(WPR/RC22/SR/9)
SUMMARY RECORD OF THE NINTH MEETING WHO Conf erenc! Hall Tuesday. 28 September 1971 at 2.30 p.m. CHAIRMAN I Dr Tran-Minh-Tung (Viet-Nam) CONTENTS 1 2
Consideration of draft resolutions
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Statement by the Representative of the United Nations Children's Fund (continued)
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Time, place and duration of the twenty-third and twenty-fourth sessions of the Regional Committee ••••••••••• Selection of topic for the Technical Discussion. during the twenty-third session of the Regional Comrni t tee •••••••••••••.•• "••••.•••...••..••.•••.•••••.••• It •
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Consideration of the report presented by the Sub-Gommittee on Programme and Budget Consideration of the report presented by the Chairman of the Technical Discussions
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REGIONAL COMMITTEE:
TWENTY-SECOND SESS~ON i
..-, ~inth
Meeting
Tuesday, 28 September
1971 at
2.30p.m~
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Representati ves of Member States . AUSTRALIA Dr H. M. Franklands Dr E. F. Thomson Dr A. Tarutia Dr C.H.Yen Dr K.P. Chen Mr J .B. Bertrand
CHINA
FRANCE JAPAN
Dr
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Kasuga
Mr K.Watanabe Mr 11. Takahashi
KHMER REPUBLIC
Dr So Satta Dr Pruoch Vann ,
IACS MAIAYSIA
Dr Phouy Phoutthasak Dr Tiao Jaisvasd Vlsouthiphongs Dato (Dr) Abdui Majid bin Ismail Dr Abdul Majid bin Tan Sri Abdul Aziz Dr Mechiel Ch8l1l Kin Chung Mr cnn bin Kayat Dr C.N.D. Taylor Dr C.S. Gatma1tan Dr D.H. Silva Ferreira Mr Sae Hoon Ahn
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NEW ZEAIAND PHILIPPINES PORTUGAL REPUBLIC OF KOREA SINGAPORE UNITED KINGDOM
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Dr V. Sundararajan D!' K. L. Thong
UNITED STATm OF AMERICA
Dr James King Mr F.S. Cruz
VIET-NAM
Dr Tran-Minh-TUng Dr Truong-Minh.Cae Dr Nguyen-Xuan-Trinh Dr J .C. Thieme
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WESTERN SAMOA
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Representatives of the United Nations and Speoialized Agepoies
UNITED NATION:! CHIL!lmN'S FUND
Mrs Margaret Gaan
III. Representatives of non-governmental organizations IN'l'ERNATI<NAL UNION FOR
HEALTH EDUCATION IN'l'EfQ(A'rIONAL COMMI'ITEE 011' CA'l'HOLIC NURS!S MEDICAL WOMEN:! INTERNATIONAL ASSOCIATION
Mrs Luisa A. Alvarez Mrs M.R. Ordonez Mrs L. Batista Dr I. Y. Zalamea
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WHO Seoretariat Dr Franoill(lo J. D.r Regional Direotor
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..-. 1 CONSIDERATION Of DRAFT ," REso~un9~? ' - - . , . '.
The Committee ,considereq 1.1
the.~RJ1~~i~~.
oraft r,esotutions:
.. Decision: The draft resolution was a40p.t.~4, withQut comment (see resolution ,WPR/RC22.R18) , 1. 2
Long-term inter-country programme in the field of 'health laboratory· services (Document WPR/RC22/WP /19)
Dr PHOUTTHASAK (Laos), Rapporteur, explained that a modification had been made to the text of paragraph 4, namely that dhe words "some of the" be deleted and replaced by "REQUESTS the Regional Director to include the}lroposals 'itf:fheAdditional List of Projects in 1972 and 1973 and to implement them in accordance with the availability of funds". Decision: The draft resolution was adopted, as amended (see resolution WPR/RC22.R19). 1.3 Establishment of a technical advisory committee on nursing (Document WPR/RC22/WP/20) Decision: The draft resolution was adopted, without comment (see resolution WPR/RC22.R20). 1.4
Cholera (Resolution WPR/RC22.RIO adopted during the sixth meeting) (continued from the sixth meeting, section 1.1)
Dr THIEME (Western Samoa), referring to his earlier suggestion that a second resolution concerning cholera be drafted with a view to covering the special problems of the smaller countries in the Region in the case of an outbreak of the disease, said that in further discussions with the Secretariat he had realized that the assistance he had in mind was already covered by operative paragraph 5 of the resolution (WPR/RC22.RlO). He therefore wished to have lit placed on record that he no longer intended to present another resolution concerning cholera. Decision: The Committee took note that no further ~raft resolution on cholera would be submitted.
