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Programme budget 2010-2011: budget performance (interim report)

31 декабря 2011 г. Всемирная организация здравоохранения

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WORLD HEALTH ORGANIZATION

ORGANISATION MONDIALE DE LA SANTE

REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL

REGIONAL COMMITTEE Sixty-second session Manila, Philippines 10–14 October 2011 Provisional agenda item 8

WPR/RC62/3 24 August 2011 ORIGINAL: ENGLISH

PROGRAMME BUDGET 2010–2011: BUDGET PERFORMANCE (INTERIM REPORT) This document presents the interim reports on the implementation of assessed and voluntary contributions for the 2010–2011 biennium by source of funding, Strategic Objective, budget centre and category of expenditure as at 31 May 2011. In monetary terms, the implementation of assessed contributions amounted to US$ 52.2 million or 67% of the current working allocation (US$ 77.9 million) for the period 1 January 2010 to 31 May 2011 (Tables 1 and 3a). In addition, the activities implemented utilizing voluntary contributions amounted to US$ 125.7 million (Tables 3a and 3b). The total implementation of all funds was US$ 177.9 million or 56.6% of the current working allocation and 63.3% of the available resources (Table 3a). of all funds by strategic objective and by budget The implementation centre is shown in

Table 4 and Table 4a, respectively. The implementation by category of expenditure is reflected in Table 5. Information on outputs and results by Strategic Objective and Organization-wide Expected Results is provided in Annex 1. Information on outputs and results by The information is based on a

Regional Expected Results is provided in Annex 2.

mid-term assessment and covers the period 1 January 2010 to 31 December 2010. Annex 1 presents the summary of progress made towards Strategic Objectives 1 to 13 while Annex 2 presents the summary of progress towards Regional Expected Results for Strategic Objectives 1 to 11. The Regional Committee may wish to review and discuss the implementation figures.

WPR/RC62/3 page 2

IMPLEMENTATION OF PROGRAMME BUDGET 2010–2011

This document presents the interim reports on the implementation of assessed and voluntary contributions for the 2010–2011 biennium by source of funding, Strategic Objective, budget centre and category of expenditure. Level of programme budget The Proposed Programme Budget 2010–2011 was presented to the Regional Committee of the Western Pacific at its fifty-ninth session in September 2008. The Global Programme Budget 2010–2011 was approved at the Sixty-second World Health Assembly in May 2009. The assessed contributions approved by the World Health Assembly for the Region amounted to US$ 78.7 million (a 1.9% decrease from the US$ 80.2 million approved for 2008–2009, reflecting the global reduction of assessed contributions due to the decrease in the projected miscellaneous income for biennium 2010–2011). Table 1. Financing sources summary: 2010–2011 and 2008–2009 (US$ million) Programme budget 2010–2011 as at 31 May 2011 Approved budget 78.7 231.6 310.3 Current working allocation 77.9 236.2 314.1 Programme budget 2008–2009 as at 31 May 2009 Approved budget 80.2 256.7 336.9 Working allocation 78.6 277.2 355.8

Source of financing

Assessed contributions Voluntary contributions Total

Owing to continuing uncertainties with regard to the payment of contributions from Member States, the Director-General initially decided to establish the working allocation at 98%, hence temporarily reducing the Western Pacific Region's assessed contributions to US$ 77.1 million. Effective May 2011, the Director-General released half of the

2% withholding which resulted in the current working allocation of US$ 77.9 million. As in previous years, dependency on voluntary contributions remained high in 2010–2011. The voluntary contributions approved by the World Health Assembly for the Region amounted to US$ 231.6 million. (a 9.8% decrease from the US$ 256.7 million approved for 2008–2009). This was established based mainly on projected implementation for 2008–2009. During the biennium, the working allocation has been increased to

WPR/RC62/3 page 3

US$ 236.2

accommodate

additional

funding

for

emergency-related

activities,

environmental health projects, implementation of the Asia Pacific Strategy for Strengthening Health Laboratory Services (2010–2015), activities funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, reforms instituted by the Regional Director, the establishment of the Country Liaison Office in the Federated States of Micronesia, supplementary immunization activities, measles and related health systems strengthening activities. The total amount of voluntary contributions mobilized as at 31 May 2011 is

US$ 203 million (Table 2), an increase of 17.3% over the US$ 173 million mobilized during the same period in the last biennium. Table 2 reveals the gaps in financing for the biennium 2010–2011 as at 31 May 2011.

Table 2: Gaps in financing for 2010–2011 by strategic objective — all funds (US$ million) Total Strategic objective Current working allocation 60.1 50.6 19.6 22.6 12.5 19.9 2.0 13.4 12.1 37.8 14.5 partnerships 20.6 28.4 314.1 Income AC 6.6 4.9 5.1 4.2 1.3 3.4 0.2 2.7 2.0 15.8 2.8 11.7 17.2 77.9 VC 58.8 43.9 11.2 9.1 6.6 9.3 1.7 8.6 6.0 20.3 10.2 7.5 9.8 203.0 Total 65.4 48.8 16.3 13.3 7.9 12.7 1.9 11.3 8.0 36.1 13.0 19.2 27.0 280.9 Gap 5.3* -1.8 -3.3 -9.3 -4.6 -7.2 -0.1 -2.1 -4.1 -1.7 -1.5 -1.4 -1.4 -33.2

1 Communicable diseases 2 HIV/AIDS, tuberculosis and malaria 3 Chronic noncommunicable conditions 4 Child, adolescent, maternal, sexual and reproductive health and ageing 5 Emergencies and disasters 6 Risk factors for health 7 Social and economic determinants of health 8 Healthier environment 9 Nutrition and food safety 10 Health systems and services 11 Medical products and technologies 12 WHO leadership, governance and 13 Enabling and support functions Total

AC–assessed contributions; VC–voluntary contributions. * Additional funds received mainly for EPI programme, particularly for Measles Elimination.

WPR/RC62/3 page 4

Implementation In monetary terms, the implementation of assessed contributions amounted to US$ 52.2 million or 67% of the current working allocation for the period 1 January 2010 to 31 May 2011 (an increase of over 5 percentage points compared to the last biennium). In addition, the activities implemented utilizing voluntary contributions during the same period amounted to US$ 125.7 million or 61.9% of the available resources (US$ 203 million). Regarding implementation between Regional Office and Country Offices, the increase in Country Office expenditure reflects the creation of the Division of Pacific Technical Support (DPS) and the related transfer of fiduciary financial responsibility to that office. The overall increase in implementation rates over the last biennium reflects strengthened regional financial management as well as improvement in operations of the Global Management System (GSM). The implementation by source and by level of funding is shown in Tables 3a and 3b. These figures have been compared with that of the previous biennium. Table 3a. Implementation of all funds (US$ million)

Implementation as at 31 May 2011 Fund Assessed contribution Voluntary contribution Total Income 77.9 203.0 280.9 Implementation 52.2 125.7 177.9 % 67.0 61.9 63.3 Fund Assessed contribution Voluntary contribution Total

Implementation as at 31 May 2009 Income 78.6 173.0 251.6 Implementation 48.5 92.1 140.6 % 61.7 53.2 55.9

Implementation includes expenditures and encumbrances.

Table 3b. Implementation by country office and Regional Office (US$ million) Implementation as at 31 May 2011 Assessed contribution 31.8 20.4 52.2 Voluntary contribution 81.9 43.8 125.7 Implementation as at 31 May 2009 Assessed contribution 27.6 20.9 48.5 Voluntary contribution 51.5 40.6 92.1

Level Country Regional Total

Total 113.7 64.2 177.9

% 63.9 36.1 100.0

Level Country Regional Total

Total 79.1 61.5 140.6

% 56.3 43.7 100.0

WPR/RC62/3 page 5

Table 4 and Table 4a show the implementation of all funds (expenditure plus encumbrances) by strategic objective and by budget centre, respectively. Table 4: Implementation by strategic objective as at 31 May 2011 (US$ million)

Strategic objective

Expenditure AC VC 36.0 24.2 5.0 5.7 5.3 5.5 0.9 4.5 2.7 11.6 5.2 3.1 5.8 115.5

Encumbrances AC 0.7 0.3 0.5 0.2 0.0 0.3 0.0 0.2 0.1 2.1 0.2 0.1 0.6 5.3 VC 2.4 3.0 0.5 0.4 0.2 0.5 0.1 0.8 0.4 0.9 0.2 0.1 0.7 10.2 AC 4.1 3.1 3.2 2.4 0.6 2.4 0.1 1.7 1.1 10.2 1.9 9.3 12.1 52.2

Total VC 38.4 27.2 5.5 6.1 5.5 6.0 1.0 5.3 3.1 12.5 5.4 3.2 6.5 125.7

Total

3.4 2.8 2.7 2.2 0.6 2.1 0.1 1.5 1.0 8.1 1.7 9.2 11.5 46.9

42.5 30.3 8.7 8.5 6.1 8.4 1.1 7.0 4.2 22.7 7.3 12.5 18.6 177.9

WPR/RC62/3 page 6

Table 4a: Implementation by budget centre as at 31 May 2011 (US$ thousand) Budget Centre AC American Samoa Brunei Darussalam Cambodia China Cook islands Fiji French Polynesia Guam Japan Kiribati Lao People's Democratic Republic Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru Niue Northern Mariana Islands, Commonwealth of the Palau Papua New Guinea Philippines Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam Pacific Island Countries Office of the Regional Director Division, Administration and Finance Division, Combating Communicable Diseases Division, Building Healthy Communities & Populations Division, Health Sector Development Division, Programme Management Division, Health Security and Emergencies Approved and Unallocated Budget Total AC–assessed contributions; VC–voluntary contributions. 72 40 3,629 8,362 447 2,820 40 40 35 899 2,971 1,606 310 529 2,620 103 106 40 124 3,837 2,250 75 2,162 40 1,901 104 1,332 131 1,641 6,204 1,434 2,107 6,496 3,250 5,797 6,570 5,001 1,959 829 77,913 Income VC 19,418 21,643 1,345 1 419 11,999 460 10 30 3,753 8 11,844 15,192 201 786 1,897 422 4 1,379 23,113 16,685 1,368 5,626 28,213 12,130 11,402 3,608 10,000 202,956 Total 72 40 23,047 30,005 447 4,165 40 40 36 1,318 14,970 2,066 320 559 6,373 111 106 40 124 15,681 17,442 276 2,948 40 3,798 104 1,754 135 3,020 29,317 18,119 3,475 12,122 31,463 17,927 17,972 8,609 11,959 829 280,869 52,229 125,687 177,916 AC 63 26 2,298 6,206 306 1,977 10 646 2,082 1,185 128 405 1,827 73 92 5 118 2,280 1,670 26 1,946 28 1,419 98 963 77 1,204 3,749 927 1,342 4,723 1,869 3,706 4,141 3,639 975 Implementation VC 13,973 14,749 552 144 7,734 205 2,303 8 6,661 8,922 143 368 1,094 273 4 839 13,900 9,988 750 4,483 17,170 6,991 6,864 1,620 5,949 Total 63 26 16,271 20,955 306 2,529 10 790 9,816 1,390 128 405 4,130 81 92 5 118 8,941 10,592 169 2,314 28 2,513 98 1,236 81 2,043 17,649 10,915 2,092 9,206 19,039 10,697 11,005 5,259 6,924 Implementation/available resources AC VC Total 87.5% 65.0% 63.3% 74.2% 68.5% 70.1% 0.0% 25.0% 0.0% 71.9% 70.1% 73.8% 41.3% 76.6% 69.7% 70.9% 86.8% 12.5% 95.2% 59.4% 74.2% 34.7% 90.0% 70.0% 74.6% 94.2% 72.3% 58.8% 73.4% 60.4% 64.6% 63.7% 72.7% 57.5% 63.9% 63.0% 72.8% 49.8% 0.0% 67.0% 0.0% 0.0% 72.0% 68.1% 0.0% 41.0% 0.0% 0.0% 0.0% 34.4% 64.5% 44.6% 0.0% 0.0% 61.4% 100.0% 0.0% 0.0% 0.0% 56.2% 58.7% 71.1% 46.8% 0.0% 57.7% 0.0% 64.7% 100.0% 60.8% 60.1% 59.9% 54.8% 79.7% 60.9% 57.6% 60.2% 44.9% 59.5% 0.0% 61.9% 87.5% 65.0% 70.6% 69.8% 68.5% 60.7% 0.0% 25.0% 0.0% 59.9% 65.6% 67.3% 40.0% 72.5% 64.8% 73.0% 86.8% 12.5% 95.2% 57.0% 60.7% 61.2% 78.5% 70.0% 66.2% 94.2% 70.5% 60.0% 67.6% 60.2% 60.2% 60.2% 75.9% 60.5% 59.7% 61.2% 61.1% 57.9% 0.0% 63.3%

WPR/RC62/3 page 7

The implementation of assessed and voluntary contributions, combined and broken down by category of expenditure, is shown below in Table 5. Table 5: Implementation by category of expenditure (US$ million) Category Staff cost Contractual services Direct financial cooperation Travel Medical supplies and literature General operating costs Others* Total Amount 79.5 28.0 20.3 17.0 8.0 7.3 17.8 177.9 % 44.7 15.7 11.4 9.6 4.5 4.1 10.0 100.0

*Others include equipment, furniture and vehicles, training, consulting, research services, telecommunications and fellowships

The largest percentage of expenditure continues to be attributed to staff costs (44.7%), a 4.2 percentage points increase over last biennium. This is followed by contractual services (15.7%), direct financial cooperation (11.4%) and travel (9.6%), for which the portion of overall expenditure remains consistent and comparable to last biennium. Efficiency-savings measures put in place especially for travel are starting to show promise with an almost 1 percentage point decrease in overall expenditures compared to last biennium. (Travel costs include official staff travel, temporary advisers, national and international group training activities, and meetings convened and/or supported by WHO.) The final reports on budget performance for biennium 2010–2011 will be presented to the sixty-third session of the Regional Committee for the Western Pacific. Outputs and results Annex 1 contains the mid-term performance report on outputs and results, summarizing progress made for the period 1 January 2010 to 31 December 2010 towards the Strategic Objectives. Annex 2 contains the mid-term performance report on outputs and results,

summarizing progress made for the period 1 January 2010 to 31 December 2010 towards the Regional Expected Results identified in the Programme Budget 2010–2011.

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WPR/RC62/3

ANNEX 1

WORLD HEALTH ORGANIZATION WESTERN PACIFIC REGION

PROGRAMME BUDGET 2010–2011 OUTPUTS AND RESULTS

SUMMARY OF PROGRESS MADE TOWARDS STRATEGIC OBJECTIVES

WPR/RC62/3 ANNEX 1

PROGRAMME BUDGET 2010–2011 OUTPUTS AND RESULTS

SUMMARY OF PROGRESS MADE TOWARDS STRATEGIC OBJECTIVES 1 January 2010–31 December 2010

AUGUST 2011

WPR/RC62/3 Annex 1

COUNTRIES AND AREAS OF THE WESTERN PACIFIC REGION COUNTRY American Samoa Australia Brunei Darussalam Cambodia ACRONYM ASM AUS BRN KHM COUNTRY New Caledonia New Zealand Niue Northern Mariana Islands, Commonwealth of the Palau Papua New Guinea Philippines Pitcairn Islands Republic of Korea Samoa Singapore Solomon Islands Tokelau ACRONYM NEC NEZ NIU MNP

China Cook Islands Fiji French Polynesia Guam Hong Kong, China Japan Kiribati Lao People's Democratic Republic Macao Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru

CHN COK FJI PYF GUM HOK JPN KIR LAO

PLW PNG PHL PCN KOR WSM SGP SLB TKL

MAC MYS MHL FSM MNG NRU

Tonga Tuvalu Vanuatu Viet Nam Wallis and Futuna

TON TUV VUT VNM WAF

WPR/RC62/3 Annex 1 List of abbreviations

ACP ADH AEFI AFHS APSED AusAID CDC

The African, Caribbean and Pacific Group of States adolescent health adverse events following immunization adolescent-friendly health services Asia Pacific Strategy for Emerging Diseases Australian Agency for International Development

EHA ERC ESCAP

Emergency and Humanitarian Action unit Ethics Review Committee United Nations Economic & Social Commission for Asia and the Pacific environmentally sustainable and healthy urban transport Food and Agriculture Organization of the United Nations foodborne trematodes National Food Safety Emergency Response gender-based violence Global Foodborne Infections Network Global Health Institute Global Outbreak Alert and Response Network Global School-based Student Health Survey URBAN Health Equity Assessment and Response Tool health emergency response operations Health Information Intelligent Platform

ESHUT FAO

FBT Centers for Disease Prevention and Control (United States) Chinese Center for Disease Prevention and Control Central Emergency Response Fund GHI CGF Collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria combines multi-year plans Division of Combating Communicable Diseases evidence-based diet and physical activities HERO DSE EBS EC ECHO Division of Health Security and Emergencies HIIP event-based surveillance system European Commission HIS European Commission Humanitarian Aid and Civil Protection HiTS HMN GOARN GSHS HEART FSER GBV GFN CERF

CDC China

cMYPs DCC DPAS

health information systems health system profiles Health Matrix Network

WPR/RC62/3 Annex 1 HQ HRH HSI HSS HTL ICATT IDD IHR IMCI Interpol IT IYCF JE JRF KAP LF MDA MDG MNCH MoVE-IT MTP Headquarters (WHO) Human Resources for Health NAIA HIV/AIDS and Sexually Transmitted Infections NCD Health Systems Strengthening NFP Health Technologies NHA IMCI computerized adaptation and training tool NRA iodine deficiency disorders International Health Regulations Integrated Management of Childhood Illness International Criminal Police Organization OWER information technology Infant and Young Child Feeding Japanese encephalitis Joint Reporting Form knowledge, attitude and practice lymphatic filariasis mass drug administration Millennium Development Goals maternal newborn and child health Monitoring of Vital Events using IT monitoring, training and planning OSER PCR PHA PHECP PICs PIEmeds PIFS POLHN Prolead QA NITAG NTD NZAID national health accounting system National Regulatory Authorities national immunization technical advisory group neglected tropical disease New Zealand Agency for International Development Organization-Wide Expected Result Office-Specific Expected Result Polymerase Chain Reaction Pharmaceuticals Public Health Emergency Contingency Plan Pacific Island Countries Price Information Exchange Pacific Islands Forum Secretariat Pacific Open Learning Health Network health promotion leadership training programme quality assurance National IHR Focal Point Ninoy Aquino International Airport noncommunicable diseases MVP Malaria, other Vectorborne and Parasitic Diseases

WPR/RC62/3 Annex 1 RAS Regional Rapid Alert System for Combating Counterfeit Medicines Regional Commission for the Certification of Poliomyelitis Eradication in the Western Pacific Region Regional Expected Result Regional Network for Asian Schistosomiasis Regional Research Plan of Action on Infectious Diseases of Poverty Southeast Asian Ministry of of Education OrganizationRegional Tropical Medicine and Public Health Network supplementary immunization activity small island states WPR SO SOPs SPC STB STI TAG TDR TRIPS TRM TSF UN Strategic Objective WPRO standard operating procedures Secretariat of the Pacific Community Stop TB and Leprosy Elimination sexually-transmitted infections Technical Advisory Group Tropical Disease Research Trade-related aspects of Intellectual Property Rights Traditional Medicine Technical Strategic Framework United Nations Western Pacific Regional Office Western Pacific Region UNDAF United Nations Development Assistance Framework United Nations SecretaryGeneral United States of America United States Agency for International Development United Nations International Children's Emergency Fund United States Pharmacopeia vaccine-derived poliovirus vaccine-preventable disease World Food Programme WHO Framework Convention on Tobacco Control

RCC

UN SG USA USAID UNICEF USP VDPV

RER RNAS RRPA

SEAMEOTROPMED

VPD WFP WHO FCTC

SIA SIS

WPR/RC62/3 Annex 1 TABLE OF CONTENTS STRATEGIC OBJECTIVE 1.............................................................................................................. 1 STRATEGIC OBJECTIVE 2............................................................................................................ 21 STRATEGIC OBJECTIVE 3............................................................................................................ 37 STRATEGIC OBJECTIVE 4............................................................................................................ 44 STRATEGIC OBJECTIVE 5............................................................................................................ 51 STRATEGIC OBJECTIVE 6............................................................................................................ 57 STRATEGIC OBJECTIVE 7............................................................................................................ 66 STRATEGIC OBJECTIVE 8............................................................................................................ 71 STRATEGIC OBJECTIVE 9............................................................................................................ 76 STRATEGIC OBJECTIVE 10.......................................................................................................... 84 STRATEGIC OBJECTIVE 11.......................................................................................................... 94 STRATEGIC OBJECTIVE 12........................................................................................................ 101 STRATEGIC OBJECTIVE 13........................................................................................................ 107

WPR/RC62/3 Annex 1

WPR/RC62/3 page 1 Annex 1 STRATEGIC OBJECTIVE 1 To reduce the health, social and economic burden of communicable diseases.

Highlights on significant programme delivery The Region is making progress in preventing vaccine-preventable diseases. Region-wide coverage with the first and second doses of measles containing vaccine (MCV1 and MCV2) has been improving, reaching 96% and 90% in 2009, respectively. MCV2 has now been introduced in

31 countries and areas and rubella containing vaccine in 30 countries and areas (as of 2010). To ensure equitable access to vaccines, nationwide, measles supplementary immunization activities (SIAs) were conducted in CHN, PNG, TUV and VNM, and in one city in the PHL and one state of FSM; a tetanus toxoid (TT) SIA was conducted in LAO. Most countries integrated other health services and disease prevention initiatives during the SIAs, including other vaccines (e.g., oral polio vaccine [OPV]), Vitamin A, and deworming medicine. Other measures toward maternal and neonatal tetanus elimination in countries concerned (CAM, CHN, LAO, PNG and PHL) included district level risk assessment and planning of interventions; often in coordination with Mother and Child Health (MCH) programmes. All low-income countries in the Region have now introduced haemophilus influenza type B (Hib) vaccine with technical support from WPRO. WHO provided technical

assistance and donated pandemic influenza (H1N1) for vaccination campaigns conducted throughout the Region. An intercountry workshop was conducted on increasing routine immunization coverage at district level and data management capacities, as well as on national immunization technical advisory group (NITAG) strengthening to improve evidence-based policy-making. Substantial

progress was made on national regulatory authority (NRA) strengthening in CHN and VNM, and WPRO supported NRA self assessments in four countries. AEFI surveillance systems were

strengthened during the pandemic influenza (H1N1), measles and TT campaigns. Effective Vaccine Management (EVM) assessment training was conducted for five countries (CHN, KHM, LAO, MNG and PHL) and vaccination supplies stock management training in four countries (LAO, MNG, PHL and VNM). The Region has remained poliomyelitis-free in spite of the constant threat of importation. Progress was made in the control and elimination of Neglected Tropical Diseases. KHM, LAO, KIR and TUV continued to maintain the WHO's global target of deworming of 75% of school-aged children at risk. The four countries where schistosomiasis is endemic, namely: CHN, KHM, LAO and PHL, continued with targeted intervention campaigns against schistosomiasis, including mass treatment of the entire population at risk in KHM and LAO; in addition CHN implemented animal host and vector control interventions. The Region continued to move towards the global goal of eliminating lymphatic filariasis (LF) by 2020; COK, NIU TON and VUT are among the countries that

WPR/RC62/3 page 2 Annex 1 will have eliminated LF by 2015. Pilot interventions to control food-borne trematodes and cestodiasis were started in VNM and KHM.

In collaboration with Tropical Disease Research (TDR) and WHO collaborating centres, capacity for operational research has improved in many member states. An operational research agenda has been identified, and technical support to implement priority issues and use emerging evidence has been intensified.

While WHO through its Country Offices and the Regional Office has continued to provide technical support and limited financial support to countries for dengue prevention and outbreak control, dengue incidence has continued to increase in the WPR through 2010, following a trend observed over the past decade. In 2010, 24 countries and areas in the Western Pacific Region reported dengue cases, compared to 25 in 2009; 353 907 cases and 1073 dengue-related deaths were reported. WHO is strengthening the capacity of Member States to implement the Dengue Strategic Plan for the Asia Pacific Region (2008–2015). This includes vector control and community mobilization to reduce and lessen the impact of outbreaks using the key principles of integrated vector management (IVM); strengthening of dengue surveillance through integration with the Asia Pacific Strategy for Emerging Diseases (APSED) and capacity-building in case management where needed.

WPRO provided technical and operational support for epidemiologic and laboratory-based surveillance for invasive bacterial diseases in four countries (MNG, PHL, PNG and VNM), rotavirus in seven countries (CHN, FJI, KHM, LAO, MNG, PNG and VNM), and Japanese encephalitis (JE) in four countries (KHM, LAO, PHL and VNM). WPRO convened an intercountry meeting, provided hands-on training, and direct technical and operational support to 10 JE laboratories in nine countries, as well as for measles and polio laboratories in countries and areas throughout the Region. Intercountry workshops on epidemiologic surveillance for these diseases and on

developing/strengthening national immunization technical advisory groups (NITAGs) were conducted to improve decision-making on new vaccine introduction and other immunization issues.

The draft Regional Research Plan of Action on Infectious Diseases of Poverty (RRPA) was further refined with inputs from Tropical Diseases Research (TDR), WHO collaborating centres (CCs), researchers and research institutions within and outside the Region, and the Regional Network for Asian Schistosomiasis and other Helminth Zoonoses (RNAS+). This plan is expected to encourage political commitment and increase allocation of resources for research. It is to be refined to cut across

WPR/RC62/3 page 3 Annex 1 all programmes in the Division including those under SO 02. Research will be at the core of the next year's World Health Report.

With the support of WHO, 15 Member States conducted the assessment using the Asia Pacific Strategy for Emerging Diseases (APSED) 2005 checklists. As a result of assessment, more than 10 countries developed a national workplan for APSED which served as the National IHR action plan.

The second regional exercise on IHR event communications (namely "IHR Exercise Crystal 2010"), with the participation of 20 National IHR Focal Points in the Region, was conducted to test and assess the functional accessibility of countries' national focal points (NFPs) contact details; and to validate IHR event notification and information sharing process. Since the new IHR entered into force in June 2007, more than 100 public health events including Zika virus, imported polio case, cholera, human infections of H5N1, H9N2 virus, the new influenza A(H1N1), MDR-TB, Ebola Reston virus infections and food contaminations have been communicated to WHO through NFPs. An informal expert consultation meeting on POE public health emergency planning was held in February 2010 to develop draft guidance on public health emergency contingency planning at designated points of entry.

WPRO maintains a fully functional regional Event-based Surveillance system (EBS). From January to December 2010, there have been 256 events reported to the regional EBS system. Ten countries such as CHN, KHM, LAO, MYS, MNG, PIC, PHL, PNG, SGP and VNM have some kind of EBS that coordinates with the Regional Office's surveillance team. The Global Outbreak Alert and

Response Network (GOARN) was strengthened at the regional level through an annual meeting and training for GOARN institutions.

WPR/RC62/3 page 4 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 1.1 Policy and technical support provided to Member States (MS) in order to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential child-health interventions with immunization. Indicator 1.1.1 Number of Member States with at least 90% national vaccination coverage (DTP3) Number of Member States that have introduced Haemophilus influenza type b vaccine in their national immunization schedule Baseline Target

On track

To end 2010 22

Based on JRF (09): 23 countries reported ≥ 90%.

1.1.2

Twenty seven countries were using Hib vaccine in their immunization programmes at the end of 2009. Countries that have not yet introduced or announced plans to introduce include: CHN, JPN, HOK (CHN) and KOR.

This OWER is on track. Based on the Joint Reporting Form (JRF) data for 2009, 23 countries and areas reported DTP3 coverage at or above 90%. While only 22 countries and areas reported 90% or greater DTP3 coverage in 2010, 3 did not submit JRFs (ASM, MAC and PHL) and one that submitted a JRF did not report DTP3 coverage (GUM). Among these, ASM and MAC likely have 90% or higher coverage. Countries that reported slightly lower than 90% DTP3 coverage but had consistently 90% or more coverage in the recent past include FSM, MNP, PLW, TUV and WAF. Thus, we would expect 29 countries and areas to achieve the target. Among the remaining countries, at least two could reach 90% in 2011. The Regional Office is analysing and developing a model to assess performance/risk for vaccine-preventable diseases (VPD) at district level, which should enable countries to better identify low-performing districts and undertake targeted intervention to improve vaccination coverage. WHO has provided technical support to Member States for decision-making on new vaccine introduction and for surveillance to demonstrate the disease burden for new vaccine-preventable diseases such as Hib meningitis. By the end of the last biennium (December 2009), 27 countries and areas in this Region had introduced Hib vaccine into their routine national immunization schedules. During 2010, an additional two countries (KHM and VNM) introduced Hib vaccine and a third country (PHL) introduced Hib vaccine in 20% of its birth cohort. PHL is expected to expand Hib vaccine use nationwide during 2011, VUT will introduce in 2011, and SGP will introduce in either 2011 or 2012, reaching the OWER target of 31 countries and areas.

WPR/RC62/3 page 5 Annex 1 OWER 1.2 Effective coordination and support provided in order to achieve certification of poliomyelitis eradication, and destruction, or appropriate containment, of polioviruses, leading to a simultaneous cessation of oral poliomyelitis vaccination globally. Indicator 1.2.1 Percentage of final country reports demonstrating interruption of wild poliovirus transmission and containment of wild poliovirus stocks accepted by the relevant regional commission for the certification of poliomyelitis eradication Baseline All countries submitted annual progress reports on maintaining their polio-free status (certified in 2000) to the Regional Certification Commission (RCC) for its 15th meeting held in December 2009. Based on the detailed information provided by all Member States on the quality of surveillance, immunization and poliovirus laboratory containment, the RCC concluded that the Region has stayed free of poliovirus circulation. Completing of phase 1 wild poliovirus laboratory containment was already attested by the RCC in December 2008. OPV cessation may only occur 4-5 years after the last wild poliovirus globally has been detected. With a timeframe of at least 7 years ahead it seems premature to already establish such timelines and strategies now. Based on national decisions though countries are shifting from OPV to IPV (MAC/CHN in 2009, MYS partially in 2009 and nationwide in 2010). Target 100%

On track

To end 2010 100%

1.2.2

Percentage of Member States using trivalent oral poliovirus vaccine that have a timeline and strategy for eventually stopping its use in routine immunization programmes

*The indicator is not yet applicable as no internationally agreed timeline is yet in place and may not be for many years depending on global progress to stop wild poliovirus transmission.

This OWER is on track. While the risk of wild poliovirus importation remained high from endemic countries and re-infected areas, the Region has remained polio-free, with overall good surveillance and a high quality laboratory network in place. Annual accreditation of polio network laboratories has been conducted for priority countries in the Region, and the Region is successfully implementing the new algorithm for virus isolation and the real time PCR for intratypic differentiation and vaccine derived poliovirus (VDPV) screening to allow rapid detection of polioviruses. Identified immunity gaps have been addressed with supplementary immunization activities, mostly in conjunction with other health/immunization interventions in CHN, LAO, MNG and PNG and will be targeted in other countries in the near future, as necessary. Risk assessment has been conducted for all countries on the potential of imported wild poliovirus to spread and national importation preparedness has been enhanced in key countries. The regional inventory of wild poliovirus infectious and potentially

WPR/RC62/3 page 6 Annex 1 infectious materials stored in laboratories has been updated. The Regional Commission for the Certification of Poliomyelitis Eradication in the Western Pacific Region (RCC) continues its active oversight and facilitated with its 16th meeting and the commemoration of the Region 10 years certified as polio-free the ongoing advocacy and resource mobilization activities. OWER 1.3 Effective coordination and support provided to Member States in order to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases. Indicator 1.3.1 Number of Member States certified for eradication of dracunculiasis Baseline 34 Target 37

On track

To end 2010 36 (not yet: BRN, because of late submission of the Declaration)

1.3.2

Number of Member States that have eliminated leprosy at subnational levels

34 (not yet: FSM, KIR, MHL)

1.3.3

Number of reported cases of human African trypanosomiasis for all disease-endemic countries

African trypanosomiasis is not reported to be endemic in the Western Pacific Region (WPR) CHN and KOR have been verified by WHO as lymphatic filariasis (LF)-free countries. KHM, KIR, LAO, TUV and VUT have reached the WHO global target of deworming more than 75% of school children

Nil (not endemic in WPR)

Nil (not endemic)

1.3.4

Number of Member States having achieved the recommended target coverage of population at risk of lymphatic filariasis, schistosomiasis and soil-transmitted helminthiases through regular anthelminthic preventive chemotherapy

6 (KHM, KIR, LAO, SLB, TUV, VUT)

5 (KHM, KIR, LAO, TUV, VUT)

This OWER is on track. Dracunculiasis eradication has been achieved in 36 countries and areas. Leprosy elimination at the national level has been achieved in 34 of 37 countries and areas: FSM, KIR and MHL have not yet achieved the leprosy elimination goal. Consultants visited FSM and MHL in September 2010, to review programme performance; provided technical assistance for implementation of the national leprosy programmes; conducted training workshops for programme managers, doctors, nurses and health care workers; and drafted plans of action in both countries. A

WPR/RC62/3 page 7 Annex 1 consultant visited KIR in July, helped conduct the national programme review and provided training for the new programme manager and staff. The missions discovered significant organizational, policy, operational and administrative challenges that are contributing to insufficient case detection and a number of "hidden cases". The Regional Director has declared leprosy elimination as a regional priority. Since the beginning of this biennium, the responsibilities for dengue prevention and control in WPRO were divided between the Malaria, Vectorborne and other Parasitic diseases (MVP) and Emerging Disease Surveillance and Response (ESR) units for better sustainability. MVP remains responsible for vector control, social mobilization, programme support and operational research, while ESR took over dengue surveillance, case management and outbreak response. Both units collaborated closely for dengue outbreak control, especially in FJI, KHM, LAO and PHL. MVP supported the dengue programme, including a programme review in LAO; provided technical support to the Asian Development Bank-funded project of community-based dengue interventions in KHM and LAO using guppy fish; supported resource mobilization in the PHL and KHM (both failed); the development of an action plan in VUT; and the replenishment and management of the Pacific dengue stockpile as well as vector surveillance in FJI. The implementation of the biregional Dengue Strategic Plan for the AsiaPacific Region (2008–2015) is in good progress. MVP secured approval of the Korea

International Cooperation Agency (KOICA)-funded proposal of US$ 1.2 million on climate change and vectorborne diseases in three countries, which will benefit dengue control. A dengue advocacy video was produced by MVP/ESR for viewing during the sixty-first session of the Regional Committee Meeting for the Western Pacific in 2010. A draft Regional Plan of Action for Neglected Tropical Diseases (NTDs) has been developed and costed, and once finalized, will serve as an advocacy and planning tool. A Regional Plan of Action for Elimination of Lymphatic Filariasis (LF) from 2010–2020 has also been developed. Countries and areas in the WPR continued to make progress towards the global goal of eliminating LF by 2020. COK, NIU, TON and VUT are among the countries that will have eliminated LF in the next two to three years. PYF, TON and VNM achieved 80% coverage over five consecutive rounds of mass drug administration (MDA). Among the "Mekong-Plus" countries, all except LAO and a few remaining endemic implementation units in MYS and PHL, have completed 5 rounds of MDA and are now conducting the stop-MDA surveys or post-MDA surveillance. After the MDA for LF elimination is completed, countries endemic for soil-transmitted helminthiasis (STH) are encouraged to continue with deworming rounds. JVC/JPN support helped to ensure

WPR/RC62/3 page 8 Annex 1 continuation of deworming in four Pacific island Countries (PIC) that completed LF MDA earlier. KHM, KIR, LAO and TUV maintained the WHO's global target of deworming of 75% of school-aged children at risk. CHN, KHM, KOR, LAO and VNM completed the mapping of foodborne trematodes (FBT). PHL is planning to conduct the mapping of FBT in the high-risk areas in Mindanao. Following the meeting of global experts on FBT and cestodiasis in Vientiane, LAO (12–16 October 2009), CHN, KHM and VNM were selected for conducting pilot interventions. LAO and VNM also continued with targeted treatment against FBT in selected areas but they represented only a fraction of population at risk; scaling up of treatment interventions was hampered due to resource constraints. Schistosomiasis is endemic in four countries in this Region (CHN, KHM, LAO and PHL). All endemic countries continued with targeted intervention campaigns against schistosomiasis, while KHM and LAO treated the entire population at risk with MDA; whereas CHN additionally implemented animal host and vector control interventions. The 10th meeting of Regional Network for Asian Schistosomiasis and other Helminth Zoonoses (RNAS +) was held from 15–19 November 2010 in Wuxi, CHN. MVP participated in this meeting and provided technical inputs, including the development of a proposal to fund RNAS – this proposal was approved and over US$ 1 million will be available from 2011 (directly to RNAS). Huge momentum has been created by the declaration of leprosy elimination as a regional priority by the Regional Director. Partners are available to support leprosy elimination, including US CDC and Pacific Leprosy Foundation, and cooperation is ongoing with women's associations. Synergies are being established with other programmes such as lymphatic filariasis and yaws elimination (jointly with MVP). A key risk factor is the limitation in human resources, in terms of sufficient staff and capacity. Dengue prevention and control in the Region gained momentum following the publication of the Biregional Dengue Strategic Plan for the Asia Pacific Region (2008–2015) in 2008 and the regional integrated vector management (IVM) framework in 2009. Dengue increasingly has been considered and supported by partners including ADB and World Bank, USAID, research institutes (e.g. Paediatric Dengue Vaccine Initiative (PDVI)), governments and agencies (e.g. ASEAN +3 and ACTMalaria). The transfer of tasks to ESR sustained operations for outbreak control, surveillance and case management in WPRO. However, funding is a challenge. There is a risk that with the unexpected stop of USAID funding in 2011 WHO dengue support in the Region will significantly be

WPR/RC62/3 page 9 Annex 1 affected, including lack of replenishment of the Pacific stockpile and the discontinuation of the services of the dengue focal point in MVP. The current achievements of the NTD programme came from years of advocacy and hard work of MVP colleagues at both the Regional Office and Country Offices, as well as the support from a limited number of donors (JVC, JICA and GNNTD). The progress so far is attractive to donors, and so is the availability of action plans and budgets. The main risks are the lack of government commitment and lack of financial and especially human resources, both in countries and with WHO, especially in the Pacific, which threaten to lose the momentum and undo the gains. There are also issues with quality and availability of anti-helminthic drugs (Di-ethyl carbamazepine [DEC]) used for MDA. OWER 1.4 Policy and technical support provided to Member States in order to enhance their capacity to carry out surveillance and monitoring of all communicable diseases of public health importance. Indicator 1.4.1 Number of Member States with surveillance systems and training for all communicable diseases of public health importance for the country Baseline 5 Member States – (this does not include developed countries) have surveillance systems and training for all communicable diseases of public health importance for the country via country office staff, and visits from Regional Office (RO) staff that have resulted in significant enhancement of countries' surveillance and monitoring systems. The RO has worked closely with the countries in provision of technical assistance to enhance the development of surveillance systems All 36 countries and areas have case-based surveillance systems for AFP and measles and report data regularly to WPRO. 1.4.2 Number of Member States for which WHO/UNICEF joint reporting forms on immunization surveillance and monitoring are received on time at global level in accordance with established timelines 7 Target 25

On track

To end 2010 13 (ESR)

36 (EPI)

This OWER is on track. Through development and implementation of APSED Strategy, member states have been supported to enhance their surveillance capacity to carry out surveillance and monitoring of communicable diseases.

