(WP/RCI4/Min/4 Rev.l)
MINUTES OF THE FOURTH MEETlNG
Legislative Council Chambers MOnday, 9 September 1963 at 5.10 p.m. CHAIRMAN: Dr R.F.R. Scragg
CONTENTS 1.
Time, place and duration of the fifteenth and sixteenth sessions of the Regional Committee Other business ............................................
144 144 146 146
2.
3.
Consideration of draft resolutions .•••••••.•..••••••••.••. 3.1 Annual Report of the Regional Director (continued) ......................................... lOlru. . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cholera. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.2 3.3 3.4 4.
146 147 151 152 155
Education and training •...•••..••••..•••••..•••••••.
Consideration of the report presented by the Sub-Committee on Programme and Budget ••••••••••.•••••••••• Draft resolution on cholera (resumed) •.••.••••..••••••••••
5.
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l42
REGIONAL COMMITTEE: FOURTEENTH SESSION
• Fourth Meeting MOnday, 9 September 1963 at 5.10 p.m. PRESENT
I.
Representatives of Member States AUSTRALIA Dr R.F.R. Scragg Dr C. Haszler Dr Kila Wari Dr Himson Mllas Dr H.E. Downes Dr
CHJNA FRANCE JAPAN
Dr C.K. Chang T.C. Hsu Dr A. Ferron
Dr E. Wa.kamatsu Dr J. Ohmura Mr Y. Matsuda Dr K. Hamano Dr Suk Woo Yun
KOREA MALAYA
Dato Dr Mohamed Din bin Ahmad Dr Raji Abbas bin Haji Alias Dr D. P. Kennedy Dr L. Uyguanco Dr F.T. Diy Dr E. L. Villegas Dr A.R. Pinto Dr C.H. Gurd Dr R. Dickie Dr C.H. James Watt Dr R.K.C. lee Dr Saipele Matagi Dr J.
NEW ZEALAND PHILIPPINES
PORTUGAL UNITED KINGDOM
UNITED STATES OF AMERICA
VIET-NAM
Dr Le-Cuu-Truong Dr J.C. Thieme ,.-
WESTERN SAMOA
MINUTES OF THE FOURrH MEETING
143
II.
Representatives of other inter-governmental organizations and of non-governmental organizations
INTERNATIONAL ASSOCIATION FOR THE PREVENTION OF BLINDNESS INTERNATIONAL COUNCIL OF NURSES DlTERNATIONAL DENTAL FEDERATION LEAGUE OF RED CROSS SOCIEn'IES
Dr
J.J. Loschdorfer
Miss V. Bignold Mr:' T.E. Hubble
Mr H. Buchanan
III.
WHO Secretariat Dr I.C. Fang Regional Director
SECREn'ARY
144
REGIONAL COMMI'l'TEE: FOURTEENTH SESSION
1.
TIME, PLACE AND DURATION OF THE FIF'l'EENTH AND SIXTEENTH SESSIONS OF THE REGIONAL COMMITTEE: Item 18 of the Agenda The REGIONAL DIRECTOR stated that, unless the Committee decided
,
otherwise, the fifteenth session would be held in Manila, in accordance with the past procedure that every second year the meeting would be held at regional headquarters. The COmmittee, at its twelfth session,
had accepted the invitation of the Government of the Republic of Korea
to hold its sixteenth session in Seoul, Korea. It was so agreed.
2.
OTHER BUSINESS: Item 19 of the Agenda. (continued from the third meeting, section 7) The CHAIRMAN said that two questions had been previously raised:
population problems and genetic profiles in developing areas. Dr YUN (Korea) stated that the question of population problems, particularly those related to maternal and child health, had been taken up earlier. At that t~
he had proposed that this point should be
covered in the resolution on the Annual Report of the Regional Director, but in subsequent discussions it had been agreed that it should be taken up separately.
After some private discussions, he thought that the
y-
matter would be better considered at the next meeting of the Regional Committee so that a more detailed study could be made, thereby making the discussions more fruitful. Dr GURD (United Kingdom) agreed that the discussion on population
p'roblems ,should be deferred until some subsequent occasion as it was a delicate problem and the difficulties faced by WHO in this connection
MINUTES OF THE FOURTH MEETING
were understandable.
Nevertheless, he supported the proposal that WHO
•
should enter this field, when it could see its way to do so, because the question of population growth exceeding economic growth was one of the major problems encountered by many countries in the area, including Fiji. Dr WATT (United States of America) associated himself with the views expressed by the previous speaker. This was a very important
subject, one which should be discussed in detail with adequate time for effective study before the meeting. His Government was very
interested in this matter and at the last World Health Assembly it had made a voluntary contribution to WHO to start research work on human population stUdies. He agreed that the proposal represented an
important agenda item for future consideration. The CHAIRMAN suggested that, if it was the feeling of the Committee that this subject should be placed on the agenda for the next meeting, a resolution to this effect might be prepared.
