WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
•
ORGANISATION MONDIAL£ DE LA SANTE
REGIONAL
CO~1ITTEE
Seventh Session Manila 7-13 September 1956
WP/RC7/21 9 September 1956 ORIGINAL: ENGLISH
DRAFT FJRST REPORT OF THE SUB-COMMITTEE ON
PROGRAMME AND BUDGET
The Sub-committee on
Prograw~e
and Budget, composed of represen-
tatives from Australia, France, Korea, Laos, Portugal and the United states, held its first meeting at 2:30 p.m., Friday, 7 September 1956, under the chairmanship of Dr. J. Bierdrager (Netherlands). 1
OPENING OF THE MEET:rnG BY CHAIRMAN OF REGIONAL COMMITTEE
The Sub-committee had before it documents WP/RC7/4, WP/RC7/5 (Parts I and II) and WP/RC7/5 !dd.l, as ",ell as certain working papers presenting analyses of the proposed progranme and budget estimates. papers appear as Annexes I-V of this report. The Sub-committee considered the questions referred to it by the Regional Committee under the followings: 2 2.1 RIDULAR FUNDS Modifications in the Basic and Supplementary Programmes and Budget for 1957 (WPjiC7!4) In reply to a query as to the difference between the Supplemental Programme and Supplementary List of Projects, the Secretary informed the Those working
WP/RC7/21 Page 2 Sub-committee that: (a) The Supplemental Programme could be implemented to the extent to which inactive members notify the DirectorGeneral that they will resume active participation in the work of the Organization. (b) The Supplementary List was, in effect, a third category. No funds were foreseen as available to finance those projects, except such savings as might accrue during the programme operation year. The Secretary provided an explanation in respect of the reduction to the 1957 programme and budget as approved by the Sixth Regional Commit tee. The programme and budget estimates had been submitted to
the Director-General for inclusion in his proposed programme and budget estimates for 1957. However, the Ninth World Health Assembly had, un~741,660
fortunately, only authorized an increase of requested increase of some ~1,239,OOO.
instead of the
Consequently, the programme and
budget for the Western Pacific Region, as well as for all regions, had to be proportionately reduced. amounted to ~151,JJO.
The reduction applied to this region
The Sub-committee requested information on how the reduction to the tentative programme and budget had been effected. that the reduction had been accommodated as follows: Projects not implemented because governments withdrew request Relegated to Supplemental Programme and Supplementary List $77,000 67,000 It was reported
WP/RC7/21 Page 3 Financed from savings, TA and Regular 13,000 $157,000 The difference between this figure and the ~151,000'is
absorbed
in plus and minus adjustments to the estimated costs of existing projects. It was pointed out by a member of the Sub-committee that whilst a total reduction in the estimates had been effected, there were also increases apparent in certain activities; for example, the estimates for the Regional Office had been amended from approximately $253,000 to approximately :D02,000; malaria from :,;>18,000 to tion from ~64,000. ~23,000 ~21,OOO;
health educa-
to
~25,000;
environmental sanitation from $41,000 to
A query was raised by one member of the Sub-committee concerning the increased provision under environmental sanitation in the revised progranme and budget for the year 1957. The Secretary referred the Sub-committee to resolution WP/RC6.R8 which states, inter alia: "Recommends that all Member Countries, parti-
cularly in developing countries, give priority to both short- and longterm planning in environmental sanitation in their annual programmes and budgets in public health". The Secretary further stressed the value derived by Member Countries as a result of composting activities at present in operation. In considering WPRO 53, Seminar on Veterinary Health, the Subccmmittee was aware of the increased importcn ce attached to virus diseases carried by animals as a public-health problem. In view of
WP/RC?/21 Page 4
the additional irf ormation required in connection with virus-borne diseases, and taking into consideration information already collected from research centres in the Region, it was considered that WHO should arrange an inter-regional conference to study insect-borne virus diseases. It was noted that, in view of the reduction in the 1957 programme and budget, only a small study group on this subject could be provided. On the other hand, certain reductions had also been noted; for example, public-health administration had been reduced from approximately ~238,OOO
to approximately ;;P136,OOO.
