Final report of the twenty-fourth session of the Regional Committee for the Western Pacific

WORLD HEALTH ORGANIZATION REGIONAL COMMITTEE FOR THE WESTERN PACIFIC TWENTY -FOURTH SESSION Wellington, 28 August - 4 September 1973 REPORT OF THE REGIONAL COMMITTEE SUMMARY RECORDS OF THE PLENARY SESSIONS MANILA October una WORLD HEALTH ORGANIZATION REGIONAL COMMITTEE FOR THE WESTERN PACIFIC TWENTY-FOURTH SESSION Wellington, 28 August 4 September 1973 REPORT OF THE REGIONAL COMMITTEE SUMMARY RECORDS OF THE PLENARY SESSIONS MANILA October 1973 NOTE The twenty-fourth session of the Regional Committee for the Western Pacific was held in the Queen Margaret College, Wellington, New Zealand, from 28 August to 4 September 1973, under the chairman- ship of Dr C.N. Derek Taylor (New Zealand), with Dr D. Singh (Fiji) as Vice-Chairman, Dr Ho Guan Lim (Singapore) and Dr Phouy Phoutthasak (Laos) were the Rapporteurs. The Regional Committee met on 28, 29, 30 and 31 August and 3 and 4 September. The report of the Committee will be found in Part I of this document on pages 1-52, the summary records of the plenary sessions in Part II on pages 59-169. The Sub-Committee on Programme and Budget met on 30-31 August and 3 September. The report of the Sub-Committee will be found in Part I of this document on pages 5-22. -u- > I II III CONTENTS INTRODUCTION •••••••.•.•••••••••••••••••••.•••••••••••••• 1 ANNUAL REPORT OF THE REGIONAL DIRECTOR COVERING THE PERIOD 1 JULY 1972 TO 30 JUNE 1973 •..••.•.•••••••••• PROPOSED PROGRAMME AND BUDGET FOR 1975 1 2 3 4 5 6 Introduction ........... <II ......... ~ , .. " ................................... .. Review of budget performance 1972 - direct services to governments of the Region by subject heading, by country and by project ....................................................................... .. Modifications to the 1973 and 1974 regular programme and budget estimates •••.••••••••••••••.•• Review of the proposed programme and budget estimates for 1975 .••••••••••••••••••••••••• Consideration of tentative projection for 1976 •••••••••.••••••••••••••••••.••••.••.•••••• Resal utions ............................................................................ .. DTRE R MA.TT ERS ................................................................................. .. 1 2 3 4 5 6 7 8 9 Celebration of the Twenty-fifth Anniversary of the World Health Organization ••••••••••••••••••• Resolutions of regional interest adopted by the Twenty-sixth World Health Assembly .•..••......• Quality of drinking water on international flights .................................................................................... .. Quality of food on international flights ••.•••••••• Disinsection of aircraft .................................................... .. Drug dependence Comprehensive and coordinated teacher training programme for health personnel Future sessions of the Regional Committee •••••••••• Technical Discussions •••••••••••••••••••••••••••••• -iii- 2 5 5 7 8 11 21 22 23 23 23 25 25 26 27 28 29 30 IV CONTENTS 10 Reports received from governments on the progress of their health activities •••..•.••••••••. RESOLUTIONS ADOPTED BY THE COMMITTEE WPR/RC24.Rl WPR/RC24. R2 WPR/RC24.R3 WPR/ RC24. R4 WPR/RC24.R5 WPR/ RC24. R6 WPR/RC24.R7 WPR/ RC24. R8 WPR/RC24. R9 WPR/RC24.RlO Annual Report of the Regional Director ••••.•.......•••.•.••.••••••.••• Resolutions of regional interest adopted by the Twenty-sixth World Health Assembly .................. . Coordination within the United Nations system: General matters Disinsection of aircraft .•••.•.•.••••.•• Quality of drinking water on international flights •••••.••••..••.••.. Quality of food on international fligh ts ...•••••••••••••.•••••••.•.•..•.. Comprehensive and coordinated teacher training programme for he al th pe rs onnel ••••.••••••••••••••..••. Drug dependence .•.•..•••••••••.•••..•... Topic of the Technical Discussions in 1974 ••.••.•.•......•...••••••••.••.•. Future sessions of the Regional 31 32 32 32 33 33 34 34 35 35 36 Commi ttee .••.••••.••••••••••••••••.••••• 36 WPR/RC24.Rll WPR/ RC24. Rl2 WPR/RC24. Rl3 WPR/RC24.Rl4 WPR/RC24.Rl5 WPR/RC24.Rl6 Budget performance 1972 - Direct services to governments Modifications made to the 1973 and 1974 programme and budget estimates Proposed programme and budget estimates for 1975 ••••••..•.••.••••.•••• Tentative projection for 1976 ..•.•.••.•. Adoption 0 f the report .•..•.••••••••.••• Resolution of appreciation •.•••••.•••••• -iv- 37 37 38 38 39 39 1 2 3 CONTENTS ANNEXES AGENDA LIS! OF REPRESENTATIVES ••••••••••••••••••••••••••••••••• LIST OF DOCU11ENI S ............................................................................ .. -v- 41 43 51 PART I REPORT OF THE REGIONAL COMMITTEE (WPR/RC24/14) INTRODUCTION The twenty-fourth session of the Regional Committee for the Western Pacific was formally opened at the Queen Margaret College, Wellington, by Mr Franklin S. Cruz, retiring Chairman. The Right Honourable N.E. Kirk, Prime Minister and Minister of Foreign Affairs, welcomed the Committee to Wellington. The Honourable R.J. Tizard, Minister of Health, also attended the opening session. The session lasted from 28 August to 4 September 1971. The session was attended by all Member States of the Region, of the Member States for territories in the Region, and of Papua New Guinea, an Associate Member. Representatives of the United Nations and United Nations Development Programme, UNICEF, the South Pacific Commission and of 15 non- governmental organizations in official relations with WHO were also present. The Director-General attended the session. The Committee elected the following officers: Chairman Dr C.N. Derek Taylor (New Zealand) Vice Chairman Dr D. Singh (Fiji) Rapporteurs in English Dr Ho Guan Lim (Singapore) in French Dr Phouy Phoutthasak (Laos) Formal statements were made by Representatives of the United Nations and United Nations Development Programme, UNICEF, the South Pacific Commission, the International Dental Federation, the International Committee of Catholic Nurses, the International Council of Nurses, the International Planned Parenthood Federation and the International Council on Alcohol and Addictions. The agenda appears in Annex 1 and the list of representatives in Annex 2. At its first plenary session, the Committee established a Sub- Committee on Programme and Budget, composed of representatives of the following countries: Australia, the People's Republic of China, Fiji, France, Japan, New Zealand, the Republic of Korea, the Republic of Viet-Nam and the United Kingdom. Further details are given in Part II of this report. In the course of eight plenary sessions, the Committee adopted 16 resolutions which are set out in Part IV. 2 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION PART 1. ANNUAL REPORT OF THE REGIONAL DIRECTOR COVERING THE PERIOD 1 JULY lq72 TO 30 JUNE 1973 The Committee noted that the strengthening of the basic health services so that these were available to the people living in the most remote areas was the primary objective of the WHO-assisted health programme in all developing countries. Limitations in resources and technical personnel made it imperative for governments to review existing resources, assess their needs, establish priorities and draw up realistic plans so that WHO resources could be deployed in the proper direction. For this reason, particular attention continued to be given to national health planning. IVHO was now trying to develop a health planning methodology which would meet the requirements of developing countries within the Region. A draft of a health planning manual had already been prepared. Health practice research was another method being employed in some countries to obtain information on the strength or weaknesses of the health services. Attention was also being focused on the management of projects. One ,If the techniques being developed in this area was project systems analysis. The three project formulation exercises carried out in the Philippines, Singapore and Malaysia in 1971 had been reviewed. Plans were now being made to hold a workshop towards the end of this year to consider how techniques could be simplified and to determine better ways of introducing this method to governments. Studies were in progress to determine whether the project systems analysis concept could be used in pJanning WHO assistance. Rapid population growth and overpopulation were considered to be the major threats to health for the majority of the people of the developing world. At one time family planning services had been considered an activity outside of the basic health services. Country appraisals had led to the development of more comprehensive projects of a multidisciplinary nature, and the concept of family health inter-linking maternal and child health, family planning, nutrition and health education had gained much wider acceptance. The need to build up the nutritional status and resistance of the individual, to strengthen the management of pregnancy, including family planning, and to improve the prevention and management of infectious diseases in the child was being emphasized. Health education was essential if health programmes were to be successful. A new activity during the period under review had been the production of educational materials for use in family health programmes. These had been developed in cooperation with various experts and agencies interested in family planning, community development, education, extension work/communications, and the social and economic aspects of family health. This integrated approach had increased interest in family planning and provided a broader basis for future work. The Committee noted that the long-term inter-country programme on health laboratory services, which had been approved by the Committee at its twenty-second session (resolution WPR/RC22.Rl9), had gained momentum. REPORT OF THE REGIONAL COMMITTEE 3 ,. __ ._-------- The production and control of biologicals were ... ere being improved. The material collected by a consultant for the Directory of Medical and Allied Laboratories in countries and territories of the Region had been consolidated and the Directory should be available for distribution next year. A number of countries were now participating in the inter-regional programme of quality control in clinical biochemistry organized by Head- quarters with the assistance of the Center for Disease Control, Atlanta. There was also increasing recognition that health laboratory services must be a component of the general health service. More laboratory support was thus being given to specialized programmf"s, particularly tll"~C related to the surveillance and control of the communicable diseases. In view of the almost universal shortage of trained health professionals, an important part of WHO's prograrrnne of assistance ,,,as the development of health manpower. A major development during the period under review had been the establishment of the Regional Teacher Training Centre in the University of New South Wales, Sydney. Aspects in this field which merited particular att.ention included the preparation of staff who would have responsibility for directing and supervising lower level categories, the adaptation of currieula to meet each country's needs, and the training of auxiliary personnel so that they may undertake multi- purpose rather than specialized work. An excellent example of how the combined efforts of governments and WlIO eould lead to success was the progress which had been made in connexion with the training of nurses in Laos. Although the communicable diseases continued to diminish in many parts of the world they still remained a major cause of mortality and morbidity in many developing countries of the Western Pacific Region. More vigorous and sustained efforts were required to combat them. For example, the re-emergence of cholera in some countries clearly stressed the need for improved sanitation, the provision of a potable water supply, and the construction of sanitary latrines. A well-organized surveillance service so that cases could be detected early and effective steps taken to control any outbreaks which should occnr was also essential. Although there had been a remarkable reduction in the mortality rate of tuberculosis in many countries and this had been accompanied by a considerable decline in morbidity, severity and infection rates, this was not, unfortunately, the case everywhere because the new experience and techniques available were not being used. Attention was drawn to the tuberculosis control programme in the Republic of Korea which demonstrated the effectiveness of BCG vaccination, case-finding by simple sputum examination, and ambulatory treatment when applied on a mass scale. The COmmittee recalled that a lO-year programme of WHO assistance in dental health had been initiated during the twelfth session of the Regional Committee, which had also been held in Wellington. This had culminated in the WHO regional workshop on dental health services held in Singapore in May 1972. The lO-year fact-finning period had given way to the period of implementation of dental health programmes. Greater emphasis was being placed on the development of preventive programmes in dentistry. At the same time, new thoughts were emerging as far as the inter-country prograrrnne was concerned. 