTH PROBLEM3 Contro~

2.1 Acute Communicable Disease

Much emphasis has been placed on cholera prevention and the control of Japanese encephalitis. In 1964, health education and sanitation measures were enforced. There were only eleven cholera cases with one death, but an epidemic of Japanese encephalitis occurred in 1964. The number of major acute COmmunicable disease cases reported in 1964 is given below: Cases Cholera .••••••••••.••••.•.••

Deaths

Typhoid Fever ..................... . Typbus ................................ ..

4 380 14 Diphtheria ••••.••.•.••••.••• 841 Japanese encephalitis ••••••• 2 952

1 124 85 966 V' ,..

Vaccination against various diseases was carried out as follows:

2 648 547 Typhoid and Paratypbus ••••••• 15 622 741 Typhus ................................ . 369 504 Cholera ................................ .. 18 351 976 Pertussis .................................... 141 394 Diphtheria ...••.••..••••... ~ •. 161 114 DPr ................................... .. 419 690 Poliomwelitis ••..•••...•.•.•. 1 450 577 SmaJ..lpox . "........................... .

persons persons persons persons persons persons persons persons

2.2 Chronic Communicable Disease Control

2.2.1 Tuberculosis control Tuberculosis in Korea has been recognized as a major public health problem with an estimated 1 000 000 cases (4% of the population) throughout the country. The Government has intensified both preventive and curative measures, and has employed mass case-finding using the tuberculin test, X-ray examination and DCG vaccination, which has been carried out by twenty.. six mobile teams and the health centres; 262 385 registered cases are under constant medical care. The pilot project, which was / established in •••

- 3 established in 1963, has been carried out with the technical advice of WHO and material support from UNICEF. The results of the activities are as follows:

No. No. No. No. 2.2.2

of of of of

cases cases case s cases

registered .•.•••..••••..• tuberculin tested ••••••••. X-rayed .........e • • • • • • • • • • BCG vaccinated .••••••••••

262 385 1

921 545

1 005 588

1 lB7 6(J{

Leprosy control

In Korea, leprosy control is a serious problem with an estimated 100 000 patients throughout the country. Every year the Government has spent an enormous portion of the national health budget on the medical care as well as the resettlement of 10 066 patients. In 1964, 1306 non-infectious patients with potential labour power were discharged from national and private leprosaria for resettlement. Now, an active casefinding pilot project is being carried out. 2.3 Local Health Services (Demonstration Province)

A local health service project, which was initiated in 1963 with WHO/UNICEF joint aSSistance, is being carried out with the aim of establishing integrated health services, upgrading local health facilities and training health personnel at the local level. In the health demonstration province of Clrungchong Namdo, there are six provincial hospitals, seventeen health centres, some health sub-centres and sixty public physician's clinics. 2.4 Training of Health Personnel

The five-year training. programme with WHO/UNICEF joint assistance has been successfully carried out by the National Institute of Health. The progress made towards the targets agreed upon is shown below:

for . Actuall;y: Traini!2fi. Over Trained :2.,.Year.Period So Far Tar~ts

, -.e.

Physicians Nurse/Midwives •••••••.• Sanitarians Laboratory ASSistants '

............ ......... .. ..

..:L 4B.2 41.4 30·5

900

BOO

400 300

276 331 193 119

39.6

Every possible effort has been made to ensure the necessary co-ordination required between the National Institute of Health and other institutions and groups involved in training. This co-ordination was assured in 1964 with the Joint undertaking of field practice in the health centres in Chungchong Namdo Health Demonstration Province.

/2. 5

Environmental •••

- 42.5 Environmental Sanitation

2.5.1 Food sanitation By the promulgation of the, Law. for Food Sanitation, 'the Government has tried its best to iqlrove food sanitation, as well as the nutritional problem, by establishing measures arui -requirements so that standardized food is produced for sale -. and export and inspections made of the manner in which public food services are handled.

2.5.2

water supply

A total of 158 925 public wells were constructed in 1964 in order to improve the drinking water supply, especially in the 10caJ. areas where iqlroved environmentaJ. sanitation is needed. In 1964:, WHO arranged for three consulting engineers from the firm of Black and Veatch InternationaJ., United states of America, to study the public water supply in the SpeciaJ. City of Seoul. A finaJ. report transmitting their apeciaJ.ized advice on the operational, management and financial aspects has been submitted to the Government.