The Secretary explained that these differences in the field activities resulted from modifications in the requests of governments since the Regional Committee had approved the programme last year. It was
usual for governments to make such changes and these modifications had been accommodated within the revised ceiling. The Sub-committ8e also noted that in so far as assistance in the field of nutrition was concerned, whilst the need was still felt, it had not been accorded sufficient importance to justify its inclusion in the reduced allocation. Nevertheless, some provision had been made for this Progra~~e.
activity in the Supplemental DECISION:
The Sub-committee agreed to recommend to the Regional
Committee that it adopt the draft resolution numbered WP/RC?RJ.
WP/RC7/21 Page 5 2.2 Basic and Supplemental Programme and Budget Estimates for 1958 (WP!RC7!5 Part I, and Annexes I and II to this report) It was noted that the costs in respect of the Singapore Epidemiological Intelligence Station were included in the total regional office estimate. This had been accomplished by means of transfer of funds, pre-
viously appropriated for that purpose to Headquarters Central Technical Services, to the regional office estimates. The Sub-committee took cognizance of the merger of the Epidemiological Intelligence Station with the Regional Office, appreciatirg that the Chief Medical Officer of that Station was able, in addition to his duties connected with the Epidemiological Intelligence Station, to carry out the role of an area representative at a very small additional cost to the regional allocation. General observations were made by various representatives concerning percentage increases proposed for 1958 in major subject headings, with the exception of three, as compared to 1957. The considered opinion
of the Sub-committee was that every effort should be made to achieve equitable distribution of funds, even though the programme is based on the governments' requests. It was recommended that a more equitable distribution of funds among major subject headings might be arrived at i f the Regional Director were to assure that during programme-planning discussions, the matter was called to the attention of governments. Specific note was taken of the fact that the provision for antimalaria~tivities
had not increased, despite the emphasis placed on
WP/RC7/;'1 Page 6 malaria eradication by the World Health Pssembly. This was, however, off-
set by the establishment of a Halaria Eradication Special P.ccount from which it was hoped that many malaria activities could be financed. Even
without the use of this separate account, the planned programme of antimalaria work in 1958, from all funds, is slightly greater than that for 1957. The Sub-committee noted that, with the exception of cost of living adjustments, the cost estimates for personnel, i~luding
statutory entitle-
ments, were uniform throughout the Orgmization.
Cost of living adjust-
ments were made on the basis of cost of living surveys carried out by the United Nations for all affiliated agencies. The Sub-committee noted that the Regional Office comprised two branches of administration, one, Administration and Finance, the other, Bureau of Health Services. Under the jurisdiction of the Director of
Health Services are two public-health administrators who co-ordinate the activities of countries in the Region. The public-health administrators At present,
are assisted in this duty by the area representatives.
there are three area representatives, one stationed in Sydney covering the South Pacific territories, Australia and New Zealand; one stationed in Singapore, covering Brunei, Halaya, North Borneo, Sarawak and Singapore; and one stationed in Saigon, covering Cambodia, Laos and Vietnam. Sub-committee further noted that, subject to availability of funds, a fourth area representative 1rlOuld be appointed to cover China, Japan and Korea. These area representatives are the Regional Director's The
representatives, and are technically responsible to the Bureau of Health
WP/RC7/21 Page 7 Services. The appointment of area representatives enabled public-health
administrators to devote more of their time to co-ordination of health activities at the regional level. Individual discussions took place on the compore nt parts of certain projects. Attention was drawn to the use of health personnel as quasiIt was agreed that in certain cases
administrative officers in projects.
such staff were an essential part of the team, particularly where health administrations could not supply staff to carry out such functions. was noted that the administrative officer on the yaws control project intho South Pacific Islands '-las, in fact, a qualified male nurse with considerable administrative experience in field campaigns. The Sub-committee considered that seminars-, ccnferences and study tours, should be planned very carefully and that the governments concerned should be made a1-lare of tho health problems to be discussed well in advance. It was pointed out that administrative arrangements for such It
projects required considerable planning, and discussiom on all aspects of such projects normally take place between the Regional Director and the governments directly concerned. It was recommonded by the Sub-
committee that the manner in which such study tours, etc., are planned, be left to the Regional Director to arrange in a satisfactory manner. DECISION: The Sub-committee agreed to recommend to the Regional
Committee that it adopt the resolution numbered WP!RC7.R4.