4 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION The Committee noted that during the period under review, WHO had provided a broad range of technical assistance in the field of environ- mental health. The first seminar in the long-term inter-country programme in environmental pollution, approved by the Committee at its twenty-third session (resolution WPR/RC23.Rl7), had taken place in May 1973. This had promoted a very successful exchange of ideas on air pollution which had led to the formulation of a considerable number of conclusions and of suggestions for regional action. The Organization was now studying means for the expansion and acceleration of the long-term programme through the organization of working groups and training courses on special aspects and a general high-level review of the position of governments vis-a-vis environmental pollution. In the ensuing discussions, 12 representatives took part. Appre- ciation was expressed of the work accomplished by the Director and staff of the Regional Office. One representative referred to the problem of malnutrition in island communities and expressed the hope that WHO would continue to support investigations in this field. Another noted particularly the attention being given to improving the quality of overall health programmes in the Region, especially as regards management techniques. The need to develop health information services was also mentioned. Information was presented on the WHO-assisted operational study on rural health in Malaysia, as a result of which a new category of health personnel had evolved, the community nurse who would eventually replace the midwives attached to the midwifery clinics. Her duties would be multi- disciplinary and include midwifery work, the provision of preventive health services and minor medical treatment. The Committee was also informed that a study was being carried out with WHO assistance in another country to determine whether the health programme was meeting the basic needs of the people, whether the health staff were being fully utilized and which were the priority items within the total programme. The progress being made in the control of filariasis in Western Samoa was mentioned. Although the microfilaria carrier rate had decreased and the density of microfilaria in the blood of carriers had been reduced to a low level, it was too early to state that the battle against filariasis had been won. It was hoped that with the continued assistance of WHO a solution to the problem would be found that would benefit also other countries where this infection was a public health problem. The Committee was also informed that the National Malaria Eradication Centre in the Philippines, which had been upgraded with WHO assistance, was now in a position to train professional and sub-professional staff not only in the Philippines but also from other countries in the Region. The Committee adopted a resolution noting with satisfaction the manner in which the programme had been planned and carried out during the period under review and congratulating the Regional Director on the preparation of a comprehensive report (see resolution WPR/RC24.Rl). • REPORT OF THE REGIONAL COMMITTEE PART II. PROPOSED PROGRAMME AND BUDGET FOR 1975 1 Introduction At its seventh session, the Regional Committee, in resolution WPR/RC7.R7, decided "that the establishment of a sub-committee on programme and budget, consisting of six members plus the Chairman of the Regional Committee, should become a routine activity of the Regional Committee"; and recommended that "the membership of this sub-committee be rotated among the Representatives of various Members, subject to the provision that any Representative desiring to be a member of the sub-committee should be entitled to participate". At its twenty-first session, the membership of the Sub-Committee was increased to halfl the Members in the Region. The Sub-Committee on Programme and Budget met on 30-31 August and 3 September 1973, under the chairmanship of Dr C.N. Derek Taylor. The attendance was as follows: Members in accordance with the principle of rotation: Australia China Fiji France Japan New Zealand Republic of Korea Republic of Viet-Nam 1 Dr H.M. Franklands Dr R.W. Cumming Mr R.J. Tyson Dr Chen Hai-feng Mr Chou Shan-yen Professor Shi Chen-hsin Dr Chang Kuang-hua Mr Tsao Yung-lin Dr D. Singh Dr J. Laigret Dr Teruhiko Saburi Dr Rintaro Okamoto Dr H.J.H. Hiddlestone Dr G. Blake-Palmer Dr R. Dickie Professor C.W. Dixon Dr Sung Hee Rhee Dr Sung Kyu Ahn Dr Kyong Shik Chang Dr Truong-Minh-Cac Dr Pham-Van Dr Nhan-Trung-Son "Half the Members" means that half an odd number would be the next higher full number - e.g., one half of 17 is 9. 5 6 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION United Kingdom Dr J.L. Kilgour Dr G. Choa Other members of the Committee also in attendance were: Khmer Republic Laos Malaysia Philippines Portugal Singapore United States of America Western Samoa Papua New Guinea Professeur Agrege Sok Heangsun Dr Kadeva Han Dr My Samedy Dr Phouy Phoutthasak Dr T~ao Jaisvasd Visouthiphong Tan Sri Datuk (Dr) Abdul Majid bin Ismail Dr S.K. Mukherjee Mr {'T'n bin Kayat Dr A.N. Acosta Dr J.B. Duarte Pinheira Dr L. Amarchande Dr Ho Guan Lim Dr J. C. King Mr F.S. Cruz Dr M. Kumangai Dr J. Nunn Honourable Seiuli Taulafo Dr J.C. Thieme Mr Faapoituulao Atoa Dr M. Wainetti Representatives of the United Nations and the United Nations Development Programme, UNICEF, South Pacific Commission, International Council on Alcohol and Addictions, International Dental Federation, International Committee of Catholic Nurses, International Council of Nurses, International Planned Parenthood Federation, International Federation of Pharmaceutical Manufacturers Associations, International Society of Radiology and the World Veterinary Association also attended. The Sub-Committee had before it the following documents: WPR/RC24/2 and Corr.l WPR/RC24/P&B/l Proposed programme and budget estimates for 1975 Suggested guidelines for the Sub-Committee on Programme and Budget WPR/RC24/P&B/2 WPR/RC24/P&B/3 WPR/RC24/P&B/4 WPR/RC24/P&B/5 WPR/RC24/P&B/6. REPORT OF THE REGIONAL COMMITTEE Budget performance 1972 - Direct services to governments of the Region by subject heading, by country and by project Proposed programme and budget estimates for 1975 (Review of the main features of the 1975 proposed programme and budget estimates and the programme changes for 1973 and 1974) Tentative projection for 1976 Proposed programme and budget estimates for 1975 (Details of consultants and fellowships provision) Modifications to the 1974 programme and budget estimates 2 Review of budget performance 1972 - direct services to. governments of the Region by subject heading, by country and by project (Document WPR/RC24/P&B/2) Dr Flache, Secretary, informed the Sub-Committee that in 1972 the overall budget percentage of obligations to the revised estimates had been 86.1%. This low rate of implementation for 1972 had resulted from the Director-General's directive not to obligate a total of US$718 784 which had been provided for the following programmes: undelivered programme in the Province of Taiwan (China), $130 894, and activities not related to any specific subject heading, $587 890. When this amount which could not be delivered was taken into account, 96.7% of the revised estimates had been implemented. The differences between the planned and delivered programmes had resulted from changes in government priorities, unexpected delays in recruitment, the advance awarding of fellowships, and other reasons beyond the control of the Regional Director. In SOme cases, the percentages of increase or decrease shown against some of the subject headings might seem excessive but a detailed examination of the actual amounts involved would show that they were relatively minimal. The Representative of Australia asked for information on the amount of $587 890 not obligated and identified as "Activities not related to any Subject Heading". Miss Newton, Chief, Administration and Finance, stated that the amount had been frozen by the Director-General for the purpose of giving assistance to the People's Republic of China following the 7 8 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION decision of the World Health Assembly of 1972. Those funds had not been obligated for that purpose in 1972 and had not been available for any other activity. 3 Modifications to the 1973 and 1974 regular programme and budget estimates (Paragraph 3 and Annexes 1 and 2 of Documents WPR/RC24/P&B/3 and WPR/RC24/P&B/6) Dr Flache, Secretary, drew the attention of the Sub-Committee to Annexes 1 and 2 of document WPR/RC24/P&B/3 which contained information on the differences between the original and the revised estimates for the two years. These reflected the revised situation based on actual performance and the changes requested by governments. In the present stage of development of some countries, and as techniques developed and became more sophisticated, some changes in the originally foreseen progranune became inevitable. Other changes became necessary as priorities changed in various programmes. The attention of the Sub-Committee was then drawn to resolution WHA26.41, the Appropriation Resolution for the Financial Year 1973. The provisions of this resolution allowed little flexibility for transfers between Appropriation Sections. The appropriations under these sections could not be exceeded and any changes requested had to be submitted to the Director-General for his decision. The Director-General was authorized to make transfers between sections only up to an amount not exceeding 10% of that appropriated for the Appropriation Section from which the transfer was made. All transfers between sections had to be reported to the Executive Board. The importance of governments bearing this fact in mind when they requested changes to the approved progranune was emphasized. The Sub-Committee noted that the estimates for the Regional Office in 1973 and 1974 were US$205 916 and $253 823 more than envisaged last year, as a result of the transfer of the four posts of assistant directors of health services and five secretaries from Public Health Services to the Regional Office, because of the changes made in the programme classification structure. The estimated cost of Regional Advisers in 1973 and 1974 was US$317 697 and $278 577 less than that reported last year,' as a result of the transfers mentioned above. In addition, the local staff salary scales and post adjustment levels for professional staff had not increased at the rates calculated when the estimates had been prepared last year. The estimated cost of WHO Representatives for 1973 and 1974 was US$21 899 and $19 426 less than the amount provided last year. The decrease had resulted from a reduction in the post adjustment rates for the Khmer Republic, Laos and the Republic of Viet-Nam, following changes in the rates of currency exchange in these countries. REPORT OF THE REGIONAL COMMITTEE A particular activity affected by programme changes was the fellowship programme. It was appreciated that because of changes in priorities, or because of difficulties encountered in finding suitable candidates for a designated fellowship in the programme and budget, governments often had very good reasons for requesting changes in the field of study. If possible under budgetary regulations, and if technically supportable, WHO endeavoured to meet all such requests. However, in some cases, changes in fellowships were requested late in the year, resulting in considerable difficulty in effecting placement in time to have the award processed within the budgetary period. It would greatly facilitate the work of the Fellowships Unit in the Regional Office if governments would request such changes well in advance and preferably along with advice of any other programme changes early in the year prior to the implementing year. The attention of the Sub-Committee was then drawn to the following changes recently requested by Fiji and the Republic of Viet-Nam: (a) Deletion in 1974 of the following fellowships: six months in dental technology, 24 months in radiology, 12 months in dermatology and 12 months in medicine. (b) Inclusion in 1974 of the following fellowships: six and 12 months for a diploma in dental public health, 12 months for a master's degree in anatomy, 12 months for a primary examination for an F.R.A.C.S. and 12 months for a diploma in child health. Republic of Viet-Nam (a) Deletion in 1974 of the following fellowships: in epidemiology, 12 months in health laboratory services months in dental health. 12 months and 12 (b) Inclusion in 1974 of the following fellowships: two for six months, one in zoology, and the other in the epidemiology of communicable diseases, two for six months in microbiology and four for t.hree months in dental health. Statements made during the discussion on specific country programmes French Polynesia The Representative of France pointed out that a WHO consultant in metabolic diseases was now working in French PolyneSia. The duration of the original assignment had been three months. Both the Administra- tion and the consultant would prefer to have this provision divided into two one-and-a half-month consultantships, one in 1973 and the other in 1974. 