Dr WATT stated that a formal resolution was not needed at the present time. Details could be worked out by the Regional Director,
if necessary with M:mber governments, between now and the next meeting. Dr YUN agreed with the representative of the United States of America and added that between now and the next meeting his Government would study the question further and consult the Regional Director and other M:mber countries, if required.
.'4.
146
REGIONAL COMMITTEE: FOURTEENTH SESSION
Regarding the question of genetics, Dr WATr said that he did not think there was any need for further discussion apart from the consideration of a resolution. (For adoption of resolution, see minutes of the
fifth meeting, section 1.)
3. 3.1
CONSIDERATION OF DRAFT RESOLUTIONS
Re onal Director (Draft resolution continued from the third meeting, section 7) The draft resolution was read by Dr UYGUANCO (Philippines),
Rapporteur • Dr VILLEGAS (Philippines) asked that the fourth line of sub .. . paragraph 4(2) be amended to read "advisory services enabling them to plan, improve and expand". Decision: There being no other comments, the draft resolution, as amended, was adopted (see resolution WP/RC14.Rl).·
..
3.2
Kuru (Draft resolution WP/RC14/wp/3) (continued from the third meeting, section 2) The draft resolution was read by Dr UYGUANCO (Philippines),
Rapporteur • Dr TRUONG (Viet-Nam) asked 'Whether the spelling of the wrd ''kuru'' in French should be either "kourou" or 't.kuru". The CHAIRMAN explained that the word ''kuru'' was the phonetic spelling in pidgin English and in the local language. It had been requested that
this disease should be listed in the International Causes of Death and this was the spelling used.
MINUTES OF TID] FOURTH MEETING
147
Decision: The draft resolution was adopted (see resolution WP!RC14.R2) •
3·3
Cholera (Draft resolution WP/RC14/wp/4) (continued from the third. meeting, section 4) Dr UYGUANCO (Philippines), Rapporteur, read the draft resolution.
Dr KENNEDY (New Zealand) stated that, although he was in entire sympathy with the principles enunciated, he felt that paragraph 3(1) had perhaps gone inadvertently a little far.
It was realized, of
course, that the resolution was directed at the south-west Pacific, but this was rather a large area and there was a lot of shipping exclusively between cholera-free areas. meant all the ships in the area. As worded, the paragraph
There was, for example, a great
deal of shipping between Australia and New Zealand, for which cholera certificates were not required, and it was for this reason that he felt the resolution could possibly be improved by some wording along the follOwing lines: II. • • •
all personnel in ships not sailing He appreciated the intention
exclusively between cholera-free areas".
of the resolution that it was to catch ships that were not initially sailing to cholera-areas but diverted to a cholera area. , ;.r.
Dr WATT (United St9.tes of .America) called the Committee's attention to an oversight. In the discussions held earlier, mention had been
made of the importance of collaboration between the Directors of the •
WHO Regional Offices for the Western Pacific and South-East Asia Regions. He wished to suggest that the Eastern Mediterranean Region
should be included, since Pakistan was an important part of that region and was an area which should be involved.
148
REGIONAL COMMITTEE: FOURTEENTH SESSION
The CHAIRMAN referred to paragraph 3(1) which stated that all
personnel in ships should be provided with valid international certificates of vaccination. should be vaccinated. replaced to read: He assumed that this implied that they
He suggested that the statement should be
"all personnel in ships should receive adequate
vaccination against cholera." Dr WATT did not think that certificates would be issued if the
personnel had not been properly vaccinated. The CHAIRMAN mentioned that there had been cases of transmission
of smallpox by persons not vaccinated but possessing certificates. Dr KENNEDY hoped that the reference to valid international
certificates of vaccination was not directed at the provisions of the International Sanitary Regulations. Dr GURD (United Kingdom) commented that the point raised by the
representative of New Zealand was important and he believed that the text should be carefully worded.
The CHAIRMAN suggested that the paragraph should be rephrased
as follows:
"all personnel in ships originating or passing through
r
cholera areas should receive adequate vaccination against cholera." Dr WATT understood that the problem was that people came into ports from areas where there was cholera, with no knowledge, or evidence of knowledge, of the international quarantine regulations, and the purpose of bringing it up had been to draw attention to the importance of the regulations and the necessity of vessels on coastal
MINUTES OF THE FOURTH MEEl'ING
149
trade complying with them.
He recalled that the Australian delegation
had raised this question and it might wish to make some comments.