2.6 Family Planning A ten-year nationaJ.f'amily planning programme to reduce the present naturaJ. increase rate of the population to 2. CJ1. by 1971 and to 1. ~ by 1980 has been prepared. In 1964, the activities -of the Family plann:lng Programme _ were as follows: Key Fersonn.el

.......................... . Centres or Tow Ot'fices Involved ••••••• Supply of Contraceptives: Condom ...................................... . Fo:rm. Tab ...................................... .,"., .. " .... ..

2 070 1 662

Jelly VasectODij'

IUD Insertion

...................................................... .. •••••••••••••••••.•.•••

............................... ' ~ .. ~ .................. .. ',' ,-""

No. of Registrations ............ -. ".11 ................ .. No.. of Consultations' ......... '....................... .. . . ............ No. of Informational Sessions . . . . . . ..

697 975 570 509 96279 110 83l. 26 256 965 717 2 998 227 5 247 537

dozens bottles boxes persons persons persons persons persons

ORIGINAL: FRENCH

REPUBLIC OF v:mr-NAM .'

:Report on the Progress of Health Activities, The war which creates insecurity, especia.ll.y in the rural areas, the exceptiona.ll.y heavy flood of November 1964, new outbreaks of cholera and plague cases, were all particularly important factors which have influenced health activities in the Republic of Viet ..Nam during the year 1964-1965. This special and unfavourable state of the country,"as regards general development, has not slowed down the activities of the health programmes: satisfactory results were even noted in the field of tuberculosis control, maternal and child health, hospital reorganization and the control of colllllDmicable diseases.

1. The Uood in the northern part of the Republic of Viet-Nam during November and December 1964 de,-a.stated'many provinces in the centre of Viet-Nam, causing 6000 deaths and making hundreds of thousands hoineless. This catastrophe presented the Government with many problems, including the need to bring medical care to the victims and take urgent preventiVe measures against the i'possible outbreak of an epidemic. To this end, fifty medico-surgical teams were sent into the field to strengthen local health services. ' M:>reover, fifteen friendly countries have helped us by sending drugs, medical equipment, prefabricated houses, ambulanceE!, etc. These facilities have considerably helped the Ministry of Health, and good results were obtained in controlling the health situation of the provinces concerned. Apart from a few sporadic outbreaks of cholera and plague in some of those prOvinces, no epidemic was reported. Water Stqlply, the disposal of dead bodies and immunizations were the ma:I.n health problems. 2. The state of war in the country, which appears to have a somewhat chronic cba.racter, made it necessary to reorganize the medical services: twenty-six operating rooms in various provincial hospitals were built or redesigned. ledico-surgical. teams from Australia, France, Italy, Japan, Korea, New Zealand, the Philippines and the UUted States of . ~rica have efficiently strengthened the hospital services in Saigon and the provinces. ' ." "' ;: " '

. '3.

The ..control of communicable diseases occupied a large place

SJDOng the health activities of the Ministry of Health.

The cholera epidemic which broke out 'in February 1964 has progressively receded until the end of the year, with a total. of 20 202 cases including 866 deaths. The standard cholera vaccine produced by the Pasteur Institute in Saigon was used for 6 931 524 vaccinations. Rehydration treatment as recommended. by NAMRU II has considerably reduced the death rate. Combined treatment with tetracycline has not given the results hoped for.

/Pla.guehas •••

*Submitted 5 August 1965.

by ,the Director-General of Health and Hospitals,

- 2 _ Plague: has become endemic: 290 cases, including 49 dea.ths, -were reported in 1964. A total of 1 873 912 vaccinations were effected, mainly in the areas where the disea.se is prevalent. With the assistance of the Walter Reed Research Center of the United States Army, the Pasteur Institute has established a special laboratory for plague control Studies have been made on the resistance of fleas to insecticides, the production of a freeze-dried plague vaccine, serological surveys in rodents and the isolation of strains in rodents for the production of anti-plague vaccine. Smallpox: no case has been registered since 1960. country, 4 531 611 vaccinations 'Were ef'fected. Throughout the