1 9 10 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION Papua New Guinea The Representative of Papua New Guinea said that his Government wished to have the assignment of the technical officer attached to the educa~ion and training advisory services project /HMn/04 (formerly 64011/ extended for another year. - Western Samoa The Representative of Western Samoa stated that the post of WHO medical officer for the tuberculosis control project had been originally requested for 1972 and 1973. The post had, however, only been filled for 13 months by two short-term consultants and since January 1973 no WHO staff had been assigned to the project. The project required considerable improvement and the advisory services of a WHO medical officer would be required fOl some 10 to 12 months. It was hoped, therefore, that in the consideration of modifications to the 1974 regular programme and budget, provision could be made for the continua- tion of a WHO medical officer for up to 12 months. General discussion Some representatives questioned the differences in amounts between the document which had been before the Regional Committee last year and the amounts shown in document WPR/RC24/2. It was pointed out that in accordance with Article 55 of the Constitution, it is the responsibility of the Director-General to prepare and submit to the Executive Board the annual budget estimates of the Organization. Article 50 of the Constitution defines the functions of the Regional Committee, which include, inter-alia, functions which may be delegated to the Committee by the Director-General. The Director- General had delegated to the Regional Committee the ~esponsibility of reviewing and making recommendations to him on the regional programme and budget proposed by the Regional Director. Proposals prepared by the Regional Director and reviewed by the Regional Committee may be amended or adjusted by Headquarters, either in contents or in costing, before they are included in the Director-Genera1's proposed programme and budget. For the 1973 programme and budget, the Regional Committee had had before it in 1971 an amount of US$185 582 as the estimated cost of the proposed programme for China. The amount now included in the 1973 column of the Director-General's Programme and Budget Estimates for ]974 (Official Records No. 204) is $661 500. Ibe Regional Committee in 1972, when it considered the proposed programme and budget for 1974, had had before it a document which showed no amount for China. The figure which appears in Official Records No. 204 for 1974 is $900 000. REPORT OF THE REGIONAL COMMITTEE In addition, both the 1973 and 1974 columns of the 1975 programme and budget had been revised and recosted in the light of the latest available information at the time the document had been prepared. The following information was later submitted to the Sub- Committee: The total estimated costs shown in the summary on page 1 of document WPR/RC23/2, Proposed Programme and Budget Estimates for 1974, for the 1974 programme to be financed from the regular budget was US$7 815 692. The amount shown in the summary on page 15 of document WPR/RC24/2, Proposed Programme and Budget Estimates for 1975, for the 1974 programme is $8 640 800, a difference of $825 108. The difference comprises the following elements: (a) Estimated costs of the programme for China (b) Difference in estimated costs for the Regional Committee (c) Recosting of various elements of the programme $800 000 24 800 308 US$825 108 For a comparison with the estimated costs of the 1974 programme 11 as considered by the Twenty-sixth World Health Assembly in May of 1973, the estimated costs shown in Official Records No. 204 Proposed Programme and Budget Estimates for the Financial Year 1 January - 31 December 1974, page 130, is US$8 715 675 and includes an amount of $900 000 for the programme in China. Leaving aside the estimated costs for China, the amount is $7 815 675 - a difference of $17, as compared to the amount shown in document WPR/RC23/2 of the 1972 Committee, which would have resulted from various recostings when Headquarters prepared the Director-General's Proposed Programme and Budget Estimates for the Financial Year 1 January - 31 December 1974. 4 et estimates for 1975 and paragraphs 1 and 4.1 General observations The Sub-Committee noted that the form of presentation of the Proposed Programme and Budget Estimates for 1975 had been substantially changed as a result of the decision of the Twenty-fifth World Health Assembly in its Resolution WHA25.23 of May 1972. It was essentially more programme-oriented than in previous years and a statement of the programme objectives in the various fields should permit an easier evaluation of the progress made. The main innovations were as follows: firstly, the new programme classification structure, which is based on 12 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION the Organization's Fifth General Programme of Work covering the period 1973 to 1977, with the principal programme objectives reflected in separate appropriation sections; and secondly, a series of programme statements of the activities assisted by the Organization. These consist of regional programme and sub-programme statements, country programme statements and functional statements concerning support to regional programmes. The country programme statements contain information on the present situation, objectives to be attained, and how targets were to be realized. Pages 1-9 of the document contain the Regional Director's programme statement, an overall view of the activities in the Region and future trends of the health programme. Page 10 contains a summary of the Regional Health Programme: Estimated Obligations by Source of Funds. The Summaries by Programme and Source of Funds appear on pages 11-15 and those by Programme and Organizational Level on pages 16-19. Pages 20-140 give the Programme and Sub-Programme Statements by appropriation sections, a completely new presentation. The Annexes contained on pages 141-158 start with a Summary of Services and Assistance to Governments, followed by Estimates for the Regional Office, Regional Advisers and WHO Representatives. Although this information had appeared in past regional programme and budget estimates, the manner in which it was established this year had been modified. The Country Programme Statements appear on pages 160-332, together with tabulations indicating the budgetary estimates for various projects. Pages 334-358 consist of a tabulation of the inter- country programme. Although there are no project narratives for these programmes, the activities which should be carried out are described in the programme and sub-programme statements included in the first half of the document. The green pages (Annex VI)" list the projects requested by governments which could not be accommodated within the budgetary allocation for the Region. The yellow pages (Annex VII) list the projects currently under negotiation for financing by UNDP or UNFPA. The Sub-Committee noted that the summary by programme and source of funds on pages 11-15 under the various Appropriation Sections was different from that used in the past. Appropriation Section 1 relates to the costs of the Regional Committee, which were being presented to the Committee for the first time this year. Appropriation Section 2 covers the Office of the Regional Director, including its Liaison and Reports Office. Appropriation Sections 3.1 through 7.2 provide for country and inter-country projects and the posts of Regional Advisers. Appropriation Section 8 did not appear in the document, as it related only to Headquarters activities. Appropriation Section 9 is subdivided into four subsections: 9.1.6, Programme Planning and Direction, which included the Office of the Director of Health Services and the Assistant Directors of Health Services; 9.2.6 covers the offices of the WHO Representatives; 9.3.6 is for General Support Services which include the administrative and financial services; and 9.4.6 covers the cost of Common Services, including maintenance of buildings and grounds, costs of utilities and communications, and general support items. REPORT OF THE REGIONAL COMMITTEE l3 Since details of fellowships and consultants were not included in the new budget presentation, a working paper provided detailed information on these provisions. 4.2 Analysis of general programme trends The total regular budget proposals for 1975 were estimated at US$9 620 000 as compared to $8 640 800 for 1974 and $7 520 839 for 1973, an increase of $979 200 or 11.33% over 1974. Of the total increase of $979 200 in 1975 over 1974, $873 624 (89%) was devoted to field activities,while the remaining 11% was required to cover the increases in the statutory and other costs of the Regional and WHO Representatives' offices. The budget for country projects had increased from US$5 199 597 in 1974 to $5 781202 in 1975, i.e., $581 605 or 11.19%. A sum of $1 470 143 had been proposed for the inter-country programme as compared to $1 213 533 for 1974, an increase of 21.15%. If the total budget comprising regular funds, as well as funds from other sources - including UNDP and UNFPA - was considered, there appeared to be a considerable decrease in 1974 and 1975 in assistance from extra-budgetary sources of funds. However, the Sub-Committee noted that only the few projects for which firm financial commitments had been made by UNDP and UNFPA had been listed in the main budget, as the budgetary cycle of these- agencies differed "from that of WHO. A special annex had been prepared listing those projects for which it was hoped funds would eventually be provided. However, even if funds were provided by UNDP and UNFPA to cover all these projects, the total assistance which might be provided would be only approximately $13 000 000 for 1975, i.e., no higher than that for each of the preceding years, 1973 and 1974. Thus, the proposed increase of 11% in the regular budget would be offset by the decrease in external assistance. This was a very unfortunate trend which the Sub-Committee hoped that ministries of health would try to reverse. In addition to funds expected to be provided by UNDP and UNFPA, some resources were available from the Voluntary Fund for Health Promotion - for example, the 1973 estimates included the sum of US$l 451 845 for construction of the National Institute of Health in Saigon and considerably smaller amounts had been, and would continue to be, made available for various activities, such as leprosy control, from this source of funds. 4.3 Regional Director's Programme Statement (pages 1-9) Regional programme and sub-programme statements, summaries by programme and source of funds and schedules (pages 10-142) The Sub-Committee noted that the programme trends were in line with the principles and criteria of the Fourth Regional Programme of Work which had been adopted by the Committee and were the result of a continuous and fruitful dialogue with governments. In this dialogue, WHO tried to play an active part - again, in accordance with the wishes of the Committee - in pointing out to governments the merits of certain 14 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION project proposals. In view of the limited resources available, only the more urgent needs of countries could be accommodated in the regional programme and budget estimates. WHO assistance was intended to supplement and not to substitute for the government's own efforts. The programme, Strengthening of Health Services, would continue to be a major priority in the regional programme in 1975. The assistance planned was designed to help governments increase the effectiveness and efficiency of their health and medical services. Assistance in planning and organizing health services at va~ious levels - such as health planning courses, provision of consultant services, and advice in management aspects which might be associated with certain studies - for example, health practice research and systems analysis - was also included under this section. In terms of budget, an increase of 14.97% over 1974 was proposed for 1975 (US$2 436 086 for 1975, as compared to $2 142 377 for 1974). A substantial increase of 25.6% over 1974 was provided for health laboratory services which were classified under this heading. The demand for assistance in the strengthening and establishment of health laboratory services was considered fully justified as it corresponded to the urgent needs of a number of developing countries in the Region. The programme for Family Health grouped the programme areas of maternal and child health, family planning, nutrition, and health education and there would be close collaboration with other health services. The priority areas would continue to include the reduction of maternal, perinatal, infant and child mortality and morbidity, and problems of nutritional deficiency diseases, particularly protein- calorie malnutrition and nutritional anaemia. This programme had been given a high priority in view of the many requests for assistance received from governments. The sum of US$350 831 was proposed for the family health programme in 1975, an increase of 32.16% over 1974. Out of this total, there was an increase of 75.77% for health education alone. For Health Manpower Development, a sum of US$2 024 345 was proposed for 1975, an increase of 5.22% over 1974. Priority was given to teacher training and it was hoped that by 1975 a number of countries in the Region would have established their own national teacher training centres. Communicable Diseases Prevention and Control continued to be a major health priority in the Region; while it would, as in the past, receive close attention, no dramatic changes in financial support were expected. Following the closure of the International Malaria Eradication Training Centre, Manila, malaria training activities in the Region would be undertaken by national malaria training centres located in Manila, Kuala Lumpur, Madang (Papua New Guinea) and the National Institute of Public Health in Saigon. WHO would support activities in all these centres by providing consultants, teaching material and fellowships through the inter-country project. REPORT OF THE REGIONAL COMMITTEE The Non-Communicable Diseases Prevention and Control programme reflected a considerable increase in activities in 1975, i.e., US$323 155 in 1975 as compared to $165 750 in 1974. This mainly resulted from the increasing importance attached to the prevention and control of alcoholism and drug abuse, the allocation for this activity having increased from $20 100 in 1974 to $145 700 in 1975. The allocation for Pro h lactic and Thera eutic Substances had decreased in 1975 to US$12 200, as compared to 19 600 in 1974. The reason for this trend was that governments tended to merge programmes for prophylactic and therapeutic substances with those of food and drug administrations, particularly at the inspectorate and supervisory level. UNDP, which was responsible largely