(wpRlRC4SISRl6)
SUMMARY RECORD OF THE SIXTH MEETING Grand Ballroom I. Crown Princess Hotel. Kuala Lwnpur Thursday. 22 September 1994 at 8.30 a.m. CHAIRMAN: Dr E. Tambisari (Vanuatu) later: Dr Abu Bakar (Malaysia)
. CONTENTS
1.
Consideration of resolutions:
....................................................... .
190 190 191 194
1.1 1.2
New horizons in health ................................................... . Programme budget for 1996-1997 ..................................... . AIDS and sexually transmitted diseases ............................. ..
1.3 1.4 1.5
Global Programme on AIDS: Membership of the Management Committee ................................................. . Eradication of poliomyelitis in the Region ........................... . Country visits: Report of the Sub-Committee of the Regional Committee on Programmes and Technical Cooperation, Part I ......................................... .. Membership of the Sub-Committee of the Regional Committee on Programmes and Technical Cooperation ................................................................ . Third monitoring of the implementation of the Strategy for Health for All by the Year 2000: Report of the Sub-Committee of the Regional Committee on Programmes and Technical Cooperation, Part II ..................................................... .. Collaboration with nongovernmental organizations: Report of the Sub-Committee, Part Ill ....................................................................... .
195 195
1.6
199
1.7
199
1.8
199
1.9
200
2.
WHO Response to Global Change: Report of the Sub-Committee, Part IV ............................................................. .
201
- 189-
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REGIONAL COMMITTEE: FORTY-FIFTH SESSION
1. 1.1
CONSIDERATION OF DRAFT RESOLUTIONS New horizons in health (Document WPRlRC45IConf. Paper No.1) Dr TAPA (Tonga) proposed the addition, in operative paragraph 2, of two subparagraphs
as follows: (3) to report to the forty-si~th
session of the Regional Committee on the progress
of implementation of this resolution; (4) to transmit the document to the Executive Board at its ninety-fifth session for
information as the Region's response in the context of global change. Dr ADAMS (Australia) proposed the substitution, operative paragraph 2(1), of "strategies and budgets" for "mechanisms". Mr LOVELACE (New Zealand) suggested that operative paragraph 2(2) might be deleted as it concerned an internal administrative action by the Regional Director, unless it involved a structural change at the Regional Office. Dr BART (United States of America) proposed the addition, in the first preambular paragraph, of the words 'as part of the overall reform in WHO in the context of global change'. In the second preambular paragraph, the words "in the context of supportive health and socioeconomic environments that facilitate healthy choices" should be added. In the third preambular paragraph he proposed that the words "health reform and" be inserted before "emerging health issues of the Region." The REGIONAL DIRECTOR asked whether in reference to Dr Tapa's proposed amendment, the Committee wished him to transmit the document directly to the Executive Board or rather to the Director-General so that he could include it as part of the overall submission on global change. Dr TAPA (Tonga) agreed that the second method would be preferable. The REGIONAL DIRECTOR said that in his opinion the United States representative's proposals concerning preambular paragraphs presented no difficulty. Nor did the Australian representative's proposal for operative paragraph 2(1). Concerning the rest of operative paragraph 2, if the Committee was happy to leave him to carry out the remaining provisions as part of his administrative tasks, he would ask that those provisions, starting with the present operative paragraph 2(2), which the representative of New Zealand had in any case suggested
SUMMARY RECORD OF THE SIXTH MEETING
191
deleting, should not be included in the draft resolution. He would report back to the Regional Committee at the appropriate time. As for the final amendment, the proposal of the representative of Tonga might be adjusted to read: "to transmit this document to the Director-General as part of the contribution of the Western Pacific Region to the work being done by headquarters in redefining or updating WHO's policy and mission for submission to the Executive Board", subject to editorial amendment. He noted that that would fit in with the work of the Development Team on WHO Policy and Mission, which was chaired by the Director-General. Dr BART (United States of America) said that, in view of the Director-General's plea on the opening day of the Regional Committee's current session and other comments on its responsibility and involvements in the process of reform, the request to the Regional Director to report back to the Regional Committee should be incorporated as a specific provision of the resolution. That would reflect the Committee's desire to remain involved in the reform process in which the transmission of the document New horizons in health was a first step. Dr TAPA (Tonga) agreed with the United States representative. The Regional
Committee had considered the document in the context of reform without a specific item having been added to its agenda, and he felt a progress report would be appropriate. He agreed with the representative of New Zealand that other administrative details could be left to the Regional Director without specific provision being made in the resolution. It was so agreed. Decision: WPRlRC4S.Rl). The draft resolution, as amended, was adopted (see resolution
l.2
Programme budget for 1996-1997 (Document WPRlRC4S/Conf. Paper No.2) Dr ADAMS (Australia) suggested that the resolution might be given an operative
paragraph (3) referring to the stated need "to allocate realistic proportions of the regular budget in order to carry out the activities relating to sexually transmitted diseases and AIDS, and leprosy elimination".