3
TEC HNICAL ASSI.sTANCE PROGRAlI]t'lE The Sub-committeo noted that Part II of WP/RC7/5 had been circula-
ted at a late date because of the procedure laid down by the Technical Assistance Board in accordance with ECOSOC Resolution No. 542 (IVIII) •. Further,
!tIP IRC? 121
Page 8 the Sub-committee noted that the Technical Assistance Committee, through the Technical Assistance Board, established annually a planning target figure for each individual government, that the departments within the f'overnment then submitted reqaired programmes for implementation under Technical Assistance funds to the governmental co-ordinating body; which established priori ties for the annual TA programmes in the country. The
priorities accorded to various projects by a government were the deciding factor as to which projects were included in category I and Category II. When approved by the governments, the total country programme is submitted to the Technical Lssistan ce Board through the resident representative of the Board, with copies to the organizations participating in the Technical Assistance programme. The Sub-committee understood that,
prior to the submission of project proposals, liaison takes place between the Organization and the appropriate government authority, at wh:ic h.. tine planning of rcquirerrlents, together with costings of elEments, are worked out. It uas further appreciated tha t such a system involved a
long process and that until the different co-ordinating bodies become accustomed to this procedure, the document for the Regional Committee would not be available in sufficient time for a thorough study to be made by representatives of Member Governments prior to the Regional Committee meeting. Whereas it was noted that the Regional Committee had adopted guiding principles in planning the use of funds oode available to governments from different sources, it was considered that these principles
WP/RC7/21 Page 9 were described in general terms and that these should be reconsidered. The Sub-committee noted that other regions had conducted seminars on quarantine and considered that, subject to the availability of funds, the proposed quarantine seminar should be held. The seminar would not
deal with legislative aspects of the matter, but with techniques required under various circumstances. It was further noted that the Technical Assistance Committee had decided that 10% of the planning target figure established by the Technical Assistance Board for 1957 could be devoted to regional (or intercountry) projects. governments. It was appreciated that neither the Regional Committee nor the Regional Office could determine priorities for technical assistance programme activities. DECISION: The decision rested with the government concerned. Such projects are normally planned with two or more
The Sub-committee agreed to recommend to the Regional
Committee that it adopt the draft resolution numbered WP/RC7.n,.
4
SUPPLEMENTARY LIST OF PROJECTS
=
The Sub-committee noted that the activities contained in the Supplementary List of Projects could be implemented only as savings arise during 1957 or 1958. A considerable number of inter-country programme activities
appear in the Supplementary List in accordance with the wish expressed by the Committee at an earlier session (WP/RC4/R4 and WP!RC5.R6) that more projects of interest to more than one country be developed. Some
WP/RC7/21 Page 10 ~embers
of the Sub-committee expressed the fear that short-term study tours The Sub-committee was assured that, should
might develop into" junkets".
savings become available to finance any of the projects in the Supplementary List, the Regional Director will consider very carefully which projects should be implemented. DECISICN: The Sub-committee agreed to recommend to the Regional
Committee that it adopt the draft resolution numbered WP/RC7.R6. 5 PROCEDURE FOR THE CONSIDERATION OF PROGRAMME AND BUDGET ESTIMATES AT FUTURE REGIONAL COHMITTEE MEETINGS
The Sub-committee noted the ad hoc manner in which the Sub-committee on Progr~e
and Budget had been established at this, as at the last, session,
although the Regional Committee seemed to feel the work of the Sub-committee was useful. It was therefore decided to propose to the Regional Com-
mittee that it adopt a resolution (WPIRC7.R7) establishing the procedure for the future. The Chairman and the Sub-committee wish to record thoir appreciation of the manner in which the documents were prepared.
WP/RC7/F&B/Working Paper 2 Annex I ANALYSIS OF PROPOSED PROORAMME AND COST ESTIV1A.TES REGULAR FUNDS (FIELD ACTIVITIES) - BASIC 1957 $ 1958 $
4,500 4,5 00 Regional Committee Meeting costs (Appropriation section 3) * 268,430 254,430 Regional Office Costs (Appropriation section 6) 47,788 48,268 Epidemiological Intelligence Station - Singapore 668,846 55 6 ,481 Field Activities (Appropriation section 5) * Excludes estimated costs of ~3,000 to be borne by Hong Kong Goverrnnent. SUMMARY OF FIELD ACTIVITIES 1 9 5 7 Continuing Field Tot a 1 Activities New Projects
-- -
-%
'II'
<!1.