for funding the pharmaceutical and drug quality control component of this programme, now seemed to be losing interest in the undertaking. No specific requests had been received by WHO for assistance to this sub-programme in 1975. In the Promotion of Environmental Health programme, the control of environmental pollution and hazards and the establishment and strengthening of environmental health services and institutions were expected to acquire greater importance, as reflected by the requests received for assistance in these fields. The sum of US$890 189 was proposed for 1975 as compared to $811 537 for 1974, an increase of 9.69%. In the Health Statistics programme, continuing assistance would be given to developing the structural framework and procedures 15 required for the accurate and comprehensive recording and interpretation of data on national vital and health statistics. In accordance with 'the wishes of the Committee, particular attention had been given to the inter-country programme, as this type of assistance allowed a more economical channelling of resources, and more than one country benefitted from the advisory services thus provided. This was especially true for the South Pacific area where country programmes were small and would not justify individual projects. Inter-country group educational activities provided an opportunity for a common forum where problems and solutions of mutual concern could be best discussed. The Sub-Committee noted that the type of assistance proposed varied in accordance with the stage of social and economic development of the countries concerned. Thus, for the most highly developed countries, a few fellowships in highly specialized fields were sufficient, although some needed assistance in medical specialties to develop their own centres of excellence. The majority of the developing countries, however, needed assistance which placed emphasis on the basic health programmes, the control and prevention of diseases, and improvement of training for all categories of health workers. Urbanization and industrialization in some areas of the Region called for specialized advice in the promotion of environmental and occupational health activities. 16 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION The trend to provide more WHO short-term consultants instead of long-term advisers, particularly in the case of teaching institutions, such as medical schools, schools of public health, etc., would continue. As institutions became better able to provide their own teaching staff, long-term staff were no longer required. The increasing number of well- trained national staff meant that activities could continue satisfactorily \>lith only the advice of short-term consultants. A total of 389 consultant months had been planned for 1975, as compared to some 356 consultant months in 1974. Provision had been made for 372 fellowships in 1975 at a total cost of US$l 886 600, as compared to $1 478 840 for 292 fellowships in 1974, an increase of 27%. Of the 213 projects proposed, 62 were new and represented 11% of the total budgetary estimates. 4.4 Regional Office (pages 144-148) Regional Advisers and WHO Representatives (pages 150-158) The Sub-Committee noted that the increase of 9% for the Regional Office covered the increased cost of existing posts, the addition of the posts of conference officer and secretary, to deal with the increasing workload required in the preparation of educational meetings and seminars, and of three clerical posts for the general support services. These were considered essential because of the increase in the activities of the Region. It was noted that the increase of 5.3% for Regional Advisers and 4.98% for WHO Representatives covered the cost of existing posts and the establishment of four clerical posts, two under Regional Advisers and two under WHO Representatives. The Sub-Committee was pleased to note that emphasis was being laid on improving the quality of programmes and that the WHO Regional Programme Committee would continue to advise the Regional Director on programme matters, the utilization of savings, the evaluation of projects and the formulation of priorities. Country review meetings, alternating with reviews of the sectoral programme, were now being held periodically in the Regional Office, and would continue in 1975, constituting a source whereby an exchange of views was possible and resulting in a better evaluation of country programme needs. The Regional Director, with some of the senior staff, would continue to carry out special missions to countries in order to evaluate country programmes on the spot, to review with the governments various aspects of WHO-assisted projects, or to make such adjustments to objectives and methods which might be necessary. It was also noted that the IlliO Representatives' role in assisting governments was being strengthened and their responsibilities increased. REPORT OF THE REGIONAL COMMITTEE 4.5 Field activities, including inter-country projects (pages 160- 358 and document WPR/RC24/P&B/5) 4.5.1 Review of individual country statements (pages 160-332) 4 • 5 .1. 1 China One representative noted that only a blanket figure had been entered for China and asked for elucidation in view of the Regional Director's statement that he had been negotiating with the Government of that country. The Regional Director replied that at the WHO Assembly this year arrangements had been made for him to visit Peking. This visit had taken place in July 1973 when he had had discussions with the Ministry of Health. China was now considering the type of assistance it would like WHO to provide, probably training of staff abroad, the provision of equipment and supplies for laboratories, hospitals, etc., and assistance with research activities. 4.5.2 -Other obs-ervations Several representatives expressed their satisfaction at the new presentation of the regional programme and budget, following the decision of the Health Assembly in its resolution WHA25.23. They found the presentation more useful and informative than that of previous years, particularly the introductions to the country programmes and Annex VII (the yellow pages), which provided a useful analysis of funds requested from sources other than the regular budget. The Representative of the United States of America expressed his pleasure at noting the increased emphasis placed on health laboratory services, maternal and child health, nutrition, malaria, and the development of health statistics, all of which were basic priorities of the Region. The immediate increase in the field of drug abuse was also appreciated. On the other hand, the increases for mental health and air pollution appeared to be insufficient to meet regional priorities. He expressed concern at the 79% decrease in funds for venereal disease control which the Regional Director had previously stated to be of major importance. The same representative pointed out that in his programme statement, the Regional Director had stated that "the trend towards an increase in inter-country activities would continue". This was so in real money terms, but as a percentage of the budget no increase had occurred since 1973 when inter-country activities amounted to 15.3% of the total; in 1974 - 14.1%; and in 1975 - 15.4%. It was hoped that this aspect would improve. He also noted that external sources of funds showed a reduction of 81% from 1973. He hoped that Member governments would see that this situation was reversed now that it had been brought to their attention. Although some items showed a very small increase or 17 18 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION decrease, in total they could be massive, for example thene was a 456% increase in the environmental pollution item although in monetary terms the increase was only from US$16 000 to $89 000. The same representative expressed concern that the rate of increase in the Region appeared greater than for WHO as a whole, although he recognized that the actual increases were small considering the diverse conditions in the Region. The savings made by the Regional Director were also recognized. He urged the Regional Director to review the total budget for 1975, so as to reduce the rate of increase in all appropriation sections. The budget did not appear to reflect the exigencies of the financial and monetary difficulties presently facing the world community. Moreover, the increase of 11.33% was higher than his Government was generally willing to support in the international organizations in which it participated. His delegation therefore felt obliged to abstain from voting on the programme and budget if presented in the existing form. The Committee noted that any savings which occurred were used to promote the most urgent items in the List of Additional Projects. The mental health and pollution programmes were not as sophisticated as they appeared and, although mental health had been increased by 133% in money terms, the increase was only from US$6500 for 1974, to $15 200 for 1975. The Regional Director had many times expressed concern at the inactivity in the venereal disease programme but was unable to go beyond inviting governments to submit requests for assistance which the Regional Office would be glad to include in its regular budget. The Regional Director referred to the suggestion of the Representative of the United States of America that the Regional Director review the costs of his total proposed programme with a view to reducing them. Members would know that the amount of the allocation gLven to the Regional Director was the prerogative of the Director- General, who must have considered it proper to provide this region \,ith an 11. 3% increase as compared to 1974. This probably meant that another region or Headquarters itself would have suffered an off- "'otting reduction. The Regional Director suggested that the increase "aJ bee.n allowed because the Director-General realized there was a Dressing need for additional assistance or perhaps because this region's record of delivery of the planned programme was good. A reduction in the cost of the Regional Director's proposed programme would not mean a reduction in the estimates for the whole Organization as savings could be programmed elsewhere. The Regional Director considered that this region was therefore fortunate to have an increase exceeding that which was likely to be proposed for the Organization as a whole. The delegation of Australia considered that the explanation by the Regional Director had done much to answer whatever doubts it had about the levels of increase. Although some doubts still existed to some extent, it agreed that the increase was required mainly because of the smaller proportion of funds raised from external sources. REPORT OF THE REGIONAL COMMITTEE The Representative of Japan said that as the increase in the budget resulted from the worldwide trend of inflation and the devaluation of th.e United States dollar he accepted it without objection. 4.6 Consideration of the 1974 and 1975 Lists of Additional Projects (pages 360-392) 19 The Sub-Committee noted that requests totalling US$l 973 305 for 1974 and $1 753 705 for 1975 had had to be placed in the Lists of Additional Projects. They could not be accommodated in the budget estimates because of limitation of funds, although they were technically valid. The Sub-Committee noted that since the document had been finalized, the following additional requests had been received: Malaysia The deletion of a 24-month fellowship in postbasic nursing and midwifery education in 1974 lkMD/02 (formerly 4401)]; the deletion of a 24-month fellowship and a lO-month fellowship for a master in public health majoring in MCH nursing in 1975 LHMD/02 (formerly 4401)] • New Caledonia The provision of two 28-month fellowships for dental nurses. Philippines The provision of a two-month consultant in 1974 to train staff at the Alabang Laboratories in the production of LEP rabies vaccine. Republic of Viet-Nam The inclusion of two fellowships in water agency management in 1974. The Sub-Committee noted that these requests would be placed in the List of Additional Projects for the year concerned. The following additional requests were made during the meeting of the Sub-Committee: Australia The inclusion in the 1974 List of Additional Projects of a nursing consultant for three months to assist in the planning and development of a postbasic nursing course in the community health care of indigenous peoples. French Polynesia The inclusion of: (a) a two-year fellowship in 1975 and 1976 to allow a health educator to obtain an MPH degree at Hawaii University, the studies starting in 1975; 20 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION (b) two fellowships in 1974, one for a health educator for training in Wellington, and the other for a dental hygienist who would be engaged in health education activities. Khmer Republic The inclusion in 1974 of the post of occupational therapist for the rehabilitation of the physically handicapped project [STR/02 (formerly 4801)] and a consultant in rheumatic heart diseases. Laos The inclusion in 1974 of the following: (a) for the Royal School of Medicine ~HMD/Ol (formerly 6201)-', three consultant months in the teaching of mental hygiene and a six- month fellowship in the teaching of anatomy for a medical officer with a French educational background; (b) a one-year fellowship in public health; (c) a one-year fellowship to allow a male nurse to obtain post-graduate training in public health; (d) a six to l2-month fellowship in the organization of medical care. Malaysia The inclusion in 1975 of the following assistance for the National Institute of Orthopaedics [STR/03 (formerly 4801)]: (a) a tutor in orthopaedic nursing for 12 months; (b) two l2-month consultantships to assist in establishing research and training programmes. Philippines The inclusion in 1974 of: (a) a consultant to assist in developing a drug education programme integrated with health education; (b) two 24-month fellowships for he_alth care administration \vith emphasis on health information systems; (c) two six-month fellowships in national health planning; (d) for the Institute of Public Health: (i) a l2-month fellowship in biostatistics, (ii) a l2-month fellowship in pharmacology, REPORT OF THE REGIONAL COMMITTEE (iii) a 12-month fellowship in physiological hygiene wi th emph,:s is on_ toxicolo.