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REGIONAL COMMITTEE: FORTY -FIFTH SESSION
Mr LOVELACE (New Zealand) suggested that, again, in order to reflect the substance of the debate in the Committee, in particular on emergency preparedness and disaster relief, a further operative paragraph should be added requesting the Regional Director "to report back to the Regional Committee at its forty-sixth session on the strategies and timetable to align future programme budgets with the regional priorities agreed upon by the Committee". It had been observed in discussion relating to this resolution that a closer alignment of the broad strategies of WHO and its regional offices with the specific resource allocations and decisions resulting from the biennial budgeting process would be helpful. Dr BART (United States of America) said that he, too, wished to see the discussions of the Committee on that subject, and in the context of zero growth, reflected in the resolution. He noted, for example, that attention to emergency preparedness would require reallocation of resources, resulting in a reduction in some other provision. In the interests of transparency the resulting shift in priorities should be mentioned. Dr TAPA (Tonga) agreed with the previous speakers on the need to express the views of the Committee, for example, on health disaster preparedness and new problems relating to old diseases. The REGIONAL DIRECTOR assured the Committee that its views and concerns would be fully taken into account at the implementation stage after the necessary adjustment of the regular budget, or through mobilization of additional resources in the light of the priorities requested. He therefore suggested that a new first operative paragraph be added requesting him "to ensure that the Regional Committee's views and concerns expressed during the review of the proposed programme budget should be fully taken into account in the implementation of the 1996-1997 programme budget" . Mr LOVELACE (New Zealand) accepted that suggestion. suggestion would also be incorporated. The REGIONAL DIRECTOR said that he had thought that the New Zealand suggestion was covered by his own, since he had allocated some 70% for the six priority areas and the country priorities were accurately reflected in the appropriate annex to the proposed programme budget. He asked whether his own
SUMMARY RECORD OF THE SIXTH MEETING
193
Mr LOVELACE (New Zealand) said he thought it was very important to be quite specific about the relation of broad strategies such as those expressed in the New horizons in
health to specific allocations and priorities in the budget. Dr TAPA (Tonga) said he felt that while some mechanisms should be the subject of specific provisions in the resolution, such as those to ensure that priorities were observed, others, such as the need for reporting back, might be considered unnecessary in the light of the obligation for full two-year reporting on·financial matters. Dr MILAN (Philippines) said that there might be difficulty in reconciling the New Zealand suggestion, regarding reporting, with the fact that the budgetary proposals had to be resubmitted at the country level. The programme budget had taken the countries' priorities into account. countries? Dr BART (United States of America) said that in his view the proposed reporting by the Regional Director was intended to ensure transparency and to clarify the link between stated priorities and declared aims in terms of activities and resources. The REGIONAL DIRECTOR said that he had noted those views. The need to relate the Committee's discussions and conclusions to the budgetary exercise in general might be met by a second operative paragraph along the following lines: Regional Committee". He would be obliged to ask Member States also to consider that what had been agreed by the Regional Committee should be fully taken into account in future programme budgeting exercises. Mr LOVELACE (New Zealand) expressed full agreement with the Regional Director's suggested wording. It was so agreed.
Would the Regional Committee have to submit the proposed realigrunents to the
"to ensure also that biennial
programme budgeting will be aligned with the regional strategies and priorities agreed to by the
Dr ADAMS (Australia) proposed a new second preambular paragraph as follows: "Noting with pleasure the quality and transparency of the new format of the proposed programme budget 1996-1997 document;"
194
REGIONAL COMMITTEE: FORTY-FIFTH SESSION
It was so agreed. Decision: The resolution, as thus amended and with the addition of new operative
paragraphs 1 and 2 in the wording suggested by the Regional Director, was adopted, fonner paragraphs (1) and (2) becoming (3) and (4), respectively (see resolution WPRlRC45.R2).