Poliomyelitis is becoming a public health problem. In 1964, 325 cases were reported. Vaccination with too Lepine vaccine has been limited because of its high price. For the f'uture it is planned to use a Sabin-type live vaccine f'or 'Wider immunization. Haemorrbagic f'ever remains a problem. In 1964, 1043 cases including 177 deaths were registered. In the field of research, the Pasteur Institute has undertaken serological surveys on children, and isolated virus strains from. IOOsquitoes. Tuberculosis: the control programme, supported by WHO, has developed satisfactorily. The principle of' BCG vaccination has been accepted. It is s:pplied to neW-bol"llS in some maternity hospitals and to children in schools and orphanages in Saigon, in collaboration with too maternal and child OOalth and school OOalth programmes. Case-finding has been extended to several population groups and has yielded interesting figures in urban and rural environments. Tuberculin tests used in both environments give figures of 3rJfo for sixyear old children and 75i for fifteen-year old children. However, in some schools where too average living.conditions of the families are better, the rate ms::r fall to 3CY/o and even 16i in the twelve-year old age-group. This survey has sho'WIl that no tertiary form of tuberculosis is present in children 'With a positive test, and only 2'fo of the children have shown a radiological prima.'ry infection in too form of' adenopathy or lung consolidation.

4. The maternal and child health programme makes satisfactory progress and has now reached the stage where it is being expanded to the rural areas. So far maternity hospitals have been renovated in 180 districts and re-equipped in 18 v111ages. The technical tra:Jning of staff still receives a high priority within the programme, where it constitutes a regular and permanent activity: training courses for midwifery supervisors and educators, refresher courses for midwives and rural midwives, training courses for paediatric nurses, and paediatric training for doctors. The first national seminar on maternal and child health is planned to take place next October.

/5.

The reorganization

- ;; 5. The reorganization of the hospitals with the help of WHO has made satisfactory progress. The Cho-Ray Hospital in Saigon has been selected as a pilot hospital in which hospital adminis'(,ration procedures will be tried out and standardized. A one-year administrator training course has been organized with twenty.students. It is planned to start a two-year training course for hospital administration personnel at the end of 1965.

6. A seminar on public health, the first to be organized with the participation of doctors from the prOvinces, and supported by a WHO adviser, has obtained very encouraging results. CONCLUSION Although depending on a special political situation, health activities in the Republic of Viet-Nam during the year 1964-1965 were intensified in both the preventive.and curative fields, and satisfactory results were achieved in many respects, as stated earlier in this report.

SINGAPORE

Report on the

ProgreSS

Health Activities, 19641

The Ministry of Health in Singapore consists of tl1e following divisions: tl1e Hospitals Division, the Health Division, the Chemistry Division and the HeadCluarters.

The progress of l1ealth activities in regard to the two lIl9.in Divisions 1s summarized below:

1 t .<

GENERAL sta,tj~

1.1 Vital

The population of Singapore was estimat~d at 1 912 991 in the middle of 1964. The follow:tng are tables with the relevant vital statistics by racial group for 1962, 196} and 1964:

Table 1Natural Increase RACIAL GROUP

Vital Statistics z 1262 LiveBirths Deaths StillBirths (C) Numbers Infant Marta-

lity

Neonatal Perinatal MartaMonality lity

(Al

(A)

/£1

ALL RACES Malay.Chinese Indians and PaktttanlJ Euraaians Europeans

48799 9617 366 3899 263 251 403

58977 11 257 41934 4 £49 361 293 483

10178 1640 7568 750 98 42 80

740 214 4113 96 3

184J 540 1142 138 13 1 9

1127 225

1593 366 1048 154 10 2

807 76 12 1

1 8

Others

Rate$ ALL RACES Malaya* Chinese Indians anll Fakistanis Eurasians Europeans 0tbeD

28.2 39.5 26.4 27.1 19.2 17.6 26.5

34.0 46.2 32.2 32.4 26.4 20,5 31.8

5.9 6.7 5.8 5.2 7.2 2.9 5.3

12.4 18.7

31.2 48,0 27.2 29.7 36.0 3.4 18.6

19.1 20.0 19.2 16.3 33.2 3.4 12.4

26.7 31.9 24.7 32.5 27.5 6~8

9.9 20.2 8.2 3.4 16.3

26.5

• Include Jndonelians (A) Bara: Pet thousand! population (B) BaIleS, Per tholllllnd l1ve-blrtbl (C) RaIleS: Per thousand totalUve-birtbs and still -births

The figures in Table 1 .above exclude: (I) 1866 live-births of wlws of DOII-Iocally domic:fled Servf.c..

pezsonnelt (il) 14 ltUl-blrtbl of wiveJ of nM-Iocally dom1cl1ed Service. (W) personnel: 72 deatba of non-locally domiclled ServiceJ peaonnel and memheJs of their (amUleJ

SUbmitted by the M1.nistry of Health6 31 August 1965

- 2 ..~,-"

.. StillBiI'.hs Infant Mottality @l Neonatal Perinatal MartaMottality lity '"

Table 2. Natural Increase

Vital. Statistics, 1963 LiveBirths

Deaths

RACIAL GROUP {A} (Al (Al

!Cl Number.