~y, and (iv) three three-month fellowships in public health nursing, mother and child health, and microbiology. The inclusion in 1975 of: (a) a 12-month fellowship in biostatistics, (b) a 12-month fe110ws&ip in parasitology, (c) a 12-month fellowship in public health nursing, (d) a 24-month fellowship in public health engineering, . (e) three three-month travel grants· for nutrition, parasitology and biostatistics. Republic of Viet-Nam 21 The inclusion in 1974 of two three-month fellowships in administration of water supply (for training in the United States of America). The Sub-Committee noted these would be placed in the List of Additional Projects for the year concerned. 4.7 Consideration of the 1973, 1974 and 1975 Lists of Projects expected to be financed by UNDP or UNFPA (pages 394-409) The Sub-Committee was informed that since the proposed programme and budget estimates had been finalized, the project documents for the nursing education project (HMD/02) in Laos covering assistance through 1974 and for the national health services development project (STR/01), in Western Samoa covering assistance through 1975, had been signed. The Sub-Committee noted again the unfavourable decrease noticed in the assistance being provided by UNDP. The decision concerning UNDP funds allocated to countries was largely in the hands of the governments themselves, and it was of utmost importance for ministries of health to stress this point adequately to their national coordinating authorities who gave the final word to UNDP on the subject. WHO was at the disposal of health ministries to provide any assistance in the formulation of requests, but the ultimate criteria for the allocation of UNDP funds were related to the place that health programmes occupied in the governments' priorities. 5 The Sub-Committee noted that the tentative projection had been prepared in response to the World Health Assembly resolution dealing inter alia with biennial programming (resolution WHA22. 53) • In the projection prepared for 1976, account had been taken of the following 22 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION elements: (a) continuation of existing activities; (b) anticipated increase in cost of the existing personnel; (c) deletion of projects expected to terminate in 1975; and (d) the priorities expressed by governments when they submitted their requests for 1975. For this purpose, the Director-General provided each Region with a tentative allocation for the year succeeding the programme and budget year under review. The tentative allocation for the year 1976 for this region was US$10 300 000. Annex 1 of the document had been prepared on the basis of the priorities established by governments for assistance in 1976. In accordance with the decision in resolution WHA26.38 adopted by the Twenty-sixth World Health Assembly in 1973, the Proposed Programme and Budget Estimates would be prepared on a biennial basis commencing with the biennium 1976/1977. However, pending the approval of Member governments of the amendments to Articles 34 and 55 of the Constitution, the World Health Assembly would approve only that portion of the biennial budget which corresponded to the next financial year. 6 Resolutions The Committee adopted the following four resolutions in connexion with the programme and budget estimates: Budget performance 1972 - Direct services to governments (resolution WPR/RC24.R11) Modifications made to the 1973 and 1974 programme and budget estimates (resolution WPR/RC24.R12) Proposed programme and budget estimates for 1975 (resolution WPR/RC24. R13) Tentative projection for 1976 (resolution WPR/RC24.R14) REPORT OF THE REGIONAL COMMITTEE PART III. OTHER MATTERS 1 Celebration of the Twenty-fifth anniversary of the World Health Organization The afternoon of Tuesday, 28 August 1973 was set aside for the celebration of the Twenty-fifth Anniversary of the World Health Organization. Statements were made by Representatives of 14 Member States, the Representative of Papua New Guinea, an Associate Member, and the Director- General of the World Health Organization. These statements were reproduced in full in a special brochure issued to commemorate the celebration of the Twenty-fifth Anniversary of the World Health Organization in the Western Pacific Region. Copies of a special publication describing some of the major accomplishments in the Region during the past 25 years were also distributed. 2 Resolutions of regional interest adopted by the Twenty-sixth World Health Assembly (Document WPR/RC24/4) The Committee considered the following resolutions: Twenty-fifth anniversary of the World Health Organization (resolution WHA26.3) Smallpox eradication programme (resolution WHA26.29) Organizational study on methods of promoting the development of basic health services (resolution WHA26.35) Coordination within the United Nations system: general matters (resolution WHA26.49) Drug dependence (resolution WHA26.52) Committee on International Surveillance of Communicable Diseases (resolution WHA26.54) Additional regulations of 23 May 1973 amending the International Health Regulations (1969), in particular with respect to Articles 1, 21, 63-71 and 92 (resolution WHA26.55) Urgent need for suspension of testing of nuclear weapons (resolution WHA26.57) WHO's human health and environment programme (resolution WHA26.58) Development of environmental manpower (resolution WHA26.59) (See resolution WPR/RC24.R2). 24 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION A summary of the comments made on specific resolutions is given below. 2.1 Committee on International Surveillance of Communicable Diseases (resolution WHA26.54) The Committee was informed that the Government of the United Kingdom fully endorsed this resolution which had resulted in the removal of an irrational requirement regarding cholera. 2.2 Additional regulations of 23 May 1973 amending the International Health Regulations (1969), in particular with respect to Articles 1, 21, 63-71 and 92 (resolution WHA26.55) The Committee noted that the Government of Japan had accepted thE's,,' additional regulations without reservation, as the joint Japan/Philippines I WHO cholera E1 Tor study and the Cholera Working Group under the Japan/ United States of America Cooperative Medical Science Program had provided new knowledge on many aspects of cholera control. The adoption of the new regulations meant the abolition of unnecessary quarantine procedures which had been imposed on travellers from abroad. 2.3 Development of environmental manpower (resolution WHA26.59) Two representatives spoke to this resolution. They considered that training in this field was of paramount importance. 2.4 Coordination within the United Nations system: general matters (resolution WHA26.49) The Committee noted that resolution 2975 XXVII of the United Nations General Assembly and resolution WHA26.49 of the World Health Assembly placed emphasis on country programming, project implementation, and the essential participation of countries in improving delivery capacity. As noted by the Committee on a number of occasions, there had been a continuing decrease in the funds allocated by UNDP. It was, therefore, important to ensure that the proposals made by the authorities found a place in the overall country programme and that projects once approved would be implemented expeditiously. The Committee noted further that the Director-General had been requested to present periodically to the Executive Board reviews on activities assisted by UNDP and on the participation of the Organization in the planning and implementation of country programmes. It was hoped that governments would keep the UNDP and WHO, as executing agency of health projects, fully informed of the progress being made in implementing approved projects. WHO was prepared to help the health authorities in whatever way it could in the formulation of 'programmes ,and projects of high quality for possible UNDP financing. The Committee adopted a resolution expressing the hope that govern- ments would: (a) cooperate 'with WHO in its effort to strengthen the planning and implementation of health programmes assisted by UNDP, and REPORT OF THE REGIONAL COMMITTEE (b) keep the UNDP and WHO, as the executing agency of health projects, fully informed of the progress being made (see resolution WPR/RC24.R3). 3 Quality of drinking water on international flights (Document WPR/RC24/5) The Committee reviewed a report presented by the Regional Director summarizing the action taken in connexion with the resolution adopted 25 at its twenty-third session on Quality of Drinking Water on International Flights (WPR/RC23.RS). The Committee noted that the resolution had been referred to the Director-General who had called the attention of all Member governments to the need for improving the quality of drinking water and food on international flights and had informed them that consultation on appropriate safeguards was taking place at inter-agency level. During the discussion, attention was drawn to the study which had been carried out in Japan since 1971 in connexion with the examination of potable water, the findings of which had been reported to the Committee at its last session. The original findings had revealed a high level of physiochemical and bacteriological contamination. Although a remarkable improvement could not be reported in the studies carried out during the period January to July 1973, gradual progress could be noted from the data obtained on ammonia, nitrogen and nitrite, nitrogen or iron. Four representatives reported on the measures being enforced in their countries to ensure that the drinking water supplied to aircraft was properly and effectively treated. One representative suggested that the international standards might be extended to cover utensils, by introducing standards of sterilization, regular draining of the water supply, cleaning of tanks, etc., and perhaps by having all supplies taken only from approved suppliers, i.e., those that met the standards which had been set. Another representative referred to the investigations being carried out in Sydney in the School of Public Health and Tropical Medicine which supported the findings of the tests carried out in Japan and the statements of the other speakers. The Committee adopted a resolution urging the Director-General to bring to the attention of Member States the importance of maintaining WHO standards for potable water on airlines and the need to establish means to enforce these standards (see resolution WPR/RC24.RS). 4 Quality of food on international flights (Document WPR/RC24/8 Rev.l) The Committee reviewed a report presented by the Regional Director summarizing the action taken in connexion with the resolution adopted at its twenty-third session on Quality of Food on International Flights (WPR/RC23.Rl2). Information had been obtained from 11 countries and nine territories on (a) the safeguards currently in effect to control the sanitary quality of food served on international flights and (b) studies done in Member countries to assess the risk of food-borne diseases on international flights. An analysis of these data showed that the health 26 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION agencies in the Region played an effective role in the protection of the health of international air travellers, although in several instances improvements in the systems of inspection and control were required. As few attempts had been made in the Region to assess the risk of food- borne diseases from international flights, it was hoped that some countries might be interested in undertaking such studies. The wider use of the WHO Guide to Hygiene and Sanitation in Aviation was also recommended. A representative referred to the Regional Director's report which mentioned the outbreak of cholera in Australia in November 1972. This illustrated the potential for the gross spread of disease that a breakdown of hygiene in the preparation of one item in a meal could have a captive audience. It also indicated the need for more comprehensive standards in the selection, preparation and storage of food for inter- national flights. Tests had since been carried out at the School of Public Health and Tropical Medicine on the microbiological quality of randomly selected airline meals. Other studies were in progress at the University of New South Wales on the stability of airline meals under different storage conditions. The Committee noted also that a brief study had been carried out in Japan in January and February on food taken from planes. This had revealed pathogens of food poisoning. This was attributed to a lack of hygiene among members of the catering staff and crew members during preparation, storage, and handling before and after loading. All representatives who spoke expressed concern about the situation and considered that the studies in progress showed that food services should be far more strictly controlled by domestic and port health authorities. The Committee adopted a resolution requesting the Director-General to bring this matter to the attention of the Executive Board so that urgent attention could be given to updating the "Guide to Hygiene and Sanitation in Aviation" and to establishing international standards (including microbiological standards) for application both on the ground and in the air in respect to: (a) the selection, (b) the preparation, (c) the storage and (d) the quality control at all stages to consumption, of food served on international flights (see resolution WPR/RC24.R6). 