WPR/RC62/3 page 10 Annex 1 The Asia Pacific Strategy for Emerging Diseases Technical Paper (2010) was published as the foundation for the APSED 2010 Strategy. APSED's next five-year strategy was later developed through extensive country consultations using a bottom-up approach throughout the process. APSED (2010) strategy was endorsed by the Regional Committee during its annual meeting in October 2010. Countries and areas receiving enhanced technical assistance from WHO in strengthening communicable disease surveillance and monitoring systems including CHN, KHM, LAO, MNG, MYS, PHL, PNG, PIC, VNM. JPN, KOR and SGP already have well-established surveillance systems. Member States have also been supported by WHO to enhance their surveillance capacity and improve their surveillance systems for vaccine-preventable diseases. Through technical support, on-site visits, and development and sharing of surveillance tools, materials, and databases, eight Member States (CHN, FJI, KHM, LAO, MNG, PHL, PNG, and VNM) have established or improved the quality of surveillance for three new vaccine-preventable diseases: rotavirus diarrhoea, and meningitis and respiratory infection due to Haemophilus influenzae b and pneumococcus. To support WHO-designated national laboratories for vaccine-preventable diseases, technical support was provided through regional hands on training courses and meetings of network laboratories. Onsite review of polio, measles and Japanese encephalitis (JE) laboratories was conducted for annual accreditation and all 43 polio laboratories, 45 out of 48 measles laboratories and 4 out of 10 JE laboratories were fully accredited as of December 2010. Financial support was provided to six polio laboratories in five Member States (AUS, CHN, MNG, PHL and VNM), 10 measles laboratories in nine MS (AUS, CHN, FJI, KHM, LAO, MNG, PHL, PNG and VNM) and six JE laboratories in five MS (CHN, KHM, LAO, PHL and VNM). Regional laboratory networks for Rotavirus and vaccinepreventable invasive bacterial diseases were established to support surveillance and monitoring impact of new vaccines introduction. In 2009, the deadline for submission of WHO-UNICEF Joint Reporting Forms (JRFs) was changed from 15 April to 15 March. Many countries and areas were unable to adjust to this new deadline on time, resulting in a baseline of 19% in 2009. By the year 2010, 75% of countries and areas submitted JRF reports on time. The relevance and importance of JRF reporting was highlighted during the 2010 Technical Advisory Group Meeting, held in Manila.

WPR/RC62/3 page 11 Annex 1

OWER 1.5 New knowledge, intervention tools and strategies that meet priority needs for the prevention and control of communicable diseases developed and validated, with scientists from developing countries increasingly taking the lead in this research. Indicator 1.5.1 Number of new and improved tools or implementation strategies, developed with significant contribution from WHO, introduced by the public sector in at least one developing country Baseline CHN has developed an integrated strategy to control schistosomiasis, and is intensively implementing in selected endemic areas. Target 2

On track

To end 2010 1 (template for national NTD strategic plans, used in KHM, LAO and VNM)

1.5.2

Proportion of peer-reviewed publications based on WHO-supported research where the main author’s institution is in a developing country

All the institutions of the main authors of the four WHO supported publications are in developing countries.

100%

This OWER is on track. The draft Regional Research Plan of Action on Infectious Diseases of Poverty (RRPA) was further refined with inputs from Tropical Diseases Research (TDR), WHO collaborating centres (CCs), researchers and research institutions within and outside the Region, and the Regional Network for Asian Schistosomiasis and other Helminth Zoonoses (RNAS+). This plan is expected to encourage political commitment and increase allocation of resources for research. The Region has managed the TDR-supported small grants scheme since 2006. TDR small grants strategically target young and/or new researchers in resource-constrained Member States, and encourage the conduct of operational research studies on NTDs. Funding for 2010 was US$ 75 000; in addition, TDR provided funds for the TDR fellow who manages and coordinates the scheme – this position has been in place for four years and could be extended for another year until November 2011. Three studies which were funded in 2008 to 2009 were completed. In 2010, the TDR small grants scheme funded four research projects: Viral infections including dengue in the aetiology of febrile seizures in children in PNG; morbidity due to Opisthorchis viverrini in LAO; sero-prevalence of major bovine-associated infectious diseases in LAO; and empowering village health workers for an integrated community-based control for food-borne trematodes among indigenous populations in the PHL; among these, the study in the PHL focuses on developing intervention tools for helminthiasis. For the 2011 TDR small grants, 25 proposals were received from seven countries.

WPR/RC62/3 page 12 Annex 1 The EPI unit supported 2 studies on immunodeficiency-related vaccine-derived poliovirus (iVDPV) in CHN and the PHL, which focused on strategy development as well as programmatic gaps. This multi-country research project seeks to establish the prevalence of prolonged and chronic poliovirus excretion among persons with primary immune deficiency disorders (PID) in middle and low-income countries. The key research question is to which extent persons with PIDs could serve as potential reservoirs for vaccine derived polioviruses (VDPVs) and subsequent polio outbreaks in countries with low population immunity. Research grants and trainings were strategically linked as part of a capacity building cycle for strengthening research in the Region. This cycle consists of: (1) support for proposal/grant writing; (2) grant support (e.g. TDR small grants); and (3) training on scientific writing to disseminate research results. In 2010, STB and MVP jointly conducted a workshop on research design,

methodology and proposal writing. The workshop helped participants from 10 countries to develop research proposals which focus on intervention tools and strategies. Six proposals were further developed after the workshop and are now seeking funding. TDR's support and activities in the Region continued to increase. These activities included meetings of the TDR Joint Coordinating Board, Disease Reference Group (for tuberculosis), and Thematic Reference Groups (Technology and innovation; Environment, Agriculture and Infectious diseases of Poverty) in the Region. MVP successfully negotiated with TDR to establish a Regional TDR training centre in this Region where the Philippine Research Institute of Tropical Medicine (RITM) was selected. Additional resources were mobilized by MVP to support research strengthening in the Region. For example, IDRC Ecohealth Research Grants was obtained for RNAS+'s multi-country study on schistosomiasis and food-borne trematodes. Technical assistance for leprosy elimination was provided to Pacific island countries and areas (PICs) and the PHL, during which the need for operational research was identified. Due to a lack of funding and human resources, no activity has been started. Success Factors/Lessons Learned: The current achievements of the NTD programme come from years of advocacy and hard work of MVP staff at both the Regional Office and Country Offices, as well as the support from a limited number of donors (Glaxo SmithKline, Japan Voluntary Contribution [JVC], Japan International Cooperation Agency [JICA], Global Network for Neglected Tropical Diseases [GNNTD] and

WPR/RC62/3 page 13 Annex 1 USAID). The progress so far is attractive to donors, and so is the availability of action plans and budgets. The main risks are the lack of government commitment and lack of financial and especially human resources. MVP has managed, through strong advocacy, to establish a strong collaboration with TDR. This was maintained and strengthened via regular teleconferences and development of joint workplans, which resulted in an increased number of TDR-supported activities in the Region. TDR's financing of two posts (research coordinator and small grants fellow) has been instrumental for the work under the RER 01.005.WP01. The Stop Tuberculosis (STB) programme has substantially increased leprosyrelated activities which may result in increased interest of donors/partners to support leprosy research in the future. However, this requires that STB can continue to further increase the visibility of leprosy-related activities in the Region. There is a strong interest in operational research in communicable diseases in this Region and there are existing research institutions capable for conducting this. The development and refinement of the Regional Research Plan of Action (RRPA) was performed in a participatory manner by involving regional stakeholders where their research needs were identified and reflected in the plan. A major challenge is funding. While research in malaria, HIV and tuberculosis have substantial funding in this Region, most of the funding for research on the diseases under the RER 01.005.WP01 comes from the TDR small grants, and there has been no funding so far for research on leprosy. With the current financial crisis in TDR, continuation of funding may be uncertain.

WPR/RC62/3 page 14 Annex 1

OWER 1.6 Support provided to Member States in order to achieve the minimum core capacities required by the International Health Regulations (2005) for the establishment and strengthening of alert and response systems for use in epidemics and other public health emergencies of international concern. Indicator 1.6.1 Number of Member States that have completed the assessment and developed a national action plan to achieve core capacities for surveillance and response in line with their obligations under the International Health Regulations (IHR) [2005] Baseline 27 countries (all these countries developed national plans during APSED 2005) Target 10 At least 10 countries are expected to develop workplans by end of 2011 under the updated strategy APSED (2010) 25

On track

To end 2010 0

1.6.2

Number of Member States whose national laboratory systems are engaged in at least one external quality-control programme for epidemic-prone communicable diseases

This OWER is considered "on track" because the process is on track. The period of 2010–2011 is considered a transitional period between two APSED strategies―APSED (2005) and the updated APSED (2010). In the Western Pacific Region, the Asia Pacific Strategy for Emerging Diseases (APSED) serves as a regional tool to meeting the IHR core capacity requirements. With the support of WHO, 15 Member States conducted an initial assessment using APSED (2005) checklists in 2007–2008. As a result of this assessment, more than 10 countries developed a national workplan for APSED (2005), which served as the National IHR action plan before 2010. All 27 countries had a national plan or equivalent to achieve IHR core capacities by 2010, though the degree of details of the plans varied. However, APSED (2010), the updated strategy, was approved by the Regional Committee for the Western Pacific in October 2010. The Technical Advisory Group (TAG) meeting on workplan development under APSED (2010) would be held in July 2011, and the target is set based on the achievements of APSED (2005), to develop updated national plans using APSED (2010) by the end of 2011.

WPR/RC62/3 page 15 Annex 1 IHR has been continuously included as one of the important agenda items in several regional and subregional meetings/workshops, including annual meetings of the Asia Pacific Technical Advisory Group (TAG) on Emerging Infectious Diseases (EIDs) such as the TAG in July 2010, the annual Regional Committee meeting (e.g. October 2010) and the meeting of Pacific National IHR Focal Points (March 2010). The countries and areas in the Region have been strongly encouraged to consider IHR as a good opportunity to strengthen their national and local surveillance and response systems, and to strengthen regional and international collaboration to contribute regional and global health security. All 27 Member States have their designated National IHR Focal Points (NFP) and most NFPs had demonstrated their functionality during the pandemic (H1N1) in 2009. All countries participated in the annual NFP meeting as part of the annual TAG meeting and about 20 countries have been supported in the Region by WHO in complying with IHR regulations. Since the new IHR entered into force in June 2007, more than 100 public health events including Zika virus, imported polio case, cholera, human infections of H5N1, H9N2 virus, the new influenza A(H1N1), MDR-TB, Ebola Reston virus infections and food contaminations have been communicated to WHO through NFP. The second regional exercise on IHR event communications (namely "IHR Exercise Crystal 2010"), with the participation of 20 National IHR Focal Points in the Region, was conducted to test and assess the functional accessibility of the National IHR Focal Points (NFPs) contact details; and to validate IHR event notification and information sharing process. The feedback from the participating NFPs indicated that such an annual exercise was very helpful. The main gaps or challenges identified included the 24/7 accessibility of the NFPs, the need for IHR briefing and training of new NFP staff (including use of IHR decision instrument and EIS posting) and language barriers in some countries. The NFPs have played an increasing role in facilitating IHR event-related communications (including event reporting, verification and notification) between Member States and WHO. It was noticed that such annual IHR event communication exercise would not need much direct budget, but require human and technical resources to implement. An informal expert consultation meeting on POE public health emergency planning was held in February 2010 to develop the draft guidance on public health emergency contingency planning at designated points of entry. Technical support was provided to the PHL to develop the Ninoy Aquino International Airport (NAIA) Public Health Emergency Contingency Plan (PHECP), including preparation and conduct of Stakeholders' planning workshop on PHECP at POE in December 2010.

WPR/RC62/3 page 16 Annex 1 The IHR core capacities for surveillance and response have been strengthened through APSED implementation (see a separate section on APSED). Laboratory is one of the focus areas of APSED (2005) and continues to be one of the important areas of work in the recently updated APSED or APSED (2010). External quality assurance programme for influenza has been implemented and more than 20 laboratories participated in the EQA programme facilitated by WHO. OWER 1.7 Member States and the international community equipped to detect, assess, respond to and cope with major epidemic and pandemic-prone diseases (e.g. influenza, meningitis, yellow fever, haemorrhagic fevers, plague and smallpox) through the development and implementation of tools, methodologies, practices, networks and partnerships for prevention, detection, preparedness and intervention. Indicator 1.7.1 Number of Member States having national preparedness plans and standard operating procedures in place for readiness and response to major epidemic-prone diseases Number of international coordination mechanisms for supplying essential vaccines, medicines and equipment for use in mass interventions against major epidemic and pandemic-prone diseases Number of severe emerging and reemerging diseases for which prevention, surveillance and control strategies have been developed Baseline 27 Target 27 (updated plans based on Pandemic 2009 experience) -

On track

To end 2010 27

1.7.2

1.7.3

2 (Virus A(H1N1); Avian Influenza)

4 (Dengue and HFMD)

This OWER is on track. The implementation of APSED continued to be the focus or the regional highest priority of the IHR implementation in 2010. The Strategy was originally endorsed by the Regional Committee for the Western Pacific in September 2005 as a regional tool for the countries to meet the surveillance and response core capacity obligations under the IHR. Significant progress has been made to implement APSED (2005). Securing our Region's Health: the Asia Pacific Strategy for Emerging Diseases has been published and distributed to Member States, donors and partners since July 2010. It highlights some examples of country achievements in The APSED (2010) common

managing emerging diseases including epidemic-prone diseases.

indicators assessment was conducted in a number of countries (including CHN, KHM, LAO, MNG, MYS, PLW and PHL) between January-April 2010. A separate report is available, showing the progress made in all five APSED capacity areas as compared with the baseline in 2007. Overall, significant progress has been achieved in developing capacities in all the five APSED programme areas. Of the 18 minimum systems or functional areas assessed in both the 2007 APSED Baseline

WPR/RC62/3 page 17 Annex 1 Data Collection and 2010 APSED Common Indicators Assessment, all have shown good progress towards achieving minimum standards in core capacities. All 27 Member States in the Western Pacific Region have developed national influenza pandemic preparedness and response plans and/or a national plan for preventing and responding to avian influenza. However, the level of details of the national plans varied. Important lessons from the pandemic preparedness and the response to pandemic (H1N1) 2009 in the Western Pacific Region have been identified. They provided important basis for revising national pandemic influenza

response plan and developing a public health emergency plan in the future. Some countries have also developed their specific strategy and guidelines for other priority diseases including dengue and Hand, Foot and Mouth Disease (HFMD). APSED has been updated building on the foundations laid out over the past 4-5 years through APSED (2005) implementation, the lessons learned from pandemic (H1N1) 2009 and inputs from countries and areas during the series country and regional-level consultations on "APSED and Beyond" between July 2009–October 2010. As a result, the updated regional strategy or APSED (2010), endorsed by the Regional Committee Meeting, is being used by countries and WHO to continue to strengthen the capacities required for managing emerging diseases and other acute public health events. OWER 1.8 Regional and global capacity coordinated and made rapidly available to Member States for detection, verification, risk assessment and response to epidemics and other public health emergencies of international concern. Indicator 1.8.1 Number of WHO locations with the global event-management system in place to support coordination of risk assessment, communications and field operations for headquarters, regional and country offices Baseline 1 Target 10

On track

To end 2010 10

This OWER is on track. A fully functioning regional Event-based Surveillance system (EBS) is with WPRO at present. From January to December 2010, there were 256 events reported to the regional EBS system. In 10 countries such as CHN, KHM, LAO, MYS, MNG, PIC, PNG, PHL, SGP and VNM had some kind of EBS that coordinated with the Regional Office surveillance team. Other achievements made under Regional and Global capacity coordinated and made rapidly available to Member States is through GOARN network and Regional Clinical Network. Global

WPR/RC62/3 page 18 Annex 1 Outbreak Alert and Response Network (GOARN) strengthened at regional level through an annual meeting and training for GOARN institutions. As a result of the Regional Clinical Advisory Network on Emerging Infectious Disease and in support of the regional strategy, the Regional Clinical Network on Emerging Infectious Diseases was formally established in 2009 to make available a platform for region-wide sharing of expertise in the diagnosis and treatment of critically ill patients during outbreaks of emerging infectious diseases. The meetings of Regional Clinical Network is held annually and recommend the ways forward for clinical management options or guidelines particularly for human infections with pandemic influenza A(H1N1) 2009, H5N1, and EV-71, etc. OWER 1.9 Effective operations and response by Member States and the international community to declared emergencies situations due to epidemic- and pandemic-prone diseases. Indicator 1.9.1 Proportion of Member States' requests for assistance that have lead to effective and timely interventions by WHO, delivered using a global team approach, in order to prevent, contain and control epidemics and other public health emergencies Baseline 80% Target 90%

On track

To end 2010 90%

This OWER is on track. WPRO has provided support to outbreak situations as required and requested from us. Such instances were for dengue and cholera outbreak situations in KHM, LAO, PHL and PNG, respectively. Successfully supported were outbreak responses in countries such as dengue in the PHL and cholera in KHM, LAO and PNG. ACTIONS REQUIRED The following are required actions: Increased political, financial and human resource commitments are critical to sustain and achieve Regional goals to maintain the Region's poliomyelitis-free status, achieve measles elimination and hepatitis B control, and achieve and sustain maternal and neonatal tetanus elimination. Such

commitments should be addressed specifically to improving routine and supplementary immunization coverage, strengthening sensitive and timely case based surveillance for VPDs, and ensuring vaccine and immunization quality and safety. Additional investments in the introduction of new or

underutilized vaccines and interventions are cost effective and should be placed high on the political agenda.

WPR/RC62/3 page 19 Annex 1 A comprehensive regional programmatic action framework for leprosy elimination is needed. Case finding activities and surveillance systems need to be strengthened in targeted countries. Leprosy services must be integrated into the general health system and improved overall to be provided not only for newly detected cases, but also for previously diagnosed and treated patients. A considerable number of cured patients with disabilities will be relying on rehabilitative services. The strengthening of human resources is crucial and different areas may require a tailored approach. Dengue has become a regional priority. It is necessary to strengthen dengue case management (translating the new dengue case management guidelines into national guidelines and training of staff) and surveillance including early warning and appropriate response to outbreaks; to put in place interoutbreak vector control and community mobilization interventions to mitigate the impact of outbreaks; and to refine dengue national plans and implement them. Massive resource mobilization is needed, both for countries as well as for WHO for technical assistance. Collaboration with dengue partners is crucial: ADB, PDVI, ASEAN +3, ACTMalaria and WHO CCs for implementation of IVM. At country level, the division of work between ESR and MVP needs to be better communicated. LF is close to elimination in a number of countries, so the job must be finished now. RD has declared LF elimination as one of the regional priorities, with emphasis on FSM, KIR and MHL jointly with leprosy elimination – a significant effort with adequate human and financial resources will be needed to achieve this. LF/NTD activities in PNG are lagging far behind, and a special effort is needed with one full time staff on the ground. The successes in deworming of school children in KHM and LAO need to be maintained and expanded. Schistosomiasis control must be intensified especially in the PHL. Case management through health services needs to be improved for all NTDs. Further refinement of the Regional Research Plan of Action on Infectious Diseases of Poverty (RRPA) with programme managers of target diseases is needed to finalize the plan. Grant seeking and resource mobilization from funding institutions and agencies are necessary to implement the RRPA. In addition, collaboration with other sectors and ministries, such as the Ministry of Science and Technology, Agriculture, and Education is also an important aspect in strengthening research activities in the Region. Monitoring and follow-up of TDR-funded projects is necessary to measure progress, provide technical advice and to assess outcomes. A scientific writing workshop targeting TDR-grant recipients is vital to help them publish the results of their TDR-supported studies. It is important to implement the new APSED 2010 in all eight focal areas collectively and in a coordinated way towards the expected outcomes, including meeting the IHR core capacity requirements. The development of workplans for each focus area is needed to implement the

WPR/RC62/3 page 20 Annex 1 strategies under APSED 2010. These workplans are now being developed by the Regional Office and Country Office staff. These workplans will help Member States to develop their own APSED national workplans. It is also necessary to continue to strengthen NFP functions and POE core capacities required under IHR (2005) through updating the technical guidance document, such as the Public Health Emergency Planning and Exercise. Despite progress made under APSED implementation, we still need to continue strengthening capacities for response in outbreak situations in countries. We need to continuously maintain our capacity to provide support to countries in outbreak situations. Annual GOARN meetings in the Region should continue.

WPR/RC62/3 page 21 Annex 1 STRATEGIC OBJECTIVE 2 To combat HIV/AIDS, tuberculosis and malaria.

The Region continues to contribute to normative guidance and programmatic innovations in all SO2 areas, with access to adequate diagnosis and care for vulnerable groups and drug resistance as important crosscutting issues. The new Regional Strategy to Stop Tuberculosis in the Western Pacific (2011–2015) was endorsed by the Member States and will lead to considerable innovations of national tuberculosis (TB) control programmes. Significant inputs were provided to Member States for all three diseases to update/revise and cost national strategic plans. Overall, the Region is on track, with significant progress made in all disease programmes. The HIV (human immunodeficiency virus), malaria and tuberculosis units have been providing extensive technical assistance to countries, both through in-country technical assistance and through regional workshops. The number of collaborative activities within the SO2 group and beyond has been increasing, including in areas such as HIV/tuberculosis, prison health, migrant health, infection control, research and the laboratory. The strengthening of in-country presence of WHO is considered crucial for countries as well as the future of WHO. All three units are engaged in supporting countries to ensure access to and continuous supply of quality medicines, diagnostics and other commodities (e.g. bednets) for prevention and case management of HIV, tuberculosis and malaria. With drug resistance in malaria and tuberculosis being a huge issue in the Region, efforts are ongoing to improve rational use of medicines and monitor the quality of medicines and diagnostics. While there is good cooperation with the WPRO Pharmaceuticals programme, more cooperation is needed with other related WHO programmes at Regional Office and Headquarters (HQ) levels to address these major issues with a health systems approach. Major progress has been made in strengthening regional and national surveillance and monitoring and evaluation (SM&E) systems for HIV, malaria and tuberculosis. Regional indicator frameworks have been refined, burden estimations and surveys supported, malaria SM&E capacity is being assessed, programme SM&E plans are being updated and all three units continued to provide intensive technical support and capacity building to key countries. Data was published in major regional and global reports, contributing to the accountability in view of the massive global investments currently being made in HIV, tuberculosis and malaria programmes. Innovations have been supported, e.g. into web-based surveillance and SMS-based reporting systems. With drug resistance for HIV, malaria and tuberculosis being a major concern in the Region, with global implications, WPRO has intensified its

WPR/RC62/3 page 22 Annex 1 support to countries to ensure timely and high-quality monitoring of drug and insecticide resistance, conducted training, improved coordination including through networks, and reviewed and published/disseminated results. HIV, tuberculosis and malaria and Coordination with the Global Fund (CGF) units have continued to intensely support countries to successfully mobilize resources, especially through the Global Fund, resulting in a massive scale-up of programme activities. Countries continue to require technical support for implementation of these grants - however, funding for WHO staff remains limited, with HSI particularly affected. Partnerships with key partners, networks as well as WHO Collaborating Centres, academia, technical partners and agencies were strengthened, and new networks like the HSI technical support network have been established. Tuberculosis and malaria have advanced the

involvement of the private sector in key countries. HIV continues to actively participate in various regional task forces to enhance the active involvement of most-at-risk populations and people living with HIV. Community-based interventions have been expanded in many countries across all the three disease control programmes. Advocacy and communication was strengthened. All the three programmes supported research, often in cooperation with partners, as one important component of their programmes, to fill knowledge gaps and improve the effectiveness of the programmes. This is in line with the ongoing efforts by the Division to develop a Regional Research Plan of Action on Infectious Diseases of Poverty (RRPA). Units mainly supported operational research, but also basic research (e.g. on artemisinin resistance). One programme (Stop TB) launched a research scheme while malaria supported the Mekong Malaria Programme (MMP) operational research agenda setting in the countries of the Greater Mekong Subregion. With research capacity still being weak in most infectious disease-endemic countries in the Region, special emphasis was paid to research capacity building; STB and MVP jointly facilitated a grant writing workshop, in collaboration with TDR. Grant writing and scientific writing workshops are a huge element of the Division's Regional Research Plan of Action drafts. The establishment of the WPRO Ethics Review Committee (ERC) and a related training for all ERC members facilitated the WHO ethical review of research proposals. Inter-unit collaboration as well as partnerships with key partners, academia, technical partners and agencies in research was strengthened. However, donor interest largely

determined the area of research to be supported, and continuation of research funding remains a challenge.

WPR/RC62/3 page 23 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 2.1 Guidelines, policy, strategy and other tools developed for prevention of, and treatment and care for patients with, HIV/AIDS, tuberculosis and malaria, including innovative approaches for increasing coverage of the interventions among poor people, and hard-to-reach and vulnerable populations. Indicator 2.1.1 Number of low- and middle-income countries that have achieved 80% coverage for (a) antiretroviral therapy and (b) the prevention of mother-to-child transmission services Proportion of diseaseendemic countries that have achieved their national intervention targets for preventing malaria Number of Member States that have achieved the targets of at least 70% case detection and 85% treatment success rate for tuberculosis Baseline Two countries (KHM and LAO) achieved more than 80% coverage for antiretroviral therapy Target Maintain two countries - KHM and LAO (New WHO guidelines have increased the denominator)

On track

To end 2010 Two countries - KHM and LAO

2.1.2

90% of the 10 WPR malaria endemic countries achieved their national intervention targets

Maintain 90%

90% of the 10 (except PNG) WPR malaria endemic countries achieved their national intervention targets 25/34 Member States achieved 70% CDR. All cases (2009); 17/32 achieved 85% treatment success (6/7 HBC – 2008 cohort); the combination of both was achieved by 11/32 countries (2/7 HBCs). For CDR, 2 countries didn't report and for treatment success, 4 countries did not report, and for both, 4 countries did not report 0 of the 3

2.1.3

21/36 Member States and areas have achieved 70% case detection (5/7 high burden countries) and 19/36 have achieved a treatment success rate of 85% (6/7 high burden countries). The combination of both has been achieved by 14/36 (5/7 high burden countries).

N/A due to change in CDR measurement from CDR SS+ to All Forms

2.1.4

Number of countries among the 27 priority ones with a high burden of multidrug-resistant tuberculosis that have detected and initiated treatment, under the WHO-recommended programmatic management approach, for at least 70% of estimated cases of multidrug-resistant tuberculosis

None of the 3 high MDR-TB burden countries in WPRO (CHN, PHL, VNM) have achieved treatment for at least 70% of estimated MDR-TB cases.

WPR/RC62/3 page 24 Annex 1 2.1.5 Proportion of high-burden Member States that have achieved the target of 70% of persons with sexually transmitted infections diagnosed, treated and counselled at primary point-of-care sites 100% (nine key countries) with 70% of persons with STIs diagnosed, treated and counselled at primary point-of-care sites 100% 100%

HIV The strong country presence of focal points on HIV resulted in enhanced responsiveness to provide support to countries in the development of a medium-term strategic plan. Majority of MTSP have undergone numerous consultations, involved multiple sectors and the community and coordinated with major country stakeholders and partners. Because of the strong WHO country presence the MTSP has adapted components of the WHO priority interventions based in specific country context. The development of guidelines and strategies has undergone a broad base consultation including most-at-risk and vulnerable populations and community-based organizations and provides guidance to countries to accelerate effective responses to the most affected key populations in the Region which are the main drivers of the HIV epidemic. All the meetings convened have supported countries to adapt various WHO guidelines and to accelerate effective responses in line with the WHO HIV strategic directions towards universal access. The outcomes of the meetings lead to concrete next steps on ways forward towards universal access to HIV prevention, treatment, care and support. Tuberculosis The new Regional Strategy was strongly endorsed by all Member States and the Sixty-first session of the Regional Committee as well as the Technical Advisory Group after broad consultation with the countries. As a result of the consultation process and comprehensive technical assistance, National Plans are being/have been harmonized with the new Strategy. However, the countries all requested further guidance on the preparation and implementation of new interventions, such as the introduction of new diagnostic tools and intensified case-finding among high-risk and vulnerable groups. Extensive technical assistance is required to assist countries to introduce these new tuberculosis control strategies and adapt diagnostic algorithms. The Global Fund provides the resources for most of these interventions, although sustainability of funding and insufficient human resource capacity pose immediate and long-term challenges.

WPR/RC62/3 page 25 Annex 1 Malaria Funding for malaria was available in the country programmes and at WHO, which enabled recruitment of the M&E Officer at RO and short-term consultants to carry out specific tasks. The Regional Action Plan for Malaria Control and Elimination (2010–2015), endorsed in 2009, increased the focus and generated increased political commitment from Member States and partners. With malaria significantly declining in most countries of the Region, national programmes realize the need to focus on strengthening surveillance system, specific risk/vulnerable groups where malaria remains/is still serious as well as to engage the private sector. The emergence of artemisinin

resistance in KHM and THA has given a push and funding to engaging the private sector and targeting mobile/migrant populations as well as to the review of national malaria treatment guidelines. OWER 2.2 Policy and technical support provided to countries towards expanded gender-sensitive delivery of prevention, treatment and care interventions for HIV/AIDS, tuberculosis and malaria, including integrated training and service delivery; wider service-provider networks; and strengthened laboratory capacities and better linkages with other health services, such as those for sexual and reproductive health, maternal, newborn and child health, sexually transmitted infections, nutrition, drug-dependence treatment services, respiratory care, neglected diseases and environmental health. Indicator 2.2.1 Number of targeted Member States with comprehensive WHOrecommended policies and medium-term plans in response to HIV, tuberculosis and malaria Baseline Countries with comprehensive policies and medium-term plans in response to: HIV: 9 (CHN, FJI, KHM, LAO, MNG, MYS, PHL, PNG and VNM) TB: all 7 high burden countries MAL: All 10 malaria endemic countries 2.2.2 Proportion of high burden countries monitoring provider initiated HIV testing and counselling in sexually transmitted infection and family planning services Number of countries among the 63 ones with a high burden of HIV/AIDS and tuberculosis that are implementing the WHO 12-point policy package for collaborative activities against HIV/AIDS and tuberculosis 100% (Nine key countries) started provider initiated HIV testing and counseling in STI services and TB facilities Nine countries are implementing the TBHIV co-infection framework, based on the WHO revised guidelines HIV: 100% (9 key countries) TB: 100% HIV: 100% (9 key countries) TB: 100% Target HIV: 9 (CHN, FJI, KHM, LAO, MNG, MYS, PHL, PNG and VNM) TB: All 7 high burden countries MAL: All 10 endemic countries

On track

To end 2010 HIV: 9 (CHN, FJI, KHM, LAO, MNG, MYS, PHL, PNG and VNM) TB: 7 (CHN, KHM, LAO, MNG, PHL, PNG and VNM) MAL: 10 (CHN, KHM, KOR, LAO, MYS, PHL, PNG, SLB, VNM, VUT)

2.2.3

HIV: 4 countries – KHM, LAO, PNG VNM TB: same as above

HIV: 3 countries – KHM, VNM, PNG TB: same as above

WPR/RC62/3 page 26 Annex 1

HIV Increased communication and dialogue across programmes is essential. Clear recommendation and guidelines on collaborative activities and articulation of roles and responsibilities across programmes in linking services and collaborative activities ensured the implementation of linked services and collaborative activities. Conflicting priorities across programmes lead to difficulties in expanding linkages between services and strengthening collaborative activities. The strong country presence of focal points on HIV resulted to enhanced responsiveness to provide support to countries. There is limited funding to address the increasing demand for technical support to a wider range of HIV issues. Due to limited funding, there is a risk of decrease in regional and country staff to provide technical support to national programmes. Tuberculosis The combination of normative activities at regional level and operational support at country level is crucial for strengthening tuberculosis control. WHO played an important role in GF grant

implementation and application (two out of three supported countries were approved in round 10). STB has developed its work plan with the need for collaboration between programmes in mind and several cross cutting activities have begun. Collaboration in the field of prison health and migrant health is promising. However, facilitating collaborative activities in countries remains a challenge due to political obstacles and the complex environment of international technical agencies. WHO in country presence turns out to be crucial for both the countries and the positioning of WHO. Malaria To have MVP country staff in most malaria endemic countries to provide technical assistance to the GF grants, sufficient funding for county programmes and political commitment were success factors for significantly decreasing malaria. PNG has the highest malaria morbidity and mortality in the Region, with little progress made - the new US$ 140 million Global Fund grant is a hope for thorough change but its implementation will be a major challenge. Artemisinin resistance and its potential spread is a major risk for malaria control and elimination in the Region.