(f)

ALLRAC2S Malay.Chinese Indians and PakflTaDiJ Eurasians Europeans Others

49392 10068 34 521 3863 231 253 41;;6

59530 11568 42215 4 614 318 305 510

10138 1500 7694 751 87 52 54

'139 187 442 93 3 7 7 Rates

1674 455 1061 137 4 12 5

1097 211 784 85 1 11 5

1592 346 1056 1S8 4 18 11

ALL RACES Malay.Chinae Indians and PaIdl1aDiJ Eurasians Europeana Others

27.8 40.4 25.9 26~4

33.5 46.4 31.6 31.6 22.1 20.3 31.9

5.'7 6.0 5.8 5.1 6.0 3.5 3.4

12.3 15.9 10.4 19.8'- , 9.3 22.4 13.5

28.1 39.3 25.1 29~7

18.4 18.2 18.6 18.4 3.1 36~1

26.4 29~3 24~8 33~6

16.0 16.9 28.5

12.6 39.3 9.8

9.8

12.5 57.7 21.3

• Include Indonedallt CA) Rate~t Per thousand population (8) Rares: Per thousand live-births eC) Rate$t Per thousand totalUve-binhs and stUl-births

Tba figures in Table 2 above excludea (I) 1984li.ve-birtils c:I wives of non-locally domicned Services personnel:

(11) 26 still-births of Wiftl of non-iocally domicUed Service.

persODDel~

'" (111) 76 deaths of non-locally dom1cnedServlceJ,penonnel and member.; of chair famllies.

- 3 Table 3. Natural Increase RACIAL GROUP

Vital Statistics, 1964 Deatbs

UwB1rtba CA)

Infant MortaUty

Neonatal Perinatal MortaMonality lity (B)

CA) !~. ::-

CA)

(B)

ALL RACES

41 783 10 074 33 124 3 784

58 217 11 709 40 937 4 512 313 254

10 434 1 635 7 813 788 81 57 60

694

1378 492 1088 139 5 6 8

1143 267 '174 90

1539 383 979 157 5 8 7

Malay.Chinese Indialll and PaldJtanis Eurasialll Europelllll Othen

232 197 372

432

188 401 93 3 4 5

2 4

Rates ALL RACES

26.3 39.1

32.0

5.7 6.3 5.7 5.3

11.8 15.8 9.7

29.9 42.0

19.6

26.1 32.2 23.7

MalaYSChinese Indians IIDd PaldJtanfl Eurasialll Europelllll OdIen

45.4 30.0 30.5 21.7 16.8

22.8 18.9 19.7

24.2 25.2 16.1 13.0 22.8

26.6 30.4 16.0 23.6 18.5

19.9 9.5 15.5 11.4

33.'1 15.8 31.0 16.0

5.6 3.8 3.7

6.4 16.7 13.9

26.5

• Include Indone.ialll (A) Rates: Per thousand population (B) Rates: Per thous~nd Ihre-births (C) Rates: Per thollcanj totallive-bilths and .tUl-birtha The figures in Table 3 abow excluc\eJ

(i)

217911w-birtha of wives of nOll-locally domicUed Services pezsonnel; 30 stUl-birtbs of ldve. of non-locally domicUed services penonnel; 76 deaths of Don-locally dOmicUed services penonnel and members of their famUies.

Cn) (iii)

1.2 Cholera OUtbreak Singapore had three outbreaks of' El Tor cholera during 1964 _ in JanuarY/Febr1JlJ.'r'y, April/JuDe and in August. During these outbreaks twenty-four cases were discovered with the occurrence of' thre~ deaths; 35 000 .people were inoculated against cholera during these outbreaks. These outbreaks kept the Mlddleton Hospital (the Ini'ectious Diseases Hospital) extremely busy, both in respect of treatment of patients and for investigation and observation of suspected cases. Altogether 24 cases and 370 suspected cases were referred to this hospital.