5 Disinsection of aircraft (Document WPR/RC24/6) The Committee reviewed a report presented by the Regional Director summarizing the action taken in connexion with the resolution adopted at its twenty-third session on Disinsection of Aircraft (WPR/RC23.R7). It noted that the joint report of ICAO and WHO on the vapour disinsection system had not been ready by the time the Twenty-sixth World Health Assembly met. It noted further that new aerosol formulations for air- craft disinsection had been approved by the Twenty-sixth World Health Assembly and would, in due course, be included in Annex VI of the Inter- national Health Regulations, 1971. REPORT OF THE REGIONAL COMMITTEE During the discussion the Representative of Japan expressed his appreciation to WHO for the work it had done in this field, especially in the development of a non-toxic vapour method, new formulas for dis- insectant, etc. He informed the Committee of the Japanese experiments being carried out with gambusia or tilapia (the natural enemies of mosquitos) on and around airports, especially in the sewage system and paddy fields. In some areas the breeding areas of mosquitos had been eliminated by the introduction of these fish. A study to find a new disinsectant only mildly toxic to fish was also in progress. The Committee noted that the Malaysian Ministry of Health had advised the agents of all international aircraft using Subang Airport, that from I July 1973 such aircraft would have to be disinsected by the "blocks away" method. 27 The Committee adopted a resolution requesting the Regional Director to submit a report to the twenty-fifth session of the Regional Committee on any action taken by the Twenty-seventh World Health Assembly on the adoption or otherwise of the vapour disinsection system and a statement of each country's position regarding vapour disinsection if this system was adopted (see resolution WPR/RC24.R4). 6 Drug dependence (Document WPR/RC24/7) The Committee noted that the Government of the United States of America would provide one consultant and funds for the recruitment by WHO of another to undertake the pilot study requested by the Committee at its twenty-third session (WPR/RC23.R8). It noted further that the Aw Boon Haw Foundation of Hong Kong might also assist the study financially. However, activities had been delayed for reasons beyond the control of the Regional Director. It was hoped that the pilot study would start in Malaysia in September and that later the team would proceed to the Philippines. The next step would be the development of a regional programme. One representative referred to the fact that the World Health Assembly had urged Member States to promote programmes of education, epidemiological studies, prevention, treatment and rehabilitation, and research in drug dependence and pointed out that the Committee at its last session had indicated its lack of information on the nature, extent of drug dependence and on the availability of treatment and rehabilitation centres in the Region. During the discussion, 11 representatives reported on the steps which their governments had taken to deal with this problem. These included the establishment of special committees, anti-drug bureaus and drug education centres; the provision of treatment and rehabilitation services; the organization of workshops, seminars and courses; the production of educational aids and literature; intensive action against illicit trafficking in drugs; the review and establishment of legislation relating to drug control and abuse. The Committee adopted a resolution requesting the Regional Director to obtain from Member States information on the nature, extent of drug dependence and the availability of treatment and rehabilitation centres in their respective countries, to continue to stimulate and develop 28 REGIONAL COMMITTEL: TWENTY-FOURTH SESSION activities in the field of the control of drug abuse and drug dependence, and to explore the possibility of inter-regional cooperation with the South-East Asia Regional Office after completion of the pilot project (see resolution WPR/RC24.R8). 7 Comprehensive and coordinated teacher training programme for health personnel (Document WPR/RC24/9) The Committee reviewed a report presented by the Regional Director summarizing the action taken in connexion with the establishment of a regional teacher training centre for health personnel. The Committee noted that a two-week workshop for deans and senior administrators of medical schools had been held at the Centre in June. This had been attended by educational leaders from medical centres in the Region. The determinants, contents and processes for the education of health personnel had been discussed. A two-week course for medical teachers and a four-week workshop for future part-time teachers and others with a proven interest in medical education would be held later in 1973. In 1974 deans of medical schools in the Region would meet to consider changes in medical education over the past decade and the role of teacher training. A l2-month master's degree course would be introduced in 1974. This would be similar to that given by the University of Illinois, Chicago, a degree in the art and science of teaching. The Committee noted further that training would initially be limited to doctors although next year other health workers would be included. The workshop or seminar approach would continue for some time as it was expected there would only be a small number of teachers with a full master's degree, although there would be many part-time teachers who had had some training and could assist the national teaching institutions. The consultant months would be used not only to strengthen the teaching but also to evaluate the courses. Information was presented on the steps being taken to solve the prohlem of manpower in China where there was a lack of doctors in the rural areas. Practice in teaching and research was combined with field work, experienced teachers helped the inexperienced. There were also full-time teacher training courses in special fields. Teachers were also provided with practical knowledge and skills in keeping with the rural situation. During the last few years a new system of training had been introduced by the establishment of rural health stations outside the colleges. The organization of mobile teams to tour the country areas enabled students to obtain more practical experience. There were three different organizations for the training of teachers: medical schools, hospitals and scientific research institutions. The period of training varied from three months to one year. The Committee was informed that the Government of the Republic of Korea wished to receive assistance from WHO in the establishment of a national teacher training centre. The Committee noted with satisfaction the progress .made in the development of the regional centre which it considered represented a maj or step forward in the t raining of teachers of heal th personnel. It expressed the hope that the fullest possible use would be made of the REPORT OF THE REGIONAL COMMITTEE the Centre by countries within the Region, that every effort would be made by governments to establish their own national centres, and that further assistance would be provided to the Centre by the United Nations Development Programme (see resolution WPR/RC24.R7). 8 Future sessions of the Regional Committee (Document WPR/RC24/ll) The Committee noted that two separate aspects of future sessions of the Regional Committee had to be discussed: (a) the twenty-fifth session in 1974 and (b) the venue of the twenty-sixth session and the question of holding alternate sessions at Regional Headquarters. As far as the first aspect was concerned, last year the Committee 29 had adopted resolution WPR/RC23.R22, in which it accepted the invitation of the Government of Malaysia to hold its twenty-fifth session (1974) in Kuala Lumpur. The sessions of the Regional Committee, when held in Manila, were covered by the Host Agreement for the Regional Office executed by the Government of the Republic of the Philippines and the Organization on 22 July 1951. Sessions held away from Manila were covered by an agreement between the Host Government and the Organization relating to the facilities and services and to the legal status afforded to the Organization on the occasion of holding the specific session of the Regional Committee on the territory of the Government; the agreements were normally written in terms of the Convention on Privileges and Immunities of the Specialized Agencies including its Annex VII which specifically related to the World Health Organization. Such agreements had been executed with the Government of the United States of America for the session in Guam last year and with the Government of New Zealand for the current session of the Regional Committee. The holding of the twenty- fifth session of the Regional Committee in Kuala Lumpur would, therefore, be dependent on the conclusion of an agreement with the Government in terms of WHO's normal practice in this, and the other regions. If such an agreement were not concluded, the meeting would have to be convened at Regional Headquarters. As to the second aspect of the agenda item, the 1972 session of the Regional Committee had decided, in its resolution WPR/RC23.R23, to consider the question of the venue of the twenty-sixth session (1975) of the Regional Committee and of holding alternate sessions at Regional Headquarters at its twenty-fourth session. Document WPR/RC24/ll contained a reference to earlier resolutions of the Committee on future sessions of the Regional Committee, with indications as to where they could be found in the Handbook of Resolutions and Decisions of the Regional Committee for the Western Pacific. Annexed to the document were extracts from the summary records of the sixth and seventh meetings of the twenty- third session of the Regional Committee. During the discussion, the Representative of Malaysia reaffirmed the invitation of his Government to hold the 1974 session of the Regional Committee in Kuala Lumpur. The necessary agreement would be signed as soon as the documents were received by the Malaysian Government. 30 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION In discussing future sessions of the Committee, three representatives considered that there were great advantages in having regular meetings of the Committee at Regional Headquarters. This permitted Members to meet all the technical staff and also resulted in considerable savings which could be used to finance fellowships and other programmes, thus providing direct assistance to Members. Another representative stated that, in principle, his Government did not favour venues other than Regional Headquarters, although it would accept meetings held elsewhere provided the host government assumed the extra costs involved. The Committee adopted a resolution confirming that the twenty-fifth session would be held in Kuala Lumpur, Malaysia, probably from 3 to 13 September 1974, the exact dates would be determined after consultations, and that the twenty-sixth session (1975) would be held at Regional Head- quarters in Manila. It also decided that annual sessions of the Regional Committee could be held in another country if an invitation was extended by a Member State, it being understood that this would not happen in two consecutive years and that all other sessions would be held at the Regional Headquarters (see resolution WPR/RC24.RlO). 9 Technical Discussions 9.1 Designation of Chairman At its eleventh session, the Regional Committee adopted a resolution (WPR/RCll.Rll) recommending that the Chairman of the Technical Discussions should be appointed well in advance of the meeting. Following consultations between the Regional Director and the Chairman of the Regional Committee, Professor C.W. Dixon, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand, was selected for this office. 9.2 Organization The theme of the Technical Discussions was "The Role of the Hospital in the Community and the Financing of Hospital-Based Medical Care". The first session consisted of introductory statements and an explanation of the procedures and techniques to be used in the Technical Discussions. The participants were then divided into three groups which met separately and conducted a free discussion in accordance with the guidelines and references provided. At the second plenary session, a summary report was considered and an evaluation made of the discussions. The report of the Technical Discussions was issued as document WPR/RC24/TD8. 9.3 §election of topic for the Technical Discussions in 1974 The Committee selected the "Control of Vector Mosquitos of Dengue Raemorrhagic Fever" as the topic for the Technical Discussions during the twenty-fifth session of the Regional Commitee (see resolution WPR/RC24. R9). REPORT OF THE REGIONAL COMMITIEE 9.4 Technical Discussions in the future The continuation of the holding of the Technical Discussions in connexion with future meetings of the Committee was discussed. It was the general feeling that these should be continued but that the topic should be particularly relevant to the Region and sufficiently restricted to enable ample time for discussion in the time allocated and for firm conclusions to be reached. 