(WPR/RC37/SR/4)
SUMMARY RECORD OF THE FOURTH MEETING WHO Conference Hall, Manila Tuesday, 16 September 1986 at 2.30 p.m. CHAIRMAN: Dr B.W. Christmas (New Zealand)
CONTENTS
1.
Consideration of proposed programme budget estimates (continued) ••••••••••••••••••••••••••••••••••••••••••••••••• 1.1 Proposed programme budget estimates, .1988-1989 (continued) . . . . . . . . . . . . . • . . . • . . • . . . . . . . . . . . . . . . . . . . . . . .
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- 115 -
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l.
CONSIDERATION OF PROPOSED PROGRAMME BUDGET ESTIMATES: Agenda (continued from the third meeting, section 3)
Item 9 of the
1.1
Proposed programme budget estimates, · 1988-1989: Item 9.2 of the Agenda (Documents WPR/RC37/5 and WPR/RC37/INF.DOC./2) (continued from the third meeting, section 3.2)
The REGIONAL DIRECTOR welcomed the comments made by representatives and agreed that the programme budget presentation was a joint effort between Member States and WHO. WHO representatives and country liaison officers in many developing countries worked closely with national counterparts. Since Niue had a specific jurisdictional relationship with New Zealand, the matter would be discussed in a private meeting in an effort to find a mutually satisfactory solution, as suggested by the representative of New Zealand. Many representatives had raised the question of the budget cuts to be made in response to the financial difficulties. It was very difficult to give detailed ideas for budget cuts in 1988-1989. The question was being examined on a programme-by-programme basis with . a view to eliminating low-priority programmes or programmes that could be funded by voluntary contributions or from other extrabudgetary resources. No increase in the regular budget could be expected for the coming year, and the only way of increasing health activities in the many developing countries in which health services were operating below the acceptable level of health care was to apply a priority programme bilaterally or multilaterally through WHO or to use other extrabudgetary resources. It was planned to discuss the question at a forthcoming meeting of WHO representatives and country liaison officers and to give suitable training to staff. It was hoped that collaborative activities in the form of training activities or workshops could be organized at the country level. Although a reduction in staffing costs might appear to be a simple way of making budget cuts, such reductions were difficult to achieve in the Region, where human resources were extremely important for programme implementation. Efforts were therefore being made to maintain existing human resources as far as possible, emphasis being placed on training of personne 1, particularly health workers. There were also difficulties in cutting supplies and equipment, which were often needed on completion of the training of health workers. Community health nurses, for example, had to be provided with transport to enable them to visit outlying areas. Although careful planning was essential, perfect planning was impossible. Flexible programme budgeting was therefore applied within the defined programme budget policy. More careful monitoring of programme implementation might make it easier to shift from one programme to another to meet the changing needs of countries resulting, for example, from natural disasters or the collapse of markets for primary products. A careful contingency plan was being followed, but there were so many unforeseen factors that details could not be given. To provide such details for 1986-1987 on a country-by-country, programme-by-programme, and interregional and regiona 1 basis would be a very lengthy exercise, although it might be possible to give some further information at the next session of the Regional Committee. There were two kinds of extrabudgetary resources: those executed by WHO and those given directly to the country concerned by bilateral contributors, with WHO coordinating the policy basis to provide better
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streamlining and allocation of resources, in accordance with the national strategy for health for all by the year 2000. It was hoped that such contributions from developed to developing countries would be increased in the future, and that an increasing number of developing countries would execute their own programmes with managerial support from WHO. That was a new trend not only for the improved utilization of the limited resources but for the more effective and rapid development of national resources based on the strategy established in the Region. The increased use of extrabudgetary resources was a collaborative effort between WHO and Member States, and it was hoped to strengthen cooperation in that respect. Because of the low value of the Philippine peso against the United States dollar, the Region was operating with low personnel costs compared with other regions or with Headquarters. It might face some recruitment difficulties as a result, but efforts would continue to be made to find suitably qualified staff. Dr HAN (Director, Programme Management) recalled that the representative of Japan had asked for an explanation on the form and method of presentation of the budget, in which programmes other than regular budget programmes were not explained. When the regiona 1 and intercountry programmes were formulated and when the