l.3
AIDS and sexually transmitted diseases (Document WPRlRC45/Conf. Paper No.3) Dr TAPA (Tonga) proposed the addition of the words "the fony-sixth session of" after
"to repon to" in operative paragraph 2(5). Miss BLACKWOOD (United States of America) stressed that the transition to the Joint and Cosponsored United Nations Programme on HIV/AIDS would be a critical period, and it would be imponant to maintain present activities while developing the multisectoraI approach with other agencies. She proposed the addition of the phrase "and its serious multisectoral implications" at the end of the second preambular paragraph. She funher proposed the addition of the words "and to the new Joint and Cosponsored United Nations Programme on HIV / AIDS, recognizing the need for an effective and transparent transition process in full consultation with Member States" at the end of operative paragraph 1.1. Finally, at the end of operative paragraph 20), she proposed the addition of the phrase "in the Joint and Cosponsored United Nations Programme on HIV / AIDS". Dato' JEGATHESAN (Malaysia) questioned the need for operative paragraph 1(6), as its context was implicit in the preamble. Mr LOVELACE (New Zealand) proposed the insenion of the word "financial" before "suppon" in operative paragraph 1(6). Dr TAPA (Tonga) suggested that the insenion proposed by the representative of New Zealand be expanded to "financial and other". Dr WILLIAMS (Cook Islands) questioned whether operative paragraphs 2(2-4) were sufficiently strongly worded to ensure that WHO was given its rightful role. Mr WAENA (Solomon Islands) proposed that the word "areas" in the third preambular paragraph be amended to "behaviours and practices" . Mrs JACOBSEN (Niue) suggested that "men" should be added to the areas for particular focus which were referred to in operative paragraph 1(2).
SUMMARY RECORD OF THE SIXTH MEETING
195
The REGIONAL DIRECTOR pointed out that men had always been the major target of efforts to control the spread of HIV infection. The four areas referred to in the resolution were areas for particular attention in the future. Mrs JACOBSEN (Niue) accepted the Regional Director's explanation. concern was to ensure that the responsibility of men was fully recognized. Dr TAPA (Tonga) suggested that a reference to the Regional Office be included in operative paragraph 2(4). Dr MILAN (Philippines), Rapporteur, pointed out that the constitutional role of WHO and the Regional Office was adequately stressed in the sixth and seventh preambular paragraphs and in operative paragraph 2(3). Decision: WPRlRC45.R3). The draft resolution, as thus amended, was adopted (see resolution Her main
1.4
Global Programme on AIDS: Membership of the Managem::nt Committee (Document WPRlRC45IConf. Paper No.4) Decision: The resolution was adopted (see resolution WPRlRC45.R4).
1.5
Eradication of poliomyelitis in the Region (Document WPRlRC45IConf. Paper No.5) Dr MONTAVILLE (France) proposed that the word "all" be inserted before "cases" in
operative paragraph 2 (3). In operative paragraph 3 it was important to indicate that all cases should be detected, of whatever origin, since experience had shown that cases were not always either imported or linked to the wild poliovirus. That was particularly important in countries with a high prevalence of HIV infection and AIDS, since the vaccine contained live virus, which might have consequences for immunodepressed individuals. The text of operative paragraph 3 should be amended accordingly. He also proposed the addition of a new subparagraph in operative paragraph 3 which would read the same as operative paragraph 3 (3) of resolution WPRlRC44.R4, "to follow the recommendations of the Expanded Programme on Immunization Global Advisory Group on the use of injectable poliovirus vaccine".
196
REGIONAL COMMITTEE: FORTY-FIFTH SESSION
Finally, he proposed the addition of a phrase to operative paragraph 5(6) to the effect that it was essential to ensure adequate quality control for locally produced vaccines. Miss BLACKWOOD (United States of America) proposed the addition of a new paragraph, as the second in the preamble, to read "Recognizing and appreciating the energetic leadership provided by the Regional Director". Dr PY AKAL YIA (Papua New Guinea) said that for Member States bordering countries that belonged to other regions of WHO it was important to ensure an adequate exchange of information on reporting of cases, and that that should be adequately reflected in operative paragraph 5(3). Mr WAENA (Solomon Islands) suggested that the Committee should record in the resolution its recognition and appreciation of the great efforts made by certain Member States to achieve the eradication of poliomyelitis. Dr WILLIAMS (Cook Islands) said that a reference should be made to the availability of vaccines beyond the target year and proposed the addition of a new subparagraph in operative paragraph 5 reading, "(7) to ensure the ready availability of vaccine to all Member States for the continuation of immunization beyond 31 December 1995". The REGIONAL DIRECTOR suggested the addition of a new preambular paragraph reading "Acknowledges the achievements made by Member States in eradicating poliomyelitis;" to meet the request of the representative of Solomon Islands. In operative paragraph 3 the replacement of "imported" by "poliomyelitis" might be appropriate to meet the first suggestion made by the representative of France. Dr BART (United States of America), referring to the second suggestion made by the representative of France, said that both the Global Advisory Group and the Regional Technical Advisory Group on the Expanded Programme on Immunization and Poliomyelitis Eradication had repeatedly recommended oral poliovirus vaccine as the single vaccine of choice. Reference to an alternative vaccine at such a late stage in the eradication programme might cause confusion, especially since vaccine purchases and preparations for supporting vaccine supplies were made so far in advance. reference to injectable vaccine. He would therefore prefer not to see the inclusion of any