WPR/RC62/3 page 27 Annex 1 OWER 2.3 Global guidance and technical support provided on policies and programmes in order to promote equitable access to essential medicines, diagnostic tools and health technologies of assured quality for the prevention and treatment of HIV/AIDS, tuberculosis and malaria, and their rational use by prescribers and consumers, and, in order to ensure uninterrupted supplies of diagnostics, safe blood and blood products, injections and other essential health technologies and commodities. Indicator 2.3.1 Number of new or updated global norms and quality standards for medicines and diagnostic tools for HIV/AIDS, tuberculosis and malaria Number of new priority medicines and diagnostic tools for HIV/AIDS, tuberculosis and malaria that have been assessed and pre-qualified for United Nations procurement Number of targeted countries receiving support to increase access to affordable essential medicines for HIV/AIDS, tuberculosis and malaria whose supply is integrated into national pharmaceutical systems (the number of targeted countries is determined for the six-year period) Number of Member States implementing quality-assured HIV/AIDS screening of all donated blood Baseline Not applicable to the region (the indicator asks for global norms/standards) Not applicable to WPR Target N/A

On track

To end 2010 N/A

2.3.2

N/A

2.3.3

HIV: 4 (KHM, LAO, PNG, VNM) TB: All 7 high burden countries and the majority of PIC MAL: 4 (KHM, PNG, SLB, VUT)

HIV: 4 (KHM, LAO, PNG, VNM) TB: 7 HBCs MAL: 8

HIV: 4 (KHM, LAO, PNG, VNM) TB: 7 HBCs (CHN, KHM, LAO, MNG, PHL, PNG, VNM) MAL: 8 (CHN, KHM, LAO, PHL, PNG, SLB, VNM, VUT)

2.3.4

Twenty four countries are implementing quality-assured HIV/AIDS screening of all donated blood Data not available

Twenty four countries are implementing quality-assured HIV/AIDS screening of all donated blood N/A

2.3.5

Number of Member States administering all medical injections using sterile singleuse syringes

WPR/RC62/3 page 28 Annex 1 HIV There is limited capacity to ensure the monitoring of quality of ART drugs. Majority of support have been provided by the WHO HIV focal points in countries. The ART technical working groups are essential to ensure that the New WHO ART guidelines are adapted in specific country context, taking into consideration the drug procurement and logistic systems, availability of quality ART drugs and to ensure that the patient most in need for ART are provided access to treatment. Majority of Member States have policies on using sterile single use syringes, however, data on this is not being collected through the HIV unit, this will need to be coordinated with blood safety. Tuberculosis The GDF missions to countries have been instrumental in improving drug management at country level. However, some countries are still experiencing stock-outs and the underlying problems,

including the functioning of the Global Drug Facility, need to be addressed urgently. In addition, the global market of second-line drug is very unstable and requires excellent forecasting at country levels. Malaria For medicines' quality improvement, intersectoral cooperation is mandatory – this had been demonstrated in the cooperation with Interpol, where health, police and customs at national levels (seven countries) and at international/regional level work together. In WPRO, there is an excellent cooperation between MVP and Pharmaceuticals. Drug quality/counterfeit issues are politically

sensitive which are a threat to progress in some countries. Addressing the issue of substandard drugs at country level at present cannot be adequately addressed in WPRO. The KHM government is committed to ban oral artemisinin monotherapy: they issued a decree and are implementing it. There are economic implications as well as access issues.

WPR/RC62/3 page 29 Annex 1

OWER 2.4 Global, regional and national systems for surveillance, evaluation and monitoring strengthened and expanded to keep track of progress towards targets and allocation of resources for HIV/AIDS, tuberculosis and malaria control and to determine the impact of control efforts and the evolution of drug resistance. Indicator 2.4.1 Number of Member States providing WHO with annual data on surveillance, monitoring or financial allocation data for inclusion in the annual global reports on control of HIV/AIDS, tuberculosis or malaria and the achievement of targets Baseline HIV: 9 priority countries and 5 high income countries provide WHO with annual data on surveillance and monitoring, for inclusion in the annual global report on progress of the health sector response towards universal access TB: All 36 countries and areas MAL: All 10 malaria-endemic countries provide annual surveillance and M&E data, which are (among others) included in the annual World Malaria Report, CHIPS statistical tables and MDG progress report HIV: Four countries report drug resistance surveillance data to WHO for HIV/AIDS TB: 30 countries and areas HIV: 4 (CHN, KHM, PNG and VNM) TB: 31 (including LAO) MAL: 10 (CHN, KHM, KOR, LAO, MYS, PHL, PNG, SLB, VNM, VUT) Target HIV: 9 priority countries and 4 other PIC TB: 36 MAL: 10 endemic countries

On track

To end 2010 HIV: 9 countries and 4 other PIC TB: All 36 MAL: 10 endemic countries

2.4.2

Number of Member States reporting drug resistance surveillance data to WHO for HIV/AIDS, tuberculosis or malaria

HIV: 4 (CHN, KHM, PNG and VNM) TB: 30 (all except JPN, KOR, LAO, NEZ, PNG and WSM) MAL: 10 (CHN, KHM, KOR, LAO, MYS, PHL, PNG, SLB, VNM, VUT)

MAL: 9 countries provide antimalarial drug efficacy monitoring data (in vivo): CHN, KHM, KOR, LAO, MYS, PHL, PNG, SLB, VNM

HIV Strong WHO regional and country support have resulted in strengthening of national surveillance, monitoring and evaluation systems and HIV drug resistance monitoring. There is a need for

continued support and advocacy to countries to keep focus on surveillance and M&E systems, as well as to maintain a regional focal point to continue technical assistance to countries, consolidate and validate country data and maintain regional data for advocacy and programming.

WPR/RC62/3 page 30 Annex 1 Tuberculosis Many countries are currently implementing or are interested in implementing web-based information systems (CHN, MNG, PHL, PIC and VNM). The quality of the data being collected at national level remains an issue for many countries, particularly for cases of MDR-TB. In addition, it is well known that many cases remain un-notified or undetected. Malaria Partner's collaboration (especially with MEASURE/Evaluation, Malaria Consortium and

CDC/Atlanta) contributed to the progress made with the biregional malaria indicator framework. Global Fund and partners are pushing countries for updated and good quality national M&E plans. The MVP country staff network was crucial for collecting and reviewing the World Malaria Report data and documents. Surveillance and M&E systems in the countries are still weak. Significant investment for surveillance/M&E and technical support for country programmes is required. For antimalarial drug efficacy monitoring planning, quality of implementation and reporting, the USAID funding to the WHO Mekong Malaria Programme/WPRO was crucial, as it enabled WHO to plan, monitor, coordinate and provide required technical assistance to these key Mekong activities and such ensure timeliness and quality of implementation in the Mekong countries. As such a network does not exist in the Pacific, these countries are lagging behind. WPR internet platform needs to be updated and aligned with HQ's internet platform as was done already for the other five regions. OWER 2.5 Political commitment sustained and mobilization of resources ensured through advocacy and nurturing of partnerships on HIV/AIDS, tuberculosis and malaria at country, regional and global levels; support provided to countries as appropriate to develop or strengthen and implement mechanisms for resource mobilization and utilization and increase the absorption capacity of available resources; and engagement of communities and affected persons increased to maximize the reach and performance of HIV/AIDS, tuberculosis and malaria control programmes. Indicator 2.5.1 Number of Member States with functional coordination mechanisms for HIV/AIDS, tuberculosis and malaria control Baseline Countries with functional coordination mechanisms for HIV/AIDS, tuberculosis and malaria control: HIV: 9 TB: all 7 high burden countries and majority of PIC MAL: 10 (all endemic countries) Target HIV: 9 TB: All 7 HBCs MAL: 10 (all)

On track

To end 2010 HIV: 9 TB: All 7 HBCs MAL: 10 (all)

WPR/RC62/3 page 31 Annex 1 2.5.2 Number of Member States involving communities, persons affected by the diseases, civil-society organizations and the private sector in planning, design, implementation and evaluation of HIV/AIDS, tuberculosis and malaria programmes Countries involving the communities, affected persons and others in programme design, planning and implementation: HIV: 9 TB: all 7 high burden countries and majority of PIC MAL: 10 (all endemic countries) HIV: 9 TB: 7 HBCs MAL: 10 (all) HIV: 9 TB: 7 HBCs MAL: 10 (all)

HIV Most successful Global Fund applications received technical support from WHO. Rigorous review from country and regional staff and enhanced coordination of inputs by WHO have resulted in successful Global Fund proposals. Staff time investment is high. Partnerships are essential to leverage support for priority HIV interventions and enhance community involvement. Tuberculosis Community involvement is crucial for patient-centred care delivery and social mobilization in the context of advocacy and early case-finding. strategy needs to be strengthened in the WPR. Malaria MVP has a skilled HR network, producing high quality proposals with a high rate of funding success the cooperation with and funding support from WPRO-CGF contributed to the success. However, this is very time-consuming. Partners trust and have confidence in WHO technical competency and accountability, and our established relationship with Member States. Many governments are The ACSM component of the global tuberculosis

committed to community-level interventions, however, for village volunteers, most countries do not have a policy on engagement and incentives. The Containment Project showed that national and international visibility of this effort is crucial, and had the funds to invest in this component. Sustaining current levels of partner support and country ownership is an issue.

WPR/RC62/3 page 32 Annex 1

OWER 2.6 New knowledge, intervention tools and strategies developed and validated to meet priority needs for the prevention and control of HIV/AIDS, tuberculosis and malaria, with scientists from developing countries increasingly taking the lead in this research. Indicator 2.6.1 Number of new and improved tools or implementation strategies for the prevention and control of HIV/AIDS, tuberculosis or malaria implemented by the public sector in at least one developing country Baseline HIV: 2 (Four countries are implementing the operational framework for linking HIV and sexual reproductive health; two countries have improved HIV testing strategy) TB: 5 (programmatic management of drug resistant TB in 3 countries (CHN, PHL, VNM); electronic registry in 2 countries (CHN, PHL); new lab techniques (liquid culture) introduces in 5 countries (CHN, KHM, LAO, PHL and VNM (solid); MDR-TB and infection control policies and guidelines developed (CHN, VNM, PHL); TB/HIV co-infection policy guidelines (KHM, PNG) MAL: 2 (a strategy for containment of artesunate resistance was developed which is implemented in 2 countries; the strategy for malaria control among ethnic minority groups is implemented in at least 2 countries) 2.6.2 Proportion of peerreviewed publications arising from WHOsupported research on HIV/AIDS, tuberculosis or malaria and for which the main author’s institution is based in a developing country. All publications arising from WHO-supported research had the main author's institution in a country of the Region. Target HIV: 3 Cost analysis tool on PMTCT Linked Response : CHN, KHM, LAO, MYS, PNG and VNM GASP (15 countries) TB: 8 PMDT - 7 HBCs, electronic registry – MNG; new lab techniques (rapid tests, incl. LED and Xpert) – at least 3 countries (CHN, PHL, VNM); MDR-TB and IC guidelines – all HBCs; TB-HIV co-infection – LAO

On track

To end 2010 HIV: 3 Cost analysis tool on PMTCT Linked Response : CHN, KHM, LAO, MYS, PNG and VNM GASP (15 countries) TB: 6 All baselines, PMDT in 6 HBCs (all but PNG); MDR-TB and IC guidelines in MOG; electronic register in ASM, FJI, FSM, GUM, MHL, MNP and PLW

MAL: 4

MAL: 3 (biregional indicator framework)

100%

WPR/RC62/3 page 33 Annex 1 HIV There is minimal support for operational research. Funds for operational research have been

mobilized from other partners such as UNICEF and National Centre for Global Health, National Center for Global Health (NCGH), JPN. Strengthened collaboration with the WHO Collaborating Centres for GASP has resulted in sustaining the GASP. It has also resulted in leveraging of funds from the WHO Collaborating Centres. Tuberculosis Thirteen proposals were submitted from seven countries and most of the topics are in line with the regional priorities (including migrants, vulnerable groups, etc.). The Regional Office should be prepared to guide countries further in the future to ensure that the proposed studies continue to be in line with these priorities. Malaria Research priorities are detailed in the Regional Action Plan for Malaria Control and Elimination (2010–2015), and in the recent Mekong research priority plan. Funding was available from interested donors and the Containment Project. Antimalarial drug efficacy monitoring is a priority activity in the Region. Good collaboration was established with some research institutions in the Region. A full WPRO Ethics Review Committee (ERC) with a fulltime secretariat became available. Major risks are limitation of scope of research by donor interests, sustained funding, and limited country research capacity. ACTIONS REQUIRED The following are required actions: HIV As majority of MTSP (eight out of the nine countries) are expiring in 2010 and 2011 based on a mapping conducted, countries will be supported to initiate the development of the 2011–2015 MTSP. The Global Health Sector Strategy on HIV/AIDS has been finalized and will be disseminated as soon as approved by the World Health Assembly, to support the development of country MTSP for 2011–2015. In addition, a regional strategy will be developed. Continue to follow up action items from the meetings and support countries to adapt new guidelines and strategies.

WPR/RC62/3 page 34 Annex 1 Continue to support countries to develop standard operating procedures on collaborative TB-HIV activities. Support countries to strengthen and expand linkages between HIV and sexual and reproductive health (SRH) including MCH services through greater engagement of HIV programme with SRH including MCH programmes. Enhance communication with other programmes to

strengthen linkages between programmes and scale-up collaborative activities. Continue to support countries through on-site technical support. Expand sustainable and quality technical support to countries through the WHO Network for HIV and health and mobilize resources to support technical assistance. Continue to maintain strategic partnerships to leverage funds for operations research. visibility of operational research in workplan and country strategic framework. Funds for financial and human resources have been spent as planned for 2010; however, there are financial gaps in the planned budget for 2011. Continue to support countries, update HIV estimation tools and increase capacity of countries on HIV estimation. Continue to strengthen partnerships and leverage support from other UN partners to strengthen national surveillance, M&E and HIV DR monitoring. Tuberculosis Guidelines will be developed for intensified case-finding, particularly among high-risk groups (e.g. prisoners) and for the introduction of new diagnostic tools. Programmatic management of drugresistant tuberculosis (PMDT) remains a focus and the Regional Office will continue to provide substantial technical assistance in this area. An inventory of the alignment of national PMDT scale up plans and laboratory scale-up plans is necessary to ensure that diagnosed multidrug-resistant tuberculosis (MDR-TB) patient have access to adequate treatment with quality drugs. The complexity of contemporary tuberculosis control, with so many ‘specialty components’, requires national technical assistance plans to ensure coordination of quality technical assistance through the TBTEAM mechanism that is managed by WPRO. Must ensure that countries have operational plans that include cross-cutting activities and provide guidance for such collaboration. WPRO needs to support the country offices to initiate and Increase

implement collaborative activities. TB team needs to be strengthened at the country level, thus ensuring the planning and coordination of quality technical assistance.

WPR/RC62/3 page 35 Annex 1 More technical assistance should be provided for proper forecasting. WPRO needs to collaborate closely with the Global Drug Facility (GDF) in case of drug shortages and/or delivery problems. To provide technical assistance to countries on data collection and timely reporting. The Regional Office will also continue to support the implementation of web-based systems. Plan an advocacy, communication and social mobilization (ACSM) regional workshop, and follow-up with countries for the development of national ACSM plans. The Regional Office has already reviewed country-submitted proposals for financial support for research. This grant mechanism is intended to function on an annual basis. The Regional Office will then have a role to play in helping countries follow-up the research results so that policy formulation is evidence-based. Malaria In the field of private-public mix (PPM), a huge number of partners and stakeholders are now engaged, especially in KHM – WHO leadership is essential. On vulnerable groups: migrants, unprecedented information is emerging from the artemisinin resistance containment project, requiring further studies and more focus on this group. Strong WHO technical support, together with strong political commitment and sufficient funding in most countries, has led to a significant decline in malaria, so that elimination can now be a goal. There is an increasing number of partners; WHO and country leadership is required, and in some cases also WHO's provision of technical guidance to the partners. Cooperation with other programmes and sectors, within and outside WHO, is required, and where possible, professional associations should be involved. Cooperation with CHN in the Mekong

network needs to be intensified. Procurement and supply management (PSM) is a major determinant of success of Global Fund grants, and needs more support. Publication of surveillance and M&E data is the basis of accountability and an advocacy tool – a regional malaria report needs to be published, and country data should regularly be published in surveillance bulletins. Collaboration/integration with health information system (HIS) has been in some countries, but HIS often is even weaker than the malaria information system - government commitment is needed to strengthen both as well as significant investment including in terms of human resources. Attention and support needs to be given to country web-based systems, and the regional database needs to be refined, possibly integrated into the new Health Information, Evidence

WPR/RC62/3 page 36 Annex 1 and Research (IER) database. For antimalarial drug efficacy monitoring, a Pacific network needs to be established – a respective meeting is planned and funded by HQ for 2011. Community-based experiences are a cornerstone of malaria control in the Region, to reach the population at risk. Community-based country experiences need to be adequately assessed and shared (publication). MOH policies need to be updated/developed. Research capacity needs to be strengthened in many countries. All WHO staff need know about ethics in human research and WHO research procedures. KHM as the epicentre of antimalarial drug resistance attracts many scientists; support is needed for research coordination. WPRO needs to try to be involved in research which is funded by Global Fund grants, and needs to broker international cooperative research, to improve the quality. Much support will be needed to get the supported research published (scientific paper writing workshop planned for 2011). Translation of research findings to programmes remains a huge task.

WPR/RC62/3 page 37 Annex 1 STRATEGIC OBJECTIVE 3 To prevent and reduce disease, disability and premature death from chronic noncommunicable diseases, mental disorders, violence and injuries and visual impairment.

Highlights on significant programme delivery Noncommunicable disease (NCD) prevention through multisectoral interventions were advanced through engagement of health and non-health sectors. NCD risk factor surveillance promoted widely and during the year reports from four countries were made available. High level advocacy for breast cancer control was organized for members of the Regional Committee Meeting. NCD prevention was introduced as a major component of healthy city initiatives in CHN. Successful resource mobilization was achieved for NCD management and blindness prevention. The WHO Pacific Islands Mental Health Network (PIMHNet) has been sustained by successful resource mobilization and active engagement with voluntary contributions by individuals and academic organizations. PIMHNet provides a mechanism to promote all work of advocacy, policy, service delivery, and human resource development for mental health in the Pacific. The project on monitoring and intervention of suicide behaviour is involving more than 10 countries and contributing to networking, capacity building and surveillance in participating countries and the Region in general as well. The Decade of Action for Road Safety 2011–2020 provided a unique platform for countries to work across sectors to reduce road traffic injuries. Member countries were supported to develop their plans for national launches of the Decade and development of road safety plans. With funding from Bloomberg Philanthropies, WHO supported multisectoral road safety interventions activities in CHN, KHM, and VNM, especially in the enforcement of motorcycle helmet, seatbelt, and drinking and driving laws. Following announcement of a WHO/AUSAID partnership for disability project, a position and activities in the area of Disability and Rehabilitation in WPRO will be supported for the next four years. Overview of the contribution to the Strategic Objective The implementation of three workplans contributing to SO3 in WPRO is on track. Of

23 indicators, targets have been achieved for 18. Activities related to hearing and visual impairments have not yet been initiated.

WPR/RC62/3 page 38 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 3.1 Advocacy and support provided to increase political, financial and technical commitment in Member States in order to tackle chronic noncommunicable diseases, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. Indicator Baseline Target On-Track

To end 2010 25*

3.1.1

Number of Member States whose health ministries have a focal point or a unit for injuries and violence prevention with its own budget The world report on disability and rehabilitation published and launched, in response to resolution WHA58.23 Number of Member States with a mental health budget of more than 1% of the total health budget Number of Member States with a unit in the ministry of health or equivalent national health authority, with dedicated staff and budget, for the prevention and control of chronic noncommunicable diseases

3.1.2

draft

published

3.1.3

3.1.4

10**

12***

20****

* AUS, BRN, CHN, COK, FJI, FSM, JPN, KHM, KIR, KOR, LAO, MNG, MNP, MYS, NEZ, NRU, PHL, PLW, PNG, SGP, SLB, TON, VNM, VUT and WSM ** AUS, CHN, FJI, JPN, KOR, MNG, MYS, PHL, VNM and VUT *** AUS, CHN, FJI, JPN, KOR, LAO, MNG, MYS, PHL, SLB, VNM and VUT **** AUS, CHN, COK, FJI, FSM, JPN, KHM, KIR, KOR, LAO, MNG, MYS, NRU, PHL, PNG, SGP, TON, VNM, VUT and WSM

NCD policy advocacy briefs were developed and advocacy was carried out at different levels. An advocacy event on breast cancer was held on the sidelines of the sixty-first session of the Regional Committee in Kuala Lumpur. Advocacy for Road Safety and contribution by the health sector has been significant in CHN, KHM and VNM. The WHO Pacific Islands Mental Health Network remains an important and active mechanism for mental health advocacy in the Pacific. NZAID pledged further funding for another three years. Efforts to integrate mental health into overall health services were reported in CHN, LAO and MNG.

WPR/RC62/3 page 39 Annex 1

OWER 3.2 Guidance and support provided to Member States for the development and implementation of policies, strategies and regulations in respect of chronic noncommunicable diseases, mental and neurological disorders, violence, injuries and disabilities together with visual impairment, including blindness. Indicator Baseline Target

On track

To end 2010

3.2.1

Number of Member States that have national plans to prevent unintentional injuries or violence Number of Member States that have initiated the process of developing a mental health policy or law Number of Member States that have adopted a multisectoral national policy on chronic noncommunicable diseases Number of Member States that are implementing comprehensive national plans for the prevention of hearing or visual impairment

3.2.2

3.2.3

20*

3.2.4

* AUS, CHN, COK, FJI, FSM, JPN, KHM, KIR, KOR, LAO, MNG, MYS, NRU, PHL, PNG, SGP, TON, VNM, VUT and WSM

Capacity of Member States was built for multisectoral interventions bringing together health and nonhealth sectors at the JPN-WHO meeting. Regional consultation on strategies to reduce salt intake was useful to develop context-specific approaches. The Regional Framework for Action on Injury and Violence 2008–2013 continues to provide guidance to countries to develop national plans and policies. Technical support was provided to mental health policy development through country visits by consultants and telecommunications to FJI, FSM, SLB and VUT. OWER 3.3 Improvements made in Member States’ capacity to collect, analyse, disseminate and use data on the magnitude, causes and consequences of chronic noncommunicable diseases, mental and neurological disorders, violence, injuries and disabilities together with visual impairment, including blindness. Indicator Baseline Target On track

To end 2010 20

3.3.1

Number of Member States that have submitted a complete assessment of their national road traffic injury prevention status to WHO during the biennium Number of Member States that have a published document containing national data on the prevalence and incidence of disabilities Number of low- and middle-income Member States with basic mental health indicators annually reported

3.3.2

3.3.3

WPR/RC62/3 page 40 Annex 1 3.3.4 Number of Member States with a national health reporting system and annual reports that include indicators for the four major noncommunicable diseases Number of Member States documenting, according to population-based surveys, the burden of hearing or visual impairment 10 13 14*

3.3.5

* AUS, CHN, FJI, FSM, JPN, KIR, KOR, LAO, MNG, MYS, NEZ, PHL, SGP and VUT.

NCD risk factor surveys using WHO STEPS approach were implemented widely. STEPS reports from KHM, LAO, MNG, PNG and SLB were made available. Capacity for Cancer Registration was built in 10 Pacific island countries. A regional meeting for training of national data coordinators for assessment of road safety status at country level is planned to be held in 2011. Data is expected to be collected by the end of 2011. All countries are involved in the mental health Atlas project. FJI, PHL, TON and VUT received technical and financial support in monitoring of suicide behaviours. OWER 3.4 Improved evidence compiled by WHO on the cost-effectiveness of interventions to tackle chronic noncommunicable diseases, mental and neurological and substance-use disorders, violence, injuries and disabilities together with visual impairment, including blindness. Indicator Baseline Target On track

To end 2010 2

3.4.1

Availability of evidence-based guidance on the effectiveness of interventions for the management of selected mental, behavioural or neurological disorders including those due to use of psychoactive substances Availability of evidence-based guidance or guidelines on the effectiveness or cost-effectiveness of interventions for the prevention and management of chronic noncommunicable diseases

3.4.2

Package of Essential NCD interventions (PEN) made available by WHO HQ

PEN disseminated to countries in the Region

On track

A package of essential NCD interventions developed by HQ was disseminated. Country capacity for NCD prevention and management was assessed as part of the global survey. A resources book on suicide prevention Towards evidence-based suicide prevention programme was published and distributed. A guide on alcohol-related legislation is being finalized and will be published soon.

WPR/RC62/3 page 41 Annex 1 OWER 3.5 Guidance and support provided to Member States for the preparation and implementation of multisectoral, population-wide programmes to promote mental health, and to prevent mental and behavioural disorders, violence and injuries, together with hearing and visual impairment, including blindness. Indicator Baseline Target At risk

To end 2010 3

3.5.1

Number of guidelines published and widely disseminated on multisectoral interventions to prevent violence and unintentional injuries Number of Member States that have initiated communitybased projects during the biennium to reduce suicides Number of Member States implementing strategies recommended by WHO for the prevention of hearing or visual impairment

3.5.2

3.5.3

Resources were mobilized for the programme on prevention of blindness and a post of a Medical Officer has been established. However, WPRO is unable to start work due to the delay in recruiting the staff for the post. The Manual on Data Systems was disseminated to countries. This manual assisted in the

strengthening and improvement of their data collection on road traffic injuries and risk factors especially in LAO, MNG and PHL. A systematic review on effectiveness of media intervention on suicide prevention was done and consultations have been conducted in CHN, HOK, JPN and KOR with different stakeholders on the role of the media in suicide prevention. OWER 3.6 Guidance and support provided to Member States to improve the ability of their health and social systems to prevent and manage chronic noncommunicable diseases, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. Indicator Baseline Target On track

To end 2010 2

3.6.1

Number of Member States that have incorporated traumacare services for victims of injuries or violence into their health-care systems using WHO trauma-care guidelines Number of Member States implementing community-based rehabilitation programmes Number of low- and middle-income Member States that have completed an assessment of their mental health systems using the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS)

3.6.2

3.6.3

WPR/RC62/3 page 42 Annex 1 3.6.4 Number of low- and middle-income Member States implementing primary health-care strategies for screening of cardiovascular risk and integrated management of noncommunicable diseases using WHO guidelines Number of Member States with tobacco cessation support incorporated into primary health care 10 13 24*

3.6.5

*AUS, BRN, CHN, COK, FJI, FSM, JPN, KHM, KIR, KOR, LAO, MNG, MYS, NEZ, NIU, NRU, PHL, PLW, SGP, TKL, TON, VNM, VUT, WSM

Health system capacity for NCD management is being assessed. Resources were mobilized for MNG amounting to US$ 6.5 million to support management of acute myocardial infarction and stroke. VNM was assisted for the development of pre-hospital and trauma care services. Funding assistance from AUSAID will support capacity building and development of national plans for communitybased rehabilitation in selected countries. With the completion of the Guidelines for Article 14 of the WHO FCTC, WHO has initiated work towards the dissemination of the Guidelines and a work plan has been developed to support improvement of cessation systems in countries. Training on brief advice in primary health care was conducted in CHN and FSM. WHO has collaborated with the Department of Health, HOK toward the development of a regional training programme for treatment of tobacco dependence with technical support and in partnership with the Mayo Clinic, USA. A meeting on a Training Network on Child and Adolescent Health and Tobacco Control has been organized with participation from CHN, HOK, JPN, KOR, MNG, PHL and VNM. A model training programme on brief advice and cessation for paediatricians has been developed and piloted in the PHL. Smoking cessation services have been established in the WPRO premises.

WPR/RC62/3 page 43 Annex 1 ACTIONS REQUIRED The following are required actions: Sustained advocacy for policy-based interventions and engagement with non-health sector ministries and partners for NCD, injury prevention, mental health and disability. In this regard, there is a need for additional resources for strengthening the work of SO3. The capacity of staff also has to be strengthened in the areas of policy advocacy and resource mobilization. Investments in training-of-trainer programmes and dissemination of best practices on tobacco cessation, sustained support for training of brief advice in primary health care; the exploration of collaboration with networks and partners who are working on "quit lines"; and the expansion of access to training on treatment of tobacco dependence to countries that have good progress in implementation of Articles 8, 11 and 13. With regard to Indicator 3.1.4, it is noted that the quantitative estimation of the number of Member States with a unit in the ministry of health or equivalent health authority with dedicated staff and budget for the prevention and control of chronic NCDs is not adequate to reflect the status of NCD prevention and control. Issues such as coverage, affordability, quality of service and treatment outcomes are important factors for consideration. To this effect, a set of indicators are being

developed to better capture and address these parameters. With regard to Indicator 3.1.3, there is currently no satisfactory data to ascertain this indicator. It is anticipated that the results of the Mental Health Atlas survey may fill this gap. Otherwise, the revision of the indicator needs to be considered.

WPR/RC62/3 page 44 Annex 1 STRATEGIC OBJECTIVE 4 To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals.

Highlights on significant programme delivery Progress was made in identifying key areas for action towards the attainment of MDG 4 and 5 along the continuum of care through the key life stages and across all levels of the health system, in collaboration with relevant programmes including those related to maternal and child health outcomes, disease control and health systems strengthening. A particular emphasis has been given to integrated service delivery and approaches to remove barriers to accessing essential maternal and child health services. To this effect, a cross-cutting informal consultation on MDG 4 and 5 actions was held involving WPRO and key country office staff from CHN, KHM, LAO, MNG, PNG, PHL and VNM. Country-specific approaches towards universal coverage for maternal and child health have also been supported. Progress was noted in eight countries to improve the proportion of deliveries assisted by skilled attendants and the use of evidence-based guidelines and tools to build capacities for clinical competencies in maternal and newborn care, data collection, analysis and reporting of results, and monitoring efforts. Six countries were supported in comprehensive aspects towards the achievement of universal access to reproductive health, including standards and guidelines on family planning and sexually transmitted infections. Good progress was made in supporting countries to improve integrated case management of childhood illness at community and facility levels to scale-up access to key interventions for newborn and child health. Technical and logistic support was provided to introduce particularly community approaches towards home-based newborn care in the LAO and VNM, updating the Integrated Management of Childhood Illness (IMCI) guidelines including those for the sick young infant, and facilitating IMCI scaling-up efforts with a computerized adaptation and training tool. Six countries were supported to improve referral level care. Regional monitoring framework for MDG 4 was likewise developed, and integrated maternal and child health monitoring efforts supported in priority countries. Technical support was provided to build capacity and develop standards for adolescent-friendly health services. A rapid programme review for adolescent health was carried out in MNG.

WPR/RC62/3 page 45 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 4.1 Support provided to Member States to formulate a comprehensive policy, plan and strategy for scaling up towards universal access to effective interventions in collaboration with other programmes, paying attention to reducing gender inequality and health inequities, providing a continuum of care throughout the life course, integrating service delivery across different levels of the health system and strengthening coordination with civil society and the private sector. Indicator Baseline Target On track

To end 2010 8

4.1.1

Number of targeted Member States that have an integrated policy on universal access to effective interventions for improving maternal, newborn and child health Number of Member States that have developed, with WHO support, a policy on achieving universal access to sexual and reproductive health

4.1.2

The Informal Consultation on MDG 4 and 5 was held among WHO regional and country staff from seven priority countries (CHN, KHM, LAO, MNG, PNG, the PHL and VNM) to identify key areas for action towards the attainment of MDG 4 and 5 and strengthen collaboration among the maternal and child health-related and health systems-focused programmes. Support was provided to PNG for the development of a strategic plan for maternal health for 2011–2015 based on the National Health Policy 2011–2020. Country-specific approaches were also outlined and successful scaling-up

experiences were discussed. A particular emphasis has been given on efforts to strengthen integrated service delivery and approaches to remove barriers to accessing essential maternal and child health services. In 2010, LAO was supported in implementing the integrated MNCH strategic planning framework and package of interventions, and KHM in implementing national strategies towards universal coverage of quality maternal and newborn services. PHL was supported in enhancing the related United Nations Development Assistance Framework (UNDAF) content to reflect the national maternal newborn child health and nutrition policy, and VNM in implementing the National Child Survival Plan and development of the sexual and reproductive health population strategy and One UN Plan on maternal and child health aspects. Policy support on universal access was also given to KIR.