programmes proposed by Member States were received, account was normally taken of possible extrabudgetary resources. As mentioned by the representative of Malaysia, the extrabudgetary resources for 1984-1985 represented more than 50% of the regular budget, while those so far certain to become available for the biennium 1988-1989 represented only 11.8%, though it was hoped that they would ultimately equal or exceed those received in the past. It was hoped that it would be possible to identify proposals that might induce donors to provide funding for implementation. Efforts were being made to strengthen the "marketing" skills of WHO officials to attract such funding. The representative of Japan had further mentioned that, in order to review the effectiveness and geographical balance of the regional programmes, it would be useful to know how those programmes were chosen and what was their outcome. The representative of Malaysia had said that a start should be made in applying the regional programme budget policy in cases where the issues, priorities and criteria had been laid down (pages 12, 13 et seq. of the proposed programme budget document and explanatory note). Because of the consideration of geographical balance or geographical characteristics to be taken into account, the Region had a higher proportion of intercountry projects than any other region. That was why efforts were being made to group activities covering two or more countries in a particular area to be serviced. Replying to the question concerning administrative costs, stipulating that more than 60% cooperation with countries. The mind, and direct participation 87.31% of the programme budget. raised by the representative of Japan he drew attention to resolution WHA29.48 of the budget should be used for direct programme had been developed with that in with countries in the Region represented
With regard to the representative of Malaysia's question concerning certain programme areas such as sexually transmitted diseases, the amalgamated figures in the document were composed of regional, intercountry
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and country activities. Some countries considered that they had completed a certain phase of the activities which would require WHO support, and they might not request such support during the current biennium. For intercountry projects, on the other hand, certain meetings held were not repeated every two years, and would therefore not be shown in the succeeding biennium; a marked decrease might therefore appear in the document. That was what had occurred in the sexually transmitted diseases programme area in one or two countries which considered that they no longer needed WHO support. Mr UHDE (Director, Support Programme), replying to the question of the 13.5% increase raised by the representative of Australia and others, said that that was the maximum rate of increase which the Director-General had felt he could permit for statutory costs and inflation increases. The total cost increase was, in fact, below that figure (at 12.52%). The Director-General was under certain pressure from major donors and recipient countries for reduced or higher increases, and the 13.5% figure could be considered a happy medium based on past experience. The inflation rate in individual countries could be higher or lower than that percentage, and the same applied to the various cost components, but the average of 6.5% to 7% per annum worked out at approximately 13.5% for the biennium. A recent IMF report indicated that inflation in the developing countries was approximately 13.7% per annum as against only 3% in the developed industrialized countries. The 13.5% figure for the biennium was considered reasonable. It was important to keep in mind the effect of exchange rates in inflationary projections. For example, although inflation in Japan was only some 3%-4%, the United States dollar had depreciated by 27% against the yen over a two-year period, so that purchases made in Japan cost more.
The representative of Australia had also raised the question of the different cost increases between country activities and regional and intercountry activities ( 13.01% and 11.91% respectively). There were many different projections as to the components of the various types of programme: long-term posts, consultants, fellowships, supplies and equipment, etc. The basic reason why the inflationary cost increase for country programmes was higher was the existence of long-term professional posts. The 1988-1989 average cost projection for long-term profess ion a 1 posts for the biennium was a decrease from 1986-1987. There were fewer long-term posts in country programmes than in regional or intercountry programmes (35% compared with 65%) and the fact that the average number of long-term professional posts was decreasing basically explained why the cost increase for regional or intercountry activities was only 11.91% compared with 13.01% for country activities. With regard to the Australian representative's question why there had been no currency adjustments for other countries, such an exercise would be complex and inaccurate. There were twenty-one currencies in the Region. The programming instructions from Headquarters required the calculation to be made only in the currency of the country in which the Regional Office was situated. That methodology had been accepted by the Executive Board and the World Health Assembly.