10 Reports received from governments on the progress of their health activities The Chairman acknowledged the following reports presented to the Committee. (1) AUSTRALIA - Brief report on health activities, 1972-1973; (2) FRENCH POLYNESIA - Brief report on health activities in 1972; (3) HONG KONG - Brief report on health activities, 1972; (4) JAPAN - Report on the progress of health activities for the fiscal year 1972 (April 1972 - March 1973); (5) KHMER REPUBLIC - Brief report on the health situation; (6) LAOS - Rapport Annue1 des Statistiques Sanitaires 1972, Rapport Annue1 du Service National d'Hygiene et de Medecine Preventive, Rapport Annue1 du Service National de 1a Protection Materne11e et Infantile, Rapport Annuel du Service National de Laboratoire de 1a Sante Pub1ique; (7) MACAU - Brief report on the progress of health activities - 1972; (8) MALAYSIA - Brief report on the progress of health activities; (9) NEW ZEALAND - Brief report on progress in health activities, 1972-1973; (10) REPUBLIC OF KOREA - Brief report on health; (11) REPUBLIC OF VIET-NAM - Brief report on the progress of health activities in 1972-1973; (12) PORTUGUESE TIMOR - Brief report on the progress of health activities in 1972. 31 32 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION PART IV. RESOLUTIONS ADOPTED BY THE COMMITTEE WPR/RC24.Rl ANNUAL REPORT OF THE REGIONAL DIRECTOR The Regional Committee, Having reviewed the Report of the Regional Director on the work of the World Health Organization in the WesternlPacific Region during the period 1 July 1972 - 30 June 1973, 1. NOTES with satisfaction the manner in which the programme was planned and carried out; and 2. COMMENDS the Regional Director and his staff for the work accomplished. Fifth meeting, 30 August 1973 WPR/RC24.R2 RES,OLUTIONS OF REGIONAL INTEREST ADOPTED BY THE TWENTY-SIXTH WORLD HEALTH ASSEMBLY The Regional Committee TAKES NOTE of the following resolutions adopted by the Twenty-sixth World Health Assembly: WHA26.3 WHA26.29 WHA26.35 WHA26.52 WHA26.54 WHA26.55 WHA26.57 WHA26.58 WHA26.59 Twenty-fifth Anniversary of the World Health Organization Smallpox Eradication Programme Organizational Study on Methods of Promoting the Development of Basic Health Services Drug Dependence Committee on International Surveillance of Communicable Diseases Additional Regulations of 23 May 1973 Amending the International Health Regulations (1969), in Particular with Respect to Articles 1,21, 63-71 and 92 Urgent Need for Suspension of Testing of Nuclear Weapons WHO's Human Health and Environment Programme Development of Environmental Manpower Fifth meeting, 30 August 1973 IT\""""~.""'""""",,,, T.'fO'Q f'Qr') I. II) REPORT OF THE REGIONAL COMMITTEE WPR/RC24.-R3 COORDINATION WITHIN THE UNITED NATIONS SYSTEH: GENERAL MATTERS The Regional Committee, Having considered resolution WHA26.49 adopted by the Twenty- sixth World Health Assembly and also A/RES/2975 (XXVII) adopted at the Twenty-seventh session of the General Assembly of the United Nations, 1. NOTES the close collaboration between WHO and UNDP in providing support to health activities related to UNDP country programmes and national developmental projects; 2. NOTES further the emphasis being laid on UNDP country programming and improved project implementation; 3. EXPRESSES the hope that governments will: (a) cooperate with WHO in its effort to strengthen the planning and implementation of health programmes assisted by UNDP; (b) keep the UNDP and WHO, as the executing agency of health projects, fully informed of the progress being made. Fifth meeting, 30 August 1973 WPR/RC24.R4 DISINSECTION OF AIRCRAFT The Regional Committee, Having considered the infonnation provided by the Regional Directorlin connexion with resolution WPR/RC23.R7 on the above subject, 1. THANKS the Regional Director for his report; 2. NOTES that the ~wenty-sixth World Health Assembly has approved the inclusion of ne .. ] aerosol formulations in Annex VI - Recommendations on the Disinsecting of Aircraft - of the International Health Regulations; 3. REQUESTS the Regional Director to submit a report to the twenty-fifth session of the Regional Committee on any action taken by the Twenty-seventh World Health Assembly on the adoption or otherwise of the vapour disinsection system and a statement of each country's position regarding vapour disinsection if this system is adopted. Fifth meeting, 30 August 1973 1 Document WPR/RC24/6. 33 34 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION WPR/ RC24. R5 QUALITY OF DRINKING WATER ON INTERNATIONAL FLIGHTS The Regional Committee, Having considered the information provided by the Regional Director on the actio~ taken in connexion with resolution WPR/RC23.R5 on the above subject, Having recognized that inter-agency consultation is taking place on measures to minimize health hazards from drinking water on international flights; URGES the Director-General to bring to the attention of Member States: (1) the importance of maintaining WHO standards for potable water on airlines, and (2) the need to establish means to enforce these standards. Fifth meeting, 30 August 1973 WPR/RC24.R6 QUALITY OF FOOD ON INTERNATIONAL FLIGHTS The Regional Committee, Taking note of the recent survey in the Western Pacific Region on food used on international flights, and noting in particular that bacteriological examination of food is not usually a routine operation; Conscious of the growing numbers of passengers at risk in flights, and knowing that not all cases of disease are r~ported; Considering the increasing public awareness of these risk generated by recent serious outbreaks of food-borne disease amongst passengers on international flights; 1. REQUESTS the Director-General to bring this matter to the attention of the Executive Board so that urgent attention can be given to updating the "Guide to Hygiene and Sanitation in Aviation" and to establishing international standards (including microbiological standards) for application both on the ground and in the air in respect to: (1) the selection, (2) the preparation, (3) the storage and (4) the quality control at all stages of consumption, of food served on international flights. Sixth meeting, 31 August 1973 1 Document WPR/RC24/5. WPR/RC24.R7 REPORT OF THE REGIONAL COMMITTEE COMPREHENSIVE AND COORDINATED TEACHER TRAINING PROGRAMME FOR HEALTH PERSONNEL The Regional Committee, 35 1. NOTES the progress in the development of the Regional Teacher Training Centre for Health Personnel since the twenty-third session of the Regional Committee; 2. NOTES FURTHER that: (a) agreement has been concluded with the Government of Australia and the University of New South Wales for the establishment of a regional teacher training centre; (b) agreement has been reached between WHO and the United Nations Development Programme for a year of preliminary assistance in 1973 with the possibility of further assistance as the project develops; 3. EXPRESSES its hope that the fullest possible use be made of the Centre for the training of teachers of health personnel; 4. REQUESTS the Regional Director to include information on the further progress made in his next annual report; 5. EXPRESSES its hope for continued UNDP support to the Centre, which is of so much importance to the development of health manpower in the Western Pacific Region. Sixth meeting, 31 August 1973 WPR/RC24. R8 DRUG DEPENDENCE The Regional Committee, Having considered the information provided by the Regional Directorlin connexion with resolution WPR/RC23.R8 on the above subject, 1. NOTES that the work necessary to formulate a proposal which may be submitted to the Director-General for possible financing by the UNFDAC or other appropriate body of a study of the epidemiology of drug abuse will soon be initiated in two countries in the Region with the assistance of the United States Government and possibly of other sources; 1 Document WPR/RC24/7. 36 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION 2. EXPRESSES the hope that the findings of this work will be useful to the Working Group on Measures for the Prevention and Control of Drug Abuse and Dependence which will take place in 1974; 3. NOTES FURTHER resolution WHA25.62 which "urges Member States to initiate and/or increase their efforts to promote programmes of education, epidemiological studies, prevention, treatment and rehabilitation, and research"; 4. REQUESTS the Regional Director to obtain from Member States information on the nature, extent of drug dependence and the availability of treatment and rehabilitation centres in their respective countries; 5. REQUESTS the Regional Director to continue: (a) to stimulate and develop activities in the field of the control of drug abuse and drug dependence; (b) to explore further the possibility of inter-regional cooperation with the South-East Asia Regional Office after completion of the pilot project and to submit to the Committee at its twenty-fifth session a report on the progress made. Seventh meeting, 3 September 1973 WPR/ RC24 • R9 TOPIC OF THE TECHNICAL DISCUSSIONS IN 1974 The Regional Committee, Having considered the topics suggested by the Government of Malaysia and the Regional Director for the Technifa1 Discussions during the twenty-fifth session of the Committee, DECIDES that the subject for the Technical Discussions in 1974 shall be the "Control of Vector Mosquitos of Dengue Haemorrhagic Fever". Seventh meeting, 3 September 1973 WPR/RC24.RlO FUTURE SESSIONS OF THE REGIONAL COMMITTEE The Regional Committee, Having considered the information provided by the Regional Director in connexion with resolution WPR/RC23.R23 on future 1Document WPR/RC24/l0. REPORT OF THE REGIONAL COMMITTEE 37 sessions of the Regional Committee,l Having been assured by the Representative of Malaysia that a satisfactory agreement between the Government and the Organi~ation would be executed, 1. CONFIRMS that Lumpur, Malaysia, exact dates to be the twenty-fifth session will be held in Kuala probably from 3 to 13 September 1974, the determined after consultations; 2. DECIDES that the twenty-sixth session (1975) will be held at Regional Headquarters in Manila; and 3. DECIDES, further, that annual sessions of the Regional Committee could be held in another country if an invitation is extended by a Member State, it being understood that this will not happen in two consecutive years and that all other sessions will be held at the Regional Headquarters. Eighth meeting, 4 September 1973 WPR/RC24.Rll BUDGET PERFORMANCE 1972 - DIRECT SERVICES TO GOVERNMENTS The Regional Committee, 1. NOTES the report of the Regional Di2ector on budget performance for the financial year 1972; and 2. REQUESTS the Regional Director to make reports of a similar nature to future sessions of the Regional Committee. Eighth meeting, 4 September 1973 WPR/RC24.Rl2 MODIFICATIONS MADE TO THE 1973 AND 1974 PROGRAMME AND BUDGET ESTIMATES The Regional Committee, 1. Having examined the report presented by the Regional Director on the modifications m~de to the 1973 and 1974 regular programme and budget estimates, TAKES NOTE of the changes made; lDocument WPR/RC24/ll. 2 Document WPR/RC24/P&B/2. 3 Document WPR/RC24/P&B/3. 38 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION 2. Having considered the revised List of Additional Projects annexed to the regional programme and budget estimates for 1974 contained in document WPR/RC24/2 and those brought forward during the meeting, REQUESTS the Regional Director to consider the List of Additional Projects revised accordingly. Eighth meeting, 4 September 1973 WPR/ RC24. Rl3 PROPOSED PROGRAMME AND BUDGET ESTIMATES FOR 1975 The Regional Committee, Having examined the proposed programme and budget estimates for 1975, including the programme planned to be financed from the Voluntary Fund for Health Promotion and those included in the List of Additional Projects,l and the report of the Sub-Committee thereon, 1. NOTES with satisfaction the continued to inter-country activities which serve to a specific activity as a first step to the activities within the countries as well as country cooperation in the Region, emphasis being given generate interest in organization of promoting inter- 2. CONSIDERS the List of Additional Projects as part of the regional programme, and 3. REQUESTS the Regional Director to transmit the proposals, as amended during the twenty-fourth session of the Regional Committee, to the Director-General for his consideration for inclusion in his proposed programme and budget estimates for 1975. Eighth meeting, 4 September 1973 WPR/RC24.R14 TENTATIVE PROJECTION FOR 1976 The Regional Committee, HaVing examined the tentative projection of the programme and budget for 19762 prepared in accordance with the requirements of resolution WHA22.53 of the World Health Assembly, 1 Document WPR/RC24/2. 