WPR/RC62/3 page 46 Annex 1

OWER 4.2 National research capacity strengthened as necessary and new evidence, products, technologies, interventions and delivery approaches of global and/or national relevance available to improve maternal, newborn, child and adolescent health, to promote active and healthy ageing, and to improve sexual and reproductive health. Indicator Baseline Target

On track

To end 2010 Not regional

4.2.1

Number of research centres that have received an initial grant for comprehensive institutional development and support Number of completed studies on priority issues that have been supported by WHO Number of new or updated systematic reviews on best practices, policies and standards of care for improving maternal, newborn, child and adolescent health, promoting active and healthy ageing or improving sexual and reproductive health 1 2

4.2.2

4.2.3

Not regional

LAO has supported institutional development with an initial grant and made new evidence, interventions and delivery approaches of national relevance available. CHN, MNG and VNM have also supported research activities. CHN was supported in carrying out an operational research in promoting natural delivery, as they have a high rate of caesarean-section delivery rate. MYS was supported in conducting studies related to abortion and family planning. OWER 4.3 Guidelines, approaches and tools for improving maternal care applied at the country level, including technical support provided to Member States for intensified action to ensure skilled care for every pregnant woman and every newborn, through childbirth and the postpartum and postnatal periods, particularly for poor and disadvantaged populations, with progress monitored. Indicator Baseline Target On track

To end 2010 8

4.3.1

Number of Member States implementing strategies for increasing coverage with skilled care for childbirth

CHN, FJI, KHM, LAO, MNG, PNG, SLB and VNM were supported in their efforts to improve access to and quality of skilled care for birth. Some WHO evidence-based guidelines and tools were used to improve quality of care in maternal health. Priority countries were supported in improving the proportion of deliveries attended by skilled birth attendants. VNM supported the establishment of two maternity waiting homes in two remote areas. Priority countries were particularly supported for the adaptation of evidence-based guidelines and tools. KHM translated into Khmer and printed the Midwifery Education Modules and distributed the

WPR/RC62/3 page 47 Annex 1 document to midwifery teaching institutions; CHN trained local project managers and MCH professionals on research proposals, data collection, diagnosis and treatment of pregnancy complications; FJI conducted skill competencies for the Maternal Health staff on maternal and newborn health; LAO conducted a workshop to improve clinical competencies on newborn care and increase community awareness and response; MNG conducted a local fellowship training on pregnancy, child birth, postpartum and newborn care at the four regional colleges for aimag and soum level and provided supplies and equipment for essential newborn care at rural health facilities; VNM funded data collection, data entry, analysis and reporting on multi-country study on maternal and perinatal health, and developed guidelines for neonatal mortality audit. OWER 4.4 Guidelines, approaches and tools for improving neonatal survival and health applied at country level, with technical support provided to Member States for intensified action towards universal coverage, effective interventions and monitoring of progress. Indicator Baseline Target On track

To end 2010 6

4.4.1

Number of Member States implementing strategies for increasing coverage with interventions for neonatal survival and health

Seven high-burden countries for newborn deaths (CHN, KHM, LAO, MNG, PNG, PHL and VNM) have updated their IMCI guidelines on newborn care for implementation in first level facilities. Three countries (KHM, LAO, and VNM) were supported to implement home-based newborn care in selected areas and the PHL is in the final stages of country adaptation prior to implementation. CHN has examined particularly interventions to decrease the incidence of prematurity and low birth-weight in newborns, KIR strengthened the continuum of care for newborns, and the PHL supported essential newborn care protocol for hospitals. OWER 4.5 Guidelines, approaches and tools for improving child health and development applied at the country level, with technical support provided to Member States for intensified action towards universal coverage of the population with effective interventions and for monitoring progress, taking into consideration international and human-rights norms and standards, notably those stipulated in the Convention on the Rights of the Child. Indicator Baseline Target On track

To end 2010 9

4.5.1

Number of Member States implementing strategies for increasing coverage with child health and development interventions Number of Member States that have expanded coverage of the integrated management of childhood illness to more than 75% of target districts

4.5.2

WPR/RC62/3 page 48 Annex 1 Several countries were supported to implement strategies to increase child health intervention coverage and quality of care. CHN and KHM supported data-based decision-making through conduct of MNCH household surveys and analysis of results and used them for improving implementation. A strategic child survival programme review was also supported in KHM. FJI conducted training for health care providers on IMCI computerized adaptation and training tool (ICATT), developed a module and training for community health workers on basic concepts of IMCI, and introduced a WHO pocket book on hospital care for children for five Pacific island countries. KIR also supported IMCI. LAO was supported in updating national IMCI guidelines, reviewing IMCI in-service training approaches, conducting hospital assessments and building capacity to improve quality of hospital care in three provinces. MNG was supported in building capacity to use ICATT as an approach for improving IMCI pre-service education specifically to set up ICATT laboratory at the Health Sciences University. PNG supported IMCI and included it as the key strategy in their National Health Plan 2011–2020. PHL updated the IMCI guidelines. Technical and logistic support was provided to introduce community case management of sick children in VNM. The Regional Monitoring

Framework has been developed and is being reviewed for finalization. FJI , KHM, and MNG have IMCI coverage more than 75% of target districts. OWER 4.6 Technical support provided to Member States for the implementation of evidence-based policies and strategies on adolescent health and development, and for the scaling up of a package of prevention, treatment and care interventions in accordance with established standards. Indicator Baseline Target On track

To end 2010 5

4.6.1

Number of Member States with a functioning adolescent health and development programme

Technical support was provided for building capacities of health workers from CHN, HOK and MAC for provision of adolescent-friendly health services (AFHS). PHL was supported in finalizing the National Standards for Adolescent Friendly Health Services (AFHS). Rapid Programme Review of Adolescent Health was supported in MNG and the outcome being used to inform policy. ADH policy and technical support was provided also for LAO. A draft Regional Framework on Improving ADH has been developed, and ADH Fact Sheets for 10 countries drafted.

WPR/RC62/3 page 49 Annex 1

OWER 4.7 Guidelines, approaches and tools made available, with provision of technical support to Member States for accelerated action towards implementing the strategy to accelerate progress towards the attainment of international development goals and targets related to reproductive health, with particular emphasis on ensuring equitable access to good-quality sexual and reproductive health services, particularly in areas of unmet need, and with respect for human rights as they relate to sexual and reproductive health. Indicator Baseline Target

On track

To end 2010 6

4.7.1

Number of Member States implementing the WHO reproductive health strategy to accelerate progress towards the attainment of international development goals and targets related to reproductive health agreed at the 1994 International Conference on Population and Development (ICPD), its five-year review (ICPD+5), the Millennium Summit and the United Nations General Assembly in 2007 Number of targeted Member States having reviewed their existing national laws, regulations or policies relating to sexual and reproductive health

4.7.2

Priority countries were supported in key aspects of reproductive health towards the achievement of universal access. CHN, KHM, LAO, MNG, MYS and the PHL were supported in implementing various activities related to family planning, preventing unsafe abortion and prevention and treatment of cervical cancer. KHM developed and implemented the fast track initiative to reduce maternal mortality and to achieve MDG5 and the maternal death surveillance and response; Tongji Medical College, CHN developed the MCH/FP essential package; and LAO adapted and disseminated the standards and guidelines on family planning, abortion and STI. OWER 4.8 Guidelines, approaches, tools, and technical assistance provided to Member States for increased advocacy for consideration of ageing as a public health issue, for the development and implementation of policies and programmes aiming at maintaining maximum functional capacity throughout the life course and for the training of health-care providers in approaches that ensure healthy ageing. Indicator Baseline Target At risk

To end 2010 7

4.8.1

Number of Member States with a functioning active healthy ageing programme consistent with WHA58.16 “Strengthening active and healthy ageing”

Only MNG has reported having provided support for building capacity and services for healthy ageing. No major progress in the healthy ageing programme has been reported.

WPR/RC62/3 page 50 Annex 1 ACTIONS REQUIRED The following are required actions: There is a need for intensified coherent support towards achieving universal coverage for maternal, neonatal and child health along the continuum of care by strengthening policies and integrated service delivery, addressing barriers to care, and monitoring progress. Further capacities need to be built for increasing coverage of skilled care at birth and implementation of evidence-based guidelines and tools for reducing maternal and newborn mortalities. Further scaling up of the integrated management of childhood illnesses at the first level of care, extending integrated care to the community and improving quality of care at the referral level remain at the core of child health priorities including a specific focus on newborn children. Improving health sector response to adolescent health needs along the continuum and implementing strategies towards the attainment of goals related to reproductive health will likewise need further support. In order to improve efficiency, programmatic linkages and collaboration along the life cycle will be further capitalized on. WHO support from different levels of the Organization can also be further strengthened through teleconferences or videoconferences with country counterparts on pressing issues related to programme implementation. Other measures to be taken include the need to

harmonize programme tools, e.g. programme review for maternal and child health and planning and management for maternal and child health which could be shared and jointly applied to support countries. Regular review of programme priorities and plans is important in order to stay focused on high priorities. Given the current human and financial resource constraints, WHO's programme on ageing could best be implemented as a collaborative effort with related programmes, such as health promotion, noncommunicable diseases and women's health, for example, with a due emphasis on the work on social determinants.

WPR/RC62/3 page 51 Annex 1 STRATEGIC OBJECTIVE 5 To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact.

Highlights on significant programme delivery Progress was made in identifying and promoting key areas for action towards the attainment of reducing health consequences of emergencies, disasters, crises and conflicts in collaboration with relevant and partner agencies. To this effect, various activities have been carried out in the areas of risk reduction, preparedness, response and recovery. For the OWERs, good progress was made, targets were on track. Some of them have actually exceeded the mid-term targets. In the area of preparedness and risk reduction, Member States have been able to review and update health emergency response plans. LAO has finalized its national emergency preparedness plan. KHM’s plan is awaiting the final official endorsement of the Ministry of Health. There has been very good progress in the development of guides and technical materials on safe hospitals particularly in the four priority countries under the ECHO funded project: KHM, LAO, PHL and VNM. There were several emergencies in 2010 that required international support. WHO provided

emergency assistance in the following emergencies: MNG dzud, Chinghai earthquake, PHL tropical cyclone, FJI tropical cyclone, VUT earthquake, KHM stampede, PHL armed conflict, CHN floods and VNM floods. Immediate response to Member States’ request for support to acute emergencies has been very good, but processes in procurement, logistics and financial support could still be improved. Networking and coordination with health partners have been consistently promoted. Strong

partnerships were maintained with the Asia Pacific Humanitarian Network: Pacific Health Team, Asian Disaster Preparedness Center, SEAMEO-TROPMED Network, University of the Philippines, Hanoi School of Public Health, Ho Chi Minh City Institute of Hygiene and Public Health and US CDC office in China. In the area of information dissemination and public information, EHA has been able to maintain its website that posts updates and news on emergencies, WHO activities, press releases, meetings/conferences and publications. The EHA webpage has one of the highest readership of the WPRO webpages.

WPR/RC62/3 page 52 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 5.1 Norms and standards developed, capacity built and technical support provided to Member States for the development and strengthening of national emergency preparedness plans and programmes. Indicator Baseline Target On track

To end 2010 16/27 (59%) 8

5.1.1

Proportion of Member States with national emergency preparedness plans that cover multiple hazards. Number of Member States implementing programmes for reducing the vulnerability of health facilities to the effects of natural disasters

15/27 (56%) 8

16/27 (59%) 10

5.1.2

Member States have been implementing emergency preparedness activities but the extent differs. This may be attributed to the degree of experiences they have on disaster/emergency events. EHA supported LAO in finalizing its national emergency preparedness plan. KHM has recently finalized its draft plan and it is just awaiting official endorsement of the Ministry of Health. Good progress has been made in the development of guides and technical references from the Safe Hospitals project being supported by ECHO. These include: assessment tool for safe hospitals, emergency exercises for health facilities, business continuity plan, advocacy manual, emergency guidelines for hospital managers. OWER 5.2 Norms and standards developed and capacity built to enable Member States to provide timely response to disasters associated with natural hazards and conflict-related crises. Indicator Baseline Target On track

To end 2010 7

5.2.1

Operational platforms for surge capacity in place in regions and headquarters ready to be activated in acute-onset emergencies. Number of global and regional training programmes on public health operations in emergency response.

5.2.2

Emergency response support was provided by WHO in the following emergencies: MNG dzud, Chinghai earthquake, PHL tropical cyclone, FJI tropical cyclone, VUT earthquake, KHM stampede, PHL armed conflict, CHN floods and VNM floods.

WPR/RC62/3 page 53 Annex 1 OWER 5.3 Norms and standards developed and capacity built to enable Member States to assess needs and for planning interventions during the transition and recovery phases of conflicts and disasters. Indicator Baseline Target At risk

To end 2010 2

5.3.1

Number of humanitarian action plans with a health component formulated for ongoing emergencies Number of countries in transition that have formulated a recovery strategy for health

5.3.2

Activities were supported for recovery activities of the Chinghai earthquake and the post tropical storm/floods in the PHL. For the latter, the innovative surveillance project called SPEED was supported by WHO and donor partners. The development of guides and

standards could not be implemented because of the absence of funds for recovery. OWER 5.4 Coordinated technical support provided to Member States for communicable disease control in natural and conflict situations. Indicator Baseline Target On track

To end 2010 100%

5.4.1

Proportion of acute natural disasters or conflicts where communicable disease-control interventions have been implemented, including activation of early-warning systems and diseases-surveillance for emergencies

50%

100%

All the acute emergencies where WHO provided support had components of integrated activities involving communicable disease control.

WPR/RC62/3 page 54 Annex 1

OWER 5.5 Support provided to Member States for strengthening national preparedness and for establishing alert and response mechanisms for food safety and environmental health emergencies. Indicator Baseline Target

On track

To end 2010 ENH: 20%

5.5.1

Proportion of Member States with national plans for preparedness, and alert and response activities in respect of chemical, radiological and environmental health emergencies Number of Member States employing WHO food safety emergency response guidelines in food safety emergency preparedness.

ENH: 10%

ENH: 30%

5.5.2

No specific projects have been initiated but continuing support was given to environmental health needs in emergencies (particularly water quality and sanitation). Support has been provided in the South East Asia Technical Working Group for environmental health. Good progress was achieved in getting Member States to employ WHO food safety emergency response guidelines on food safety emergency preparedness. OWER 5.6 Effective communications issued, partnerships formed and coordination developed with other organizations in the United Nations system, governments, local and international nongovernmental organizations, academic institutions and professional associations at country, regional and global levels. Indicator Baseline Target On track

To end 2010 1/8 (12%)

5.6.1

Proportion of Member States affected by acute-onset emergencies and those with ongoing emergencies and a humanitarian coordinator in which the Inter-Agency Standing Committee Humanitarian Health Cluster is operational in line with IASC cluster standards Proportion of Member States with ongoing emergencies and a humanitarian coordinator having a sustainable WHO technical presence covering emergency preparedness, response and recovery

2/8 (25%)

3/8 (38%)

5.6.2

1/2 (50%)

1/1 (100%)

WHO collaborated with the following: Asia Pacific Humanitarian Network; Pacific Health Team, Asian Disaster Preparedness Center, SEAMEO-TROPMED Network, University of the Philippines, Hanoi School of Public Health, Ho Chi Minh City Institute of Hygiene and Public Health. EHA is implementing its second phase of the DIPECHO Safe Hospitals Project which actively collaborates

WPR/RC62/3 page 55 Annex 1 with regional and national health partners. EHA provided support and co-organized with the WPRO nursing unit the Third conference of the Asia Pacific Emergency and Disaster Nursing Network. EHA has been maintaining its webpage for information dissemination of emergency updates, news on EHA activities, press releases, training activities, meetings/conferences and publications. webpage has one of the highest readership of WPRO webpages. The

OWER 5.7 Acute, ongoing and recovery operations implemented in a timely and effective manner. Indicator 5.7.1 Proportion of acute-onset emergencies for which WHO mobilizes coordinated national and international action. Baseline 10% above baseline Target 20% above baseline

On track To end 2010 at least six emergency events supported by WHO 1/1 (100%)

5.7.2

Proportion of interventions for chronic emergencies implemented in accordance with humanitarian action plans' health components

1/1 (100%)

EHA has provided immediate support to requests of Member States in acute emergencies. Resource mobilization through the United Nations Central Emergency Response Fund (UN CERF) and/or the Regional Director Development Programme (RDDP) has provided financial support to response activities. Bilateral donors have also provided support to WHO activities in acute emergencies. ACTIONS REQUIRED The following are required actions: • Identification of priority results to which existing or future funding will be allocated or

reprogrammed by OWER and Major Office. The aim is to realign resources to focus on key activities, including support to Member States on risk reduction, emergency preparedness, as well as for implementing strategies towards the attainment of goals related to environmental health in emergencies and food safety in emergencies. • Development of specific plans to achieve efficiencies and cost reductions

This includes reviewing programme priorities and plans regularly and conducting more teleconferences/videoconferences with country and HQ counterparts instead of international travel.

WPR/RC62/3 page 56 Annex 1 • Identification of specific results which will not be achieved due to lack of financial resources

and therefore will be sunset or abandoned. Because of financial constraints, there are insufficient funds for activities on environmental emergencies and post disaster recovery, including further development of relevant guides and standards. Key efforts made included the development of a post-disaster assessment guide/tool and the activities on post disaster recovery from Typhoon Ketsana in the PHL.

WPR/RC62/3 page 57 Annex 1 STRATEGIC OBJECTIVE 6 To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex.

Highlights on significant programme delivery STEPS surveys were completed in KHM and MNG during 2010. The Global school-based student health survey (GSHS) has been done in MNG in 2010. PHL has initiated GSHS. STEPS report of SLB has been published. Progress has been achieved in advocacy and capacity-building for health promotion through technical networks for Healthy Cities, health promotion foundations and healthy islands. Targets for the biennium are close to completion at mid-term indicating a strong interest and effort to comply with the WHO FCTC despite the difficulties posed by tobacco industry interference in public health policy-making. Adoption of a global strategy to reduce harmful use of alcohol at WHA in May 2010 has put more emphasis on work in the area of alcohol policies and programmes. A number of countries have been supported with different activities, both government and the nongovernmental organization (NGO) sector, to further strengthen country capacity (especially in KHM, LAO, MNG and VNM). A legislation guide is being finalized to support the specific area of effective alcohol control policies. The meeting on sustainable alcohol policy was slightly postponed but will be held in March 2011 covering more than 10 Pacific countries. Support provided for the Pacific Food Summit and the adoption and implementation of the Framework for Action on Food Security. Physical Activity and Food-Based Dietary Guidelines communicated through the national campaigns. Evidence-based Diet and Physical Activity (DPAS) intervention programmes (policies, supportive environment, community-based lifestyle programmes) developed and implemented with technical support provided to Pacific island countries (PICs). Regional consultation was held to develop strategies to reduce salt intake. Tobacco use is a leading risk factor for four major noncommunicable diseases (NCD). Evidencebased and cost-effective interventions have been agreed on through the WHO Framework Convention on Tobacco Control (WHO FCTC). All Member States of the Region are Parties to the WHO FCTC. Advocacy efforts for full implementation of the treaty have been stepped up and these have resulted in new regulations, policies and actions linked to WHO FCTC Articles 5.3, 8, 11 and 13. National

WPR/RC62/3 page 58 Annex 1 action plans have been reviewed and updated in two countries. Amendments to existing laws and/or new legislation and regulations have been filed in some legislatures. Capacity building activities to support WHO FCTC implementation at the regional level were: Meeting on the Control of Betel Nut and Tobacco Chewing for concerned Pacific Island Countries, Workshop on Indicators for Tobacco Control, Regional Training Workshop on Tobacco Taxation (through the Bloomberg Initiative) and Meeting on a Training Network on Child and Adolescent Health and Tobacco Control. Seven countries have been working on projects on health promotion foundations and tobacco taxes using the Prolead approach. WPRO's leadership in tobacco control is highlighted by the successful bid of KOR to host the Fifth Session of the Conference of Parties in 2012. Tobacco surveillance and strengthening of surveillance systems continues to be a pillar of the programme. The Global Adult Tobacco Survey (GATS) was completed in three countries and is planned for a fourth country. Member States participated in the data collection for the Third Global Tobacco Control Report that focuses on health warnings but also provides updated information on the MPOWER policies. Training on the Global Youth Tobacco Survey (GYTS) was also conducted for six countries. Overview of the contribution to the Strategic Objective Capacity-building, multisectoral and multidisciplinary action, technical support, monitoring and evaluation and other activities reflecting the core-functions, technical and country strategic frameworks for health and development have been provided and coordinated in the Western Pacific Region. Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 6.1 Advice and support provided to Member States to build their capacity for health promotion across all relevant programmes, and to establish effective multisectoral and multidisciplinary collaborations for promoting health and preventing or reducing major risk factors. Indicator 6.1.1 Number of Member States that have evaluated and reported on at least one of the action areas and commitments of the Global Conferences on Health Promotion. Baseline 12 Target 12

On track

To end 2010 17 (5 PICs – FSM, NIU, NRU, PLW, and TUV) Not Regional

6.1.2

Number of cities that have implemented healthy urbanization programmes aimed at reducing health inequities

N/A

WPR/RC62/3 page 59 Annex 1 Health promotion through healthy settings was promoted. Frameworks for scaling up and extension of healthy cities and revitalization of healthy islands were finalized. Technical consultation was held to support the development of regional and national technical networks for healthy cities. Seventeen Pacific island countries and territories were supported to advance the programme on healthy islands as a platform for health promotion. In the PHL, the guidelines for healthy settings and healthy workplaces were updated in 2009 and implemented in 2010. Support to local initiative for the promotion of healthy lifestyle was provided. Efforts to reduce health inequity in the urban settings have been advanced through the use of the Urban Health Equity Assessment and Response Tool (Urban HEART) and are being expanded to seven Member States. A collaborative effort for health promotion foundations and tobacco taxes has been developed with the Southeast Asian Tobacco Control Alliance using the health promotion leadership training programme (Prolead) as an approach to innovative financing for tobacco control, health promotion and NCD prevention. Seven countries have initiated one year projects on health promotion

foundations and tobacco taxes in KHM, LAO, MYS, MNG, PHL, WSM, TON and VNM. Some countries have included specific provisions on using tobacco taxes for health promotion and

tobacco control in their draft tobacco control laws in LAO, SLB, VNM and WSM. OWER 6.2 Guidance and support provided in order to strengthen national systems for surveillance of major risk factors through development and validation of frameworks, tools and operating procedures and their dissemination to Member States where a high or increasing burden of death and disability is attributable to these risk factors. Indicator 6.2.1 Number of Member States with a functioning national surveillance system for monitoring major risk factors to health among adults based on the WHO STEPwise approach to surveillance Number of Member States with a functioning national surveillance system for monitoring major risk factors to health among youth based on the Global school-based student health survey methodology Baseline 16 Target 18

On track

To end 2010 22

6.2.2

35%

50%

41%

Progress has been achieved in COK, KHM, LAO, MNG, PNG, and SLB.

WPR/RC62/3 page 60 Annex 1 NCD risk factor surveillance has been promoted through STEPS surveys. They cover the age group 15 to 64 years. The Global School-based Student Health Survey (GSHS) covered younger children in schools. STEPS surveys are completed in KHM and MNG during the year 2010. GSHS has been done in MNG in 2010. PHL has initiated the GSHS. The STEPS report of SLB has been published. OWER 6.3 Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed, and technical support provided to Member States with a high or increasing burden of disease and death associated with tobacco use, enabling them to strengthen institutions in order to tackle or prevent the public health problems concerned; support also provided to the Conference of the Parties to the WHO Framework Convention on Tobacco Control for implementation of the provisions of the Convention and development and implementation of protocols and guidelines. Indicator 6.3.1 Number of Member States having comparable adult tobacco prevalence data available from recent national representative surveys, such as the Global Adult Tobacco Survey (GATS) or STEPS Number of Member States with comprehensive bans on smoking in indoor public places and workplaces Number of Member States with bans on tobacco advertising, promotion and sponsorship Baseline 27 Target 32

On track

To end 2010 32

6.3.2

6.3.3

The Regional Action Plan for the Tobacco Free Initiative in the Western Pacific Region (2010–2014) continues to guide the medium-term implementation of the WHO Framework Convention on Tobacco Control in Member States. Advocacy efforts for full implementation of the treaty have been stepped up and these have resulted in new regulations, policies and actions to curb the tobacco epidemic. National action plans have been reviewed and updated in KHM and MNG. Amendments to existing laws and/or new legislation and regulations have been filed in BRN, KHM, FJI, HOK, KOR, LAO, PHL, SGP, SLB and VNM. Progress in relation to Article 8 of the WHO FCTC on bans on indoor smoking in public places or work places have moved more quickly at the sub-national levels (e.g. regional, provincial, city or state) or within specific sectors (e.g. health facilities, educational facilities) in CHN, JPN, MAC, FSM and PHL. Stronger regulations and enforcement on bans on advertising, promotion and sponsorship of tobacco products have been reported and noted in BRN and MYS. Progress on work related to Article 6 on prices and taxes is noteworthy. A Regional Training Workshop on Tobacco Taxation was conducted with several countries. Eight countries have been

WPR/RC62/3 page 61 Annex 1 working on projects related to innovations in tobacco control financing by using tobacco taxes and/or for health promotion foundations and tobacco control in KHM, LAO, MYS, MNG, PHL, TON, VNM and WSM. Prices and taxes have increased in AUS, BRN, GUM and JPN. Tobacco surveillance and strengthening of surveillance systems continues to be a pillar of the programme. A Workshop on Indicators for Tobacco Control was implemented with participation from 32 Member States. The Global Adult Tobacco Survey (GATS) was completed in CHN, PHL and VNM. GATS has been initiated in MYS. A national survey patterned after the GATS has been initiated in KHM. A Meeting on the Control of Betel Nut and Tobacco Chewing was held and recommendations to address this problem have been put forward for FSM, GUM, KHM, MHL, PNG, SLB and VUT. All Member States started their reports for the Third Global Tobacco Control Report that focuses on health warnings but also provides updated information on the MPOWER policies. Training for the Global Youth Tobacco Survey (GYTS) has been conducted with GUM, KHM, LAO, MAC, PHL and VNM. OWER 6.4 Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed, and technical support provided to Member States with a high or increasing burden of disease or death associated with alcohol, drugs and other psychoactive substance use, enabling them to strengthen institutions in order to combat or prevent the public health problems concerned. Indicator 6.4.1 Number of Member States that have developed, with WHO support, strategies, plans and programmes for combating or preventing public health problems caused by alcohol, drugs and other psychoactive substance use Number of WHO strategies, guidelines, standards and technical tools developed in order to provide support to Member States in preventing and reducing public health problems caused by alcohol, drugs and other psychoactive substance use Baseline 10 Target 15

On track

To end 2010 14

6.4.2

N/A

6.4.1 Progress reported on track by FJI, MNG, SLB and VUT. Adoption of a global strategy to reduce harmful use of alcohol at the World Health Assembly in May 2010 has put more emphasis on work in the area of alcohol policies and programmes. A number of countries have been supported with different activities, both government and NGO sector, to further strengthen country capacity (especially KHM, LAO, MNG and VNM). A legislation guide is being finalized to support the specific area of effective alcohol control policies. Further progress is

WPR/RC62/3 page 62 Annex 1 expected as a follow-up to the first global meeting on network of WHO national counterparts for implementation of the global strategy, planned for 8 to 11 February 2011 in Geneva. For surveillance on alcohol, majority of countries contributed some data for the global Alcohol and Health survey, which included alcohol use, drinking patterns, morbidity/mortality and policies. Not much attention is paid to the surveillance, from the perspective of country requests for technical assistance. With no funding to support countries or do capacity-building it is not expected that countries develop specific surveillance systems for alcohol. The WHO four-country workshop on sustainable alcohol policy was held in Bangkok, THA, from 7 to 9 April 2010, and was participated by KHM, LAO, MNG, and VNM. Very little funding is available for the general area of substance abuse (including alcohol) and although there is more global momentum it is not currently projected that this will increase available funding. For human resources, no specific staff in any country or liaison offices working for

substance abuse area and only one staff at the regional level. OWER 6.5 Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed and technical support provided to Member States with a high or increasing burden of disease or death associated with unhealthy diets and physical inactivity, enabling them to strengthen institutions in order to combat or prevent the public health problems concerned. Indicator 6.5.1 Number of Member States that have adopted multisectoral strategies and plans for healthy diets or physical activity, based on the WHO Global Strategy on Diet, Physical Activity and Health Number of WHO technical tools that provide support to Member States in promoting healthy diets or physical activity Baseline 20 Target 24

On track

To end 2010 30

6.5.2

developed and are available on the WHO South Pacific website. Physical Activity and Food-based Dietary Guidelines were communicated through the national campaigns. Evidence-based Diet and Physical Activity (DPAS) intervention programmes (policies, supportive environment, communitybased lifestyle programmes) developed and implemented with technical support provided to PICs. Regional consultation on strategies to reduce salt intake was carried out and recommendations were

WPR/RC62/3 page 63 Annex 1 provided to Member States. A regional meeting on multisectoral interventions for NCD focused on promotion of healthy diet and physical activity and outcomes were provided to the Member States. Out of the 37 countries and areas, 20 have a policy and budget for diet and physical activity (these are ASM, AUS, BRN, CHN, COK, FJI, HOK, JPN, KOR, MAC, MYS, MNG, NRU, NEZ, PLW, PYF, SGP, TON, VNM and WSM). At the end of 2010, the following 10 countries and areas have been added: FSM, KIR, MHL, MNP, NIU, PNG, SLB, TKL, TUV and VUT. OWER 6.6 Evidence-based and ethical policies, strategies, interventions, recommendations, standards and guidelines developed and technical support provided to Member States to promote safer sex and strengthen institutions in order to tackle and manage the social and individual consequences of unsafe sex. Indicator 6.6.1 Number of Member States generating evidence on the determinants and/or consequences of unsafe sex Number of Member States generating comparable data on unsafe sex indicators using WHO STEPS surveillance tools Baseline 10 Target 10

On track

To end 2010 11

6.6.2

N/A

Not Regional

Technical and financial support have been provided to MYS in carrying out a Knowledge, Attitude and Practice (KAP) study related to preventing unsafe abortion (under SO4, OWER 7). No funding is allocated under OWER 6.6. Related activities are accommodated under SO4 OWER 7, subject to availability of funds. The key achievements are as follows (under SO4, OWER 7): 1. Reproductive Health Library dissemination and evidence-based decision-making for sexual and reproductive health workshops (VNM). 2. LAO adapted and disseminated the standards and guidelines on abortion.

WPR/RC62/3 page 64 Annex 1 ACTIONS REQUIRED The following are required actions: Sustained capacity-building and new mechanisms for engaging with non-health sectors need to be strengthened. Management systems for healthy cities and islands need to be further elaborated. Efforts are needed to move towards a sustained surveillance system. Institutional capacity has to be developed at national level. More work is needed to use the data for policies and programmes. Tobacco control work is highly political and recognition of political opportunity and timing is the key. The role of the WHO Representatives in providing Regional TFI with cues on political timing is very important. TFI needs to be ready with resource persons who can quickly provide support to countries when draft legislation goes up for discussion in parliament. A calendar of legislative schedules for countries that expect to pass laws this year should be prepared. TFI should also be prepared to provide in-country support for updating of national action plans and providing technical assistance in prioritizing evidence-based tobacco control interventions. Partnership with SEATCA and the Johns Hopkins Tobacco Control Programme has resulted in several cost-sharing arrangements that allow WHO-TFI to leverage support for countries in a resource-constrained environment. Flexibility is needed for partnerships to thrive and oftentimes we struggle through internal regulations and procedures that are designed for WHO-driven activities and do not apply to the new and evolving working arrangements that are required by partnerships and networks. Working across technical units is also proving to be very important now particularly with NCDs and Health Promotion, MCHN, Mental Health, Health Systems and Tuberculosis Control. Other specific actions pertaining to tobacco control activities include: sustain actions to implement the WHO FCTC with specific reference to Articles 5.3, 6, 8, 11, 13 and 14; expand training and build capacity for surveillance systems in Member States; continue to partner with regional and national NGOs to promote good international practices; sustain in-country technical support for teams that have projects to raise tobacco taxes and use some of this for health promotion, NCD prevention and tobacco control (Prolead programme). There is little expectation that countries would develop surveillance systems on alcohol. WHO should rather promote combining some specific alcohol indicators in already existing health monitoring schemes and other health surveys. The indicator 6.4.2 could either be revised or abandoned. Very little funding is available for the general area of substance abuse (including alcohol) and although there is more global momentum it is not currently projected that this will increase available funding.

WPR/RC62/3 page 65 Annex 1 For human resources – no specific staff in any country or liaison offices working for substance abuse area and only one staff at the regional level. Sustained advocacy and capacity building is needed to move towards healthier dietary options and promotion of physical activity. Mechanisms for engaging non-health sectors have to be strengthened. Health impact assessment capacity needs to be built up in Member States. Promoting safer sex and managing consequences of unsafe sex should be put in a broader context of improving reproductive health. For this reason, the activities are accommodated under SO4, OWER 7 (Reproductive Health).

WPR/RC62/3 page 66 Annex 1 STRATEGIC OBJECTIVE 7 To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches.

Highlights on significant programme delivery Work under this Strategic Objective aims to provide technical advice and tools to Member States and collaborate with other technical programmes, regions and agencies to promote more equitable, pro-poor, gender-responsive and human rights-based health policies, programmes and interventions, in the context of efforts to achieve Millennium Development Goals (MDGs) and of the broader development agenda. The contribution of the Regional Office in all five OWERs under SO 7 is rated as being on track. The overall approach of the Regional Office has been, first, to build the awareness, skills and capacity of technical programmes and countries on poverty/equity, gender and human rights issues in health and on to develop, disseminate and promote the use of tools to support this work. Second,

implementation support has also been provided to technical programmes and countries to address poverty/equity, gender and human rights in their policies, programmes and actions. A third approach has been to strengthen capacity on equity analysis, monitoring and measurement, as well as collection, analysis and use of health information that is disaggregated by relevant social stratifiers. To promote recognition of the significance of the social determinants of health and intersectoral collaboration in addressing them, a regional meeting on social determinants of health and health equity will be held in June 2011, in which officials from 13 countries from the Region and various other partners and stakeholders will participate. Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 7.1 Significance of social and economic determinants of health recognized throughout the Organization and incorporated into normative work and technical collaboration with Member States and other partners. Indicator 7.1.1 Number of WHO regions with a regional strategy for addressing social and economic determinants of health as identified in the Report of the Commission on the Social Determinants of Health endorsed by the Director-General Baseline 4 Target 5

On track

To end 2010 No regional strategy in WPRO

WPR/RC62/3 page 67 Annex 1 The Region is on track in its contribution to this OWER. Support was provided in five countries to contribute to equity-focused health policy development and implementation. information is given below. Four countries (CHN, KHM, MNG and VNM) were supported to translate selected technical materials into local languages, one of whom, namely Mongolia, was supported to strengthen capacity on equity, gender and human rights. Seven cities in the PHL worked to assess and address urban health equity with the Urban HEART tool. OWER 7.2 Initiative taken by WHO in providing opportunities and means for intersectoral collaboration at national and international levels to address social and economic determinants of health, including understanding and acting upon the public health implications of trade and trade agreements, and to encourage poverty-reduction and sustainable development. Indicator 7.2.1 Number of published country experiences on tackling social determinants for health equity Number of tools to support countries in analysing the implications of trade and trade agreements for health Baseline 10 Target 14

More specific

On track

To end 2010

7.2.2

1 tool created

The Region is on track in its contribution to this OWER. Two activities were initiated at the Regional Office level (in collaboration with WHO/HQ) and others undertaken in three countries to contribute to the achievement of this OWER. More specific information is given below. As a follow-up to the recommendations of the Commission on Social Determinants of Health, and in collaboration with WHO/HQ, two activities were initiated on intersectoral action in health at Regional Office level, namely, a capacity-building workshop on health in all policies, and a series of materials to guide health policy-makers in dialogue with other sectors to promote health in all policies and intersectoral action for health (with four sectors being taken up in the first phase, namely, agriculture, business/private sector education and housing). In trade and health, PHL was supported with regard to the increasing knowledge and awareness on trade in health services. PHL and VNM were

supported with regard to increasing knowledge and awareness on the implications of intellectual property provisions in trade agreements. implement certain TRIPS flexibilities. KHM was supported to review draft legislation to

WPR/RC62/3 page 68 Annex 1

OWER 7.3 Social and economic data relevant to health collected, collated and analysed on a disaggregated basis (by sex, age, ethnicity, income, and health conditions, such as disease or disability). Indicator 7.3.1 Number of country reports published during the biennium incorporating disaggregated data and analysis of health equity Baseline 35 Target 40

On track

To end 2010 No country reports produced; however, 4 countries supported

The Region is on track in its contribution to this OWER. Activities were undertaken in three countries to contribute to the achievement of this OWER. More specific information is given below. In collaboration with WHO/HQ, financial and technical support was provided to seven participants from four WPRO countries (CHN, MYS, PHL and VNM) to attend the global meeting “A policy dialogue to strengthen evidence to improve women's health through gender and health statistics”. Follow-up activities were undertaken. The Regional Office participated in and made a presentation at the Global Forum on Gender Statistics, organized by the United Nations Statistics Division. A chapter on equity issues in achieving the MDGs was developed for inclusion in the regional MDG progress report. In the PHL, the conduct of the URBAN Health Equity Assessment and Response Tool (HEART) was scaled up to other cities. OWER 7.4 Ethics and human rights-based approaches to health promoted within WHO and at national and global levels. Indicator 7.4.1 Number of tools produced for Member States or the Secretariat giving guidance on using a human rights-based approach to advance health Number of tools produced for Member States or the Secretariat giving guidance on use of ethical analysis to improve health policies Baseline 28 Target 37

On track To end 2010 1 tool created

7.4.2

No separate tool was developed under this indicator in WPRO

WPR/RC62/3 page 69 Annex 1

The Region is on track in its contribution to this OWER. Activities were undertaken in three countries to contribute to the achievement of this OWER. More specific information is given below. PHL and MNG were supported in the area of health in prisons; and CHN on disabilities. Joint activities were undertaken with the tuberculosis programme on health in prisons; and with the injury and violence prevention and nursing units on disabilities. OWER 7.5 Gender analysis and responsive actions incorporated into WHO's normative work and support provided to Member States for formulation of gender-responsive policies and programmes. Indicator 7.5.1 Number of WHO tools or documents developed or updated, or joint activities by WHO technical units undertaken, in order to promote gender-responsive actions into the work of WHO Number of gender mainstreaming activities conducted in Member States and supported by WHO Baseline 54 Target 70

On track

To end 2010 1 technical document developed

7.5.2

107

155

6 countries supported

The Region is on track in its contribution to this OWER. Activities were undertaken in six countries to contribute to the achievement of this OWER. More specific information is given below. Support was provided to the infectious diseases programme managers and staff of the PHL's Department of Health, and to SLB's Ministry of Health staff. Gender analysis and actions are being integrated into maternal, child and neo-natal health district planning and health centre micro-planning in LAO. Work on gender-based violence was supported in VNM and under the UNiTE campaign in the Pacific island countries. In PNG, the focus is on gender-based violence, especially sexual

violence. Support was provided on gender mainstreaming to the Division of Health Security and Emergencies (DSE); and to malaria and other infectious diseases in the PHL.