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STATEMENT BY THE REPRESENTATIVE OF THE UNITED NATIONS CHILDREN'S FUND: Item 22 of the Agenda (continued from the sixth meeting, section 2)
Mrs GAAN conveyed the greetings of the UNICEF Regional Director to the Chairman and the WHO Regional Director of the Western Pacific. Through UNICEF's activities in the field of health a strang association had been developed with WHO during a period of more than "wenty years. Health programmes accounted for more than 50% of the funds allocated by the UNICEF Executive Board. Emphasis on the various programmes had changed throughout this long association. Long-term programmes, based on sound national health planning, could now be submitted to the Board and the initiative of WHO in this field played an important role. The health aspects of population dynamics was of immediate interest. UNICEF's poli~y in this field was to ensure that at the same time as assistance was given to family planning programmes, health, education and welfare services would continue to receive attention. UNICEF was the only UnitE\d Nations agency with a direct mandate for the benefit of children and youth and was therefore concerned with every aspect affecting the child. New channels were being discovered through which influence an behalf of children and youth could be exerted. In the field of nutrition progress had been somewhat more limited. Malnutrition remained a threat of unknown proportions to children. It was difficult to reach the age groups most affected and when this was possible it involved the social welfare or education services rather than the health services. To attempt to combat malnutrition through these services involved high ~ capita cost operations which would not correct the basic cause malnutrition. Other means had to be sought and WHO had proved to be a most co-operative and interested partner in this fight against malnutrition. Co-operation with WHO, particularly in this region, was through a most cordial relationship whose fruitfulness was increasing yearly. On behalf of UNICEF and the Regional Director, she expressed appreciation and gratitude for the happy association. 3 TIME, PLACE AND DURATION OF THE TWENTY-THIRD AND TWENTY-FOURTH SESSIONS OF THE REGIONAL COMMITTEE: Item 25 of the Agenda (Document WPR/RC22/l6)
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Mr CRUZ (United States of America) said that his delegation had noted that no invitation had yet been extended for the session i.n 1972, although the New Zealand Government had invited the Committee to meet in Wellington in 1973. Accordingly, his delegation had begun to explore the possibility of extending an invitation to the Committee to hold its twenty-third session in Guam, the westernmost territory
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of the' "United 'States • That P'ossibility had now received a response both frbril' th:~ 'United States'Go'iernttientand· from theloclal Government. Before leaving from Guam, he had talked with the Goventor. the Honourable Carlos G. Camacho, who had been very receptive to the idea. As Dr,. Ehrlich had remarked, it was an honour and .a privilege for a country to have Ii, WHO meeting held cinits .territory. Manila housed the Regional Office and was the most appropriate place for meetings but he felt sure that representatives would be interested in visiting Guam and viewing the :health situation in that part oftihe Pacific. The GoverIUllent was prepare&to shoillder the additional expenses over and above the cost of holding the session at regional headquarters. For the time being, he'was extending an informal invitation pending confirmation from the Governor of Guam. but he was confident that' the formal invitation would be forthcoming later this 'year. The CHAIRMAN thanked the representative of the United States of America on behalf of the Committee for his proposal. Dr TAYLOR (New Zealand) pointed out that, if the formal invitation was not received by a certain date, possibly the Elnd of 1971, the session would have to be 'held in Manila. The Secretariat needed due warIling to make appropriate preparations. The REGIONAL DIRECTOR confirmed that considerable time was required to organize meetings away from Manila; as he had informed countries in the Region last year, the normal deadline 'was not later than 31 December 1971. Dr GATMAITAN (Philippines) said that his delegation wished to have recorded its thanks to the Representative of the United States of America for extending the invitation. Dr TAYLOR (New Zealand) drew attention to document WPR/RC22/16 which reproduced the invitation from the New Zealand Government to hold the session in 1973 in Wellington. The Government was willing to meet the increased costs of holding the session in New Zealand. The REGIONAL DIRECTOR proposed that, in both instances, the time of the session should be 'the month of September andthiljt the duration of each sessio~ shouid be eight working days as in the 'present session. '." I •
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Dr THIEME (Western Samoa) agreed with the Regional Director in principle but wished to avoid any clashing of dates with the South Pacific Commission, which was in fact meeting this year at the same time as the Regional Committee. It was necessary for him to attend the meetings of both organizations. The REGIONAL DIRECTOR said that sessions of all the Regional Committees of WHO were normally held towards the end of Septeaber. This was because of the cycle of work. All documents were sent to WHO Headquarters in Geneva where the global programme was prepared in December for the meeting of the Executive Board in January. He could enquire what dates had been set by the South Pacific Commission, but it was very important for the Regional Office that the session be held in September. The exact dates of the session were established by the Regional Director in consultation with the Chairman. As to 1973, the Prime Minister of New Zealand had specified that the meeting had to be held in September. Dr TAYLOR (New Zealand) confirmed that, since the session would probably be held in a University building, it must be held in Sept~mber, starting. if possible, at the end of August • •
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Dr KING (United States of America) also appealed for an avoidance of any overlapping dates with the meeting of the Regional Committee for the Americas. As the 1972 session was to be held in Guam. the United - States delegation was particularly involved. The REGIONAL DIRECTOR said that it was difficult to co-ordinate dates. A good deal depended on air line schedules. He would discuss the matter of possible dates for the session in Guam with the Chairman and inform all concerned at the earliest possible date. The CHAIRMAN asked the Rapporteurs to prepare appropriate resolutions. (For consideration of draft resolutions, see minutes of the tenth meeting, sections 1.2 and 1.3.)