- 4From the epidemiological. point of view, despite the tact that &1.1 the three outbreaks were brought under control as a result of the hard Work done by the staff of the Environmental. H~al.th and Quarantine and ~idelll1O logy Branches of the Public Health Division, El Tor cholera had become endemic in Malaysia. 2

PROGRESS OF HEALTH ACTIVITIES m THE HOSPrrALS DIVISION out-p~tient

The Hospita.lfl Divisioncom;prises the hospitals and dispensaries which provide the "curative" services.

OVer 90 per cent. of the hospital beds in the State aJ:'e in government hospitals, and a major proportion of the people w:h.o rer..uired admission te hospitals were admitted to gpvernment hospitals. Two significant ill!J?rovements were made in the Hoc<pit,al Service one "las tbe reerganization of the OUt-patient Services and t:1C o\.her. the establishment of a second General Hospital at Thomson Ro:::d. The reorgani7.atien of the OUt-patient Services, which 'oRS undertakE'n on 1 August 1964, has as its .primary purpose te d.;centralize tbe OUt-pl;I.'l;ient Services. Previously, the largest OUt.-pa;f;i.ent r,,~part me:.:t ""'as at the General Hespital. This was closed down and in its place W!'.s formed an Emer~ncy and Admission Unit fer the HOG::,?ital. Only en;.~rgen-::ies req":Li.r lng immediate attentien attended this uni-:;, while DOllor injuries and miner illnesses are treated at the Out-patient DispensaJ:'ies. Some ill!J?ortant development projects were started, while ethers were conq;>leted during the yeaJ:'. In April, work began on the building .of the Thoracic Uni.t for the Tan Tock Seng Henpital. When cenq;>leted, this hospital will hl'1.ve its own surgical operation theatres fer the treatment of pull!lonary tuberculosis. Qperation theatres were also cell\Pleted for the Eye Unit at the Gener:li Hospi.tal thereby doubling its operative facilities; 8.."ld another operation theatre was aJ.so cell!J?leted at TrafalgaJ:' Home (the treatment hespital for leprosy cases). At the Thomsen Road Hospital, in keeping with the policy of the extenl'lion of hospital services, the cOnq;>letion of' the st1rgical and outpati"'lt block turned this hospital inte a second GelY'r"J]. Hespital of thG f;;;,,,;ce. A rr1!;i:nl M:ldical Unitl censisting .of 160 bed;;, was al.so instituted e.~:. tfr~ General Hespi tal. To sta:f'f' a.ll the develepment projects a training schoel f'or assistant nurses at Thomson Road Hospital was begun. The conq;>leted school will then provide a permanent school for assistant nurses. The International Union Sympesium en Cancer .of the Nasopharynx was held in kllgust in Singapore, and the Anti-Cancer Society was formed. "-

- 5• In September, West AustraJ.ia· s offer to help out in cases of open heart surgery was accepted, and a $50 000 Open Heart Surgery Fund Drive

was started. This was foliowed by the launching of the "Hole-in-theHeart" Laboratory Fund in November.

PROORESS OF HEALTH ACTIVITIES IN THE PUBLIC HEALTH DIVISIOO

Public cleansing has always been one of the major problems in the Health Ministry. As a result of the Minister of Hea:lth's personal interest in the reorganization of the Public Cleansing Depertment, a "Spring Cleaning Campaign 11 was initiated. This lasted for four months during which problemn connected with refuse disposal a~d collection were brought to the surface for investigation and study. At the end of the campaign Singapore City looked brighter and cleaner. As a natural follow-up of the "Spring Cleaning Campaign" (from February to May 1964), the Public Health Advisory Board was formed in order to formulate practical health measures for the control and maintenance of tht~ highest possible standards of public health in all its aspects of S~.D.gapore. As a result of the formation Of the Board, a new Hawkers B~ard was formulated and better co-ordination with other government depart.ments represented on the Board was achieved. The problem of stray cattle in the state causing public health problems, traffic obstructions and public nuisances had remained unchecked for a I:l'.nIDer of years. It was decided towal'ds the end of 1964 to introduce legis~ation in order to deal effectively with this rather pressing problem. Since the passing of the "Cattle Ordinance", the outstanding nuisances in connexion with stray cattle have been eliminated.