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A further question had been whether the 11.91% increase in regional and intercountry activities was considered realistic. It was fairly realistic, though on the conservative side. If it proved during implementation to be inadequate, it was hoped that other funds could become available to enable the activities to be carried out as planned. The only alternative would be for the Regional Director to make programme reductions. In reply to the representative of Japan, the way the 13.5% increase had been calculated had already been explained. In regard to cost-effective management, the Regional Director had always emphasized the importance of cost containment, and budgeting, planning and monitoring activities took cost-effectiveness fully into account. Travel costs were being drastically reduced, for instance, through rational routing and the amalgamation of missions so that one journey only was necessary instead of several. The cost of communications had also been considerably reduced by installing a more modern telephone system in the Regional Office. Substantial savings had been made through a vigorous energy conservation programme. In regard to the separation of administrative costs from programme costs, there was possibly a confusion in the terminology used by governments and that used by WHO. In WHO most salary and duty travel costs came under the estimates for programme activities. The WHO format for budgeting and reporting, which had been approved by the Organization's governing bodies, was being used. Administrative support costs, or in WHO parlance "support services costs", comprised the cost of staffing and some duty travel for the Budget and Finance and the Personnel units, the cost of the General Administrative Services unit, which looked after the pfemises, employed a considerable number of general services staff and provided common services and hard-core administrative services, and the cost of staffing and some duty travel for the Supply Services unit, Support services costs were estimated at 6.25% of the regular budget for the 1988-1989 biennium but, when activities financed from extrabudgetary sources were taken into account the percentage would fall to 5% or less, a figure considered not unreasonable, which would bear favourable comparison with the figures for Headquarters and the other regions. In reply to the point raised by the representative of Tonga, the Regional Director was well aware of the concerns and needs of the small South Pacific countries, as was shown by the considerable increase in the allocations for the South Pacific in the proposed programme budget estimates for 1988-1989 as compared with the previous biennium. In addition intercountry programmes and programmes financed from extrabudgetary sources could reasonably be expected to provide still further funds for the small South Pa~ific countries. In reply to the questions raised by the representative of the United States of America, the figure of 12.52% for the increase in respect of statutory costs and inflation had had to be based on certain assumptions reflecting past experience and anticipated trends regarding the mix of components in the country programmes and in regional and intercountry programmes, although there were more hard data available for the latter group. The fact that statutory costs had increased despite the freeze on United Nations salaries, which had already been in force for many years, was due to the cost of salary increments, usually annual, changes in dependency
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status due to additions to staff members' families, possible increases in the cost of education allowances, promotions and many similar factors. Increases due to rises in statutory costs were estimated at 2.5%. This left a 10% increase for the biennium, or about 5% per annum, which could not be considered unreasonable in the circumstances. In reply to the question on cost absorption, consultant services, duty travel, common services, overtime and other items were undercosted in the estimates, thus providing a considerable element of cost absorption in the budgeting process. As for exchange rates, the 1988-1989 estimates had been formulated at a time when 19 Philippine pesos equalled one United States dollar, as against the present United Nations rate of 20.33. Unless the rate fell to 22 or more pesos to the dollar, it was probable that no recalculation would be made. In any event the Executive Board and the World Health Assembly would have to decide whether any recalculation was necessary in each specific instance. It should be remembered also that exchange rates could ·go the other way, as had already happened on occasion ,within the past year for the Philippine peso. As for the reporting by objects of expenditure, the question was a very complex one. Before 1980-1981, WHO budgets had been presented in great detail, broken down by project and component, but resolution WHA30.23, adopted in 1977, had introduced biennial programme budgeting, starting