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SELECTION OF TOPIC FOR THE TECHNICAL DISCUSSIONS DURING THE TWENTY-THIRD SESSION OF THE REGIONAL COMMITTEE: Item 23 of the Agenda (Document WPR!RC22!15)
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The REGIONAL DIRECTOR referred to document WPR!RC22/l5, which contained suggestions for topics for the technical discussions during the twenty-third session in 1972. It was for the Committee to decide whether to select one of the four topics suggested or to consider a topic that was not included in the document. A list was attached
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REGIONAL COMMIT'l'EE:
TWENTY -SECONDSESS ION
indicating the subjects chosen for dis.cussion during thei years from 1952 to 1971. Normally, when a session was held outside, the regional headquarters, a topic was selected by the Committee whic~ had particular relevance to the location of the meeting. For example, when the Committee had met at Wellington, New Zealand, some years ago, the topic selected had been dental health, since representatives had been able to get first-hand information in that particular field. Dr TRUONG-MINH-CAC (Viet-Nam) said that although the question of environmental pollution was fast becoming of importance Ito the Region, i t was a new problem and perhaps not one to be tackled ait present by the Regional Committee. It was to be thoroughly discussed next year at the United Nations Conference in Stockholm. The role of the national health services in family planning had been considered on several cases and i t did not seem necessary to discuss this again so soon. The epidemiology and prevention of accidents was an important subject but did not only concern the health services. A seminar with the participation of other disciplines would be a better forum. There remained the role of the hospital in the community, and his deleg~tion supported that as the subject for discussion in 1972. The subject' had not, so far as he knew, been discussed before, yet the problem was common to many countries in the Region. The discussion should help them to-orient their hospital services to the needs of the community. Dr THIEME (Western Samoa) supported the proposal of the Representative of Viet-Nam. In his country, hospitals absorbed 601 per cent. of the total health budget and anything that could be done Ito improve hospital services would enable some of that money to be diverted to other health services. Mr WATANABE (Japan) said that, at first. his delegation had favoured discussion of new. emergent problems such as pollution of the environment but as the Representative of Viet-Nam had pointed out, the time might not yet be ripe for such discussions, in the Western Pacific Region. Japan, Australia and New Zealan~ had done some work already regarding environmental pollution. In 1972 WHO was planning to appoint an air pollution consultant to make a survey in this region and in 1973 a seminar would help to make programmes more meaningful. As to family planning. the subject had been discussed in 1967 in China. Prevention of accidents was an interesting theme but it would be more of an-innovation to discuss the role of the hospital in the community. It was necessary to stress that medicine could play a curative as well as a preventive role. His: delegation supported the proposal of the Representative of Viet-Nam.
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SUMMARY RECORD OF THE NINTH MEETING
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Dr KING (United States of America) said that he was not opposed to the views expressed by the previous speakers but he felt that the environment was a fundamental challenge and of universal interest to man. In Guam, which was a small island with developing resources, particular attention had been given to the control of environmental pollution. Countries could learn from the experience of others in overcoming pollution, and thus avoid earlier mistakes.
The REGIONAL DIRECTOR suggested that it might be possible to arrange an educational tour during the weekend in Guam for the purpose of observing the environmental pollution control programme. If the subject were not chosen for discussion, representatives could nevertheless obtain some knowledge of that important and growing problem.
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Dr GATMAITAN (Philippines) said his delegation felt that priority should be given to the topic dealing with environmental pollution, as the United States representative had suggested.