An outbreak of malaria at the PUyong Estate off Bukit Timah Road in August and September 1964 made indigenous malaria appear again in

the state after E".:l. absence of seven years. Altogeth~r t1U.rteen cases were reported and the outbreak was brought under control quite easily, as this was the result mainly of control measures having broken down temporarily . The Public Health Engineering unit of the Public Health Division

had a very active year in 1964, especially in connexion with "WOrk on

improvements to enviror..mental sanitation in kampongs or villages. Kampong sanitation involves mainly the building of drainage, r~6iting of latrines and the provision of water supply for the village people. Altoget~ler a::pproximately $105 000 were spent in materiaJ. and labour for improvements to about forty kampongs.

-. TRUST TERRITORY OF THE PACIFIC ISLANDS

Report on the Progress of Health al1d. Medical Services* Medical services in the Trust Territory of the Pacific Islands are provided by the Trust Territory Government, and there are no medical services outside the Government although missions provide limited medical treatment and medication for their own personnel. The Department of M:!dical Services includes medical, dental and sanitation experts as well as the nursing school, dental nursing school and hospital administration. Each of the six Trust Territory districts has a M:!dical Services Department headed by a District Director. There are six district hospitals, three of which have been built since 1961. New hospital plants with modern facilities are scheduled for the district centers in Yap, Truk and Ponape. In addition, there are field hospitals at Kusaie, ponape District; Rota in the Mariana Islands District; and Ebeye in the Marshall Islands District. These field hospitals are also scheduled for replacement or rehabilitation in the Trust Territory Government's long-range public health program. out-patient clinics are operated in connexion with each hospital, and there are, additionally, 121 field dispensaries. In 1964, a terri tory-wide immunization program was launched, and immunization against smallpox, diphtheria,pertussis, tetanus, typhOid, paratyphoid, pOliomyelitis, and BCG for tuberculosis is now being given routinely as part of this program. By the end of April 1965, i = i zation was complete for the Marianas District and was scheduled to be completed for the Palau District by the end of June. The Yap District Center area was completed and the out-island area program scheduled for completion in July of this year with the visit of a specially equipped field trip vessel. The immunization program was 75~ complete in Truk, 80% colltrllete in ponape and well advanced in the more heavily populated ..~·eas of the Marshall Islands. Out-island immunization in the Marshalls has been somc",hl'l.+' dp.1a~d primarily because of the many logistic factors involved in the tremendous spread of these islands. The Trust Territory has been plagued by recent outbreaks of influenza and rubella, al1d a major effort to reduce the incidence of these diseases is being undertaken by the Trust Territory Government in conjunction with the United States Public Health Service.

*Submitte~ Health,

Educat~on,and

by the Office of In~ernational Health, Department of Welfare, Wash~ngton D.C., 20 July 1965.

~T lak.9quct~on:

ON PROGRESS 011'

HEALTH· ACTIVITI!§ 1 964=1965.

Western Samoa is an ind6pebdent o~try since 1 January 196~ which lies sguth ot0 the Equator between 13 and 15 mel welt of Jae date-line between

7 and 9

•

The estimated population of Western Samoa tor the year endin8 31 December 1964. was 120.982 with total birth of 4,335 and total death of 659 as regutersd by tbl village regutrars. Our figures bued on the reportll from the aedieal statt are Miller and are IJ! follows:

Birth rate Death rate

45 per. 1,000 7 per 1 ,000

The :Estimates of Expenditures for the year ending 31 Deceaber 1965 are £279,665 of which .£272,9}5 a.ce for maintenance ani £6,7}o for capital. The allocation to the Healtr. Se-rvi06f! in 19(,5 repre~erlt approximately 10.9 per cent of the total budge t. f.enortl, Revi~:

In the it.blll!lnce of alt\'" major outbreak!! or epidai 011 ofcOIJIIIuni cable diaeasef! concentration WILS jllllde on i.llprovement in the Health Services.

The extension of the ·)perllting theatl'fl hall beenoo:npletedand :Is providing better faoi1itie:s for the 3urgicu.l team. A new operating t a.b14 .. rived at .the end of ~96i. for Apia Gellers1 HO.!lpitul.

The lnatitute tor Technical Intercl'an.g., .ut West Centre or~ani.d a oonlarence at the Apia Hospi tal which "u co-sponsored by the. Go'W!rnmSl t ot Weatern Samoa on interchange in medical information and surgiea.l tec'rnique. end of AU!uat 1965. Participants of this meeting were doctore l'r0lll American 811110a, Fiji, Tahiti, TOll8a, United States Truat Territory and Western Suao .... The :last West Centre sent four speciallata from Honolulu whioh were a lla'geon specialillt, paediatrician, gyn .. oalo~ at, and 11ft lntemat.