WPR/RC62/3 page 70 Annex 1 ACTIONS REQUIRED The following are required actions: In general, capacity in Member States in technical programmes is still weak. However, increasing interest and demand for support is observed. There is a need for continued support and using windows of opportunity. Resource availability for activities in this SO has improved in this biennium, mostly from voluntary contribution (VC) sources. A staff member is being recruited on a 12-month temporary appointment professional (TAP) contract to strengthen Regional Office capacity. The Regional Office will coordinate closely with SO7 focal points in country offices to provide the needed support and ensure timely implementation.

WPR/RC62/3 page 71 Annex 1 STRATEGIC OBJECTIVE 8 To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health.

Highlights on significant programme delivery The most significant event was the Second Ministerial Regional Forum on Environment and Health in Southeast and East Asian Countries, organized by the WHO Regional Offices for the Western Pacific and South-East Asia, in collaboration with the United Nations Environment Programme Regional Office for the Asia and the Pacific, in Jeju, Republic of Korea in July 2010. The Ministers attending the Forum approved the work plans for 2010–2013 of seven regional Thematic Working Groups on priority environmental health issues (air quality; water, sanitation and hygiene; solid and hazardous waste; toxic chemicals; climate change; environmental health emergencies; and health impact assessment) and established a task force to improve the governance, partnership and impacts of the Regional Forum. WHO's support to assess health vulnerability and strengthen the health sector's response to climate change has been extended to 20 developing countries. WHO's support and collaboration has also continued to be provided to countries in water safety plans, household water treatment and storage, national environmental health action plan, health-care waste management, health impact assessment, health issues of the transport sector, poison centres, asbestosrelated diseases and occupational health. The contributions of the Western Pacific Region to all OWERs but one are rated on track. The one rated at risk relates to the development of WHO norms, standards or guidelines (OWER 08.001, Indicator 8.1.2). The main reason for the at risk rating for OWER 08.001 is that while the Regional Office continues to support and participate in the development of global WHO guidelines (e.g. drinking water quality guidelines, indoor air quality guidelines, guidelines for assessment of health vulnerability and adaptation to climate change, etc.) and Country Offices support countries to develop national standards based on WHO guidelines, both the Regional Office and Country Offices do not usually develop WHO norms and guidelines.

WPR/RC62/3 page 72 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 8.1 Evidence-based assessments made, and norms and standards formulated and updated on major environmental hazards to health (e.g., poor air quality, chemical substances, electromagnetic fields, radon, poor-quality drinking-water and waste-water reuse). Indicator Number of Member States with proven capacity to conduct assessments of specific environmental threats to health, in order to quantify, with WHO technical support, the environmental burden of disease, so as to add sustainability to MDG 4, 5 and 6 achievements. Number of new or updated WHO norms, standards or guidelines on occupational or environmental health issues published during the biennium Baseline Target

At risk

To end 2010

8.1.1

8.1.2

The contribution to the OWER is rated at risk. For indicator 8.1.1, the three countries expected to have conducted assessments of specific environmental threats to health with WHO technical support during the biennium are: CHN, MNG and VNM. However, for indicator 8.1.2, no WHO norms, standards or guidelines have been published, although at the country level, WHO supported to develop five norms, standards or guidelines and regulations, including national drinking water quality standards in FJI and KHM; national indoor and outdoor air quality standards; guidelines on healthcare waste management; and regulations on insecticides and disinfectants. OWER 8.2 Technical support and guidance provided to Member States for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings (e.g. workplaces, homes or urban settings) and among vulnerable population groups (e.g. children). Indicator Number of Member States implementing, with WHO technical support, primary prevention interventions to reduce pneumonia in children, diarrhoeal and noncommunicable diseases in at least one of the following settings: workplaces, homes or urban settings Baseline Target

On track

To end 2010

8.2.1

The contribution to the OWER is rated on track. For indicator 8.2.1, the 11 countries expected to have implemented primary prevention interventions for reducing environmental risks to health with WHO technical support and guidance are: COK, KHM, KIR, LAO MNG, NRU, PNG, WSM, SLB, TON and VNM. All ongoing activities are expected to be completed by end of 2011.

WPR/RC62/3 page 73 Annex 1 OWER 8.3 Technical assistance and support provided to Member States for strengthening national occupational and environmental health risk management systems, functions and services. Indicator Number of Member States that have implemented, with secretarial support, national action plans or policies for the management of occupational health risks, such as in relation to the global plan of action on workers’ health 2008–2017. Baseline Target

On track

To end 2010

8.3.1

The contribution to the OWER is rated on track. For indicator 8.3.1, the three countries expected to have implemented activities related to the development of national programmes on the elimination of asbestos-related diseases by end of 2011 with support from WHO are: MNG, PHL, and VNM. While not directly related to the indicator, WHO supported six countries, namely KHM, LAO, MYS, PHL, SLB and VNM, to develop or implement their national environmental health action plans.

OWER 8.4 Guidance, tools and initiatives created in order to support the health sector in influencing policies in other sectors to allow policies that improve health, the environment and safety to be identified and adopted. Indicator Number of Member States implementing WHO-supported initiatives to reduce noncommunicable and communicable diseases through healthy agriculture, energy, and transportation policies. Baseline Target

On track

To end 2010

8.4.1

The contribution to the OWER is rated on track. For indicator 8.4.1, the eight countries expected to have implemented WHO-supported initiatives to address the health impacts of activities in the transport sector (called environmentally sustainable and healthy urban transport or ESHUT) are: CHN, JPN, KHM, KOR, LAO, MNG, PHL and VNM. Further activities in these and other countries are expected to be implemented by end of 2011.

WPR/RC62/3 page 74 Annex 1

OWER 8.5 Health-sector leadership enhanced for creating a healthier environment and changing policies in all sectors so as to tackle the root causes of environmental threats to health, through means such as responding to emerging and re-emerging consequences of development on environmental health and altered patterns of consumption and production and to the damaging effect of evolving technologies. Indicator Number of studies or reports on new and re-emerging occupational and environmental health issues published or co- published by WHO Number of reports published or jointly published by WHO on progress made in achieving water and sanitation objectives of major international development frameworks, including the Millennium Development Goals Number of high-level regional forums on environment and health issues organized or technically supported by WHO biennially Baseline Target

On track

To end 2010

8.5.1

8.5.2

8.5.3

The contribution to the OWER is rated on track. For indicator 8.5.1, the two publications on emerging environmental and occupational health issues that are expected to have been finalized are: Paper on Asia-Pacific Water Safety Plan Network, and Regional Framework for Action for Occupational Health: 2011–2015. For indicator 8.5.2, two national water and sanitation sector

assessment reports: one in LAO and the other in VNM, are being prepared and will be completed by end of 2011. For indicator 8.5.3, two ministerial meetings that were held in 2010 are the Second East Asia Ministerial Conference on Sanitation and Hygiene, and the Second Ministerial Regional Forum on Environment and Health in South-East and East Asian countries. OWER 8.6 Evidence-based policies, strategies and recommendations developed, and technical support provided to Member States for identifying, preventing and tackling public health problems resulting from climate change. Indicator Number of studies or reports on the public health effects of climate change published or co- published by WHO Number of countries that have implemented plans to enable the health sector to adapt to the adverse effects on health of climate change Baseline Target

On track

To end 2010 3

8.6.1

8.6.2

The contribution to the OWER is rated on track. For indicator 8.6.1, the three reports that have been completed on the health effects of climate change in 2010 were those in KHM, PNG and VNM. There are similar studies being conducted in 12 other countries that are expected to produce reports by end of 2011. For indicator 8.6.2, the five countries that have implemented plans and programmes to strengthen capacity of the health sector to adapt to climate change are CHN, FJI, KHM, MNG, and

WPR/RC62/3 page 75 Annex 1 PHL. Three more countries plan to implement capacity-building activities for the health sector adaptation to climate change in 2011. ACTIONS REQUIRED Closer coordination across the three levels of the Organization is required in supporting country activities. Joint planning, fund-raising and coordination in implementation of planned activities between the Headquarters, Regional Office and Country Offices should be enhanced. The Regional Office and Country Offices should continue to improve collaboration with international and regional partners and stakeholders in environmental and occupational health (e.g. UNEP, UNICEF, ILO, UNDP, World Bank, Asian Development Bank, Secretariat for the Pacific Community; Secretariat of the Pacific Regional Environment Programme, etc.) and promote multi-sectoral collaboration in countries. The following are required actions: Enhance support and raise and allocate more resources for (1) the Regional Forum on Environment and Health in Southeast and East Asian Countries, particularly the work of the task force and the implementation of the work plans of the various Thematic Working Groups; (2) promotion of water safety plan and policy development, programmes on elimination of asbestos-related diseases, and environmentally sustainable and healthy urban transport initiatives; and (3) implementation of national strategies and/or action plans for the health sector response to climate change. Reduce the number of regional meetings, particularly of general nature (e.g. to raise awareness of specific environmental health issues) while strengthening the capacity of country offices in supporting countries (hence reducing the need of regional staff travels to support countries) and engaging country office staff in regional and global initiatives. WHO regional norms and guidelines will not be developed, unless the subject/issue is region-specific, and there is no global effort in developing such norms and guidelines. The regional resources are better utilized for contributing to the global efforts in developing norms and guidelines and for supporting countries to use WHO norms and guidelines to develop their own policies and standards.

WPR/RC62/3 page 76 Annex 1 STRATEGIC OBJECTIVE 9 To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development.

Highlights on significant programme delivery Support was provided to targeted countries through the National Plan of Action for Nutrition workshop held annually and the Pacific Food Summit held in April 2010. Support was also provided to Asian countries (KHM, LAO, PHL and VNM) to address nutrition problems through intersectoral programmes. An analysis of the cost-effectiveness of the Yen Bai WIFS for WRA programme was conducted by a collaborating institution (Melbourne University) and submitted to the WHO Bulletin for publication. A guide for the implementation of programmes on weekly iron and folic acid supplementation for women of reproductive age (WIFS for WRA) was produced. Continuing support was being provided to countries on infant and young child feeding, micronutrient supplementation, promotion of healthy diets, nutritional assessment and surveillance; management of malnutrition; capacity building in Nutrition. Support was also provided for the Pacific Food Summit and the adoption and implementation of the Pacific Framework for Action on Food Security. Physical activity and food-based dietary guidelines were communicated through national campaigns. Food standards were introduced as part of

legislation for selected Pacific countries (for wheat flour and salt fortification, and for fat levels in food). Significant advances have been made by Member States in building national systems for food safety. Of particular note in relation to advancing their basic food law are CHN, KIR, MHL, WSM, and VNM; in advancing food regulations and standards are several Pacific island countries; in strengthening their enforcement capacity are LAO and VNM; in taking steps to introduce risk-based imported food control are PNG and SLB; and in food safety education for mass gatherings and increasing consumer participation in food safety is CHN. NRU has become a Codex member. All countries are participants in International Food Safety Authorities Network (INFOSAN) and efforts to increase national INFOSAN networks are under way.

WPR/RC62/3 page 77 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 9.1 Partnerships and alliances formed, leadership built and coordination and networking developed with all stakeholders at country, regional and global levels, in order to promote advocacy and communication, stimulate intersectoral actions, increase investment in nutrition, food-safety and food-security interventions, and develop and support a research agenda. Indicator Number of Member States that have functional institutionalized coordination mechanisms to promote intersectoral approaches and actions in the area of food safety, food security or nutrition Number of Member States that have included nutrition, foodsafety and food-security activities and a mechanism for their financing in their sector-wide approaches or Poverty Reduction Strategy Papers Baseline Target

On track

To end 2010

9.1.1

9.1.2

Not relevant to WPRO

The Framework for Action on Food Security in the Pacific was finalized and endorsed by 22 countries at the Pacific Food Summit and at Pacific Forum Leaders meeting. Five Pacific island countries (COK, FJI, FSM, KIR and VUT) held their own national food summits to develop coordination mechanisms to promote intersectoral approaches and actions in the area of food safety, food security or nutrition complementary to the Framework for Action. The National Plan of Action for Nutrition (NPAN) and NCP plans' implementation were supported through a workshop with six US associated Pacific islands (ASM, FSM, GUM, MHL, MNP and PLW). With the support of WHO/FAO, the government of the SLB approved an integrated food security, food safety and nutrition policy in the first half of 2010. The UN in CHN started action on a programme of work focusing on an integrated approach to address food safety, nutrition and food security for women and children in the poorest counties of the country. Resource mobilization for nutrition and food safety programmes was initiated (16 proposals submitted to resource mobilization agency).

WPR/RC62/3 page 78 Annex 1

OWER 9.2 Norms, including references, requirements, research priorities, guidelines, training manuals and standards, produced and disseminated to Member States in order to increase their capacity to assess and respond to all forms of malnutrition, and zoonotic and non-zoonotic foodborne diseases, and to promote healthy dietary practices. Indicator Number of new nutrition and food-safety standards, guidelines or training manuals produced and disseminated to Member States and the international community Number of new norms, standards, guidelines, tools and training materials for prevention and management of zoonotic and non-zoonotic foodborne diseases Baseline Target

On track

To end 2010

9.2.1

9.2.2

To facilitate the introduction of standards in the small island states, a Practical Guide to Introducing Food Standards to Promote Health and Trade for Small Island States (SIS) was drafted and being trialled along with efforts to advance standards in SIS. Draft food complaints guidelines had been initiated. The following documents were prepared or finalized: (1) Weekly Iron-Folic Acid Supplementation (WIFS) for Women of Reproductive Age (WRA) - Its Role in Promoting Optimal Maternal and Child Health; (2) A guide on Best Practices for WIFS for WRA programmes; (3) A communication strategy to scale up WIFS for WRA programmes. OWER 9.3 Monitoring and surveillance of needs and assessment and evaluation of responses in the area of nutrition and diet-related chronic diseases strengthened, and ability to identify best policy options improved, in stable and emergency situations. Indicator Number of Member States that have adopted and implemented the WHO Child Growth Standards Number of Member States that have nationally representative surveillance data on major forms of malnutrition Baseline Target

On track

To end 2010 6

9.3.1

9.3.2

MYS, PHL, SLB and other countries have introduced a new training course on growth monitoring and IYCF.

WPR/RC62/3 page 79 Annex 1 Support was provided for: (1) National Nutrition Survey in MNG; (2) Evaluation of the programme on WIFS for WRA in KHM; (3) Evaluation of the programme on WIFS for WRA in VNM; (4) Assessment of Zinc status in the PHL population; and (5) Integrated Food Security Information Systems promoted in the Pacific.

OWER 9.4 Capacity built and support provided to target Member States for the development, strengthening and implementation of nutrition plans, policies and programmes aimed at improving nutrition throughout the life-course, in stable and emergency situations. Indicator Number of Member States that have implemented at least three high- priority actions recommended in the Global Strategy for Infant and Young Child Feeding Number of Member States that have implemented strategies to prevent and control micronutrient malnutrition Number of Member States that have implemented strategies to promote healthy dietary practices for preventing diet-related chronic diseases Number of Member States that have included nutrition in their responses to HIV/AIDS Number of Member States provided with support to optimize nutrition in emergencies (covering the preparedness planning, emergency response and recovery phases) Baseline Target

On track

To end 2010

9.4.1

9.4.2

9.4.3

9.4.4

9.4.5

Important progress was made in the PHL through the Essential Newborn Care programme; a press statement was published on WHO HQ and WPRO websites in December 2010 highlighting the achievements of this programme. Micronutrient deficiencies prevention and control: (1) A guide on best practices for weekly iron and folic acid supplementation (WIFS) programmes for WRA was produced;

WPR/RC62/3 page 80 Annex 1 (2) The communication strategy to scale up WIFS for WRA programmes was developed; (3) Implementation and evaluation of WIFS for WRA programmes was supported in KHM and VNM; (4) A meeting on anaemia prevention strategy throughout the life cycle was held in VNM; (5) Iodized Salt and Wheat Flour Fortification was supported together with UNICEF, Flour

Fortification Initiative and other partners; (6) Assessment and monitoring of iodine status was promoted in six US Associated Pacific Islands and the IDD survey in WSM was agreed by MOH; and (7) Contribution was made on the development of New Nutrition Guidelines through “NUGAG” Nutrition Guidelines Advisory Expert Group (on Micronutrients). Consultation on strategies for the reduction of salt intake was conducted in SGP, in collaboration with the NCD programme and WHO Collaborating Centres. The participation in a workshop on HIV and Nutrition (organized by WFP) allowed to promote interventions in this area and to identify new opportunities for mobilizing resources to improve nutritional status through the prevention and treatment of HIV, including social marketing strategies to promote exclusive breastfeeding. A training in the prevention and management of moderate and severe malnutrition in children was conducted in KHM and LAO. Participation in a workshop on IYCF in emergencies (organized by UNICEF) provided an opportunity to promote common strategies for improving IYCF practices in emergencies and in normal conditions.

WPR/RC62/3 page 81 Annex 1

OWER 9.5 Systems for surveillance, prevention and control of zoonotic and non-zoonotic foodborne diseases strengthened; food-hazard monitoring and evaluation programmes established and integrated into existing national surveillance systems, and results disseminated to all key players. Indicator Number of Member States that have established or strengthened intersectoral collaboration for the prevention, control and surveillance of foodborne zoonotic diseases Number of Member States that have initiated a plan for the reduction in the incidence of at least one major foodborne zoonotic disease Baseline Target

At risk

To end 2010

9.5.1

9.5.2

Foodborne disease surveillance, food hazard monitoring and risk assessment:

The capacity of

Member States to obtain food safety data through hazard monitoring and to conduct risk assessments was enhanced through: burden of foodborne disease training; risk assessment training; the provision of technical advice on the establishment of national expert committees and training institutes; and training in both food analysis and better outbreak investigation. CHN has initiated a large pilot project in more than 300 sites in Qingdao to improve collection and handling of data on foodborne disease surveillance. Asia FoodNet is established to share information on foodborne diseases and surveillance among Listserve members. However, despite progress made, additional work is required to facilitate system development in the area of foodborne disease surveillance and food contamination monitoring in addition to the activities reported above. OWER 9.6 Capacity built and support provided to Member States, including their participation in international standard-setting in order to increase their ability to assess risk in the areas of zoonotic and non-zoonotic foodborne diseases and food safety, and to develop and implement national food-control systems, with links to international emergency systems. Indicator Number of selected Member States receiving support to participate in international standard-setting activities related to food, such as those of the Codex Alimentarius Commission Number of selected Member States that have built national systems for food safety with international links to emergency systems Baseline Target

On track

To end 2010

9.6.1

10*

9.6.2

COK, FJI, KHM, LAO, MNG, PNG, PHL, SLB, TON and WSM.

WPR/RC62/3 page 82 Annex 1 Policy guidance and legislation: As a basis for guiding future action by Member States of the Western Pacific, the drafting and community consultation process for a Western Pacific Regional Food Safety Strategy 2011–2015 was initiated. Also a Food Safety Bill was drafted and being discussed with key stakeholders in WSM, KIR finally gazetted its Food Safety Act 2006, MHL moved forward on primary food legislation, and VUT amended its legislation to better address micronutrient deficiencies in that country. Food regulations and standards based on Codex were being drafted in COK, FSM, MHL, NRU, NIU, SLB, and TUV. In addition, technical support was provided in the development of food legislation in CHN and VNM. NRU became the latest member of Codex. Enhancing enforcement and education: As countries adopt new laws, regulations and standards, there is an increasing need for inspectors to be appropriately trained in order for them to be able to enforce the legislation effectively and efficiently. In support of this, inspectors from FSM, PLW and PNG were trained in food safety auditing with the latter being mentored by the New Zealand Food safety Authority. Food safety was also enhanced through collaborative action on food safety education and on setting-based community action. With WHO technical advice, a consumer information platform was established with the aim of making health authorities the primary and most trusted source of information for consumers on food safety matters in CHN. In VNM, together with FAO, efforts were made to provide key food safety messages to communities and businesses as well as establishing a community-based food complaint system. Technical support for mass gatherings and emergency response preparedness: On risk management associated with mass gatherings, technical advice was provided to health and food and drug authorities in association with the Shanghai WORLDEXPO 2010. Finally, from a risk management perspective, a Global Foodborne Infections Network (GFN) and Asia FoodNet meeting was conducted in association with WHO, to introduce key personnel to the FAO/WHO Framework for Developing National Food Safety Emergency Response (FSER) Plans. FSER planning was also initiated through training in FJI, KHM, LAO, MNG, and VNM. ACTIONS REQUIRED The following are required actions: For FOOD SAFETY, future funding under SO 9 will be allocated to ensuring food safety capacity is built in the Region in line with the proposed Western Pacific Regional Food Safety Strategy 2011–2015.

WPR/RC62/3 page 83 Annex 1 For NUTRITION, assured funding should also be allocated in SO 9 to ensure support in nutrition surveillance and analyses of programme effectiveness and cost-effectiveness, as well as the scaling up of programmes for the prevention of anaemia, other micronutrient deficiencies and infant and young child feeding. Priority will be given to the promotion of improved communication for behavioural change and the targeting of consumers, policy-makers and the food industry to promote healthier diets and physical activity, through environments that help make healthy choices easy. Greater investments by governments in nutrition programmes will be encouraged.

WPR/RC62/3 page 84 Annex 1 STRATEGIC OBJECTIVE 10 To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research.

Highlights on significant programme delivery The contribution of the Regional Office in all OWERs under Strategic Objective 10 is rated as being on track. All the planned activities as well as those arising from the requests of the Member States have overall been timely implemented. Strategic Objective 10 encompasses four major teams/areas aligned with the six building blocks. They are (1) leadership and health services delivery, (2) health information and research, (3) human resources for health, and (4) health care financing. Overall, the regional indicators, therefore reflect the number of countries that have received WHO support in these key areas. In any of the four major areas of intervention, the implementation of the planned activities and those requested by member countries have been well implemented. The Regional Strategy on Health Systems Based on the Values of Primary Health Care was adopted in October 2010 after a two-year consultation process. The contributions to the Strategic Objective are summarized as follows: Support has been provided to most countries in the Region on quality assurance, patient safety, national health policy and planning processes, and aid effectiveness. Workshops and support were provided to improve quality and application of health information at country and regional level through introducing and applying WHO analysis tools, building capacity at country, and improving data analysis and utilization at country and regional level. Cross-sectoral efforts/networks to strengthen workforce production and educational quality, as well as support to the creation of Education Development Centres for the Pacific Region and the Mekong countries have also been provided. Regional launch of Health Financing Strategy and launch of the World Health Report in six priority countries increased policy focus and commitment to modify health financing systems to move quickly to universal coverage.

WPR/RC62/3 page 85 Annex 1 Progress of the contribution to achievement of organization-wide expected results, including indicator targets The Western Pacific Regional Office's contribution to the 13 OWERs under SO10 is rated as being on track. The overall approach has been to address the Region's and countries' needs based on the direct requests from the Member States and their respective plans. OWER 10.1 Management and organization of integrated, population-based health-service delivery through public and nonpublic providers and networks improved, reflecting the primary health care strategy, scaling up coverage, equity, quality and safety of personal and population-based health services, and enhancing health outcomes. Indicator Number of Member states that have regularly updated databases on numbers and distribution of health facilities and health interventions offered Baseline Target

On Track

To end 2010

10.1.1

Support has been provided to quality assurance in nine countries through small projects for trainers. Support has also been provided on global health initiatives in five countries for the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), with support on grant negotiations in four countries, and support with the GAVI/GFATM joint platform funding processes in two countries. Much progress has been made on collaboration with disease control programmes and health systems. All countries and territories have sufficient information on health facilities to report regularly for the country health information profiles (CHIPs) compiled by the Health Management Information System (HMIS) unit. However, the information is not adequate on distribution of facilities, for example, urban – rural distribution, or public – private distribution. KHM and LAO reported their country office work on health planning under this OWER and MNG reported on their PHC capacity building exercises.

WPR/RC62/3 page 86 Annex 1

OWER 10.2 National capacities for governance and leadership improved through evidencebased policy dialogue, institutional capacity-building for policy analysis and development, strategy-based health system performance assessment, greater transparency and accountability for performance, and more effective intersectoral collaboration. Indicator Number of Member states that have in the last five years developed comprehensive national health planning processes in consultation with stakeholders Number of Member states that conducted a regular or periodic evaluation of progress, including implementation of their national health plan, based on a commonly agreed performance assessment of their health system Baseline Target

On Track

To end 2010

10.2.1

10.2.2

The Western Pacific Regional Strategy for Health Systems Based on the Values of Primary Health Care was adopted at the Regional Committee Meeting in October 2010, after a two-year consultation process with Member States. Two multi-country inception workshops for the Global Learning Programme (GLP) on National Health Policies, Strategies and Plans (NHPSP) have been carried out, one for the Pacific island countries and one for MNG, MYS, and PHL country teams. The response has been positive with increased capacity and interest in the topic on the part of WHO staff. The remainder of the regional workshops is planned for in 2011 and this needs to be completed and follow-up maintained. Substantive support by country offices and the Regional Office has been given for health planning and health policy dialogue in seven countries so far this biennium (CHN, KHM, LAO, MYS, PNG, SLB and VNM). Sectoral reviews of various types have been supported in seven countries (FJI, KHM, LAO, MNG, PNG, SLB and VNM). Sectoral reviews have taken on increased importance with GAVI and the Global Fund, particularly in KHM and VNM, and also in SLB. Support in law and regulation development and has been provided to three countries (LAO, NRU and SLB) and some more (CHN, FJI and SLB) are being planned. Intersectoral collaborative work has been done in relation to the public-private mix (PNG, MYS and VNM) and also in regard to antimicrobial resistance where a cross cutting working group has been formed in WPRO.

WPR/RC62/3 page 87 Annex 1

OWER 10.3 Coordination of the various mechanisms (including donor assistance) that provide support to Member States in their efforts to achieve national targets for healthsystem development and global health goals improved. Indicator Number of Member States where the inputs of major stakeholders are harmonized with national policies, measured in line with the Paris Declaration on Aid Effectiveness Baseline Target

On Track

To end 2010

10.3.1

Donor coordination is supported in multiple countries, although frequently the activities are funded with links to RER 10.2. However, in the Region, no country is fully harmonized with the Paris Declaration principles on Aid Effectiveness. Strong donor coordination activities with strong WHO involvement occur in many countries (KHM, LAO, MNG, PNG, SLB, VNM, VUT and WSM, and partially in FJI). Particularly, joint assessments in KHM and VNM have been useful. The PHL has seen increased involvement and building of staff capacity in this area. OWER 10.4 Country health-information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major international goals strengthened. Indicator Proportion of low- and middle-income countries with adequate health statistics and monitoring of health-related Millennium Development Goals that meet agreed standards Baseline Target

On Track

To end 2010

10.4.1

Substantive support from the Regional Office staff to the Member States to strengthen their national Health Information Systems (HIS) by addressing gaps and opportunities identified in recently completed HIS assessments using the Health Metrics Network (HMN) framework and tools. National health information working plans have been developed in KHM, LAO and PNG. A series of workshops and trainings co-sponsored by other partners are being planned to address and follow-up on priority needs.

WPR/RC62/3 page 88 Annex 1 OWER 10.5. Better knowledge and evidence for health decision-making assured through consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas, and global leadership in health research policy and coordination, including with regard to ethical conduct. Indicator Proportion of countries for which high quality profiles with core health statistics are available from its open-access databases Number of countries in which WHO plays a key role in supporting the generation and use of information and knowledge, including primary data collection through surveys, civil registration or improvement or analysis and synthesis of health facility data for policies and planning Effective research for health coordination and leadership mechanisms established and maintained at global and regional levels Baseline Target

On Track

To end 2010

10.5.1

10.5.2

10.5.3

The Regional Office has worked with HQ to apply the WHO Country Health System Surveillance (CHeSS) tool in CHN and KHM. The Regional Office team is working with other units in transforming its regional health databank and online data generator into a next generation regional Health Information Intelligent Platform (HIIP) to provide better access to timely information; and increase the quality and better use of health information across the Region. Draft governance documents for the Observatory were prepared and discussed with stakeholders in 2010. A basic agreement has been reached and an interim Steering Committee has been established.

OWER 10.6 National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society. Indicator Baseline Target

On Track To end 2010 Information not available in WPRO, progress cannot be measured

10.6.1

Proportion of low- and middle-income countries in which national health-research systems meet internationally agreed minimum standards

The Regional Ethics Review Committee (ERC) has been established. The Regional Office is working with country offices to identify and implement priority actions specifically to improve health research

WPR/RC62/3 page 89 Annex 1 governance and management based on national health system assessment undertaken in several Member States between 2002 and 2007.

OWER 10.7 Knowledge management and eHealth policies and strategies developed and implemented in order to strengthen health systems. Indicator Number of Member States adopting knowledge management policies in order to bridge the “know-how” gap particularly aimed to decrease the digital divide Number of Member States with access to electronic international scientific journals and knowledge archives in health sciences as assessed by the WHO Global Observatory for eHealth biannual survey Proportion of Member States with eHealth policies, strategies and regulatory frameworks as assessed by the WHO Global Observatory for eHealth biannual survey Baseline Target

On track To end 2010

10.7.1

10.7.2

10.7.3

26%

Five countries (CHN, LAO, MYS, PHL and VNM) with evidence-based informed network (EVIPnet) are still continuing. Training on WHO Collaborating Centres (CC) has been conducted at regional and country level to improve the management and performance of WHO Collaborating Centres in the Region. One WHO CC on health information and informatics is being established in CHN. The website on CC has been improved substantially. OWER 10.8 Health-workforce information and knowledge base strengthened, and country capacities for policy analysis, planning, implementation, information-sharing and research built up. Indicator Number of countries reporting two or more national data points on human resources for health within the past five years, reported in the Global Atlas of the Health Workforce Number of Member states with an national policy and planning unit for human resources for health Baseline Target

On track

To end 2010

10.8.1

10.8.2

The WPR 10.8 OWER contributions are on track, though the indicators differ in WPR, both sets contribute to similar outcomes –WPR indicators focus on HRH unit/personnel capacity-building for reliable health workforce information management systems (IMS) and databases (focused on minimum data sets, contributing to the breadth of HRH data points as reported in the global health workforce atlas) to support evidence-based HRH strategies and policies. Such work is supported by WHO tools and guidelines partnerships and networks for improved evidence, research, practice and

WPR/RC62/3 page 90 Annex 1 overall governance. At least seven countries were above baseline (CHN; FJI; KHM, LAO; PHL; PNG and WSM). Contributing partners and networks to 10.8 indicator targets include an existing WHO CC at the University of Technology; and two nursing networks, the American Pacific Nurse Leaders Council's (APNLC) analysis of nursing/midwifery HRH professional development needs; and the South Pacific Chief Nursing and Midwifery Officers Alliance's (SPCNMOA) capacity-building efforts at building data literacy and application/use of the HRH Minimum Data sets. OWER 10.9 Technical support provided to Member States, with a focus on those facing severe health-workforce difficulties in order to improve the production, distribution, skill mix and retention of the health workforce. Indicator Proportion of 57 countries with critical shortage of health workforce, as identified in The World Health report 2006 with a multi-year plan for human resources in health Proportion of 57 countries with critical shortage of health workforce, as identified in The world health report 2006 which have an investment plan for scaling up training and education of health workers Baseline Target

On Track

To end 2010

10.9.1

10.9.2

The WPR 10.009 RER indicators differ from the OWER 10.9, as regional expected result indicators enable tracking of application of evidence-based policies, tools, educational quality improvement as well as partnerships/networks to strengthen workforce capacities, including HRH strategic planning capacities and cross-sectoral support for HRH investment plans in priority Member States. The WPR 10.009 indicators therefore contribute to OWER 10.9 and are on target, in terms of reaching at least six countries above baseline, in regard to application of evidence-based tools and guidelines and capacities for improved educational standards (CHN, FSM, KHM, KIR, LAO, MHL, MNP, PHL, PNG, PLW, SLB and WSM). Two new supportive partnerships/networks for research and HRH, workforce capacity-building in priority counties, region were established: (1) An Academic Quality Improvement Network for research, funding, in partnership with Sigma Theta Tau International (STTI), ICN, and academic partner Institutions and one new WHO CC (the WHO Collaborating Centre for Nursing and Midwifery Education, Research and Capacity-Building, of James Cook University, Australia), with emphasis on health workforce strengthening; Workforce surveys have been completed in four countries (FSM, MHL, MNP and PLW). Workforce retention case studies have also been implemented in LAO and VUT.

WPR/RC62/3 page 91 Annex 1 OWER 10.10 Evidence-based policy and technical support provided to Member States in order to improve health-system financing in terms of the availability of funds, social and financial-risk protection, equity, access to services and efficiency of resource use. Indicator Number of Member States provided with technical and policy support to develop health financing systems to attain or maintain universal coverage Number of key policy briefs prepared, disseminated and their use supported, which document best practices on revenue-raising, pooling and purchasing, including contracting, provision of interventions and services, and handling of fragmentation in systems associated with vertical programmes and inflow of international funds Baseline Target

On Track

To end 2010

10.10.1

10.10.2

The regional launch of Health Financing Strategy and launch of the World Health Report in six priority countries increased policy focus and commitment to modify health financing systems to move quickly to universal coverage. WHO technical support was provided to countries in Asia and the Pacific on increasing health investment, government spending, reducing out-of-pocket payments, financial barriers, catastrophic health expenditure, impoverishment, and efficient and effective use of financial resources. Studies on distribution of health payments were conducted in six priority

countries and policy briefs on fiscal space increase and reduction on out-of-pocket payments were developed and advocated.