with the 1980-1981 biennium. The Region followed WHO budgeting guidelines drawn up in consultation with the Executive Board and the World Health Assembly; so far those guidelines had proved acceptable. Reports on objects of expenditure were in fact sent regularly to Headquarters during every biennium. In the case of country programmes, details for the forthcoming biennium were contained in some of the budget proposals sent in by Member States, but they were not available for all countries in the Region. Indeed the decision to adopt budgeting by broad programme had been partly due to the large number of changes always made in the detailed items of expenditure between adoption of the estimates and implementation of the projects. Mr KATO (Japan) thanked the Secretariat for clarifying the proposed programme budget estimates, which his delegation supported. The financial situation would be further discussed at the next Executive Board session and the Fortieth World Health Assembly, when it would be possible to assess the global situation and to compare the situation in the Region with that in other WHO regions. The CHAIRMAN proposed that the programme budget document be considered programme by programme. 1. Governing bodies (pages 19-20) There were no comments. 2. WHO's general programme development and management (page 22)
Mr CAO YONGLIN (China) expressed full support for the proposed targets and activities. The training and development of health leaders were most important for the successful implementation of the health-for-all
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strategies. Several symposia on the development of health leaders had been held in collaboration with WHO, which had helped Member States to strengthen their national capabilities for such implementation. The Ministry of Public Health, which had a great interest in health manpower development, had participated in and benefited from those activities.
A WHO-supported national colloquium on health-for-all leadership would be held in China in November 1986 to study how the implementation of health-for-all strategy priorities might be accelerated in accordance with the new social and economic situation. WHO's continued support in familiarizing health staff from Member States with its strategy policy and working procedures would be of great benefit. Despite the financial constraints, the Secretariat had already allocated funding for the establishment of the Regional Learning Centre, the first of its kind in any of WHO's six regions. China had sent three groups of health staff to undergo training there, and some had already returned and were actively participating in cooperation between WHO and China. It was important to utilize fully the equipment in the Centre and to maintain a high standard of teaching in order to train more, better-qualified national health staff. 3. Health system development (pages 32-46)
Dr RHIE (Republic of Korea) expressed satisfaction at the proposed increase of 37.46% in the allocation to programme 3.1 Health situation and trend assessment compared with the previous biennium. The need to strengthen national capability in data collection, analysis and utilization in his country had increased sharply recently, following the decision of the Government to embark on an ambitious social welfare system from January 1988. It was hoped that, from that date, the rural population would be covered by the health insurance scheme and that by January 1989 the entire population would be covered either by that scheme or by the medical aid programme. In addition, by 1990, all workers would be covered by the national pension scheme. While creating a great administrative burden, the plans would facilitate the modernization of the national health information system. The Government already had a plan to mobilize a national health information network, and wished to continue collaboration with WHO in that area. Dr DE SOUZA (Australia) said that the proposed increase of 37.46% in the allocation to programme 3.1 reflected the acceptance that progress in that area was not satisfactory and that governments had requested stronger health information support. It was intended to provide help by means of the development of multi-use health information systems utilizing minimum basic data sets, various technical cooperation activities and training. He asked how much money would be allocated to such multi-use information systems and what were the chances of their success. Dr ROBEY (Regional Adviser in Health Information) said that it was not intended that new information systems be developed but that countries be encouraged to reorient existing systems towards a more general use rather
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than towards individual programmes. The necessary resources would come from within the countries themselves, WHO support being mainly 1n terms of technical collaboration, organization of training opportunities, etc.
4.
Organization of health systems based on primary health care {pages 4 7-51) There were no comments.
5.