% 3.77 8.34 12.14 21.17 13.72 4.55 3.43 0.81 11.50 7.60 87.03
$
% 2.27 0.90 3.28 0.98 3.65 1.89
$
Malaria Tuberculosis Venereal diseases & treponematoses Endemo-epidemic diseases Public health administration Nursing Health education of the public Maternal and child health Hental health Environmental sanitation Other projects Total
20,999 46,403 67,568 117,796 76,326 25,334 19,093 4,500 63,998 42 z28 5 484,302
12,629 5,000 18,250 5,500 20,300 10,500
72,179 12.97 1 9 5 8
20,999 3.77 46,403 8.34 80,197 14.41 5,000 0.90 136,046 24.45 81,826 14.70 25,334 4.55 7.08 39,393 15,000 2.70 63,998 11.50 7.60 42,2 28 5 556,481 100.00
---2.00 22,458 3.36 64,563 9.65 91,153 13.63 158,056 23.63 77,157 11.54 31,586 4.72 65,714 9.83 25,540 3.82 57,378 8.58 75,,241 11.24 668,846 100.00
Malaria Tuberculosis Venereal diseases & treponematoses Public health administration Nursing Health education of the public Maternal and child health Mental health Environmental sanitation other projects Total
22,458 51,163 91,153 158,056 77,157 21,086 31,104 25,540 57,378 51,941. 587,036
3.36 7.65 13.63 23.63 11.54 3.15 4.65 3.82 8.58 7.76 87.77
13,400
10,500 34,610
1.57 5.18
23,300 3.48 81,810 12.23
WP/RC7/B&B/Wbrking Paper 3 Annex II MJALYSIS OF PROPOSED PROGRAMME AND COST ESTIMATES REGULAR FUNDS (FIELD ACTIVITIES) SUPPLEMENTAL SUMMARY" OF FIELD ACTIVITIES 1 9 57 Expansion of Existing Projects New Projects $ % $ % Malaria Tuberculosis Venereal diseases and treponematoses Endemo-epidemic diseases Public health administration Nursing Maternal and child health Mental health Nutrition Environmental sanitation Other projects Total Field Activities 2,000 6,600 1.24 4.11 4,500 4,500 2.80 2.80 Tot a 1 - - -$ % 4,500 6,500 6,600 10,900 18,100 9,500 12,100 26,800 7,600 5,000 2.80 4.04 4.11 6.78 11.26 5.91 7.53 16.68 4.73 3.11 33.05 100.00
2,600 4,500 10~000
1.62 2.80 6.2~
25,700
16.00
10,900 6~78 18,100 11.26 9,500 5.91 9,500 5.91 22,300 13.88 7,600 4.73 5,000 3.11 4~:103 26.82 5~z103 135,003 84.00 160,703 195 8 _ ... _-
-=
Malaria Tuberculosis Public health administration l1aternal and child health Mental health Other projects Total Field Activities
4,400 13,750 4;500 21,984 44,634
2.57 8.02 2.62 12.82 26.03
16,458 9.60 20,858 18,507 10.80 18,507 8,300 4.84 22,050 25,753 15.02 25,753 4,500 79,768 57,784 33.71 126,802 73.97 171,436
12.17 10.80 12.86 15.02 2.62 46.53 100.00
WP/RC7/B&B/Working Paper 4 Annex III ANALYSIS OF PROPOSED PROGRAMME AND COST ESTIMATES TECHNICAL ASSISTANCE FUNDS (FIELD ACTIVITIES) CATEGORY I
122.7. Regional Office Costs Field activities $ 72,731 $599,365
1958 $ 74,491 $648,849
SUMMARY OF FIELD ACTIVITIES 1957 Continuing Field Tot a 1 New Projects Activities $ Malaria 84,943 Tuberculosis 2,940 Venereal diseases & treponematoses 15,223 Endemo-epidemic diseases 32,352 Public health administration 44,383 Nursing 119,954 Health education of the public Maternal and child health 49,203 Nutrition 9,438 Environmental sanitation 40,522 Other projects 59 z2 97 Total 458,255
% 14.17 0.49 2.54 5.40 7.LJ.