OWER 10.11 Norms, standards and measurement tools developed for tracking resources, estimating the economic consequences of illness, and the costs and effects of interventions, financial catastrophe, impoverishment, and social exclusion, and their use supported and monitored. Indicator Key tools, norms and standards to guide health financing policy development and implementation for universal coverage developed, disseminated and their use supported. Number of Member States provided with technical support for using WHO tools relating to health financing for universal coverage. Baseline Target

On Track

To end 2010

10.11.1

10.11.2

Increasing number of countries aim to improve their country-specific evidence and information on health care financing. WHO tools and methodologies were advocated and applied to respond to this demand in priority countries in Asia and the Pacific. National experts from Member States were trained in the application of WHO tools on distribution of health payments and organizational

WPR/RC62/3 page 92 Annex 1 assessment for improving and strengthening health system financing (OASIS). Consultations on revision of a system of health accounts (SHA-2) were organized in countries of Asia and the Pacific. OWER 10.12 Steps taken to advocate additional funds for health where necessary; to build capacity in framing of health-financing policy and interpretation and use of financial information; and to stimulate the generation and translation of knowledge to support policy development. Indicator 10.12.1 WHO presence and leadership in international, regional and national partnerships Number of Member States provided with support to build capacity in the formulation of health financing policies and strategies and the interpretation of financial data Baseline 0 Target 18

On track To end 2010 10

10.12.2

Global update of system health accounts together with the development of a region-specific technical guidance and framework for developing and institutionalizing national health accounts in the Pacific.

OWER 10.13 Evidence based norms, standards and measurement tools developed to support Member States to quantify and decrease the level of unsafe health care provided. Indicator Key tools, norms and standards to guide policy development, measurement and implementation disseminated and their use supported Number of Member States participating in global patient safety challenges and other global safety initiatives, including research and measurement Baseline Target

On track To end 2010

10.13.1

10.13.2

A workshop to introduce safe surgery checklist was conducted in Ha Noi for KHM, LAO MNG, and VNM, and a follow-up has been planned. Some 2000 institutions have signed the hand hygiene pledge.

WPR/RC62/3 page 93 Annex 1 ACTIONS REQUIRED The following are required actions: WPRO will continue to provide technical support to Member States in the Region to improve National Health Information system and evidence-based policy making at all levels. High quality information and policy support products will be produced from Asia Pacific Observatory regional Health Information Intelligent Platform (HIIP) to health countries for better policy development. Technical guidance and support will enable countries to improve their national health research policy and management. Efforts will be made in the Region to ensure that workforce planning capacities and strategies respond to population and service needs; to continue to up-skill an inter-professional, flexible, competent workforce; maximize functions of the health workforce, staff and skill-mix efficiency and management and retention to improve service delivery and to strengthen health workforce crosssectoral planning, policy coherence, regulations and partnerships. Specific plans to achieve efficiencies and cost reductions: Through better coordinating and working with international partners at regional and country level, WPRO will help countries to develop national strategic plans to improve their overall efficiencies.

WPR/RC62/3 page 94 Annex 1 STRATEGIC OBJECTIVE 11 To ensure improved access, quality and use of medical products and technologies.

Highlights on significant programme delivery The contributions of the Regional Office in all OWERs under Strategic Objective 11 are rated as being on track. All the planned activities as well as those arising from the requests of the Member States had been implemented timely. The regional work under Strategic Objective 11 is divided into three broad areas, namely, to provide support to the Member States in (1) formulating, monitoring and revising national policies on access to, (2) improving the quality assurance and regulation, and (3) promoting cost-effective and rational use of medical products and technologies. The regional indicators therefore reflect the number of countries that have received WHO support in these three areas. In all of these three areas, the implementation of all of the planned activities and those requested by Member States in the Pharmaceuticals, Health Technologies and Laboratory and the Traditional Medicine programmes, respectively, have been well implemented. Some of the major activities implemented under the Strategic Objective included the development and launch of the Regional Framework for Action on Access to Essential Medicines (2011–2016), strategic collaboration between WHO and the Member States on improving access to essential medicines; the official launch of the regional web-based Price Information Exchange (PIEmeds) for selected essential medicines; support to the development of the National Laboratory Policy and Plan in eight Member States; and the development and expert discussion of the draft Regional Strategy for Traditional Medicine in the Western Pacific Region (2011–2020).

WPR/RC62/3 page 95 Annex 1

OWER 11.1 Formulation and monitoring of comprehensive national policies on access, quality and use of essential medical products and technologies advocated and supported. Indicator Number of Member States receiving support to formulate and implement official national policies on access, quality and use of essential medical products or technologies Number of Member States receiving support to design or strengthen comprehensive national procurement or supply systems Number of Member States receiving support to formulate and/or implement national strategies and regulatory mechanisms for blood and blood products or infection control Publication of a biennial global report on medicine prices, availability and affordability, based on all available regional and national reports Baseline Target

On Track To end 2010

11.1.1

11.1.2

Not regional

11.1.3

11.1.4

Not regional

Pharmaceuticals (PHA) A Regional Framework for Action on Access to Essential Medicines (2011–2016) has been finalized, serving as a guide for strategic collaboration between WHO and the Member States in improving access to essential medicines. Thirteen Member States participated in a Consultation on the Regional Framework for Action on Access to Essential Medicines in the Western Pacific 2011–2016, in Manila, in September 2010 (BRN, CHN, FJI, KHM, LAO, MNG, MYS, PHL, PLW, SLB, TON VNM and WSM). Ten Member States have been supported to revise or develop national medicines policies and to improve access to essential medicines (BRN, FSM, FJI, KHM, MNG, PLW, TON, TUV, VNM and VUT). Strategic collaboration on universal access had been agreed with CHN and VNM. A regional web-based Price Information Exchange (PIEmeds) for selected essential medicines have been officially launched, involving 21 Member States (BRN, CHN, COK, FJI, FSM, KIR, LAO, MNG, MYS, NRU, NIU, PHL, PLW, PNG, SGP, SLB, TON, TUV, VNM, VUT and WSM). Eleven Member States (COK, FJI, FSM, KIR, PLW, PNG, WSM, SLB, TON, TUV and VUT) in the Pacific have received the year 6 of the WHO/EC/ACP Partnership Project in Pharmaceutical Policies

WPR/RC62/3 page 96 Annex 1 and Access to Essential Medicines. The project has been successfully implemented with 100% implementation rate. A final evaluation of the project has been undertaken in August 2010 with positive results. Health Technologies and Laboratory (HTL) Eight Member States (FJI, KIR, MNG, MYS, NRU, PNG, SLB and TUV) were provided technical support to develop their National Laboratory Policy and Plan. A biregional workshop was conducted on Blood Donor Management. Eleven Member States (CHN, FJI, KHM, KOR, LAO, MNG, MYS, PHL, PNG, SGP and VNM) attended. The objectives were to discuss the principles, objectives, key elements of and share experiences on the planning, management and monitoring of national blood donor programmes; to review progress in its implementation and to identify strategic action for strengthening national blood donor management programmes in Member States; and A draft "Guidance document for the development of National Laboratory Policy and Plan" was developed. Traditional Medicine (TRM) An Informal meeting on Strategic Directions for Traditional medicine in the Western Pacific Region was held in the PHL in May 2010; The draft Regional Strategy for Traditional Medicine in the Western Pacific Region (2011–2020) has been developed and discussed at the experts' consultation meeting on the Regional Strategy for Traditional Medicine in the Western Pacific Region, held in HOK from 18 to 19 November 2010. Technical support was provided to LAO and KHM to develop their National Policy on Traditional Medicine. Systematic reviews and assessments of the policies for countries with existing strategy were carried out in CHN, JPN, KOR, LAO, MNG and PHL.

WPR/RC62/3 page 97 Annex 1

OWER 11.2 International norms, standards and guidelines for the quality, safety, efficacy and cost-effective use of medical products and technologies developed and their national and/or regional implementation advocated and supported. Indicator Number of new or updated global quality standards, reference preparations, guidelines and tools for improving the provision, management, use, quality, or effective regulation of medical products and technologies Number of assigned International Non-proprietary names for medical products Number of priority medicines, vaccines, diagnostic tools and items of equipment that are prequalified for United Nations procurement Number of Member States for which the functionality of the national regulatory authorities has been assessed or supported Baseline Target

On track

To end 2010

11.2.1

Not regional

11.2.2

Not regional Not regional

11.2.3

11.2.4

Pharmaceuticals (PHA) Eleven Member States (CHN, FJI, KHM, KIR, LAO, MNG, PHL, PLW, TON, TUV and VNM) were supported to strengthen medicines quality assurance system and regulation, such as prequalification, GMP inspection, safety surveillance, legislation etc.. The WHO/INTERPOL joint Operation STORM 2 will be completed during the final meeting in January 2011; Three (3) Mekong countries completed their participation in the INTERPOL/WHO joint operation STORM to combat counterfeit medicines. Experts from nine Member States and partners organizations (INTERPOL and USP) participated in an Expert Consultation on the Surveillance and Alert System for Counterfeit Medicines (February, 2010) in Manila. As one of its follow ups, the regional Rapid Alert System for Combating Counterfeit Medicines (RAS) is being revised. Six Member States (KHM, LAO, PHL, PNG, TON and VNM) were supported to participate in the 14th International Conference of Drug Regulatory Authorities (ICDRA), in December in SGP. Sixteen Member States and areas (AUS, BRN, CHN, FJI, HOK, KHM, KOR, LAO, MYS, MNG, NEZ, PNG, PHL, SGP, TON and VNM) participated in a Meeting of Medicines Regulators from the Western Pacific Region (4 December 2010) in SGP, to facilitate information exchange between/with

WPR/RC62/3 page 98 Annex 1 regulators in the Western Pacific Region, and to increase awareness on selected technical and regulatory developments. Health Technologies and Laboratory (HTL) The WHO-CDC Lab QMT training toolkit was shared with and disseminated to the laboratory managers from the 13 Pacific island countries: COK, FJI, FSM, KIR, MHL, NRU, PNG, PLW, SLB, TON, TUV, VUT, WSM. A draft " Regional Laboratory Quality Standards" with a Checklist was developed. An agreement for performance of work was undertaken with the Pacific Paramedical Training Centre (PPTC) to conduct the 2010 Regional External Quality Assessment (REQAS) Programme in 19 national laboratories; most of them in the Pacific island countries in the WP Region. Technical support was provided to MNG to revise their organ donor law and develop the deceased donor programme. Traditional Medicine (TRM) Support on strengthening quality control of herbal medicine and its regulation was provided to LAO, KHM, MNG and the PHL. An in-country workshop on strengthening the quality control of herbal medicine was organized and conducted in LAO. OWER 11.3 Evidence-based policy guidance on promoting scientifically sound and costeffective use of medical products and technologies by health workers and consumers developed and supported within the Secretariat and regional and national programmes. Indicator Number of national or regional programmes receiving support for promoting sound and cost-effective use of medical products or technologies Number of Member States using national lists, updated within the past five years, of essential medicines, vaccines or technologies for public procurement or reimbursement Baseline Target

On track

To end 2010

11.3.1

11.3.2

Not regional

WPR/RC62/3 page 99 Annex 1 Pharmaceuticals (PHA) Eleven Member States (KHM, CHN, COK, FJI, LAO, PLW, PNG, SLB, TON, TUV, and VNM) have been supported to improve medicines selection and develop/use treatment guidelines. Four Member States ((KHM, CHN, MNG, and PHL) have been supported to implement a focused rational use interventions, namely monitoring, training and planning (MTP) and consumers interactive learning. Support has been provided to three Member States (COK, PLW, and VUT) to establish Medicines/Drug and Therapeutic Committee. One Member State (WSM) has been supported to finalize its findings and report on medicines use study at health facilities. Two Member States (FJI and VUT) were supported to participate in National Medicines Symposium, Melbourne, April 2010. Pacific common approach for management of diabetes has been drafted in collaboration with the NCD unit. A joint workshop with the Federation of Asian Pharmaceutical Association (FAPA) on promoting the role of pharmacists in health care was organized in Seoul in August 2010. Health Technologies and Laboratory (HTL) Nine countries (AUS, CHN, FJI, HOK, JPN, LAO, MYS, KOR and the PHL) participated in developing the Framework for action for Medical Devices. Traditional Medicine (TRM) "Medicinal Plants" in LAO and MNG has been developed. Support provided to MOH of VNM to develop the project proposal on accessible traditional medicines in mountainous remote areas of VNM.

WPR/RC62/3 page 100 Annex 1 ACTIONS REQUIRED The following are required actions: Technical support is needed by countries and areas to develop, revise, implement, and monitor national policies on and to improve access to good quality medical products and technologies and their rational use. There is a need to prioritize the use of the limited funds for priority areas. There is also a need of limiting nonessential travel for staff and national counterparts. The lack of financial resources will have an impact on the capacity to provide technical support to countries. For example, discontinuation of ACP/EC/WHO Partnership Project of Pharmaceutical Policies and Access to Essential Medicines, which was provided to 14 PIC during the last six years, will severely reduce WHO capacities to support PICs. Efforts to minimize such impacts are being done in consultation with other agencies.

WPR/RC62/3 page 101 Annex 1 STRATEGIC OBJECTIVE 12 To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh General Programme of Work.

Highlights on significant programme delivery The sixty-first session of the Regional Committee was successfully held in Putrajaya, Malaysia, in October 2010. All senior officials of Member States of the Western Pacific Region (WPR)

participated in the meeting of the Regional Committee. All proposed resolutions were adopted by the Regional Committee. Two consultations of WHO Representatives and Country Liaison Officers (WRs/CLOs) and one region-wide Programme Management Officers Network meeting were held in 2010. Since the last biennium, seven Country Cooperation Strategies (CCS) have been renewed, six of which are of the second generation and one is of the third generation. In 2010 alone, three CCS were finalized. One CCS renewal is in the final process and one Member State, being one of the eight global One UN pilot countries, is in the process of developing the second five-year One UN Plan. Aid effectiveness continued to be enhanced through alignment and harmonization of WHO priorities with those of WPR countries. To strengthen WPRO collaboration with countries, re-aligning its health strategies with national priorities and operationalizing the CCS, the Country Strategic Framework (CSF) was developed in 2010. At the regional level, to ensure that the strategic work at the Regional Office is in harmony with the CSFs, a similar tool, the Technical Strategic Framework (TSF), has been developed. In view of the need to streamline some overlapping areas and realign related ones, some restructuring in WPRO was undertaken, as follows: The previously 31 technical programmes have been trimmed down to 17 Teams. The functions related to gender have been transferred from the Maternal and Child Health and Nutrition (MCN) unit in the Division for Building Healthy Communities and Populations (DHP) to the Health Care Financing (HCF) unit of the Division for Health Sector Development (DHS), which is also in charge of human rights and equity issues.

WPR/RC62/3 page 102 Annex 1 The creation of two new divisions, namely, the Division of Health Security and Emergencies (DSE) and the Division of Pacific Technical Support (DPS) and the opening of a new CLO office in Northern Micronesia have further enhanced the governance of WPRO as a whole on the one hand, and facilitated WHO's support to the smaller Member States in the Pacific on the other. To foster and strengthen partnership, collaboration and communication with countries, the External Relations and Communications Unit (ERC) has been formed within the Regional Office under the Division of Programme Management (DPM). The unit comprises the External Cooperation and Partnerships (ECP), Public Information (PIO) and the Programme on Technology Transfer (PTT). The aim of the ERC unit will be to bring together our external relations and communications functions and, through more effective outreach, strengthen the visibility of the Organization and its capacity to mobilize resources. The unit has been strengthened with more staff with additional responsibilities, including management of awards, proposal tracking and donor relations. In order to align Information Technology with the global organizational structure, the Information Technology unit has been transferred to the Division of Administration and Finance. Progress of the contribution to achievement of organization-wide expected results, including indicator targets

OWER 12.1 Effective leadership and direction of the Organization exercised through enhancement of governance, and the coherence, accountability and synergy of WHO’s work. Indicator Percentage of documents submitted to governing bodies within constitutional deadlines in the six WHO official languages Baseline Target

On track

To end 2010 100%

12.1.1

90%

95%

With regard to the Governing Body meetings (Regional Committee/Programme Sub-committee), all documents were delivered well in advance before the meetings. Governance has been strengthened through regular and ad hoc Programme Committee (PC) meetings, Programme Management Officer network teleconferences and meetings and Award Oversight Group (AOG) meetings. The AOG is a subsidiary part of the PC.

WPR/RC62/3 page 103 Annex 1

OWER 12.2 Effective WHO country presence established to implement WHO country cooperation strategies that are aligned with Member States’ health and development agendas, and harmonized with the United Nations country team and other development partners. Indicator Number of Member States where WHO is aligning its country cooperation strategy with the country’s priorities and development cycle and harmonizing its work with the United Nations and other development partners within relevant frameworks, such as the United Nations Development Assistance Framework, Poverty Reduction Strategy Papers and Sector-Wide Approaches Percentage of WHO country offices which have reviewed and adjusted their core capacity in accordance with their country cooperation strategy Baseline Target

On track

To end 2010

12.2.1

33 of the 145 Country Cooperation Strategies

12.2.2

9/15 or 60%

80%

100%

At the end of 2010, a total of eight WPR countries had the up-to-date CCS developed. They are CHN, KHM, LAO, MYS, MNG, PHL, PNG, and the Pacific island countries (PIC), which includes 15 countries. Four of which were developed during Programme Budget 2008–2009 while four others were developed in 2010. VNM does not have the CCS but being a pilot country of the One UN Initiative, it is joining hands with other UN agencies to develop the 2nd 5-year One UN Plan. As a tool to operationalize the strategic directions of the CCSs, all WPR countries have developed a CSF for their respective health sectors. All technical divisions of the Regional Office have developed a Technical Strategic Framework (TSF) to align and harmonize with the work of the regional and country offices To provide essential technical assistance to Member States to implement their CCSs/CSFs, to ensure coherence with policy orientation and accountability of the work of the Organization and to strengthen partnership and leadership on health, WHO staff continued to provide strong support to Ministries of Health and other key counterparts and stakeholders.

WPR/RC62/3 page 104 Annex 1

OWER 12.3 Global health and development mechanisms established to provide more sustained and predictable technical and financial resources for health on the basis of a common health agenda which responds to the health needs and priorities of Member States. Indicator Number of health partnerships in which WHO participates that work according to the best practice principles for Global Health Partnerships Percentage of health partnerships managed by WHO that comply with WHO partnership policy guidance Percentage of countries where WHO is leading or actively engaged in health and development partnerships (formal and informal), including in the context of reforms of the United Nations system Baseline Target

On track

To end 2010

12.3.1

12.3.2

100%

12.3.3

10/15

80%

100%

Despite the global economic downturn, the resource mobilization efforts in the Region have been making good progress with US$ 54 885 525 mobilized through 99 awards in 2010. All 15 countries with WR/CLO offices present are leading or actively engaged in health and development partnerships, including in the context of reforms of the UN system. These countries are: CHN, FJI, FSM, KHM, KIR, LAO, MNG, MYS, PHL, PNG, SLB, TON, VNM (in the One UN Initiative) VUT and WSM. WHO's collaboration with other UN agencies, intergovernmental bodies, nongovernmental organizations, and other partners in a number of health areas, continued to be strengthened in 2010. All 11 partnerships in 2010, managed by WHO, complied with WHO partnership policy guidance. Countries involved in the partnership are AUS, CHN, FJI, JPN, KHM, KOR, LAO, MNG, PNG, PHL and VNM. However, there is no significant progress in establishing regional health and development mechanisms to provide more sustained and predictable technical and financial resources for health on the basis of a common agenda to respond to the health needs and priorities of Member States. Even in VNM where WHO is a member of the One UN Initiative, the amount of One UN Fund available every year is unstable and unpredictable.

WPR/RC62/3 page 105 Annex 1

OWER 12.4 Essential multilingual health knowledge and advocacy material made accessible to Member States, health partners and other stakeholders through the effective exchange and sharing of knowledge. Indicator Average number of visits per month to the WHO headquarters’ web site Number of pages in languages other than English available on WHO country and regional offices’ and headquarters’ web sites Baseline Target

On track

To end 2010 N/A

12.4.1

N/A

6.7 million

12.4.2

HQ's data unknown; WPRO (Regional Office and countries - 1736 postings on non-English pages)

Multilingual health knowledge and advocacy materials have been made available through the development of a number of bilingual WHO official country office websites. Examples of these bilingual websites are WHO country websites of CHN and VNM. WHO publications or health promotion and training materials have been translated and published in national languages by WHO country offices. In comparison with 2009, there were few emergencies that occurred in the WPR in 2010 and there was a decreased media attention for the EHA programme. Still, WPRO continued to lend support to EHA in the updating of information on their webpage. The demand for information from WHO in the WPR continued to rise with the volume of visitors to the WHO Regional Office website increased from 1.5 million visitors in 2009 to 2.9 million in 2010. The achievement in 2010 has exceeded the target set for the entire biennium. This increase has further raised WHO's profile as the leading public health authority within the Region. ACTIONS REQUIRED The following are required actions: WHO country presence is effectively led at the country level, harmonized with other development partners and guided by Country Cooperation Strategies (CCS) that support the national health agendas of Member States in the context of the Eleventh General Programme of Work. There is a need to further align WHO's Country Cooperation Strategy with the country’s priorities and development cycle and harmonize its work with the United Nations and other development partners within relevant frameworks, such as the United Nations Development Assistance Framework, Poverty Reduction Strategy Papers and Sector-Wide Approaches

WPR/RC62/3 page 106 Annex 1 There is a need to provide more sustained and predictable technical and financial resources for health based on a common health agenda that responds to the health needs of and priorities of Member States in the Region. To achieve this, it is necessary that WHO receives more flexible and unearmarked funds, not just more funding from the donors.

WPR/RC62/3 page 107 Annex 1 STRATEGIC OBJECTIVE 13

To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively

Highlights on significant programme delivery The detailed analyses of the current planning and programme management situation were carried out in cooperation with budget centres leading to the identification of the Organization's weaknesses and strengths and areas requiring improvement. The various monitoring and report generating tools that were made available to all offices helped provide reliable information and determine project performance at any given time. The monthly Programme Committee meetings support improved fund management through monitoring the implementation of the Programme Budget (PB) and Human Resources (HR) plans. Improved controls have also been put in place by introducing checklists for various committal documents. A rationalized staff development and training programme was developed targeting competency blocks by grade level. Improved compliance in utilizing the Performance Management and Development System (PMDS), WHO's staff evaluation system, added to improved communication among staff. The regional rotation and mobility scheme has been successfully implemented leading to the rotation of over 20 staff. Efforts to ensure qualified female candidates are included in the recruitment

shortlists have resulted in steady progress on staff gender balance. The renovation of the conference hall and structural upgrades of the Regional Office buildings were close to completion resulting in improved air quality, improved drainage and sanitation, additional green space, additional parking and expanded and improved functionality of conference facilities. The security and safety of staff has been enhanced through improved compliance with the Minimum Operating Security Standards (MOSS) and Minimum Operational Residential Security Standard (MORSS) in WHO offices in the Region. In order to be able to handle growing amounts of server utilization of the regional infrastructure, servers have been consolidated and virtualized. Local network and Global Private Network (GPN) connectivity services have been provided to all offices in the Region for the past 12 months. Server consolidation is an approach to the efficient usage of computer server resources in order to reduce the total number of servers or server locations that an Organization requires.

WPR/RC62/3 page 108 Annex 1 Server virtualization uses a software application to divide one physical server into multiple isolated virtual environments. Rejections in supplier creation management in the Global Management System (GSM) were reduced through monthly monitoring and targeted training. Progress of the contribution to achievement of organization-wide expected results, including indicator targets OWER 13.1 Work of the Organization guided by strategic and operational plans that build on lessons learnt, reflect country needs, are elaborated across the Organization, and used to monitor performance and evaluate results. Indicator Percentage of country workplans that have been peer reviewed with respect to their technical quality, that they incorporate lessons learnt and reflect country needs Percentage of Office-Specific Expected Results for which progress status has been updated within the established timeframes for periodic reporting Baseline Target

On track

To end 2010 100% achieved 100% achieved

13.1.1

75%

90%

13.1.2

80%

85%

Out of the 883 valid OSERs for 2010–2011, the status of progress for 100% of them have been reported and updated. Of the 883 OSERs, 758 are either progressing towards achievement or delivery while 107 OSERs are at risk/partially achieved and 18 others are in trouble/not likely to be achieved. Some of these at risk or in-trouble OSERs lack sufficient funding or no allocation to support the implementation of the planned activities. Active resource mobilization and improved management of voluntary contributions are being undertaken to address the funding issues in these areas. WPRO's planning process has been strengthened through the development of Country Strategic Frameworks (CSF) which operationalize the Country Cooperation Strategy (CCS). The development and refinement of the Technical Strategic Framework (TSF) harmonized the work of country offices and the Regional Office. Programme management training was provided to programme management staff to enhance their capacities in programme planning, management and operations. Preparation of PB 2012–2013 planning has been initiated.

WPR/RC62/3 page 109 Annex 1

OWER 13.2 Sound financial practices and efficient management of financial resources achieved through continuous monitoring and mobilization of resources to ensure the alignment of resources with the programme budgets. Indicator Baseline Int'l. Public Sector Accounting Standards implemented US$200 million Target

On track

To end 2010

13.2.1

Degree of compliance of WHO with International Public Sector Accounting Standards

N/A

On track

13.2.2

Amount of voluntary contributions that are classified as fully and highly flexible

US$300 million

Not regional

With the GSM becoming more stable and the integrated systems on programme budget development and controls in place, most of the offices within the Region feel more confident with the system. Implementation of financial resources is efficiently performed with high degree of reliability. Analysis and efficient monitoring of programme budget implementation are better achieved. Management is provided reliable information on regional achievements and performance through efficient coordination of programme budget allocation, implementation monitoring and reporting. Financial resources are effectively managed and administered in accordance with WHO financial rules and regulations and International Public Sector Accounting Standards (IPSAS). Sound financial practices and internal control mechanisms are in place. Reliable, regular and timely financial reports are submitted to management for information and decision making. Sound financial reports are submitted based on standards agreed with donors and partners. Sound financial practices and controls are in place and have been maintained throughout the Region.

WPR/RC62/3 page 110 Annex 1

OWER 13.3 Human resource policies and practices in place to attract and retain top talent, promote learning and professional development, manage performance, and foster ethical behaviour. Indicator New human resources policies implemented in line with the United Nations General Assembly and World Health Assembly resolutions. Baseline Target

On track

To end 2010 100% achieved Mobility policy implemented (Achieved)

13.3.1

75%

85%

13.3.2

Number of staff assuming a new position or moving to a new location during a biennium

300

13.3.3

Percentage of staff in compliance with the cycle of the Performance Management Development System

75%

85%

99% On track

In response to the needs identified during the Fit for the Future and the continuous effort to assess the learning requirements for the most number of staff, various training programmes have been identified and some have already been conducted within the Region. Completion of the Staff

Development Plan (Section F) of the PMDS became mandatory starting 2010 whereby staff have to indicate their training needs in consultation with their supervisors. An assessment of the training needs as a result of the Fit for the Future is proving to be an essential tool in providing the various training programmes suited to the staff members' learning requirements There is a continuous effort to increase the recruitment of female staff in the Region. Of the selections conducted as at 13 December 2010, more than 50% of the selected candidates are female. Staff members are being equipped through training programmes and by keeping them informed on the updates of various HR policies. Of the 19 selections made as at 13 December 2010, ten of the selected candidates are female. Training programmes in line with the needs identified through the Fit for the Future exercises are being offered to improve the skills of staff members for them to become more effective in managing tasks. Policy guidance and relevant references are disseminated to empower staff members by keeping them informed.

WPR/RC62/3 page 111 Annex 1

OWER 13.4 Management strategies, policies and practices in place for information systems, that ensure reliable, secure and cost-effective solutions while meeting the changing needs of the Organization. Indicator Number of information technology disciplines implemented Organization-wide according to industrybest-practices benchmarks Baseline Target

On track

To end 2010

13.4.1

Not regional

13.4.2

Proportion of offices using consistent real-time management information

HQ, 5 Regional Offices & associated country offices

100% Achieved

The day-to-day information and communications technology (ICT) operations of the regional end-user support services are well under way, with a number of tools used to monitor the regional ICT environment. Update has been made to the regional workstation environment. This will provide faster and more secured access to regional and global on-line information. A consolidated and virtualized infrastructure and applications system solution is underway and picking up speed. The country ICT support staff in six (6) offices are working well with the ICT country support staff in the Regional Office. Videoconferencing equipment has been installed in four country offices and

additional installations are underway. All Information Technology training has been restarted and a pilot e-Learning materials project is underway. New datasets on Tobacco Free Initiative and Sexually Transmitted Infections including HIV/AIDS were uploaded to the Health Data Bank. Discussion on the new Regional Health

Information Observatory is ongoing. Some of the regional production and development servers have been consolidated and virtualized. All regional ICT projects are coordinated globally via ITT/HQ project management office. A number of new websites and applications have been developed for use in the Regional Office and country offices.

WPR/RC62/3 page 112 Annex 1

OWER 13.5 Managerial and administrative support services necessary for the efficient functioning of the Organization provided in accordance with service-level agreements that emphasize quality and responsiveness. Indicator Proportion of services delivered by the Global Service Centre according to the criteria in service-level agreements Transaction processing errors to be reduced by 15% Baseline Target

Progress status To end 2010 N/A

13.5.1

N/A

13.5.2

This is specific to the Global Service Centre (GSC) only.

However, interactions and

coordination have been improved between GSC and regional and country offices through more focused communications and joint problem solving in such areas as encumbrance management, travel recoveries, personal account reconciliations, etc. Although improvements are notable, much remains to be done to continue improving the service levels and functionality of the end-to-end processes.

OWER 13.6 Working environment conducive to the well-being and safety of staff in all locations. Indicator 13.6.1 The percentage of offices which are MOSS compliant. Level of funding and execution of the biennial Capital Master Plan Baseline 60% Target 75%

On track To end 2010 75% Achieved 75% On track

13.6.2

50%

80%

Although a survey has not been conducted to ascertain degrees of satisfaction, increased communication through various forums including cabinet, technical team leaders meetings, WRs/CLOs meetings, etc. point to an improved satisfaction from clients across the Region. Annual Regional Administration Network meetings and regular visits to country offices have also helped focus the work and support to technical projects and country offices. All contracts are in good order, including those affecting construction and renovation projects. Of the six construction/renovation projects undertaken in 2010, three were successfully completed (structural investigation, new drainage system and new elevated car park) while the other three projects (conference hall, fresh air and landscaping) are scheduled to be completed in the first quarter of 2011.

WPR/RC62/3 page 113 Annex 1 ACTIONS REQUIRED The following are required actions: To integrate the Country Strategic Frameworks (CSF) and the Technical Strategic Frameworks (TSF) into the planning process. To continue the improvement of technical evaluation, monitoring, indicator and target rationalization. To start planning for PB 2012–2013 budget. To continue to look for cost reduction opportunities in order to prioritize to match expenditure with the expected income in SO 12 and SO 13. To finalize the reorganization of each unit under the Division of Administration and Finance to maximize client support, improve controls and avoid duplication in the GSM environment. To fully implement outstanding audit recommendations. To continue full IPSAS implementation in line with global direction, especially concentrating on full asset management accounting and management. To continue monitoring HR plans through the Programme Committee and to timely identify actions to be taken. To continue implementing the regional mobility policy and establish/implement a General Service Staff rotation policy for the Regional Office. To continue to actively monitor and follow-up on PMDS compliance and staff communication. To finish building and ground renovation projects before end of first half of 2011. To achieve continued progress in the implementation of global IT initiatives.