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Dr TAYLOR (New Zealand) considered that there was a vast difference between observing a problem during a short study tour and thoroughly discussing it. Both subjects were of particular interest and either one could be handled during the session in New Zealand •
• \--. Dr FRANKLANDS (Australia) drew attention to the fact that technical discussions involving environmental health had been held in 1962 and 1966 and, although conditions had improved since then, the problem of the environment was of vital importance in developed as well as in developing countries. Some of the developed countries in the Region might have systems for controlling pollution but they had certainly not overcome the problem. The less developed countries were just beginning to see the urgency of the need to take action against the growing menace of pollution. As to the role of the hospital in the community, it seemed to him that a hospital was looked on as a necessity, but more stress should be laid on keeping people out of hospitals than on buidling ever larger hospitals. Diseases should be controlled by preventive measures in health centres, which were more appropriate nowadays than were hospitals for dispensing health services. He therefore advocated the selection of the topic concerning the control of environmental pollution problems.
The CHAIRMAN invited representatives to express their preference by a show of hands.
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REGIONAL COMMITTEE:
TWENTY -SECOND SESSION
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Decision: The topic selected for the technical discussions during the twenty-third session of the Regional Committee was "Environmental Pollution Problems and Approach to Their Control in the Western Pacific Region". The CHAIRMAN invited the Rapporteurs to prepare an appropriate draft resolution. (For consideration of draft resolution, see minutes of the tenth meeting, section 1.1.)
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CONSIDERATION OF THE REPORT PRESENTED BY THE SUB-COMMITTEE ON PROGRAMME AND BUDGET: Item 8.2 of the Agenda (Document WPR/RC22/18) Decision:. The report presented by the Sub-Committee on Programme and Budget was adopted. The Committee considered the following draft reso1~tions: !
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Budget performance 1970 - Direct services to governments (Document WPR/RC22/P&B/WP/l) Decision: The draft resolution was adopted, withoult comment (see resolution WPR/RC22.R21).
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Modifications made to the 1971 and 1972 programme apd budget estimates (Document WPR/RC22/P&B/WP/2) Decision: The draft resolution was adopted, without comment (see resolution WPR/RC22.R22).
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Proposed programme and budget estimates for 1973 (Document WPR/RC22/P&B/WP/3)
Dr KING (United States of America) said that his delegation would abstain from voting on this resolution. The budget increase of 9.7% over that of 1972 would be more than his Government would be willing to support on a world-wide basis. While the extent of and continuing upward trend. in budgets was recognized, it was felt that such a trend should reflect local economic growth. The 9.7% level was in the opinion of his delegation higher than the economic growth rate of the average country in the Western Pacific Region. It would also seem appropriate to mention that careful consideration must be given to the capacity of
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countries to absorb increased inputs and also of the Regional Office to programme such inputs. An input of too high a level created a very real risk of inappropriate or inefficient utilization of funds. It was recognized that a reduction in the budget of the Western Pacific Region would not necessarily produce world_ide savings. The setting of the overall budget of WHO by the World Health Assembly would mean that reductions proposed by the Western Pacific Region could possibly be passed on to other projects or to other regions. Decision: The draft resolution was adopted with two abstentions: the United Kingdom and the United States of America (see resolution WPR/RC22.R23). 5.4 Tentative projection for 1974 (Document WPR/RC22/P&B/WP/4) Decision: The draft resolution was adopted. without comment (see resolution WPR/RC22.R24). 6 CONSIDERATION OF THE REPORT PRESENTED BY THE CHAIRMAN OF THE 'TECHNICAL DISCUSSIONS: Item 24 of the Agenda (Document WPR/RC22/TD7 and Corr.l)
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Dr CHEN (China). Chairman of the Technical Discussions. presented the report of the Technical Discussions on "Health Manpower in the _ Developing Countries: Problems and Needs" (WPR/RC22/TD7). He drew attention to two corrections in the document which were incorporated in document WPR/RC22/TD7 Corr.l. He regretted the omission of Dr C.N. Derek Taylor's name as General Rapporteur. The CHAIRMAN thanked Dr Chen. the Officers of the Technical Discussion Groups and the Rapporteur for their work. 7 ANNOUNCEMENT BY THE REGIONAL DIRECTOR
The REGIONAL DIRECTOR said that he had invited the Governments of Tonga and Fiji to send observers to the twenty-second session. Neither Government was a Member of WHO. He was pleased to inform the Committee that the Government of Fiji had replied. saying that although it was not possible to send an observer to the present session.Fiji hoped to attain full membership of WHO in 1972 •
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The meeting rose at 4.20 p.m •
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