Dr DOWNES (Austral.ia) stated that his delegation I s purpose was
to point out the necessity of complying with the International. Sanitary Regulations. Australian legislation required all persons
arriving in Australia by air from any proclaimed place to have a valid cholera vaccination, and this involved not only the two traditional sources of cholera, namely India and Pakistan, but all places in South~
East Asia and the Western Pacific that had had cholera in the last two years. The REGIONAL DIRECTOR stated that it was a matter of routine
that the persons
~n
all ships on an international route should be The question that had
vaccinated and given vaccination certificates.
been raised was that some of the ships which were fisJUng in the open sea and had no intention of calling anywhere, had sometimes been forced into a port because of poor weather. were detained. As they had no certificates, they
Paragraph 3(1) did not appear to apply to the situation
that had been raised. Dr GURD endorsed the united States of America. appro~h
taken by the representative of the
The international regulations were valid and In the case of fishing boats that
provided protection in most places.
entered ports due to storm, these would be given quarantine and treated as special cases. If they entered territorial water illegally, then
diplomatic channels would cover those cases.
150
REGIOOAL COMMITl'EE: FOURTEENTH SmSION
, Dr HASZLER (Australia) said that when the matter had been brought
up he had been thinking of small ships outside of the international route going closely between countries and accidentally entering ports either due to sickness or a breakdown. There had been no intention of
entering foreign ports and the ships 'Were not on on international route. The CHAIRMAN stated that one point that had not been mentioned in connection with this problem was that many countries had outlying ",'
islands.
These ships could easily reach these islands without their
p;esence being known and bring disease which might spread throughout the country. Since the presence of the ships was not known, it would
not be possible to make representations through diplomatic channels. Dr WATI' said that he understood the problem, but he was at a loss to know how to deal with it without getting the Committee involved in a complicated matter. The only controls were the country of origin
of such ships and. the international quarantine regulations that existed. Wherever a ship had been guilty of violation, this fact should be reported to the country of origin and the appropriate remedial action should be taken by that country. Dr TRUONG (Viet-Nam) wondered whether the draft resolution could ( -1-
specify that all personnel in ships going to sea, whatever their destination, should be provided with valid mternational certificates of vaccination. The REGIONAL DIRECTOR suggested that the matter might be referred to the Committee on International Quarantine. AJ3 stated by the
representative of the United Kingdom, this was a rather complicated matter and a legal mind was required to formulate an appropriate text.
MINUTES OF THE FOURTH MEETING
151
The CHAIRMAN presented to the Committee the suggestion that the question of adequate vaccination of personnel on fishing and other ships occasionally moving from country to country should be referred to the Committee on International Quarantine. Dr WATT felt that this was a problem for which the Regional Committee itself could devise an appropriate oolution. He believed
that bringing this problem to the attention of the Regional Director was sufficient, as he would know what to do and it was up to him to determine the action to be taken thereafter. Dr GURD suggested that the resolution should be redrafted accordingly. Decision: There being no objection, the draft resolution was referred to the Secretariat for redrafting. (For adoption of resolution, see section 5 belOW.)
3.4
Education and training (Draft resolution WP/RC14/wp/5) (continued fram the third meeting, section 3) Dr FERRON (France), Rapporteur, read draft resolution WP/RC14/wp/5
to the Committee. Dr KENNEDY (New Zealand) proposed that the last paragraph should be reworded as follows: "RECOMMENDS that efforts should be made
by
governments to encourage refresher courses, in-service training programmes and ensure facilities for continuation studies for health workers. " Decision: The draft resolution, as amended, was adopted unanimously (see resolution WP/RCl4.R4).
152
REGIONAL COMMITTEE: FOURTEENTH SESSION
• 4. CONSIDERATION OF THE REFORI' PRESENTED BY THE SUB-COMMITTEE ON
PROGRAMME AND BUDGET: Item 8.2 of the Agenda. (Document WP/RC14/ll Rev.l) (continued from the first meeting, section 8) The CHAIRMAN presented the draft report and invited comments.
Section 1.
Introduction (pages 1-2)
..,.'
The CHAIRMAN noted that the names of three representatives of
Australia who had attended the meeting had not been recorded. Section 3.1. 6 Papua and New Guinea (page 8)
The CHAIRMAN asked that the last sentence should be corrected to
read "in or after 1965 all fellowships except that in surgery in 1965, with particular emphasis on leprosy, were for national. personnel. " Draft resolution WP/RC14/wp/4 The CHAIRMAN presented draft resolution WP/Rc14/wp/4 on the
proposed. programme and budget estimates for 1965. Dr FERRON (France) stated that during the Technical Discussions on leprosy, several countries had expressed the opinion that it would be valuable to have frequent meetings on this subject. He enquired
...
~
whether it would be possible to include a leprosy seminar in the list of inter-country group educational activities in 1965. The REGIONAL DIRECTOR stated that the allocation received from the
Director-General had been fully utilized, and much as. he would like to implement the proposed project, this could only be done if the members of the Committee were willing to delete one of the six seminars listed in the draft resolution.