WPR/RC62/3 ANNEX 2

WORLD HEALTH ORGANIZATION WESTERN PACIFIC REGION

PROGRAMME BUDGET 2010–2011 OUTPUTS AND RESULTS

SUMMARY OF PROGRESS MADE TOWARDS REGIONAL EXPECTED RESULTS

WPR/RC62/3 Annex 2

WPR/RC62/3 ANNEX 2

PROGRAMME BUDGET 2010–2011 OUTPUTS AND RESULTS

SUMMARY OF PROGRESS MADE TOWARDS REGIONAL EXPECTED RESULTS

1 January 2010–31 December 2010 (SOs 1-11)

AUGUST 2011

WPR/RC62/3 Annex 2

COUNTRIES AND AREAS OF THE WESTERN PACIFIC REGION COUNTRY American Samoa Australia Brunei Darussalam Cambodia

ACRONYM ASM AUS BRN KHM CHN COK FJI PYF GUM HOK JPN KIR LAO MAC MYS MHL FSM MNG NRU

COUNTRY New Caledonia New Zealand Niue Northern Mariana Islands, Commonwealth of the Palau Papua New Guinea Philippines Pitcairn Islands Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam

ACRONYM NEC NEZ NIU MNP PLW PNG PHL PCN KOR WSM SGP SLB TKL TON TUV VUT VNM WAF

China Cook Islands Fiji French Polynesia Guam Hong Kong, China Japan Kiribati Lao People's Democratic Republic Macao Malaysia Marshall Islands Micronesia, Federated States of Mongolia Nauru

Wallis and Futuna

WPR/RC62/3 Annex 2

List of abbreviations ACP The African, Caribbean and Pacific Group of States adolescent health ERC AEFI adverse events following immunization adolescent-friendly health services ESHUT APSED Asia Pacific Strategy for Emerging Diseases FAO AusAID Australian Agency for International Development Centers for Disease Prevention and Control (United States) Chinese Center for Disease Prevention and Control Central Emergency Response Fund Collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria combines multi-year plans GSHS DCC Division of Combating Communicable Diseases HEART DPAS evidence-based diet and physical activities Division of Health Security and Emergencies event-based surveillance system European Commission European Commission Humanitarian Aid and Civil Protection HERO Global School-based Student Health Survey URBAN Health Equity Assessment and Response Tool health emergency response operations Health Information Intelligent Platform health information systems health system profiles Health Matrix Network FBT FSER ESCAP Ethics Review Committee United Nations Economic & Social Commission for Asia and the Pacific environmentally sustainable and healthy urban transport Food and Agriculture Organization of the United Nations foodborne trematodes National Food Safety Emergency Response gender-based violence Global Foodborne Infections Network Global Health Institute Global Outbreak Alert and Response Network

EHA

Emergency and Humanitarian Action unit

ADH

AFHS

CDC

CDC China

GBV GFN

CERF

CGF

GHI GOARN

cMYPs

DSE

EBS

HIIP

EC ECHO

HIS HiTS HMN

WPR/RC62/3 Annex 2 MVP HQ HRH HSI Headquarters (WHO) NAIA Human Resources for Health HIV/AIDS and Sexually Transmitted Infections Health Systems Strengthening NHA HTL ICATT Health Technologies IMCI computerized adaptation and training tool iodine deficiency disorders International Health Regulations Integrated Management of Childhood Illness International Criminal Police Organization information technology Infant and Young Child Feeding Japanese encephalitis Joint Reporting Form knowledge, attitude and practice lymphatic filariasis mass drug administration Millennium Development Goals maternal newborn and child health Monitoring of Vital Events using IT monitoring, training and planning NRA national health accounting system National Regulatory Authorities national immunization technical advisory group neglected tropical disease New Zealand Agency for International Development Organization-Wide Expected Result Office-Specific Expected Result Polymerase Chain Reaction Pharmaceuticals Public Health Emergency Contingency Plan Pacific Island Countries Price Information Exchange Pacific Islands Forum Secretariat Pacific Open Learning Health Network health promotion leadership training programme quality assurance NCD NFP HSS Malaria, other Vectorborne and Parasitic Diseases Ninoy Aquino International Airport noncommunicable diseases National IHR Focal Point

IDD IHR

NITAG

NTD NZAID

IMCI

Interpol

OWER

IT IYCF

OSER

PCR PHA PHECP

JE JRF KAP

PICs PIEmeds PIFS

LF MDA MDG

POLHN

MNCH

Prolead

MoVE-IT

MTP

WPR/RC62/3 Annex 2 RAS Regional Rapid Alert System for Combating Counterfeit Medicines UNDAF United Nations Development Assistance Framework United Nations SecretaryGeneral United States of America United States Agency for International Development United Nations International Children's Emergency Fund United States Pharmacopeia vaccine-derived poliovirus vaccine-preventable disease World Food Programme WHO Framework Convention on Tobacco Control Western Pacific Region Western Pacific Regional Office

RCC

Regional Commission for the Certification of Poliomyelitis Eradication in the Western Pacific Region Regional Expected Result Regional Network for Asian Schistosomiasis Regional Research Plan of Action on Infectious Diseases of Poverty Southeast Asian Ministry of of Education OrganizationRegional Tropical Medicine and Public Health Network supplementary immunization activity small island states

UN SG

USA USAID

RER RNAS

UNICEF

RRPA

USP VDPV

SEAMEOTROPMED

VPD WFP WHO FCTC

SIA

SIS SO SOPs SPC

WPR Strategic Objective WPRO standard operating procedures Secretariat of the Pacific Community Stop TB and Leprosy Elimination sexually-transmitted infections Technical Advisory Group Tropical Disease Research Trade-related aspects of Intellectual Property Rights Traditional Medicine Technical Strategic Framework United Nations

STB

STI

TAG TDR TRIPS

TRM TSF

WPR/RC62/3 Annex 2

TABLE OF CONTENTS STRATEGIC OBJECTIVE 1 ............................................................................................................. 1 STRATEGIC OBJECTIVE 2. ............................................................................................................ 7 STRATEGIC OBJECTIVE 3. .......................................................................................................... 10 STRATEGIC OBJECTIVE 4. .......................................................................................................... 13 STRATEGIC OBJECTIVE 5. .......................................................................................................... 17 STRATEGIC OBJECTIVE 6. .......................................................................................................... 20 STRATEGIC OBJECTIVE 7. .......................................................................................................... 23 STRATEGIC OBJECTIVE 8. .......................................................................................................... 26 STRATEGIC OBJECTIVE 9. .......................................................................................................... 28 STRATEGIC OBJECTIVE 10. ........................................................................................................ 31 STRATEGIC OBJECTIVE 11. ........................................................................................................ 36

WPR/RC62/3 Annex 2

WPR/RC62/3 page 1 Annex 2

OUTCOMES 1 JANUARY 2010 – 31 DECEMBER 2010 STRATEGIC OBJECTIVE 1: To reduce the health, social and economic burden of communicable diseases. Regional Expected Result 01.001.WP01 Policy and technical support provided to Member States to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential child health interventions with immunization.

Immunization activities and coverage against an increasing array of vaccine preventable diseases (VPDs) continue to improve. Based on WHO-UNICEF Joint Reporting Form (JRF) data received in 2011 for 2010, 24 countries and areas likely have DTP3 coverage at or above 90%, and another five reported coverage just below 90%. WPRO has provided technical support to improve routine coverage through training and development of monitoring tools, improve equity in immunization coverage by reaching all children during supplementary immunization activities (SIAs), improve quality through strengthening national regulatory authorities (NRAs) and surveillance for adverse events following immunization (AEFIs), improve financing through combined multi-year plans (cMYPs), and support decision-making by strengthening surveillance and lab networks for diseases targeted by new and underutilized vaccines and providing intercountry training to strengthen national immunization technical advisory groups (NITAGs). WPRO is developing a model to assess performance/risk for VPDs at district level that should enable countries to better identify low-performing districts and undertake targeted intervention to improve vaccination coverage. WPRO has provided technical support to Member States for decision-making on new vaccine introduction and for surveillance to demonstrate the disease burden for newly vaccine-preventable diseases, such as pneumococcal and Hib meningitis and rotavirus diarrhoea. By the end of 2010, 29 countries and areas in this Region had introduced Hib vaccine into their routine national immunization schedules.

Delivery progress: On Track

Regional Expected Result 01.002.WP01

Effective coordination and provision of support to Member States to retain certification of poliomyelitis elimination and to achieve destruction, or appropriate containment, of polioviruses, leading to simultaneous cessation of oral polio vaccination.

The Region has remained polio-free, with overall good surveillance and a high-quality laboratory network in place. Annual accreditation of polio network laboratories has been conducted for priority countries in the Region, and the Region is successfully implementing the new algorithm for virus isolation and the real time polymerase chain reaction (PCR) for intratypic differentiation and vaccine derived poliovirus (VDPV) screening to allow rapid detection of polioviruses. Identified immunity gaps have been addressed with supplementary immunization activities, mostly in conjunction with other health/immunization interventions in CHN, LAO, MNG and PNG and will be targeted in other countries in the near future, as necessary. Risk assessment has been conducted for all countries on the potential of imported wild poliovirus to spread and national importation preparedness has been enhanced in key countries. The regional inventory of wild poliovirus infectious and potentially infectious materials stored in laboratories has been updated. The Regional Commission for the Certification of Poliomyelitis Eradication in the Western Pacific Region (RCC) continues its active oversight and facilitated with its 16th meeting and the commemoration of the Region 10 years certified as polio-free the ongoing advocacy and resource mobilization activities.

Delivery progress: On Track

WPR/RC62/3 page 2 Annex 2

Regional Expected Result 01.003.WP01

Effective coordination and support provided to Member States to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases.

Good progress has been made in the Region in the control and elimination of neglected tropical diseases (NTDs), although the biggest obstacles remain the lack of commitment and funding. (1) Leprosy has been eliminated in all but three countries in the Region. Those remaining countries (FSM, KIR and MHL) are now the focus of intensified elimination efforts, after the WHO Regional Director declared leprosy and lymphatic filariasis (LF) elimination as regional priorities. (2) Technical assistance for dengue outbreak control was provided to FJI, KHM, LAO and PHL. A dengue control programme review was conducted in LAO. WPRO provided technical support to the Asian Development Bank-funded project of community-based dengue interventions in KHM and LAO using guppy fish; supported resource mobilization in KHM and the PHL (both failed); the development of an action plan in VUT; and the replenishment and management of the Pacific dengue stockpile as well as vector surveillance in FJI. FJI KHM, LAO and PHL are implementing the biregional Dengue Strategic Plan for the Asia-Pacific Region (2008–2015), and efforts are under way to increase the number of countries further. (3) A Regional Plan of Action for Elimination of Lymphatic Filariasis (LF) (from 2010–2020) has also been developed. Countries and areas in the WPR continued to make progress towards the global goal of eliminating LF by 2020. COK, NIU, TON and VUT are among the countries that will have eliminated LF in the next 2–3 years. PYF, TON and VNM achieved 80% coverage over five consecutive rounds of mass drug administration (MDA). Among the "Mekong-Plus" countries, all except LAO have completed five rounds of MDA and are now conducting the stop-MDA surveys or post-MDA surveillance. The PHL has yet to complete the five rounds of MDA in all implementation units. (4) CHN, KHM, KOR, LAO and VNM completed the mapping of foodborne trematodes (FBT). PHL is planning to conduct the mapping of FBT in the high-risk areas in Mindanao. Following the meeting of global experts on FBT and cestodiasis in Vientiane, LAO (12– 16 October 2009), CHN, KHM and VNM were selected for conducting pilot interventions. LAO and VNM also continued with targeted treatment against FBT in selected areas but they represented only a fraction of population at risk; scaling up of treatment interventions was hampered due to resource constraints. (5) Schistosomiasis is endemic in four countries in this Region (CHN, KHM, LAO and PHL). All endemic countries continued with targeted intervention campaigns against schistosomiasis, while KHM and LAO treated the entire population at risk with MDA; whereas CHN additionally implemented animal host and vector-control interventions. The 10th meeting of Regional Network for Asian Schistosomiasis (RNAS) and other Helminth Zoonoses was held from 15–19 November 2010 in Wuxi, CHN. WPRO provided technical input into this meeting, including for developing a proposal to fund RNAS. This proposal was approved and over US$ 1 million will be available from 2011 (directly to RNAS).

Delivery progress: On Track

WPR/RC62/3 page 3 Annex 2

Regional Expected Result 01.004.WP01

Policy and technical support provided to Member States to enhance their capacity to carry out surveillance and monitoring of all communicable diseases of public health importance.

The Asia Pacific Strategy for Emerging Diseases (APSED 2010) Technical Papers were published as the foundation for the APSED 2010 Strategy. APSED's next five-year strategy was later developed through extensive country consultations using a bottom-up approach throughout the process. The Regional Committee for the Western Pacific endorsed APSED (2010) during its annual meeting in October 2010. The countries and areas receiving enhanced technical assistance from WHO in strengthening communicable disease surveillance and monitoring systems are CHN, KHM, LAO, MNG, MYS, PHL, PNG, and VNM and some countries in the South Pacific. Countries such as JPN, KOR, and SGP already have well-established surveillance systems. Member States have also been supported by WHO to enhance their surveillance capacity and improve their surveillance systems for vaccine-preventable diseases. Through technical support, on-site visits, and development and sharing of surveillance tools, materials, and databases, eight Member States (CHN, FJI, KHM, LAO, MNG, PHL, PNG, and VNM) have established or improved the quality of surveillance for three new vaccine-preventable diseases: rotavirus diarrhoea; and meningitis and respiratory infection due to Haemophilus influenzae b; and pneumococcus. To support WHO-designated national laboratories for vaccine-preventable diseases, technical support was provided through regional hands-on training courses and meetings of network laboratories. On-site review of polio, measles and Japanese encephalitis (JE) laboratories was conducted for annual accreditation and all 43 polio laboratories, 45 out of 48 measles laboratories and 4 out of 10 JE laboratories were fully accredited as of December 2010. Financial support was provided to six polio laboratories in five Member States (AUS, CHN, MNG, PHL and VNM), 10 measles laboratories in nine Member States (AUS, CHN, FJI, KHM, LAO, MNG, PHL, PNG and VNM) and six JE laboratories in five Member States (CHN, KHM, LAO, PHL and VNM). By the year 2010, 75% of countries and areas submitted the Joint Reporting Form (JRF) reports on time. The relevance and importance of JRF reporting was highlighted during the 2010 Technical Advisory Group Meeting, held in Manila.

Delivery progress: On Track

WPR/RC62/3 page 4 Annex 2

Regional Expected Result 01.005.WP01

New knowledge, intervention tools and strategies that meet priority needs for the prevention and control of communicable diseases developed and validated, and scientists from developing countries and areas increasingly taking the lead in this research.

Despite financial constraints, the number of activities supporting operational research in the prevention and control of communicable diseases increased in this Region. The WPRO research programme on infectious diseases of poverty is located in the Malaria and other Vectorborne and Parasitic Diseases unit (MVP), covering all units of the Division Combating Communicable Diseases (DCC); its two staff are supported by Tropical Disease Research (TDR). A Technical Strategic Framework (TSF) was developed, based on the draft Regional Research Plan of Action on Infectious Diseases of Poverty (RRPA). Progress was made in research capacity-building, identification of research priorities, partnership and resource mobilization. MVP facilitated and supported TDR's engagement in the Region. TDR funded several regional consultations and workshops addressing programmatic gaps. However, funding to support staffing and activities are in jeopardy although efforts are under way to mobilize additional resources. Publication of operational research studies on target diseases was still limited. The STB unit provided technical support to countries to develop new implementation strategies for leprosy elimination in the remaining countries that have not yet achieved leprosy elimination. This SO1 RER 5 report covers the communicable disease research activities of all four units under DCC, including HIV/STI, tuberculosis and malaria which are under SO2.

Delivery progress: On Track

Regional Expected Result 01.006.WP01

Support provided to Member States in achieving the minimum capacities and functions required by the International Health Regulations (2005), specifically related to advocacy, National International Health Regulations Focal Points and the core capacities for designated points of entry.

All planned activities have been implemented. IHR (2005) continued to be an important agenda item for various national and regional meetings and workshops to increase awareness about IHR, including sessions of the Regional Committee for the Western Pacific, the Asia Pacific Technical Advisory Group (TAG) meeting and several national workshops in 2010. IHR (2005) has provided a framework for the Region to update the Asia Pacific Strategy for Emerging Diseases (APSED). Public health emergency preparedness and response has now been included into APSED (2010). The National IHR Focal Points (NFP) played a vital role in IHR event communications between Member States and WHO including reporting, verification and notification related to cholera and measles outbreaks. The second regional IHR exercise (IHR Exercise Crystal 2010), with the participation of 20 National IHR Focal Points in the Region, was conducted to test and assess the functional accessibility of the National IHR Focal Points (NFPs) contact details; and to validate the IHR event notification and information-sharing process. Such an annual exercise has proven to be useful to maintain the functions of NFPs and the WHO IHR Contact Point. An interim guidance on public health emergency contingency planning at designated points of entry under IHR was developed as a result of various discussions, especially an informal expert consultation meeting on POE public health emergency planning held in February 2010. Technical support was provided to the PHL to develop the Ninoy Aquino International Airport (NAIA) Public Health Emergency Contingency Plan (PHECP).

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 5 Annex 2

Regional Expected Result 01.007.WP01

Support provided to Member States to achieve the minimum capacities required for the preparedness, detection, assessment of and response to emerging diseases, including major epidemic and pandemic-prone diseases such as influenza, by effectively implementing the Asia Pacific Strategy for Emerging Diseases (APSED).

Considerable achievements on APSED implementation have been made in 2010. The APSED (2010) common indicator assessments showed that good progress has been made in strengthening the national capacities for all the APSED five areas of work including surveillance and response, laboratory, zoonoses collaboration between human and animal health sectors, infection control and risk communication. For example, all countries now have their surveillance systems to detect and respond to emerging disease outbreaks and acute public health events, despite the continuing need for further improvement in some countries. Pandemic (H1N1) 2009 provided a real-world event to test the national pandemic preparedness and response plans as well as the national and regional systems and capacities that have been developed through APSED implementation. In 2010, with support of WHO, a number of countries started reviewing lessons learnt from the pandemic response. Such lessons are being used to revise national pandemic influenza response plan and will be used to develop public health emergency response plan for all other emerging infectious diseases and acute public health events. One notable achievement in 2010 was the development of an updated APSED, known as APSED (2010), that was endorsed by the Regional Committee for the Western Pacific in October 2010. Facilitated by WHO, APSED (2010) has been developed through a series of country and regional-level consultations on "APSED and Beyond" between July 2009 and October 2010. The experiences and lessons learnt from APSED (2005) implementation and pandemic preparedness and response have been incorporated into the new strategy. It is currently being used as a common framework for managing future emerging disease threats and as a road map for meeting the IHR core capacities in the Region.

Delivery progress: On Track

Regional Expected Result 01.008.WP01

Coordinated regional capacity made rapidly available to Member States for detection, verification, risk assessment of and response to epidemics and other public health emergencies of regional and international concern.

All planned activities are being implemented accordingly. A fully functioning regional Event-based Surveillance system (EBS) is present with 256 events reported in 2010. Regionalization of Global Outbreak Alert and Response Network (GOARN) was strengthened through annual meetings and training for GOARN institutions, and development of Regional GOARN Clinical Network.

Delivery progress: On Track

WPR/RC62/3 page 6 Annex 2

Regional Expected Result 01.009.WP01

Effective operations and response by Member States and the international community to declared emergency situations due to epidemic- and pandemic-prone diseases.

Support has been provided to outbreak situations as required and when requested from WPRO, including technical, human, financial, material and logistic resources. WPRO has provided support to outbreak situations such as dengue in the PHL, and cholera in KHM, LAO and PNG.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 7 Annex 2

STRATEGIC OBJECTIVE 2: To combat HIV/AIDS, tuberculosis and malaria. Regional Expected Result 02.001.WP01 Regional guidelines, policies, strategies and other tools developed (adapting global ones, as appropriate) for prevention, treatment and care for STI and HIV/AIDS, malaria and tuberculosis (including innovative approaches for increasing coverage of the interventions among the poor, hard to reach and vulnerable populations).

The Region continued to contribute to normative guidance and programmatic innovations in all SO2 areas, with access to adequate diagnosis and care for vulnerable groups and drug resistance as important cross-cutting issues. The new Regional STB Strategy 2011–2015 was endorsed by the Member States and will lead to considerable innovations of the national tuberculosis control programmes. Significant input was provided to Member States for all three diseases to update/revise and cost national strategic plans. Overall, the Region is on track, with significant progress made in all disease programmes.

Delivery progress: On Track

Regional Expected Result 02.002.WP01

Policy, technical and coordination support provided to countries and areas for the implementation of prevention, treatment and care interventions for STI, HIV/AIDS, malaria and tuberculosis and their scaling-up to reach the populations most in need (including integrated training and service delivery; wider service-provider networks; strengthened laboratory capacities and better linkages with other health services).

The HIV/AIDS and STI (HSI), Malaria, other Vectorborne Parasitic Diseases (MVP) and Stop TB and Leprosy Elimination (STB) units have been providing extensive technical assistance to countries, both through in-country technical assistance and through regional workshops. The number of collaborative activities within the SO2 group and beyond has been increasing, including in areas such as HIV/TB, prison health, migrant health, infection control and the laboratory. The strengthening of in-country presence of WHO is considered crucial for countries as well as the future of WHO.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 02.002.WP02

Policy, technical and coordination support provided to countries and areas for the implementation of child and adolescent health interventions related to STI and HIV/AIDS, malaria and tuberculosis.

Technical support was provided to priority Member States for strengthening linkages between adolescent-friendly health services and sexually transmitted infections (STI), HIV/AIDS prevention, treatment and care. Updated malaria guidelines for children under-5 were also reflected in the revised Integrated Management of Childhood Illness (IMCI) guidelines.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 8 Annex 2

Regional Expected Result 02.003.WP01

Guidance and technical support provided on policies and programmes to promote equitable access to essential medicines of assured quality for the prevention and treatment of STI and HIV/AIDS, malaria and tuberculosis, and their rational use by prescribers and consumers; and on uninterrupted supply of quality diagnostics, safe blood and other essential commodities.

All three units are engaged in supporting countries to ensure access to and continuous supply of quality medicines, diagnostics and other commodities (e.g. bednets) for prevention and case management of HIV, tuberculosis and malaria. With drug resistance to malaria and tuberculosis a significant issue in the Region, efforts are ongoing to improve rational use of medicines and monitor the quality of medicines and diagnostics. While there is good cooperation with the WPRO Pharmaceuticals programme, more cooperation is needed with other related WHO programmes at the Regional Office and HQ levels to address these major issues with a health systems approach.

Delivery progress: On Track

Regional Expected Result 02.004.WP01

Regional and national surveillance, evaluation and monitoring systems strengthened and expanded to monitor progress towards targets and resource allocations for STI and HIV/AIDS, malaria and tuberculosis control, including monitoring of drug and insecticide resistance and the impact of control efforts.

Major progress has been made in strengthening regional and national surveillance and monitoring and evaluation systems for HIV, malaria and tuberculosis. Regional indicator frameworks have been refined, burden estimations and surveys supported, and all three units continued to provide intensive technical support and capacity-building to key countries. Data was published in major regional and global reports, contributing to the accountability in view of the massive global investments currently being made in HIV, tuberculosis and malaria programmes. Innovations have been supported, e.g. into web-based surveillance systems. With drug resistance for HIV, malaria and tuberculosis being a major concern in the Region, with global implications, WPRO has intensified its support to countries to ensure timely and high-quality monitoring of drug and insecticide resistance, conducted training, improved coordination including through networks, and reviewed and published/disseminated results.

Delivery progress: On Track

WPR/RC62/3 page 9 Annex 2

Regional Expected Result 02.005.WP01

Political commitment sustained and mobilization of resources ensured through advocacy and nurturing of STI and HIV/AIDS, malaria and tuberculosis partnerships at country, regional and global levels; support provided to countries and areas as appropriate to develop/strengthen and implement mechanisms for resource mobilization and utilization; and engagement of communities and affected persons increased to maximize the reach and performance of STI and HIV/AIDS, malaria and tuberculosis control programmes.

HSI, MVP, STB and the Collaboration with Global Fund (CGF) units have continued to intensely support countries to successfully mobilize resources, especially through the Global Fund to Fight AIDS, Tuberculosis and Malaria, resulting in a massive scale up of programme activities. Countries continue to require technical support for the implementation of these grants. However, funding for WHO staff remains limited, with HSI particularly affected. Partnerships with key partners, networks as well as WHO Collaborating Centres, academia, technical partners and agencies were strengthened, and new networks, such as the HSI technical support network, have been established. Tuberculosis and malaria have advanced the involvement of the private sector in key countries. HIV continues to actively participate in various regional task forces to enhance the active involvement of most-at-risk populations and people living with HIV. Community-based interventions have been expanded in many countries across all the three disease control programmes. Advocacy and communication were strengthened.

Delivery progress: On Track

Regional Expected Result 02.006.WP01

Operational research for the prevention and control of STI and HIV/AIDS, malaria and tuberculosis supported and research capacity strengthened in target countries and areas.

All the three programmes supported research, often in cooperation with partners, as one important component of their programmes, to fill knowledge gaps and improve the effectiveness of the programmes. They mainly supported operational research, but also basic research (e.g. on artemisinin resistance). The STB unit even launched a research scheme. With research capacity still being weak in most infectious disease-endemic countries in the Region, special emphasis was paid to research capacity-building: STB and MVP jointly facilitated a grant writing workshop, in collaboration with TDR. Also WHO staff's capacity in research needs to be strengthened, especially in the field of research ethics. The establishment of the WPRO Ethics Review Committee and related standard operating procedures was facilitating the WHO ethical review. Inter-unit collaboration as well as partnerships with key partners, academia, technical partners and agencies were strengthened. However, donor interest determined the area of research to be supported, and continuation of research funding was not secured.

Delivery progress: On Track

WPR/RC62/3 page 10 Annex 2

STRATEGIC OBJECTIVE 3: To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence, injuries and visual impairment. Regional Expected Result 03.001.WP01 Advocacy and support provided to increase political, financial and technical commitment in Member States in order to tackle chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness.

Along with a number of major global developments related to programmes under SO3, more attention is now being given to noncommunicable diseases, injury and mental health in the Region. Noncommunicable diseases policy advocacy briefs were developed and advocacy was carried out at different levels. An advocacy event on breast cancer was held in Kuala Lumpur, MYS as a side event to the Sixty-first session of the Regional Committee. Advocacy for Road Safety and contribution by the health sector has been significant in CHN, KHM and VNM. The WHO Pacific Islands Mental Health Network remains an important and active mechanism for mental health advocacy in the Pacific. NZAID pledged further funding for another three years. Efforts to integrate mental health into overall health services were reported in CHN, LAO and MNG.

Delivery progress: On Track

Regional Expected Result 03.002.WP01

Guidance and support provided to Member States for the development and implementation of policies, strategies and regulations related to chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities.

Capacity of Member States was built for multisectoral interventions bringing together health and non-health sectors at the Japan-WHO Meeting on Multisectoral Interventions for NCD Prevention, which was held in Saitama, Japan from 27 to 30 July 2010. Regional consultation on strategies to reduce salt intake was useful to develop context-specific approaches. The Regional Framework for Action on Injury and Violence 2008–2013 continues to provide guidance to countries to develop national plans and policies. Technical support was provided to mental health policy development through country visits by consultants and telecommunications to FJI, FSM, SLB and VUT.

Delivery progress: On Track

WPR/RC62/3 page 11 Annex 2

Regional Expected Result 03.003.WP01

Improvements made in Member States' capacity to collect, analyse, disseminate and use data on the magnitude, causes and consequences of chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities together with visual impairment, including blindness.

Noncommunicable Disease (NCD) risk factor surveys using WHO STEPS approach was implemented widely. STEPS reports from KHM, LAO, MNG, PNG and SLB were made available. Capacity for cancer registration was built in 10 Pacific island countries. A regional meeting for training of national data coordinators for assessment of road safety status at country level is planned for 2011. Data are expected to be collected by the end of 2011. All countries are involved in the mental health Atlas project. financial support in monitoring of suicide behaviours. FJI, PHL, TON and VUT received technical and

Delivery progress: On Track

Regional Expected Result 03.004.WP01

Improved evidence compiled by WHO on the costeffectiveness of interventions to tackle chronic noncommunicable conditions, mental and neurological and substance-use disorders, violence, injuries and disabilities together with visual impairment, including blindness.

A package of essential NCD interventions developed by WHO Headquarters was disseminated. Country capacity for NCD prevention and management was assessed as part of the global survey. A resource book on suicide prevention Towards evidence-based suicide prevention programme was published and distributed. A guide on alcohol-related legislation has been finalized and will be published soon.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 12 Annex 2

Regional Expected Result 03.005.WP01

Guidance and support provided to Member States for the preparation and implementation of multisectoral populationwide programmes to promote mental health and to prevent mental and behavioural disorders, violence and injuries, together with hearing and visual impairment, including blindness.

Resources were mobilized for the programme on prevention of blindness and a post of Medical Officer has been established. The Manual on Data Systems was disseminated to countries. This manual assisted in the strengthening and improvement of their data collection on road traffic injuries and risk factors especially in LAO, MNG and PHL. A systematic review on effectiveness of media intervention on suicide prevention was conducted and consultations have been conducted in CHN, HOK, JPN and KOR with different stakeholders on the role of the media in suicide prevention.

Delivery progress: At risk/ Partially achieved

Regional Expected Result 03.006.WP01

Guidance and support provided to Member States to improve the ability of their health and social systems to prevent and manage chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness.

Health system capacity for NCD management is being assessed. Substantial resources were mobilized for MNG to support management of acute myocardial infarction and stroke. VNM was assisted for the development of pre-hospital and trauma care services. With the completion of the Guidelines for Article 14 of the WHO Framework Convention on Tobacco Control (FCTC), WHO has initiated work towards dissemination of the guidelines and a workplan has been developed to support improvement of cessation systems in countries. Training on brief advice in primary health care was conducted in CHN and the FSM. WHO has collaborated with the Department of Health, HOK toward development of a regional training programme for treatment of tobacco dependence with technical support and in partnership with the Mayo Clinic, United States of America. A meeting on a Training Network on Child and Adolescent Health and Tobacco Control has been organized with participation from CHN, HOK, JPN, KOR, MNG, PHL and VNM. A model training programme on brief advice and cessation for paediatricians has been developed and piloted in the PHL. Smoking cessation services have been established in the WPRO premises.

Delivery progress: On Track

WPR/RC62/3 page 13 Annex 2 STRATEGIC OBJECTIVE 4: To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. Regional Expected Result 04.001.WP01 Support to Member States to develop a comprehensive policy, plan and strategy for scaling up towards universal access to effective interventions in collaboration with other programmes, paying attention to gender inequality and gaps in health equity, providing a continuum of care throughout the life course, integrating service delivery across different levels of the health system and strengthening coordination with civil society and the private sector.

Progress was made in identifying key areas for action towards the attainment of Millennium Development Goals (MDG) 4 and 5 along the continuum of care along the life stages and across the levels of care within the context of strengthened health systems and in collaboration with relevant programmes. The Informal Consultation on MDG 4 and 5 was held among WHO regional and country staff from seven priority countries (KHM, CHN, LAO, MNG, PNG, the PHL and VNM) to identify key areas for action towards the attainment of MDG 4 and 5 and strengthen collaboration among the maternal and child health-related and health systems-focused programmes. Support was provided to PNG for the development of a strategic plan for maternal health for 2011–2015 based on the National Health Policy 2011–2020. Country-specific approaches were also outlined and successful scaling-up experiences were discussed. A particular emphasis has been given for efforts to strengthen integrated service delivery and approaches to remove barriers to accessing essential maternal and child health services. In 2010, LAO was supported in implementing the integrated maternal newborn and child health (MNCH) strategic planning framework and package of interventions, and KHM in implementing national strategies towards universal coverage of quality maternal and newborn services. PHL was supported in enhancing the related United Nations Development Assistance Framework (UNDAF) content to reflect the national maternal newborn child health and nutrition policy, and VNM in implementing the National Child Survival Plan and development of the sexual and reproductive health population strategy and a One UN Plan on maternal and child health aspects. Policy support on universal access was also given to KIR.

Delivery progress: On Track

WPR/RC62/3 page 14 Annex 2

Regional Expected Result 04.002.WP01

National research capacity strengthened as necessary and new evidence, products, technologies, interventions and delivery approaches of global and/or national relevance available to improve maternal, newborn, child and adolescent health, to promote active and healthy ageing, and to improve sexual and reproductive health.

While operational research is useful in implementing programmes, the work is hampered by the limited institutional capacity to support the work. However, some countries have attempted to build research capacities and undertake research-related activities. LAO has been supported on institutional development with an initial grant and made new evidence, interventions and delivery approaches of national relevance available. CHN, MNG and VNM have also supported research activities. CHN was supported in carrying out an operational research in promoting natural delivery, as they have a high rate of caesarean-section deliveries. MYS was supported in conducting studies related to abortion and family planning.

Delivery progress: On Track

Regional Expected Result 04.003.WP01

Technical and policy support provided to Member States for implementing national plans of action for the reduction of maternal and newborn mortality by achieving universal coverage of skilled attendants on maternal and newborn care.

Progress was noted in priority countries to improve the proportion of deliveries assisted by skilled attendants and the use of evidence-based guidelines and tools. CHN, FJI, KHM, LAO, MNG, PNG, SLB and VNM were supported in efforts to improve access to and quality of skilled care for birth. Some WHO evidence-based guidelines and tools were used to improve quality of care in maternal health. VNM supported the establishment of maternity waiting homes in two remote areas. Priority countries were particularly supported for the adaptation of evidence-based guidelines and tools. KHM translated into Khmer and printed the Midwifery Education Modules and distributed the document to midwifery teaching institutions; CHN trained local project managers and MCH professionals on research proposals, data collection, diagnosis and treatment of pregnancy complications; FJI conducted skill competencies for the Maternal Health staff on maternal and newborn health; the LAO conducted a workshop to improve clinical competencies on newborn care and increase community awareness and response; MNG conducted local fellowship training on pregnancy, child birth, postpartum and newborn care at the four regional colleges for aimag and soum levels and provided supplies and equipment for essential newborn care at rural health facilities; VNM funded data collection, data entry, analysis and reporting on a multi-country study on maternal and perinatal health, and developed guidelines for neonatal mortality audit.

Delivery progress: On Track

WPR/RC62/3 page 15 Annex 2

Regional Expected Result 04.004.WP01

Guidelines, approaches and tools for improving neonatal survival and health applied at country level, with technical support provided to Member States for intensified action towards universal coverage, effective interventions and monitoring of progress.

Seven high-burden countries for newborn deaths (CHN, KHM, LAO, MNG, PNG, PHL and VNM) have updated their IMCI guidelines on newborn care for implementation in first-level facilities. Three countries (KHM, LAO, and VNM) were supported to implement home-based newborn care in selected areas and the PHL is in the final stages of country adaptation prior to implementation. CHN has examined interventions to decrease the incidence of prematurity and low birth-weight in newborns, KIR strengthened the continuum of care for newborns, and the PHL supported essential newborn care protocol for hospitals.

Delivery progress: On Track

Regional Expected Result 04.005.WP01

Policy and technical support provided to Member States for intensified action towards agreed goals ensuring universal access, coverage and quality of key public health interventions for newborn and child survival.

Several countries were supported to implement strategies to increase child health intervention coverage and quality of care. KHM and CHN supported data-based decision-making through the conduct of MNCH household surveys and analysis of results and used them for improving implementation. A strategic child survival programme review was also supported in KHM. FJI conducted a training for health care providers on IMCI computerized adaptation and training tool (ICATT), developed a module and training for community health workers on the basic concepts of IMCI, and introduced a WHO pocket book on hospital care for children for five Pacific island countries. KIR also supported IMCI. LAO was supported in updating national IMCI guidelines, reviewing IMCI inservice training approaches, conducting hospital assessments and building capacity to improve quality of hospital care in three provinces. MNG was supported in building capacity to use ICATT as an approach for improving IMCI pre-service education specifically to set up ICATT laboratory at the Health Sciences University. PNG supported IMCI and included it as the key strategy in their National Health Plan 2011–2020. PHL updated the IMCI guidelines. Technical and logistic support were provided to introduce community case management of sick children in VNM. The Regional Monitoring Framework has been developed and is being reviewed for finalization. FJI, KHM and MNG have IMCI coverage more than 75% of target districts.

Delivery progress: On Track

WPR/RC62/3 page 16 Annex 2

Regional Expected Result 04.006.WP01

Policy and technical support provided to Member States for coordinated implementation of evidence-based strategies, norms and standards for the prevention and care of diseases and health-compromising behaviours in adolescents, as well as conditions that place adolescents at risk.

Technical support was provided for building capacities of health workers from CHN, HOK and MAC for provision of adolescent-friendly health services (AFHS). PHL was supported in finalizing the National Standards for AFHS. Rapid Programme Review of ADH was supported in MNG and the outcome being used to inform policy. Adolescent health (ADH) policy and technical support was provided also for LAO. A draft Regional Framework on Improving ADH has been developed, and ADH Fact Sheets for 10 countries drafted.

Delivery progress: On Track

Regional Expected Result 04.007.WP01

Technical support provided to Member States for accelerated action towards implementing the Global Reproductive Health Strategy and improving family planning and reproductive health care.

Priority countries were supported in key aspects of reproductive health towards the achievement of universal access. CHN, KHM, LAO, MNG, MYS and PHL were supported in implementing various activities related to family planning, preventing unsafe abortion and prevention and treatment of cervical cancer. KHM developed and implemented the fast track initiative to reduce maternal mortality and to achieve MDG5 and the maternal death surveillance and response; Tongji Medical College (CHN) developed the MCH/FP essential package; and LAO adapted and disseminated the standards and guidelines on family planning, abortion and sexually transmitted Infections.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 04.008.WP01

Technical support provided to Member States for increased advocacy for the implementation of policies and programmes, and for training programmes for health care providers on healthy ageing. MNG has reported having

No major progress in the healthy ageing programme area has been reported. provided support for building capacity and services for healthy ageing.

Delivery progress: At risk/ Partially achieved

WPR/RC62/3 page 17 Annex 2 STRATEGIC OBJECTIVE 5: To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. Regional Expected Result 05.001.WP01 Norms and standards developed, capacity built and technical support provided to Member States for the development and strengthening of national emergency preparedness plans and programmes.