Health manpower (pages 52-56)
Mr CAO YONGLIN (China) said that the key to realizing health for all by the year 2000 lay with health manpower, equipped with the knowledge and technology of modern health care. China had therefore consistently selected health manpower development as the major area of cooperation with WHO in order to use the limited resources available to train the backbone of health personnel needed to carry out health-for-all tasks in China. Those key personnel were playing an important role in organization and management in the fields of scientific research, medical education, medical and health care, preventive medicine and health management, and in further health manpower development by training other personnel in those areas. In future collaboration with WHO, China would continue to emphasize health manpower development. It was an area of concern not only in China but throughout WHO and in many Member States, and that was reflected in the considerable budget allocation made for health manpower development programmes both at Headquarters and in the Regional Office. At the national level, despite different situations, health manpower development also received a considerable proportion of the budget allocation, in some cases more than 50%. The objectives of the proposed health manpower development programme for 1988-1989 were practical and effective and the proposed allocation of funds was based on the actual needs of Member States; those proposals were fully supported by his delegation. Mr THOMPSON (United States of America) noted that there was a slightly above-average increase for fellowships. He had no objection, but recalled the Director-General's comments on fellowships and urged that the resources be used as carefully as possible for the purpose of achieving the goal of health for all. Dr REILLY (Papua New Guinea) supported the two previous speakers. He had already stressed the needs of the smaller countries in the Pacific area. WHO's cooperation in coordinating health manpower development and planning was vital for the rational and efficient use of the resources available. Mr TOEOLESULUSULU (Samoa) supported the budget proposals manpower, which was a priority problem in the Pacific region. for health
Dr TAPA {Tonga) associated himself with the remarks of the previous speakers and expressed satisfaction at the continued high priority accorded to the development of health manpower, essential for the achievement of health for all.
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6.
Public information and education for health (pages 57-61) There were no comments.
7.
Research promotion and development (pages 62-64)
Dr KHALID (Malaysia) reiterated the need to further promote the development of health systems research capability at country level, in view of its importance for the overall health-for-all strategy - particularly in relation to resource distribution and the improvement of health systems management. 8. General health protection and promotion (pages 65-76) There were no comments. 9. Protection and promotion of the health of specific population groups {pages 77"-90)
Dr BROYELLE (France) noted that there was. a reduction of 3.8% in the provision for programme 9.1 Maternal and child health, including family planning, while an increase of more than 28.86% was shown for programme 9.4 Health of the elderly; the provision for the latter in fact amounted to some 69% of that for the former. While she fully appreciated the need to increase the provision for health of the elderly - a growing problem in the Region - she felt that there was some imbalance, for maternal and child health was still a problem of major concern. The health of adolescents had been included in the programme - which was highly desirable, since it was also giving rise to concern; however, on the whole the problems involved were behaviour-related rather than organic (concerning, for instance, drugs, tobacco and accidents). Moreover, the inclusion of those activities in the programme necessitated the use of a proportion of the limited funds allocated to maternal and child health. Dr KHALID (Malaysia) shared the concern expressed by the previous speaker. Maternal and child health was still a big problem in many parts of the Region. He noted that the figure given for obligations for country or area activities under Other sources was only US$1 387 900 (compared with US$10 854 50() for 1986-1987). That indicated a decrease in activity for 1988-1989, even if the figure was not actually final. Was th~re any possibility of making good that decrease in the provision for such an important programme? Dr TAPA (Tonga) agreed with the remarks made by the two previous speakers, but thought that the apparent decrease might be due to some reclassification, which might be explained by the Secretariat. At the same time, he was pleased to note the increase in the allocation for health of the elderly. Dr REILLY (Papua New Guinea) supported the remarks of the previous speakers, and particularly stressed the importance of family planning, in view of the budgetary restrictions.
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Dr HAN (Director, Programme Management) said that the maternal and child health programme was multidisciplinary and some activities were also carried out, for example, under the expanded programme on immunization. The reduction under programme 9.1 was due to the fact that a couple of countries had reduced their requirements for WHO support. Regarding extrabudgetary funding, there were twenty-five UNFPA-funded projects for the 1986-1987 biennium; for 1988-1989, fourteen projects were awaiting funding commitment from UNFPA, which could not be reflected in the budget figures. Replying to a question raised by the representative of Malaysia, the REGIONAL DIRECTOR said that there had been a considerable increase in UNICEF funds for the Child Survival programme, covering particularly nutrition.