The Lu1'ilufi Hospital. about 16 miles east6'CIGl tll8 capital Apia, which hu been destroyed by atorm in 1961 iJS under ca:atr\.lCtion by tbt .diatr1ot people

"I.' ."

...

'~'~ ,

• ubl1diaed by the GoT.rnaent. Ootob.r ot thi II y.ar.

It 1. cp.ct.4 . . , j,t

1d.~

lIe·.,aplet.cl in

Iyr&l. He&l.th

Public Health .... 1n1atr.t1OD, Dr •• 10 oollaboration .ith tbI Direotor ot H.al1h 4U!p1 ·1n.1""- &rur&lhM.l.iIIl d• .,.lopaent proj.ct .hiob w.. diaoulud in • •'1:iI.nc in .ith _ Pr1Jll. Ifiniater, the 0.1f. lhs1on&l. lep~8Iltath., IUd....._ DirectQl" fit Health; Secr.tary to u. GOYernamt aDd ill. . . Ad-ri.aeI' ODPubUc IIMlth Ada1n1.tration. '1'ht prineipl. ~ ibtproJ.eot .... .to.t to 'b. ,000d e4 a d.ta1l.d ......m.nt ot CDlt tor iapl._tat1oD ot the proJeot .... t ...ar4ect to the Koonaic D..,.lopll.nt S.cretariat wbar. it ... refVl'lKl to ill. Health Advillo17 COIaIIitt•• tor t~ir awroTal. ·and nec•••ary reCD...a4ation to tl. Icanoa1c Development Bowd with 111. a1.a to ba incl\aC1i14 in iIl.tin-,. ... dn.loJ&.nt Icheme ot the aoftrllMnt 16·· ....tel'l1 ...oa.

8.m CPt: 'l'be WJI) Mri.r or

1aral4e_. ..,,9&.

l£.F."II1. C_oJ)trol Pro.1tg,ts Th. 1ftI) Allllillted 'llariu:ia Contro 1 Projeot 00._ _ in Aucuat 1965 wi 1h Dr D.D. IfcCarth;y &I lmO Adviser. ~prox1llat.:q 7 .Ul1on ot d:1.eth;ylDarb8IDuine were .""pli.d by URICIll', ao:1 3 millioM by lew Zealao:1 according to a tripartite ~._~t betwe.n 1nI),UJlICII' am. 111. Gowrnact ot .... tem Samoa. !'urtb.....!atallc. prorldect by funda trca I_ ,.al.aD4 (lfedloal. a•.,ardl CouncU) inolud. . tran.port ~d IItatt. A pUotpro.t.ot .tarted by 1964. in two inlanl 'V1ll~.a Del . , co_tal rill.... to trytbe .....nO\lll . .thoda of . .1n1.trat ion ot tlad1etbylcan_t.in.tUlet.. .ach p ... ell IIWIt ban 16· do... ap:re1l4 eWer 12 .outb•• It ... planned that

Wore tr.atalllt ... given blood .-.pl. microfUaria. and tha reaul ta . . . . tollowsl

'b7

t1npr

niak wretak. luaU.,. 1

fQl"

!i11M'· 'rill-a•• Lalaaqa

IDlu4~'..:l.n1lO

30' ,,,

bl1tiu ::130.8~ 22.£ 1

~69.2J

n.4.

I~.

..c

vUl~..

Coaa tal~ 8010.010 '1'0 . . .

A .. cond blood .x.1nation atter liz aonb t treatact with dietl\Ylcarb ....1ne _ &.o..d tallow_ reaultJ

179 752 tlU • .s.

16~1'.'~ s.. 20.5

71~81.6J 5 79.5

......

3. ~~hiU Nos SZf S~ecl!-....J:

f2.a. t !V! 2(O.7jC) nil

HIM1.!xe

Inlllld Till~es

~ falev 110

Lalcaqa

Z79 118 821

11 1~

27~99.3~

O&stal vlll~es

(Sol08010

69}

7~O.~~ 7 1.'"