$ 6,731 3,000 9,000
% 1.12 0.50 1.50 8.34
$
- - - -% 14.17 1.61 2.54 5.90 8.91 20.02 8.34 8.21 1.57 14.29 14.44 100.00
20.02 50,000 8.21 1. 57 6.76 45,148 9.89 27,231 76.46 141,110 1958
7.53 4.55 86~528 23.54 599,365
84,943 9,671 15,223 35,352 53,383 119,954 50,000 49,2 03 9,438 85,670
Malaria 67,946 Tuberculosis 21,304 Venereal diseases and treponematoses 16,507 Endemo-epidemic diseases 30,505 Public health administration 75,496 Nursing 141,154 Health education of the public 10,914 Maternal and child health 74,954 Nutrition 9,215 Environmental sanitation 75,542 Other projects 87 z383 Total 610,920
10.47 3.28 2.54 4.70 11.64 21.76 1.68 11.55 1.42 11.64 1~.47
10,729
6,100
94.15
2,700 18 2400 37,929
1.65 78,675 21,304 16,507 30,505 0.94 81,596 lLJ.,154 10,914 74,954 9,215 0.42 78,242 2.84 105~78~ 5.85 648~849
12.12 3.28 2.54 4.70 12.58 21.76 1.68 11.55 1.42 12.06 16.31 100.00
WPIRC7 /F&B11rfor king Pap er 5 Annex IV ANALYSIS OF PROPOSED PROGRAMME AND COST ESTIMATES TECHNICAL ASSISTANCE FillIDS (FIELD ACTIVITIES) CATEGORY II - 1957 Expan sion of Existing Projects $
New Projects ~
%
% 7.36 7.65 5.36 5.36
Tot a 1 - - -$ %
Tuberculosis Venereal diseases & treponematoses Endemo-epidemic diseases Public health administration Nursing Health education of the public Maternal and child health Environmental sanitation other projects Total
5,500 10,368 13,500 7,354 26,499 63,221
4.21 7.94 10.33 5.63 20.28 48.39
9,621 10,000 7,000 7,000 6,000 5,500 3,500 18,800 67,421
9,621 7.36 10,000 7.65 12,500 9.57 17,368 13.30 13,500 10.33 6,000 4~59 4.59 4.21 12,854 9.84 2.68 2.68 3,5 00 14.40 45,299 34.68 51.61 130,642 100.00
WP/RC7/B&B/Working Paper 6 Annex V SUMMARY BY MAJOR SUBJECT HEADINGS FOR ALL FUNDS FOR 1957 & 1958 HITH PERCENTAGES
12.2.1 BASIC Nalaria 20,999 Tuberculosis 46,403 Venereal diseases & treponematoses80,197 Endemo-epidemic diseases 5,000 Public health administration 136,046 81,826 Nursing Heal th education of the public 25,334 Maternal and child health 39,393 Nental health 15,000 Nutrition Environmental sanitation 63,998 Other projects 42 z28 5 Total 556,481 SUPPLENENTAL 4,500 6,500 6,600 10,900 18,100 9,500 12,100 26,800 7,600 5,000 53 2103 160,703 TA-I 84,943 9,671 15,223 35,352 53,383 119,954 50,000 49,203 TOTAL
! 8.39 4.75 7.75 3.89 15.76 16.05 5.72 7.65 3.18 1.29 11.75 13.82 100.00
110,442 62,574 102,020 51,252 207,529 211,280 75,334 100,696 41,800 17,038 9,438 154,668 85,670 181 2 916 862528 599,365 1,316,549 1958
Malaria 22,458 Tuberculosis 64,563 Venereal diseases & treponematoses91,153 Endemo-epidemic diseases Public health administration 158,056 Nursing 77,157 Health education of the public 31,586 Maternal and child health 65,714 Mental health 25,540 Nutrition Environmental sanitation 57,378 other projects 75 2241 Total 668,846
20,858 18,507 22,050 25,753 4,500 79 ~ 768 171,436
78,675 21,304 16,507 30,505 81,596 141,154 10,914 74,954
121,991 104,374 107,660 30,505 261,702 218,311 42,500 166,421 30,040 9,215 9,215 78,242 135,620 105z78~ 26° 2792 648,849 1,489,131
8.19 7.01 7.23 2.05 17.57 14.66 2.85 11.18 2.02 .62 9.11 17.51 100.00