All planned activities have been implemented accordingly. The KHM health preparedness plan has been integrated in the national disaster preparedness plan. LAO had completed its emergency preparedness plan. It is also further developing an emergency medical service system plan. The hospitals safe from disasters campaign activities were implemented in four priority countries: KHM. LAO, PHL and VNM.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 05.002.WP01

Norms and standards developed, capacity built and technical support provided to Member States for a timely response to disasters associated with natural and human-generated hazards.

All planned activities have been implemented accordingly. A training course on health emergency response operations (HERO) was conducted. The Emergency and Humanitarian Action unit (EHA) WPRO was able to provide support to acute emergencies within 48 hours upon the request of Member States. For the Chinghai earthquake, WHO China provided support to the national government in providing emergency support for the provision and restoration of health services of damage health facilities in the affected communities. A severe snowstorm disaster badly affected Mongolia and the WHO Mongolia office provided leadership in the health cluster response to the emergency.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 05.003.WP01

Norms and standards developed, capacity built and technical support provided to Member States for assessing needs and for planning and implementing transition and recovery actions in post-disaster and post-conflict situations.

All planned activities have been implemented accordingly.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 18 Annex 2

Regional Expected Result 05.004.WP01

Coordinated technical support provided to Member States for communicable disease control in disasters resulting from natural and human-generated hazards.

All planned activities have been implemented accordingly. Because of the single platform for response under the Division of Health Security and Emergencies, communicable disease control has been integrated into emergency response activities.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 05.005.WP01

Coordinated technical support provided to Member States on environmental health and food safety in disasters resulting from natural and human-generated hazards.

Good progress has been made. Five activities to develop food safety emergency response plans have been implemented in five countries (FJI, KHM, LAO, MNG and VNM). Food safety is integrated into emergency response activities of WHO.

Delivery progress: On Track

Regional Expected Result 05.005.WP02

Support provided to Member States for strengthening national preparedness and for establishing alert and response mechanisms for food safety and environmental health emergencies.

EHA supported activities of the Regional Technical Working Group on environmental health emergencies.

Delivery progress: On Track

Regional Expected Result 05.006.WP01

Effective communications issued, partnerships formed and coordination developed with other organizations in the United Nations system, governments, local and international nongovernmental organizations, academic institutions and professional associations at country, regional and global levels.

All planned activities have been implemented accordingly. EHA continued to strengthen partnerships with other UN agencies and international development partners, including Asia Pacific Humanitarian Network, Pacific Health Team, academic institutions (national and international) and donor agencies (national universities, Chinese Center for Disease Control and Prevention, China, Southeast Asian Ministry of Education Organization-Regional Tropical Medicine and Public Health Network (SEAMEO-TROPMED Network, and the Asian Disaster Preparedness Center).

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 19 Annex 2

Regional Expected Result 05.007.WP01

Acute, ongoing and recovery operations implemented in a timely and effective manner.

All planned activities have been implemented accordingly. Whenever there was a major emergency, WHO provided support and coordinated health sector response through the health cluster approach. Resource mobilization was also pursued with existing partner agencies (e.g., bilateral agencies, European Commission Humanitarian Aid & Civil Protection, AusAID or USAID) or though the Central Emergency Response Fund (CERF) mechanism.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 20 Annex 2

STRATEGIC OBJECTIVE 6: To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. Regional Expected Result 06.001.WP01 Advice and support provided to countries and areas to strengthen their health promotion capacity across all relevant programmes, and to establish effective multisectoral and multidisciplinary mechanisms and collaborations to promote health and prevent and reduce the occurrence of major behavioural and structural risk factors.

Health promotion through healthy settings was promoted. Frameworks for scaling up and extending of Healthy Cities initiatives and the revitalization of Healthy Islands were finalized. In the PHL, guidelines for healthy settings and healthy workplaces were updated in 2009 and implemented in 2010. Technical consultation was held to support the development of regional and national technical networks for Healthy Cities. Seventeen Pacific island countries and areas were supported to advance the programme on Healthy Islands as a platform for health promotion. Efforts to reduce health inequity in the urban settings have been advanced through the use of the Urban Health Equity Assessment and Response Tool (Urban HEART) and are being expanded to seven Member States. A collaborative effort for health promotion foundations and tobacco taxes has been developed with the Southeast Asian Tobacco Control Alliance using the health promotion leadership training programme (Prolead) as an approach to innovative financing for tobacco control, health promotion and NCD prevention. Seven countries have initiated one-year projects on health promotion foundations and tobacco taxes (KHM, LAO, MNG, MYS, PHL, TON, VNM and WSM). Some countries have included specific provisions on using tobacco taxes for health promotion and tobacco control in their draft tobacco control laws (LAO, SLB, VNM and WSM).

Delivery progress: On Track

Regional Expected Result 06.002.WP01

Guidance and support provided to strengthen national systems for major risk factor surveillance by developing, validating and disseminating programme and evaluation frameworks, tools and operating procedures to countries and areas with a high or increasing burden of premature death and disability attributable to the major behavioural risk factors.

Progress has been achieved in COK, KHM, LAO, MNG, PNG and SLB. NCD risk factor surveillance has been promoted through STEPS surveys. They cover the age group 15–64 years. The Global School-Based Student Health Survey (GSHS) covered younger children in schools. STEPS surveys were completed in KHM and MNG during the year 2010. GSHS has been conducted in MNG in 2010. PHL has initiated GSHS. A STEPS report of SLB has been published.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 21 Annex 2

Regional Expected Result 06.003.WP01

Technical assistance, training and advocacy support provided to countries and areas with a high and increasing burden of disease and death associated with tobacco use to strengthen institutions in order to address and/or prevent public health problems concerned. Support provided to the Conference of the Parties to the WHO Framework Convention on Tobacco Control for implementation of the provisions of the Convention.

Advocacy efforts for full implementation of the treaty have been stepped up and these have resulted in new regulations, policies and actions to curb the tobacco epidemic. National action plans have been reviewed and updated in KHM and MNG. Amendments to existing laws and/or new legislation and regulations have been filed in BRN, CHN, FJI, HOK, KHM, KOR, LAO, PHL, SGP, SLB and VNM. Progress in relation to Article 8 of the WHO FCTC on bans on indoor smoking in public places or workplaces have moved more quickly at the subnational levels (e.g. regional, provincial, city or state) or within specific sectors (e.g. health facilities, educational facilities) in CHN, FSM, JPN, MAC and PHL. Stronger regulations and enforcement on bans on advertising, promotion and sponsorship of tobacco products have been reported and noted in BRN and MYS. Progress on work related to Article 6 on prices and taxes is noteworthy. A Regional Training Workshop on Tobacco Taxation was conducted with several countries. Eight countries have been working on projects related to innovations in tobacco control financing by using tobacco taxes and/or for health promotion foundations and tobacco control in KHM, LAO, MYS, MNG, PHL,TON, VNM and WSM. Prices and taxes have increased in AUS, BRN, GUM and JPN.

Delivery progress: On Track

Regional Expected Result 06.004.WP01

Technical support provided to countries and areas with a high or increasing burden of risk factors and disease in order to strengthen institutions to prevent public health problems associated with alcohol, drugs and other psychoactive substance use.

Progress reported on track by FJI, MNG, SLB and VUT. Adoption of global strategy to reduce harmful use of alcohol at the World Health Assembly in May 2010 has put more emphasis on work in the area of alcohol policies and programmes. A number of countries have been supported with different activities, both government and the nongovernmental organization sector, to further strengthen country capacity (especially KHM, LAO, MNG and VNM). A legislation guide is being finalized to support the specific area of effective alcohol-control policies. For surveillance on alcohol, a majority of countries contributed some data for the global Alcohol and Health survey, which included alcohol use, drinking patterns, morbidity/mortality and policies. Not much attention is paid to the surveillance, from the perspective of country requests for technical assistance. With no funding to support countries or do capacity-building, it is not expected that countries develop specific surveillance systems for alcohol. The WHO four-country workshop on sustainable alcohol policy was held in Bangkok from 7 to 9 April 2010, with participation by KHM, LAO, MNG and VNM. Very little funding is available for the general area of substance abuse (including alcohol) and although there is greater global momentum it is not currently projected that this will increase available funding. No specific staff in any Country or Liaison Office is working exclusively on substance abuse, and only one staff at the regional level is.

Delivery progress: On Track

WPR/RC62/3 page 22 Annex 2

Regional Expected Result 06.005.WP01

Evidence-based and ethical policies, strategies, recommendations, standards and guidelines developed and technical support provided to countries and areas with a high or increasing burden of disease or death associated with unhealthy diets and physical inactivity to strengthen institutions in order to address and/or prevent public health problems concerned.

The Pacific Food Summit was organized and the Framework for Action on Food Security in the Pacific was adopted by the Pacific Island Forum Secretariat and is being discussed for implementation. Guidelines on Physical Activity for Pacific Island Countries (PICs) have been developed and are available on the WHO South Pacific website. Physical Activity and Food-based Dietary Guidelines were communicated through national campaigns. Evidence-based Diet and Physical Activity (DPAS) intervention programmes (policies, supportive environment, community-based lifestyle programmes) developed and implemented with technical support provided to PICs. A regional consultation on strategies to reduce salt intake was carried out and recommendations were provided to Member States. A regional meeting on multisectoral interventions for NCD focused on the promotion of healthy diet and physical activity and outcomes were provided to the Member States. At the end of 2010, 30 countries and areas (out of 37) have a policy and budget for diet and physical activity.

Delivery progress: On Track

Regional Expected Result 06.006.WP01

Evidence-based and ethical policies, strategies, interventions, recommendations, standards and guidelines developed, and technical support provided to countries and areas to promote protected sex and strengthen institutions in order to address and manage social and individual consequences of unsafe sex.

MYS has been supported in carrying out a Knowledge, Attitude and Practice (KAP) study on preventing unsafe abortion. Relevant activities were accommodated under Strategic Objective 4, Organization-Wide Expected Result 7 (Reproductive Health). The key achievements include: reproductive health library dissemination and evidence-based decision-making for sexual and reproductive health workshops conducted in VNM; and LAO adapted and disseminated the standards and guidelines on abortion.

Delivery progress: On Track

WPR/RC62/3 page 23 Annex 2 STRATEGIC OBJECTIVE 7: To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive, and human rights-based approaches. Regional Expected Result 07.001.WP01 Support provided to strengthen the capacity of the Organization and Member States to reduce health inequities, address socioeconomic determinants of health and promote more equitable and pro-poor policies, programmes and interventions.

Four countries (CHN, KHM, MNG and VNM) were supported to translate selected technical materials into local languages, one of which, namely MNG, was supported to strengthen capacity on equity, gender and human rights. Seven cities in the PHL worked to assess and address urban health equity with the URBAN Health Equity Assessment and Response Tool (HEART).

Delivery progress: On Track

Regional Expected Result 07.002.WP01

Opportunities created and mechanisms used to facilitate action across sectors to reduce health inequities and address the socioeconomic determinants of health.

Two activities were initiated on intersectoral action in health at the Regional Office level, namely, a capacitybuilding workshop on health in all policies, and a series of materials to guide health policy-makers in dialogue with other sectors to promote health in all policies and intersectoral action for health. Activities planned for 2010 in VNM were fully implemented.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 07.002.WP02

Opportunities created and mechanisms used to facilitate action across sectors to address the socioeconomic determinants of health in specific settings (e.g. urban setting).

All activities have been implemented as planned/are on track. As a follow-up to the recommendations of the Commission on Social Determinants of Health, and/or in collaboration with WHO/HQ, two activities were initiated on intersectoral action in health at the Regional Office level, namely, a capacity-building workshop on health in all policies, and a series of materials to guide health policy-makers in dialogue with other sectors to promote health in all policies and intersectoral action for health (with four sectors being taken up in the first phase, namely, agriculture, business/private sectors education and housing). In trade and health, the PHL was supported with regard to the increasing knowledge and awareness on trade in health services. The PHL and VNM were supported with regard to increasing knowledge and awareness on the implications of intellectual property provisions in trade agreements. KHM was supported to review a draft legislation to implement certain Trade-related aspects of Intellectual Property Rights (TRIPS) flexibilities.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 24 Annex 2

Regional Expected Result 07.003.WP01

Support provided to strengthen country capacity to collect, analyse and use information on health and social determinants that is disaggregated by various relevant indicators of social exclusion, such as sex, age, ethnicity, income, or location.

CHN, MYS, PHL and VNM were supported to attend a global meeting on gender and health statistics and followup actions developed. In the PHL, the conduct of the URBAN Health Equity Assessment and Response Tool (HEART) was scaled up to other cities.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 07.004.WP01

Support provided to strengthen the capacity of the Organization and Member States to promote ethical human rights-based approaches to health.

MNG and PHL were supported in the area of health in prisons; and CHN on disabilities. Joint activities were undertaken with the tuberculosis programme on health in prisons; and with injuries and violence prevention and nursing units on disabilities.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 07.005.WP01

Support provided to strengthen the capacity of the Organization and Member States to promote more genderresponsive health policies, programmes and interventions.

Support was provided to the infectious diseases programme managers and staff in the PHL, and to the SLB Ministry of Health staff. Gender analysis and actions are being integrated into Maternal Neonatal and Child Health (MNCH) district planning and health centre micro planning in LAO. Work on gender-based violence (GBV) was supported in VNM and under the United Nations Secretary-General's campaign –– UNiTE to end violence against women in the PICs. In PNG, the focus is on GBV, especially sexual violence. Support was provided on gender mainstreaming to the Division of Health Security and Emergencies (DSE).

Delivery progress: On Track

WPR/RC62/3 page 25 Annex 2

Regional Expected Result 07.005.WP02

Support provided to build capacity of Member States to implement the Strategy for Integrating Gender Analysis and Actions into the Work of WHO, including support for Member States to mainstream gender and rights into reproductive, women, maternal and child health.

Supported PNG to develop its country profile on gender, equity and human rights issues in health.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 26 Annex 2

STRATEGIC OBJECTIVE 8: To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. Regional Expected Result 08.001.WP01 Evidence-based assessments made and norms and standards formulated and updated on major environmental hazards to health (e.g. poor air quality, chemical substances, electromagnetic force, radon, drinking-water, waste-water reuse).

The three countries expected to have conducted assessments of specific environmental threats to health with WHO technical support during the biennium are: CHN, MNG and VNM. No WHO norms, standards or guidelines have been published, although at the country level, WHO supported to develop five norms, standards or guidelines and regulations, including national drinking water quality standards in FJI and KHM; national indoor and outdoor air quality standards; guidelines on health-care waste management; and regulations on insecticides and disinfectants.

Delivery progress: At risk / partially achieved

Regional Expected Result 08.002.WP01

Technical support and guidance provided to countries and areas for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings and among vulnerable population groups.

Good progress has been made. Eleven countries have been supported by WHO in implementing primary prevention interventions to reduce environmental health risks. These are COK, KHM, KIR, LAO, MNG, NRU, PNG, SLB, TON, VNM and WSM.

Delivery progress: On Track

Regional Expected Result 08.003.WP01

Technical assistance and support provided to Member States for strengthening national occupational and environmental health risk management systems, functions and services.

The three countries expected to have implemented activities related to the development of national programmes on the elimination of asbestos-related diseases by end of 2011 with support from WHO are MNG, PHL and VNM. While not directly related to the indicator, WHO supported six countries, namely KHM, LAO, MYS, PHL, SLB and VNM to develop or implement their national environmental health action plans.

Delivery progress: On Track

WPR/RC62/3 page 27 Annex 2

Regional Expected Result 08.004.WP01

Guidance, tools, and initiatives created in order to support the health sector in influencing policies in other sectors to allow policies that improve health, environment and safety to be identified and adopted.

The eight countries expected to have implemented WHO-supported initiatives to address the health impacts of activities in the transport sector (called environmentally sustainable and healthy urban transport or ESHUT) are CHN, JPN, KHM, KOR, LAO, MNG, PHL and VNM. Further activities in these and other countries are expected to be implemented by end of 2011.

Delivery progress: On Track

Regional Expected Result 08.005.WP01

Health-sector leadership enhanced for creating a healthier environment and changing policies in all sectors in order to tackle the root causes of environmental threats to health, through means such as responding to emerging and reemerging consequences of development on environmental health and altered patterns of consumption and production and to the damaging effect of evolving technologies.

The two publications on emerging environmental and occupational health issues that are expected to have been finalized are: Paper on Asia-Pacific Water Safety Plan Network, and Regional Framework for Action for Occupational Health: 2011–2015. Two national water and sanitation sector assessment reports: one in LAO and the other in VNM, are being prepared and will be completed by end of 2011. Two ministerial meetings that were held in 2010 are the Second East Asia Ministerial Conference on Sanitation and Hygiene, and the Second Ministerial Regional Forum on Environment and Health in South-East and East Asian countries.

Delivery progress: On Track

Regional Expected Result 08.006.WP01

Evidence-based policies, strategic and recommendations developed, and technical support provided to Member States for identifying, preventing and tackling public health problems resulting from climate change.

The three reports that have been completed on the health effects of climate change in 2010 were those in KHM, PNG and VNM. There are similar studies being conducted in 12 other countries that are expected to produce reports by end of 2011. The five countries that have implemented plans and programmes to strengthen capacity of the health sector to adapt to climate change are CHN, FJI, KHM, MNG and PHL. Three more countries plan to implement capacity-building activities for the health sector adaptation to climate change in 2011.

Delivery progress: On Track

WPR/RC62/3 page 28 Annex 2

STRATEGIC OBJECTIVE 9: To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. Regional Expected Result 09.001.WP01 Partnerships formed and support provided to countries and areas to increase political, financial and technical commitment to addressing nutrition, food safety and food security through intersectoral action.

Partnerships have been formed and sustained with many international and regional organizations (e.g. Food and Agriculture Organization of the United Nations [FAO], UNICEF, World Food Programme [WFP], Secretariat of the Pacific Community [SPC], Pacific Islands Forum Secretariat [PIFS] and Global health Institute [GHI]) and other development partners to advance intersectoral action and funding for food security, nutrition and food safety and action has been taken through workshops to advance National Plans of Action for Nutrition; through a Pacific Food Summit attended by 22 countries; through national Food Summits held in six Pacific island countries; and through intersectoral MDG-funded activities in Asia (e.g. CHN, KHM, LAO, PHL and VNM). With the support of WHO/FAO, the government of SLB approved an integrated food security, food safety and nutrition policy in the first half of 2010. The United Nations in CHN started action on a programme of work focusing on an integrated approach to address food safety, nutrition and food security for women and children in the poorest counties of the country.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 09.002.WP01

Evidence-based norms, assessments and guidance developed, adapted, where appropriate and disseminated to enable countries and areas to implement cost-effective interventions responding to all forms of malnutrition and foodborne diseases, and to promote healthy dietary practices in the Western Pacific.

Guidelines on the implementation of weekly iron and folic acid supplementation programmes for women of reproductive age were finalized. To facilitate the introduction of standards in the small island states (SIS), a Practical Guide to Introducing Food Standards to Promote Health and Trade for SIS was drafted and being trialed along with efforts to advance standards in SIS. Draft food complaints guidelines had been initiated.

Delivery progress: On Track

WPR/RC62/3 page 29 Annex 2

Regional Expected Result 09.003.WP01

Improved capacity in countries and areas to collect, analyse, disseminate and use data on the magnitude, causes and consequences of under-nutrition and over-nutrition, inappropriate diets and physical inactivity.

Support provided to priority countries in the Region for the following: National Nutrition Survey in MNG, evaluation of the programme on Weekly Iron-Folic Acid Supplementation for Women of Reproductive Age in KHM and VNM, assessment of Zinc status in the PHL population and Integrated Food Security Information System promoted in the Pacific. The Nutrition Country Profiles are currently being reviewed/updated to ensure that the latest data from all countries and areas are used in the profiles. MYS, PHL and SLB have introduced a new training course on growth monitoring and Infant and Young Child Feeding (IYCF).

Delivery progress: On Track

Regional Expected Result 09.004.WP01

Capacity built and support provided to target Member States for the development, strengthening and implementation of nutrition plans, policies and programmes aimed at improving nutrition throughout the life-course, in stable as well as humanitarian crisis situations.

Continuing support being provided in the area of infant and young child feeding, micronutrient supplementation, and promotion of healthy diets among countries. Important progress achieved in the PHL through the Essential Newborn Care programme. A press statement published in the WHO Headquarters and WPRO websites in December 2010 highlighted the achievements. A meeting on anaemia prevention strategy throughout the life cycle was conducted in VNM. Assessment and monitoring of iodine status promoted in six USA-associated Pacific Islands and support provided to the Iodine Deficiency Disorders (IDD) survey in WSM agreed by the Ministry of Health. Training in the prevention and management of moderate and severe malnutrition in children conducted in KHM and LAO.

Delivery progress: On Track

WPR/RC62/3 page 30 Annex 2

Regional Expected Result 09.005.WP01

Foodborne disease surveillance and food contamination monitoring programmes strengthened regionally and in targeted countries and areas.

The capacity of Member States to obtain food safety data through hazard monitoring and to conduct risk assessments was enhanced through: burden of foodborne disease training; risk assessment training; the provision of technical advice on the establishment of national expert committees and training institutes; and training in both food analysis and better outbreak investigation. CHN has initiated a large pilot project in more than 300 sites in Qingdao to improve collection and handling of data on foodborne disease surveillance. Asia FoodNet has been established to share information on foodborne diseases and surveillance among Listserve members.

Delivery progress: On track

Regional Expected Result 09.006.WP01

National capacity built to enable countries and areas to set up food-control systems based on risk-analysis principles, to implement effective food safety education, and to operate food-safety emergency response systems with links to international systems.

Policy guidance and legislation: As a basis for guiding future action by Member States of the Western Pacific, the drafting and community consultation process for a Western Pacific Regional Food Safety Strategy 2011–2015 was initiated. Also a Food Safety Bill was drafted and being discussed with key stakeholders in KIR and WSM finally gazetted its Food Safety Act 2006, MHL moved forward on primary food legislation, and VUT amended its legislation to better address micronutrient deficiencies in that country. Food regulations and standards based on Codex were being drafted in COK, FSM, MHL, NIU, NRU, SLB and TUV. In addition, technical support was given in the development of food legislation in CHN and VNM. NRU became the latest member of Codex. Enhancing enforcement and education: As countries adopt new laws, regulations and standards, there is an increasing need for inspectors to be appropriately trained in order for them to be able to enforce the legislation effectively and efficiently. In support of this, inspectors from FSM, PLW and PNG were trained in food safety auditing with the latter being mentored by the NEZ Food safety Authority. Food safety was also enhanced through collaborative action on food safety education and on setting-based community action. With WHO technical advice, a consumer information platform was established with the aim of making health authorities the primary and most trusted source of information for consumers on food safety matters in CHN. In VNM, together with FAO, efforts were made to provide key food safety messages to communities and businesses as well as establishing a community-based food complaint system. Technical support for mass gatherings and emergency response preparedness: On risk management associated with mass gatherings, technical advice was provided to health and food and drug authorities in association with the Shanghai WORLDEXPO 2010. Finally, from a risk management perspective, a Global Foodborne Infections Network (GFN) and Asia FoodNet meeting was conducted in association with WHO, to introduce key personnel to the FAO/WHO Framework for Developing National Food Safety Emergency Response (FSER) Plans. FSER planning was also initiated through training in FJI, KHM, LAO, MNG and VNM.

Delivery progress: On Track

WPR/RC62/3 page 31 Annex 2

STRATEGIC OBJECTIVE 10: To improve health services through better governance, financing, staffing and management informed by reliable and accessible evidence and research. Regional Expected Result 10.001.WP01 Improved management and organization of health service delivery, through both public and non-public providers and networks, reflecting the principles of integrated primary health care with increased coverage, equity, and quality of health services leading to better health outcomes.

The overall progress in the Region with seven out of 10 OSERs being reported on track with only KIR and MYS reporting three OSERs at risk. The KIR OSER should improve with stronger capacity in Health Systems Strengthening (HSS) at country level with a CLO experienced in HSS in place and in MYS there is some uncertainty about future directions for health sector reform, but the Quality Assurance (QA) aspects of the OSERs are actually on track. Support in QA has been provided to nine countries so far so this regional indicator is on track.

Delivery progress: At risk/ partially achieved

Regional Expected Result 10.002.WP01

Improved national capacities and practices for governing, steering, and regulating the health sector through (i) evidence-based policy dialogue, (ii) policy analysis, (iii) greater transparency and accountability for performance, and (iv) more effective intersectoral collaboration.

There are 11 OSERs, four reported as being on track, six at risk or partially implemented, and one off track (in KIR with no funding under the OSER other than staff time, which is important but under the CLO office). The at-risk OSERs are relatively small in total amount of funds and should be able to be put on track by end of 2011.

Delivery progress: At risk/ partially achieved

Regional Expected Result 10.003.WP01

Improved coordination of the various mechanisms (including donor assistance) that support Member States in their efforts to achieve national targets for health system development and global health goals.

All eight OSERs reported as on track. Paris Declaration principles are still mainly aspirational, including for WHO. Perhaps the focus on harmonization and alignment with National Health Policies, Strategies and Plans will be beneficial for WHO to improve its compliance.

Delivery progress: On Track

WPR/RC62/3 page 32 Annex 2

Regional Expected Result 10.004.WP01

Contribute to strengthened country health information systems that provide and use high-quality and timely information for health planning and for monitoring of country and major international goals.

A series of workshops and training co-sponsored with other partners have been conducted to improve national Health Information Systems (HIS) strategic plans, implement international standards, enhance data quality, and improve information use in the Region. Technical assistance was provided to CHN, FJI, KHM, LAO, PHL and VNM has focused on HIS improvements through country-led and better coordinated processes, better quality and use of routine health information, better use of new information technology. Effective coordination is under way across multiple partners and related activities, including alignment with the United Nations Economic & Social Commission for Asia and the Pacific (ESCAP) and Secretariat of the Paciofic Community (SPC) action plan for vital statistics and with partners implementing the new Health Matrix Network (HMN) Monitoring of Vital Events using IT (MoVE-IT) initiative to improve vital registration and better use of health and vital statistics.

Delivery progress: On Track

Regional Expected Result 10.005.WP01

Better knowledge and evidence for health decision-making, by consolidation and publication of existing evidence, facilitation of knowledge generation in priority areas and leadership in health research policy and coordination, including ensuring ethical conduct.

A major output of the Asia Pacific Health Observatory on Health Systems and Policies is health systems profiles (HiTs), which are now complete or underway in five countries: FJI, MNG, MYS, PHL and SGP in 2010. For addressing fragmentation health information systems (HIS) and mitigate the overwhelming data demands on countries, WHO is transforming its regional health databank and online data generator into a next generation Health Information Intelligent Platform (HIIP) for the Western Pacific to help maximize data use at both country and regional levels by extracting, analysing, and using more intelligence out of available information.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 10.006.WP01

National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society.

The Ethics Review Committee (ERC) for the Western Pacific Regional Office of WHO was formally established in November 2010. The standard operating procedures were developed and published. An electronic research portal was established to ensure prospective registration, tracking and monitoring of all research conducted/supported by the Western Pacific Region.

Delivery progress: On Track/ Fully achieved

WPR/RC62/3 page 33 Annex 2

Regional Expected Result 10.007.WP01

Improved use of e-health applications (such as electronic medical records and distance learning) and networking including the network of WHO collaborating centres–to strengthen health systems.

Technical support for PLW analysed the information technology (IT) architecture of their health information systems (HIS) and produced recommendations to improve efficiency and reliability of their systems. Launch of the new WHO Collaborating Centre for Health Information and Informatics at the Centre for Health Statistics and Information within the Ministry of Health in China will aid other countries in the Region by promoting the use of standards and sharing and learning of HIS development and management of eHealth solutions.

Delivery progress: On Track

Regional Expected Result 10.007.WP02

Implementation of the knowledge management strategy, including improved access to health information via portals, such as the Global Health Library, Regional Index Medicus and HINARI.

Planned activities for 2010 have been fully implemented.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 10.008.WP01

Support provided to strengthen health-workforce information and knowledge base, to build up capacity of countries and areas for policy development and planning, and to enhance research, networking and information-sharing.

Progress remains satisfactory–excellent with achievement of all three indicator targets, including focus on priority countries. Country health workforce profiles have been standardized to support improved policy and strategy development. Country experiences were collated and utilized in case studies to support the development of the Regional Human Resources for Health (HRH) Action Framework. Technical support was provided to priority countries to evaluate and strengthen national HRH policies, from a cross-sectoral approach.

Delivery progress: On Track

WPR/RC62/3 page 34 Annex 2

Regional Expected Result 10.009.WP01

Technical support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces.

Progress is satisfactory towards targets of all three indicators. However, some delays in Fellowships implementation/encumbrances in CHN, TON, VUT, and WSM (not necessarily evident by indicator reporting targets). Progress continues to be satisfactory—excellent towards the achievement of all three indicator targets. Technical support has been provided to priority countries to improve their health workforce production and uptake, in terms of both quantities and quality. WHO evidence-based retention guidelines were disseminated to promote distribution and manage migration and applied research undertaken on potential retention interventions in selected priority countries. Collaboration with institutions, professional associations and networks to strengthen the standards and regulations of nursing and medical education paved way for the establishment of education development centres in priority countries in partnership with other stakeholders. An indicator template to support operational application of the WHO global nursing and midwifery academic quality standards was completed in preparation for consensus reaching within and across regions. Continued professional development of health workers in countries was ensured through the provision of fellowships and study tours. Monitoring of fellowship implementation was strengthened through the application of an implementation/encumbrances matrix for use by countries. Online courses offered by the Pacific Open Learning Health Network (POLHN) were further expanded in terms of number of courses and the population reached. Alliances and networks were sustained and further strengthened in the areas of Human Resources for Health (HRH) professional education, academic quality standards and regulation frameworks as well as in areas of core competencies of all health professionals, including patient safety, infection control and disaster preparedness.

Delivery progress: On Track

Regional Expected Result 10.010.WP01

Technical support provided to improve health system financing in terms of the availability of funds, social and financial risk protection, equity, access to services and efficiency of resource use.

Technical support was provided along with the Regional Health Financing Strategy and World Health Report 2010 that focused on universal coverage.

Delivery progress: On Track/ Fully achieved

Regional Expected Result 10.011.WP01

Norms, standards and measurement tools are used for tracking resources and estimating economic consequences of illness, the costs and effects of interventions, financial catastrophe and impoverishment, and social exclusion.

WHO tools on distribution of health payments to assess catastrophic health expenditure and impoverishment were applied and the result of the study is expected to be shared in March 2011. Policy briefs will be developed during the planned meeting in March 2011.

Delivery progress: On Track

WPR/RC62/3 page 35 Annex 2

Regional Expected Result 10.012.WP01

Health financing data, information and evidence are used for developing, implementing and monitoring health financing policies and strategies.

Health financing data information was updated for all WPR countries in 2008. The national health accounting system (NHA) strengthened in the Pacific with the establishment of NHA expert network. Health financing policies and strategies are reviewed and updated with better and reliable information.

Delivery progress: On Track

Regional Expected Result 10.013.WP01

Implementation of norms, standards and measurement tools by Member States to quantify and decrease the level of unsafe health care provided and to improve the quality of the health care system.

Four out of five OSERs are reported on track and one at risk. The at risk in PHL is due to no funds but the Regional Office will be able to supplement. There is good progress on having the safe surgery checklist adopted as well as pledges for hand hygiene and just beginning on safe newborn care.

Delivery progress: At risk/partially achieved

WPR/RC62/3 page 36 Annex 2

STRATEGIC OBJECTIVE 11: To ensure improved access, quality and use of medical products and technologies. Regional Expected Result 11.001.WP01 Support provided to countries and areas to develop, monitor or revise comprehensive policies on access, quality and use of essential medical products and technologies.

The progress is on track. The planned activities for 2010 of the Pharmaceuticals (PHA), Traditional Medicine (TRM) and Health Technologies (HTL) have been implemented successfully. A financial gap will be encountered in 2011 for the PHA programme in the Pacific island countries due to the termination of the African Caribbean and Pacific Group of States/WHO/European Commission (ACP/WHO/EC) partnership project in Pharmaceutical Policies and Access to Essential Medicines. A Regional Framework on Access to Essential Medicines 2011–2016, has been finalized, serving as a guide for strategic collaboration between WHO and the Member States in improving access to essential medicines. A regional web-based Price Information Exchange (PIEmeds) for selected essential medicines has been officially launched. On the HTL programme, selected Member States were also provided technical support in developing their National Laboratory Policy and Plan. A draft "Guidance document for the development of National Laboratory Policy and Plan" was later developed as a result of this technical support. For the Traditional Medicine programme, a draft of the Regional Strategy for Traditional Medicine in the Western Pacific Region has been developed.

Delivery progress: On Track

Regional Expected Result 11.002.WP01

Support provided to countries and areas to implement internationally accepted norms, standards and guidelines for the quality, safety, efficacy and cost-effectiveness of medical products and technologies, and to strengthen the national regulatory and quality assurance system.

The progress is on track. The planned activities for 2010 of the Pharmaceuticals (PHA), Traditional Medicine (TRM) and Health Technologies (HTL) have been implemented successfully. Financial gap will be encountered in 2011 for the PHA programme in the Pacific island countries due to the termination of the ACP/WHO/EC partnership project in Pharmaceutical Policies and Access to Essential Medicines. The WHO/INTERPOL Joint Operation STORM 2 has been completed. Experts from nine Member States and partner organizations (INTERPOL, United States Pharmacopeia) participated in an Expert Consultation on the Surveillance and Alert System for Counterfeit Medicines (February 2010) in Manila. As one of its follow-ups, the Regional Rapid Alert System for Combating Counterfeit Medicines (RAS) has been revised. For the HTL programme, the WHO-CDC Lab QMT training toolkit was shared with and disseminated to the laboratory managers in the 13 Pacific island countries. A draft "Regional Laboratory Quality Standards" with a checklist was also developed. Under TRM, support was provided on strengthening quality control of herbal medicine and its regulation in four Member States and an In-country workshop on Strengthening the Quality Control of Herbal Medicine was organized and conducted in LAO.

Delivery progress: On Track

WPR/RC62/3 page 37 Annex 2

Regional Expected Result 11.003.WP01

Support provided to countries and areas to promote evidencebased, scientifically sound and cost-effective use of medical products and technologies and traditional medicine by health workers, practitioners and consumers.

The progress is on track. The planned activities for 2010 of the Pharmaceuticals (PHA), Traditional Medicine (TRM) and Health Technologies (HTL) have been implemented successfully. Financial gap will be encountered in 2011 for the PHA programme in the Pacific island countries due to the termination of the ACP/WHO/EC partnership project in Pharmaceutical Policies and Access to Essential Medicines. Eleven Member States have been supported to improve medicines selection and develop/use the treatment guidelines. Selected Member States were also supported to implement a focused rational use interventions, namely, monitoring training and planning (MTP) and consumers interactive learning and to establish Medicines/Drug Therapeutics Committee. The HTL programme supported the development of a Framework for Action for Medical Devices and data collection on medical devices. Under TRM, the Ministry of Health in VNM was supported in the development of a project proposal on accessible traditional medicines in mountainous remote areas of the country.

Delivery progress: On Track

Основные сведения

Организация Всемирная организация здравоохранения (ВОЗ / WHO)

Тип документа Technical Documents

Дата принятия 31 декабря 2011 г.

Источник Всемирная организация здравоохранения