MINUI'ES OF THE FOURTH MEETING
153
Dr WATT (United states of America) thought that a conference on leprosy as a continuing activity might be more important than a conference on radiation. In many countries in the Region, radiation was a problem
of relatively small consequence compared to leprosy.
The leprosy
seminar might, therefore, be inserted instead of the conference on radiation. Dr KENNEDY (New Zealand) stated that although the subject of
protection against ionizing radiation was of considerable interest to his country, which had no leprosy, he would be happy to support the proposal that a seminar, which had a far greater significance in the Region, should replace the conference on radiation. Dr TRUONG (Viet-Nam) supported the proposal of the representative of the United states of America. He suggested further that if funds
were available, the conference on radiation should be held the follOwing year. Dr YUN (Korea) also supported the above proposal. It was so agreed. Dr WATT referred to paragraph I.l which endorsed the proposed
programme and asked for clarification as to what commitment was involved in the word "endorses". There was mention in the report of the Sub-
Committee that there were questions as to how the proposed budget fitted into the total overall budget of the Organization. He felt that
the budget should be reviewed in relation to those of the other regions. His Government was agreed that the programme was a sound one and cOlJl)limented the Regional Director on the development of a well-balanced
154
ROOICUAL CaooTTEE: FOURTEENTH SESSION
progrEllllll2.
It was not prepared, however, to endorse unequivocably the
8.111)unt of money requested, as this had to be reviewed in relation to the projects submitted by other regions and by the Director-General. himself. It might be found that the total. had to be adjusted and that
certain activities might not appear so high on the priority list when reviewed against the other proposals. He wished, therefore, to request
the Regional Director to interpret the word "endorses" with a view to determining how strong the commitments were.
The REGIONAL DIRECTOR referred to Annex 1 on page 13 of the report which listed the questions to be answered by the Sub-Committee in drawing its conclusions. Endorsement did not, in any way, mean that governments
were committed to make the contributions which the budget called for. The representative of the United states of America, besides being a
member of the Regional COmmittee, was also a member of the Executive Board and. was, therefore, worried about the Western Pacific Region receiving a 20 per cent increase. As he had previously stated, this was an unusual situation. When the African Region had. started, it had As time
,
had a much sma.l.ler budget than the Western Pacific Region.
-
went on, as a result of the increasing number of independent countries in that region, its budget had been greatly increased. On
a number of
occasions he had drawn the Director-General' s attention to the fact that the Western Pacific Region had been neglected and. in 1965 an increase had been received. Dr WATT asked if it would be possible to amend the statement to
''RECOMMENDS that the proposed programnM:l under the regular budget and those proposed to be financed from the MUs.ria Eradication Special Account and the Special Account (or the Community Water Supply
.
/
---
MINUTES OF THE FOURTH MEEn'ING
155
Programme be forwarded to the Director-General".
In other words I the
Committee should merely recommend that the Regional Director should transmit the budget to the Director-General. The CHAIRMAN, having referred to the resolution passed on the f ":';,:
same subject at the thirteenth session of the Regional Committee, said that this was apparently the standard phraseology used. Decision: There being no other comments, the draft resolution was approved (see resolution WP/RC14.R3).
5·
DRAFT RESOLUTION ON CHOLERA (Draft resolution WP/RC14/wp/3 Rev.l) (resumed from section 3.3 above) The CHAIRMAN read the amended paragraphs 3(1) I (2) and (3) and
asked for comments. Dr WATT (United states of .America) stated that he was a little concerned about the suggestion that the Regional Committee should refer
.-
..
the problem to the Committee on International Quarantine, with which the Regional Committee had no direct relationship. He would be more
comfortable if this were left in the capable hands of the Regional Director for appropriate action. This amendment was approved. Dr TRUONG (Viet-Nam) suggested that all crews of deep-sea fishing vessels, irrespective of their destination, should be in possession of a valid international certificate of vaccination. The CHAIRMAN stated that this point had been covered by the New Zealand representative. He wondered whether there was any further
REGIONAL COz.t4I'PrEE: FOURl'EENTH SESSION
, need to revise the paragraph again or whether it was now adequate. Dr TRUONG said he had suggested the above a.men~nt
because he
felt that, generally speaking, all personnel in ships undertaking international voyages should have a valid international certificate of vaccination. It was felt that fishing vessels, which did not actually
intend to sail to another country, should also come under this rule. The REGIONAL DIRECTOR said that what the Committee was actually
concerned about were casual visits of fishing boats which, because of engine trouble or natural calamities, were forced to call at ports and were detained. Dr TRUONG stated that, in view of the circumstances, he would agree with the resolution. Decision: The draft resolution was adopted (see resolution WP!RCl4.R5) .
The meeting adjourned at
6.25 p.m.