81~99.1") 686 9~)

The . . . tHatalDt 1II.th 41.etbylcarb. . u1De tablet. hu be.n @c14ed. to be u follOl'lal 1 dosa&e of 5 88ID per kilo to be 81:,.n ODO. a _MIt fbI' 6 w. . . then follo.ed by 1 do. once a IIOn1l1 tar 12 IIOIltba.

'--f

, .

Uter scae del., and a f.w weeks litter the c~DCe_nt fI ta e 'Uariaaia CoIltrol Project, the old _th'. bUildiJ18 in 1be Apia town n8U' till Be&Gh oad b.. been conwrted to the J'ilar1&au Headquarter. with leboratory IDd 1re.-.nt centre. \

lIa ternal am Chll d Heal th: On 'the reco IDIDllldation of tht 1ftI)/spc .Advisory Te. on llaternal and Child Heal th a tripartite agre.lIlt "i 1b lim, tlfICIP and tbl GovermalDt at e.tern Samoa wu made to establish an~_ to stHDBtmn in the rural areaa lIaternal and. Chilr Health Servicee.

The "IJ)luntary service of a paediatrician troll He" Zealalli for two yeara W&II more than nlcaae to oarry out thia project. Special .. tteDtion in cooperation tlith tbe WHO JdTi.er on Public Health ~.tzoaUon haa })• • pa14 to tbe imnmiaation of pre-.chool childr_.

Y£I ln41cat~: '!'he auoo•• atul YaJI. ~a11D reacbe4 1I1e .tate ot ",re-er!l4kat1on" in We. tern 8&110&0 The children bOrM .moe 1be ~1'ftniDI ot tbl o.-pa1sD have hed DO Otlltact rl1b the diaeue .nd are bret'ore ~ ~ .u.oept1ble 1D41v14ual. to an infeotion " tb '1'reponeaa pertin"e. Aa .. tollQllr-~ ot 1be Yaw. C.-paiID an cmual ya". weeki were beld IIld single cu.. d Y.I uero reported t'raII varioull ...al. '1'. eval».ate the re.ults ot oentral aotiviti.. undertaklll in thl p .. t &6&1nlt y • • , 11 would be nece.lary to dete1'lline tbI preTalmce rate of ol1n1cal cd latent ou.a. The eoveMlleat ~ ••• tem 8&IIOa requ_ted tbl ...iataftce ot 1JI) am tIM 1ftI) Yaw. Auea.ent'1'e. arrived. in 1964. A .erologioal lIIborator,y at tbl Apia Ho.p1tal \1&11 set up whicb p8l1llit. to ex_ina tba .~le population ot 8,000 per.en. b)' the IIpecific 1.T.A. telltS. Until the nlul ta ot 1b••e en.inationll wUl be

•

anillble y•••urve:Ulance will b. Uaited to perioc!1c nW"ati_ child populati<m \mderttlcen by the ....utm. nNl hMltat.en1oe •• ~.rcul.oa1.t

or.

In Jim. 1961.. .,..tern Suoa w .. T.1.ait.c! b7 til. _ IDter"'OGUDtz7T••• A4v1Mr te_ to naluate the -Q.i).,culo.b OQlltrol wi.in ,l••1Ienl aaao.. ., th. . . . tiM con-"ct.d a tr&1DiD, oaura. tor DUtrlot IfUn•• _ T••~ e.wal. faIb"CIllilltt.t1a.c41C1 ftOcd.Dat-. ft. pUot • ..., • • . . . in tiro 'rill .... wi..... populaUon ot 1,1m, 78 p . . . ., ...........

tb.

culo.1. IIIpti:" MIl "ere g1ven .BCGftOoiDat1oa, .·15 aboa4 pWa0D&r7 leaion.

282.p..... -.n I-J'If'tI4

'!1M .... ~ t\Iberot'lo.b poaitl... .-oDf oMlc1nDb ...... 15J ........f1t .... hlll1Doreued in U. t_ rill.... 1961 to 1961.- tJo. }.'" to ....)'. • oom.era1on Nt• ...,.. oh114ren IIDdIr 15 ,.. ..... , .... h . . . 4 . . . ., pb•• ot tbe WJI) ..... ute4 Tub.roulod. CODtzool PJ'oJeot b. NeD pl. . ., with 1Ia. introdUction ot BCG tar 1966•

Key facts

Organisation World Health Organization (WHO)

Document type Technical Documents

Adoption date December 31, 1965

Source World Health Organization