2 Document WPR/RC24/P&B/4. REPORT OF THE REGIONAL COMMITTEE 1. NOTES the tentative projection for 1976 for the Western Pacific Region, as presented by the Regional Director; and 2. REQUESTS the Regional Director to transmit the tentative projection to the Director-General. Eighth meeting, 4 September 1973 WPR/RC24.15 ADOPTION OF THE REPORT The Regional Committee, Having considered the draft report of the twenty-fourth session of the Committee, ADOPTS the report. Eighth meeting, 4 September 1973 WPR/RC24.16 RESOLUTION OF APPRECIATION The Regional Committee EXPRESSES its appreciation and thanks to: (1) The Government and people of New Zealand for: (a) having invited the Regional Committee to hold its twenty-fourth session in Wellington; (b) the excellent arrangements and facilities provided: (c) the generous hospitality received, and (d) the interesting tours which have enabled representatives to see some of the achievements of the country; (2) the Right Honourable N.E. Kirk, Prime Minister and Minister of Foreign Affairs, for having addressed the formal opening of the twenty-fourth session of the Regional Committee; (3) the Honourable R.J. Tizard, Minister of Health, for having addressed the formal opening of the twenty-fourth session of the Regional Committee; 39 40 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION (4) The Director-General of Health, Dr H.J.H. Hiddlestone, and his staff for the excellent arrangements made for the meeting; (5) the Chairman and other officers of the Committee; (6) Professor C.W. Dixon for having so ably served as Chairman of the Technical Discussions, the plenary session rapporteur, the chairmen and rapporteurs of the three discussion groups and the other experts who assisted with the Technical Discussions; (7) the representatives of the United Nations, the United Nations Development Programme, the United Nations Chi1drens' Fund, the South Pacific Commission, and the non-governmental organizations who made statements; (8) the Regional Director and the Secretariat for their work in connexion with the meeting. Eighth meeting, 4 September 1973 REPORT OF THE REGIONAL COMMITTEE ANNEX 1 AGENDA 1 Opening of the session 2 Address by retiring Chairman 3 Address by the Director-General 4 Election of new officers: Chairman, Vice-Chairman and Rapporteurs 5 Celebration of the Twenty-fifth Anniversary of the World Health Organization 6 Address by incoming Chairman 7 Adoption of the agenda 8 Technical Discussions Statement by the Chairman of the Technical Discussions 9 Proposed programme and budget estimates for the financial year 1 January - 31 December 1975 9.1 Establishment of the Sub-Committee on Programme and Budget 9.2 Consideration of the report presented by the Sub-Committee on Programme and Budget 10 Acknowledgement by the Chairman of brief reports received from governments on the progress of their health activities 11 Report of the Regional Director 12 Resolutions of regional interest adopted by the Twenty-sixth World Health Assembly 13 Quality of drinking water on international flights 14 Disinsection of aircraft 15 Drug dependence 16 Quality of food on international flights 17 Comprehensive and coordinated teacher training programme for health personnel 41 42 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION 18 Statements of representatives of the United Nations, the Specialized Agencies, of intergovernmental and non-governmental organizations in official relations with WHO 19 Selection of topic for the Technical Discussions during the twenty-fifth session of the Regional Committee 20 Future sessions of the Regional Committee 21 Consideration of the report presented by the Chairman of the Technical Discussions 22 Adoption of the draft report of the Committee 23 Adjournment AUSTRALIA AUSTRALIE CHINA CHINE REPORT OF THE REGIONAL COMMITTEE LIST OF REPRESENTATIVES LISTE DES REPRESENTANTS 1. REPRESENTATIVES OF MEMBER STATES REPRESENTANTS DES ETAT MEMBRES Dr H.M. Franklands Deputy Director General Department of Health Dr R.W. Cumming Director International Health Department of Health Mr R.J. Tyson Office of Australian High Commission Wellington Dr Chen Hai-feng Director Department of Education and Scientific Research Ministry of Health Mr Chow Shan-yen Second Secretary Chinese Embassy in New Zealand Professor Shih Chen-hsin Adviser to Chinese Academy of Medical Sciences Dr Chang Kuang-hua Health Officer Peking Quarantine Station Mr Tsao Yung-lin Office of Foreign Affairs Ministry of Health ANNEX 2 ANNEXE 2 43 (Chief Representative) (Chef de delegation) (Alternate/Supple ant) (Adviser/Conseiller) (Chief Representative) (Chef de delegation) (Alternate/Suppleant) (Adviser/Conseiller) (Adviser/Conseiller) (Secretary/Secretaire) 44 FIJI FIDJI FRANCE JAPAN JAPON KHMER REPUBL IC REPUBLIQUE KHMERE LAOS MALAYSIA MALAISIE REGIONAL COMMITTEE: TWENTY-FOURTH SESSION Dr D. Singh Permanent Secretary for Health Medical Department Dr J. Laigret Directeur de l'Institut de Recherches medicales "Louis Malarde" Medecin-Chef du Service d'Etat des Grandes Endemies et Directeur de la Sante publique en Polynesie fran~aise Dr Teruhiko Saburi Director Health and Welfare Statistics Department Ministry of Health and Welfare Dr Rintaro Okamoto Senior Medical Officer International Affairs Division Ministry of Health and Welfare Professeur Agrege Sok Heangsun Ministre de la Sante publique Dr Kadeva Han Directeur general adjoint de la Sante, charge des relations exterieures Dr My Samedy Dr Phouy Phoutthasak Directeur-general du Ministere de la Sante publique Dr Tiao Jaisvasd Visouthiphong Directeur des Hopitaux Ministere de la Sante publique (Chief Representative) (Chef de delegation) (Alternate/Suppleant) (Chief Representative) (Chef de delegation) (Alternate/Suppleant) (Alternate/Suppleant) (Chief Representative) (Chef de delegation) (Alternate/Suppleant) Tan Sri Datuk (Dr) Abdul Majid bin Ismail Director General of Health (Chief Representative) Malaysia (Chef de delegation) Dr S.K. Mukherjee Director of Medical Services Sarawak (Alternate/Suppleant) • REPORT OF THE REGIONAL COMMITTEE 45 MALAYSIA (continued) MALAISIE (suite) NEW ZEALAND NOUVELLE-ZELANDE PHILIPPINES PORTUGAL REPUBLIC OF KOREA REPUBLIQUE COREE Mr Onn bin Kayat Assistant Secretary Ministry of Health Malaysia (Alternate/Supple ant) (External Liaison) Dr H.J.H. Hiddlestone Director-General of Health (Chief Representative) (Chef de delegation) Dr C.N. Derek Taylor (Alternate/Suppleant) Deputy Director-General of Health Dr G. Blake-Palmer (Alternate/Suppleant) Deputy Director-General of Health Dr R. Dickie Deputy Director Division of Hospitals Mr D.K. McDowell Ministry of Foreign Affairs Professor C.W. Dixon Department of Preventive and Social Medicine University of Otago Medical School Dunedin Dr A.N. Acosta Head Executive Assistant of the Department of Health Dr J.B. Duarte Pinheira Director-General of Health and Welfare Ministry of Overseas Lisbon Dr L. Amarchande Acting Chief of Health and Welfare Services Dili, Portuguese Timor Dr Sung Hee Rhee Director Public Health Bureau Ministry of Health and Social Affairs Mr Byoung Rok Lee Second Secretary Korean Embassy in New Zealand (Alternate/Suppleant) (Alternate/Suppleant) (Adviser/Conseiller) (Chief Representative) (Chef de delegation) (Alternate/Suppleant) (Chief Representative) (Chef de delegation) (Alternate/Suppleant) 46 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION REPUBLIC OF KOREA (continued) REPUBLIQUE DE COREE (suite) REPUBLIC OF VIET-NAM REPUBLIQUE DU VIET-NAM SINGAPORE SINGAPOUR UNITED KINGDOM ROYAUME-UNI UNITED STATES OF AMERICA ETATS-UNIS D'AMERIQUE Dr Sung Kyu AIm (Alternate/Suppleant) Chief Tuberculosis Prevention Section Ministry of Health and Social Affairs Dr Kyong Shik Chang Chief Family Planning Section Public Health Bureau Ministry of Health and Social Affairs Dr Truong-Minh-Cac Directeur general de la Sante Dr Pham-Van (Alternate/Suppleant) (Chief Representative) (Chef de delegation) (Alternate!Suppleant) Directeur de la Medecine curative Dr Nhan-Trung-Son (Alternate/Suppleant) Chef du Service d'Administration hospitaliere Dr Ho Guan Lim Permanent Secretary (Health)/ Director of Medical Services Ministry of Health Dr J.L. Kilgour Chief Medical Adviser (Chief Representative) (Chef de delegation) Foreign and Commonwealth Office Overseas Development Administration and Head of International Health Division, Department of Health and Social Services London Dr G. Choa Director of Medical and Health Services Medical and Health Department Hong Kong Dr J.C. King Deputy Director Office of International Health Department of Health Education and Welfare Mr F.S. Cruz Director of Public Health and Social Services Territory of Guam (Alternate/Suppleant) (Chief Representative) (Chef de delegation) (Alternate/Suppleant) UNITED STATES OF AMERICA (continued) ETATS-UNIS D' AMERIQUE (suite) WESTERN SAMOA SAMOA- OCCIDENTAL REPORT OF THE REGIONAL COMMITTEE 47 II. Dr M. Kumangai (Adviser/Conseiller) Director of Health Services Trust Territory of the Pacific Islands Dr J. Nunn (Adviser/Conseiller) LBJ Tropical Medical Center American Samoa Mr T. J. Waj da American Embassy Wellington Honourable Seiuli Taulafo Minister of Health Dr J.C. Thieme Director of Health Mr Faapoituulao Atoa (Adviser/Conseiller) (Chief Representative) (Chef de delegation) (Alternate/Suppleant) (Secretary/Secretaire) REPRESENTATIVE OF ASSOCIATE MEMBER REPRESENTANT DU MEMBRE ASSOCIE PAPUA NEW GUINEA PAPUA-NOUVELLE-GUINEE Dr M. Wainetti Medical Officer Department of Public Health III. REPRESENTATIVES OF THE UNITED NATIONS AND RELATED ORGANIZATIONS REPRESENTANTS DES NATIONS UNIES ET DES ORGANISMES QUI LUI SONT RATTACHES UNITED NATIONS AND UNITED NATIONS DEVELOPMENT PROGRAMME NATIONS UNIES ET PROGRAMME DES NATIONS UNIES POUR LE DEVELOPPEMENT UNITED NATIONS CHILDREN'S FUND FONDS DES NATIONS UNIES POUR L'ENFANCE Mr W. Hussey Regional Representative of the United Nations Development ~ Programme in the Western Pacific Apia Mr A.H. Aslam UNICEF Representative Manila !:t8 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION IV. REPRESENTATIVES OF OTHER INTER- GOVERNMENTAL ORGANIZATIONS REPRESENTANTS D'AUTRES ORGANISATIONS INTERGOUVERNEMENTALES SOUTH PACIFIC COMMISSION COMMISSION DU PACIFIQUE SUD Dr Anne-Laure Bourre Medical Officer South Pacific Commission New Caledonia V. REPRESENTATIVES OF NON-GOVERNMENTAL ORGANIZATIONS REPRESENTANTS DES ORGANISATIONS NON GOUVERNEMENTALES INTERNATIONAL COUNCIL ON Mr P.J. Reid ALCOHOL AND ADDICTIONS CONSEIL INTERNATIONAL SUR LES PROBLEMES DE L'ALCOOLISME ET DES TOXICOMANIES INTERNATIONAL UNION OF PURE AND APPLIED CHEMISTRY UNION INTERNATIONALE DE CHIMIE PURE ET APPLIQUEE INTERNATIONAL DENTAL FEDERATION FEDERATION DENTAlRE INTERNATIONALE MEDICAL WOMEN'S INTERNATIONAL ASSOCIATION ASSOCIATION INTERNATIONALE DES FEMMES MEDECINS INTERNATIONAL COMMITTEE OF CATHOLIC NURSES COMITE INTERNATIONAL CATHOLIQUE DES INFIRMIERES ET ASSISTANTES MEDICO-SOCIALES Executive Director National Society on Alcoholism and Drug Dependence, N.Z., Inc. Wellington Mr H.V. Brewerton Chemistry Division Department of Scientific and Industrial Research Brigadier J. Ferris Fuller Wellington Dr E. Gibbons Regional Vice-President Medical Women's International Association Wellington Miss P. Dudderidge Christchurch REPORT OF THE REGIONAL COMMITTEE 49 INTERNATIONAL COUNCIL OF NURSES CONS ElL INTERNATIONAL DES INFIRMIERES INTERNATIONAL FEDERATION OF GYNAECOLOGY AND OBSTETRICS FEDERATION INTERNATIONALE DE GYNECOLOGIE ET D'OBSTETRIQUE WORLD FEDERATION OF OCCUPATIONAL THERAPISTS FEDERATION MONDIALE DES ERGOTHERAPEUTES INTERNATIONAL PLANNED PARENTHOOD FEDERATION FEDERATION INTERNATIONALE POUR LE PLANNING FAMILIAL WORLD ASSOCIATION OF SOCIETIES OF (ANATOMIC AND CLINICAL) PATHOLOGY ASSOCIATION MONDIALE DES SOCIETES DE PATHOLOGIE (ANATOMIQUE ET CLINIQUE) INTERNATIONAL FEDERATION OF PHARMACEUTICAL MANUFACTURERS ASSOCIATIONS FEDERATION INTERNATIONALE DE L'INDUSTRIE DU MEDICAMENT INTERNATIONAL SOCIETY OF RADIOLOGY SOCIETE INTERNATIONALE DE RADIOLOGIE Miss T. Burton National Secretary New Zealand Nurses' Association (Inc.) Wellington Miss S. Burrell (Alternate/Suppleant) Assistant Secretary New Zealand Nurses' Association (Inc.) Wellington Dr A.M. Rutherford President New Zealand Council of the Royal College of Obstetricians and Gynaecologists Miss B. Brown Occupational Therapy Department Auckland Hospital Board Dr R. Black Member of Regional Medical Committee Auckland Dr F.B. Desmond Wellington Mr P.D. Coyne , Pharmaceutical Manufacturers Association (New Zealand) Inc. Wellington Dr G.D.T. Harper Radiologist Wellington Hospital Member of the Australasian College of Radiologists 50 REGIONAL COMMITTEE: TWENTY-FOURTH SESS ION INTERNATIONAL FEDERATION OF SURGICAL COLLEGES FEDERATION INTERNATIONALE DES COLLEGES DE CHIRURGIE WORLD VETERANS FEDERATION FEDERATION MONDlALE DES ANCIENS COMBATTANTS WORLD VETERINARY ASSOCIATION ASSOCIATION VETERINAIRE MONDIALE Mr J.W.E. Raine Mr E.D. McCabe Vice-President of the WVF Wellington Mr W.H. Carson New Zealand Council Member Mr R. C. Watson (Alternate!Suppleant) REPORT OF THE REGIONAL COMMITTEE 51 WPR/RC24/l Rev.l WPR/RC24/l Rev.l Add.l WPR/RC24/1-a WPR/RC24/2 and Corr.l WPR/RC24/3 WPR/RC24/4 WPR/RC24/5 WPR/RC24/6 WPR/RC24/7 WPR/RC24/8 Rev.l WPR/RC24/9 WPR/RC24/10 WPR/RC24/11 WPR/RC24/12, Add.l and 2 WPR/RC24/13 WPR/RC24/l4 WPR/RC24/P&B/l WPR/RC24/P&B/2 ANNEX 3 LIST OF DOCUMENTS Provisional agenda Supplementary agenda Annotated agenda Proposed programme and budget esttmates for 1975 Twenty-third Annual Report of the Regional Director Resolutions of regional interest adopted by the Twenty-sixth World Health Assembly Quality of drinking water on international flights Disinsection of aircraft Drug dependence Quality of food on international flights Comprehensive and coordinated teacher training programme for health personnel Selection of topic for the Technical Discussions during the twenty-fifth session of the Regional Committee Future sessions of the Regional Committee List of representatives Report of the Sub-Committee on Programme and Budget Report of the twenty-fou~h session of the Regional Committee Suggested guidelines for the Sub-Committee on Programme and Budget Budget performance 1972 - Direct services to governments of the Region, by subject heading, by country and by project 52 REGIONAL COMMITTEE: TWENTY-FOURTH SESSION WPR/RC24/P&B/3 WPR/RC24/P&B/4 WPR/RC24/P&B/5 WPR/RC24/P&B/6 WPR/RC24/TD1 WPR/RC24/TD2 WPR/RC24/TD3 WPR/RC24/TD4 WPR/RC24/TD5 WPR/RC24/TD6 and Add.1 WPR/RC24/TD7 Rev.l WPR/RC24/TD8 WPR/RC24/TD9 (unnumbered) Proposed programme and budget estimates for 1975 (Review of the main features of the 1975 proposed programme and budget estimates and the programme changes for 1973 and 1974) Tentative projection for 1976 Proposed programme and budget estimates for 1975 (Details of consultants and fellowships provision) Modifications to the proposed programme and budget estimates for 1974 The limitations of the hospital as the centre of medical services The role of the hospital in the community and the financing of hospital-based medical care Hospital services in the Western Pacific Region Technical Discussions programme Procedures and techniques for the Technical Discussions Guidelines for the Technical Discussions Discussion group memberships Report of the Technical Discussions Individual evaluation questionnaire Brief reports received from governments on the progress of their health activities