10.
Protection and promotion of mental health (pages 91-100)
Dr BIUMAIWAI (Fiji) referred to programme 10.2 Prevention and control of alcohol and drug abuse. For Fiji health and social problems related to alcohol were sufficiently serious and widespread to call for coherent national action. They imposed a considerabl,e economic burden on the country; at the same time, revenue from the production and sale of alcohol contributed to the economy and the availability of alcohol was important for the tourist industry. It was therefore essential to achieve a balance between economic interests and public health, and Fiji's national policy regarding alcohol should take its place within its overall national development policy. He would urge that the budgetary allocation to the programme be reconsidered. Mr THOMPSON (United States of America) also expressed concern about the reduction in the allocation for the programme on alcohol and drug abuse. The decrease was, admittedly, small; on the other hand the sum allocated for the programme in 1986-1987 had itself been very modest. Dr TAPA (Tonga) shared the concern expressed by the two previous speakers, but felt that the decrease might be only appare nt. Very little had been said during the Committee's discussions about the protection and promotion of mental health - despite the fact that specific reference to mental and social wellbeing was included in the definition of health in WHO's Constitution. But that did not mean that nothing was being done about the very important programme. His Government for instance was currently studying the long list of recommendations made by the joint South Pacific Commission/WHO Conference on Alcohol-related Problems, held 1n Noumea in
1985. The REGIONAL DIRECTOR said that the Organization was well aware of the seriousness and importance of the alcohol and drug abuse problem in some countries of the Western Pacific and South-East Asia Regions. Some additional extrabudgetary funds were expected, and it was hoped that some allocation might be made from the Regional Director's Deve l opment Programme. Considerable work was being done in the Region, in particular with the collaboration of Malaysia, in preparing for the 1987 United Nations Conference on the subject. Dr SHINFUKU (Regional Adviser in Mental Health) thanked representatives for the interest shown in the mental health programme and particularly in alcohol and drug abuse. He agreed that alcohol abuse was a complicated
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problem that merited increased attention. He hoped that every effort would be made to compensate for the decreased allocation for 1988-1989 by mobilizing extrabudgetary resources, as had been done for the 1986-1987 biennium. Meanwhile he felt that a minimum level of activities for mental health could be maintained in the existing areas with the proposed allocation under the regular budget.
11.
Promotion of environmental health (pages 101-116)
Mr TOEOLESULUSULU (Samoa) said that his Government was emphasizing food safety, for example, in connection with food imports from New Zealand and the United States of America, and hoped that WHO would add its support to that of Japan in training quality control inspectors. However, he not;ed that no allocations had been made for regional and intercountry activities under that programme. Dr KHALID (Malaysia) supported the proposed increase programme 11.1 Community water supply and sanitation. of
24.04%
1n
He requested that WHO consider measures to make good the lack of internationally agreed safety regulations on radiation contamination; the need had become so evident since the Chernobyl catastrophe, which could well prove not to be an isolated incident. Dr BIUMAIWAI (Fiji) also supported the proposed increase 1n programme Community water supply and sanitation. His country had made satisfactory progress in that area in spite of cyclone and floods. However, it was hoped that WHO would provide a consultant to complete the work left half done in 1985 in its cooperation on the construction of ferrous concrete water tanks. He was concerned about the reduction in the provision for Suva-based offices in relation to the environmental health programme. the
· 11.1
Fiji was free of malaria but close to a malarious area, and a visit by a WHO vector control expert, to collaborate in monitoring the situation, was overdue. Could one be provided in 1986 or early 1987? Dr TAPA (Tonga) supported the remarks of the representative of Samoa on food safety. Recently, fish caught in Tonga had been found to. have a high mercury content. WHO's support in investigating such cases of contamination would be appreciated. He was pleased to note the proposed substantial increase in technical cooperation in the community water supply and sanitation programme for the South Pacific. Mr FUNIFAKA (Solomon Islands) noted with appreciation that his Government's request for cooperation in training health inspectors and environmental health officers was reflected in the increased allocation under the 1988-1989 proposed programme budget estimates, for the Region. Such staff were necessary to alleviate the problems of water supply following cyclones, for example. A course would be held in 1987 for which it was hoped a WHO expert could be provided.
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Dr REILLY (Papua New country's gain in terms of cement water tanks, were it be giving. He asked whether
Guinea) said that Fiji's loss might be his WHO cooperation in the construct ion of ferrous not for the problems that such tanks seemed to WHO was aware of such problems•
He supported the remarks of the representative of Malaysia on radiation, and reminded the meeting of the strong statement made by his country's representative on that prime concern of the Region at an earlier meeting. He strongly supported the addition of the element of housing 1n programme 11.2 Environmental health in rural and urban development and housing, and hoped its importance would be emphasized, remembering its role in sanitation and disease control in developing countries, and the decisive effect that adequate housing had had in measures to combat tuberculosis, for example, before penicillin was in use. Dr TAPA (Tonga) asked for an explanation estimates for that programme in 1988-1989. of the reduction 1n the
Dr MAOATE (Cook Islands) asked that cooperation 1n community water supply and sanitation be increased to extend rural water supply coverage in his country in the near future. The REGIONAL DIRECTOR said that the number of questions raised showed the importance of the whole programme for the promotion of environmental health in the Region. Efforts must continue to extend services, for example for water supply, as an essential part of primary health care. Dr HAN (Director, Programme Management), in reply to the representative of Samoa, said that food safety measures carried out as part of the activities of the Western Pacific Regional Centre for the Promotion of Environmental Planning and Applied Studies (PEPAS) were not shown under the programme currently under discussion but came under PEPAS. He had noted the representative of Fiji's request for a WHO consultant to help complete work on water tanks, and WHO would react favourably. On the question of vector control, a regional meeting had been held in Solomon Islands and, as a follow up, a regional adviser or consultant entomologist would visit Fiji in 1986 or early 1987. Dr KREISEL (Regional Adviser in Environmental Health) replied to the representative of Malaysia that there were no established WHO standards concerning safety levels for radiation contamination of food, although the Organization had frequently received inqu1r1es since the Chernobyl catastrophe, particularly concerning iodine and caesium. What WHO had done was to collaborate, among other things, with the International Atomic Energy Agency in establishing "derived intervention levels", which were basically guidelines for countries to set their own standards. The Director-General had allocated US$40 000 for activities related to such measures, which, it was hoped, would be completed early in 1988. It was very desirable to provide a scientific rationale for these guidelines, which referred to low radiation effects on health.
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WHO also hoped to strengthen regional chemical safety activitiest which would also concern mercury in fish in rivers and coastal waters. A regional workshop was to be held in Kuala Lumpur in November 1986t whicht it was expectedt would provide guidance on chemical safety in the Region. The International Programme on Chemical Safety (IPCS) had objectives that were partly covered by programme 11.3 Control of environmental health hazards. Activities under that programme would be strengthened. WHO was in the process of designating the National Institute for Minamata Disease in Japan as a WHO collaborating centre for studies on the health effects of organic mercury. Dr CARTIER (Regional Adviser in Environmental Health)t replying to the question on ferrous cement water tanks; said thatt although WHO had received reports of badly constructed tankst especially in the South Pacific, he could assure the representative of Papua New Guinea that, since its early experience with them, WHO itself had had no such problems. The WHO consultant in that country had particular exp~rience in such construction work. He urged any country having difficulties to report them to the Secretariat through the WHO representative. The emphasis on training in ongoing environmental health would ensure that capacities for maintenance and repair strengthened. activities would be
Concerning the question of the representative of Solomon Islands, the training course for assistant health inspectors faced a problem of funding; so far it had not been possible to find extrabudgetary sources, and it might be necessary to finance the course from savings in other programme areas.
The meeting rose at 5 p.m.