SUMMARY RECORD OF THE SIXTH MEETING
197
Dr HOP (Viet Nam), Rapporteur, supported the previous speaker. Dr MONTA VILLE (France) said that his suggestion to include a reference to the injectable vaccine was for countries and areas that were no longer reporting poliomyelitis cases. He agreed that for countries still reporting cases the recommendation was for use of the oral vaccine. Dr ADAMS (Australia) supported the view that reference to the injectable vaccine might be confusing. Australia, which was no longer reporting cases, was not considering the use of injectable vaccine and had no plans to do so in the future. Dr BART (United States of America) said that small countries and areas that were no longer reporting cases were continuing to purchase most of their vaccines, with WHO sponsorship, through UNICEF. Strategies were currently based only on oral poliovirus vaccine. In the future, beyond eradication, consideration might be given to strategies including the injectable vaccine with a view to elimination of circulating polioviruses of vaccine origin. However, if the Regional Office was not considering any purchases of injectable vaccines in the near future, the inclusion of a reference to such vaccines would not be relevant. Dr MILAN (Philippines), Rapporteur, suggested that since a reference to injectable vaccine was included in resolution WPRlRC44.R4, which was still in force, it should not be necessary to include it in the draft resolution before the Committee. The REGIONAL DIRECTOR said that the Regional Office had no plans to purchase injectable vaccine or to advise donors to do so. As the previous speaker had stated, resolution WPRlRC44.R4 would remain in force until superseded. The Committee might wish to consider the use of such vaccine at its next session, which would be held in the target year for eradication, rather than including a reference to it in the draft resolution under discussion. It would be preferable for Member States to concentrate all their current efforts on the eradication process. It was so agreed. The REGIONAL DIRECTOR replied to the representative of Papua New Guinea that the Western Pacific Regional Office was cooperating with the Regional Office for South-East Asia in respect of surveillance and reporting of cases in neighbouring countries. The Regional Office was also collaborating with the Regional Office for Europe in the development of poliomyelitis eradication programmes for the newly independent countries of eastern Europe.
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REGIONAL COMMITTEE: FORTY-FIFfH SESSION
He proposed that the words "ensuring efficacy and safety" should be added at the end of operative paragraph 5(6) to meet the concerns of the representative of France. Dr BART (United States of America) said that the point made by the representative of France was broader in scope than the words suggested by the Regional Director. Control and regulation involved aspects such as good manufacturing and good laboratory practices, which were important government responsibilities in relation to local production of vaccines. It might be preferable to include the words "control and regulation" in the text. The REGIONAL DIRECTOR suggested that since the term "self-sufficiency"
encompassed all the key components of control, regulation and quality assurance as to efficacy and safety, it might not be necessary to make any amendment to operative paragraph 5(6). Dr MONTAVILLE (France) was not convinced that "self-sufficiency" included all aspects of safety, since a country could be self-sufficient without having an effective regulation and control mechanism. He was sure that a suitable phrase could be found including the words "quality control" or "safety". Mr WAENA (Solomon Islands) asked whether current experience of local vaccine production warranted any fears as to safety and efficacy. Dr ADAMS (Australia) proposed the addition of the words "that meet WHO standards" at the end of paragraph 5(6) as a way of addressing the concerns that had been raised. Dr BART (United States of America) supported that proposal. Recent experience with the production of vaccines in Viet Nam had shown that there was some cause for concern. The Government had produced sufficient vaccine to meet its own needs but there was some question as to whether it had passed an independent test focusing on safety and efficacy. It was essential to ensure that efficacy and safety were independently verified. The REGIONAL DIRECTOR said that WHO standards included the idea of good manufacturing practices, which were not always in place even though the vaccines produced might be safe and effective. The use of the phrase suggested by the representative of Australia might therefore have serious repercussions in that many developing countries would find the "good manufacturing practices" aspect of the WHO standards hard to meet. The Committee might prefer to add "including strengthening national capabilities in quality control, aiming at meeting WHO standards".
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It was so agreed. Decision: The resolution, as amended, was adopted (see resolution WPRlRC44.R5).
1.6
Country visits: Report of the Sub-Committee of the Regional Conunjttee on Programmes and Technical Cooperation. Part I (Document WPRlRC45/Conf. Paper No.6) Dr TAPA (Tonga) proposed inserting in the preambular paragraph the words "Part lor'
after "Having considered" in order to be consistent with wording of the other resolutions on the reports of the Sub-Committee to the Regional Committee. It was so agreed.
Decision: WPRlRC45.R6).
The draft
resolution,
as
amended,
was
adopted (see
resolution
1.7
Membership of the Sub-Committee of the Regional Committee on Progranunes and Technical Cooperation (Document WPRlRC45/Conf. Paper No.7) Decision: The draft resolution was adopted (see resolution WPRlRC4S.R7).
1.8
Third monitoring of the implementation of the Strategy for Health for All by the Year 2000: Report of the Sub-Committee of the Regional Committee on Programmes and Technical Cooperation. Part II (Document WPRlRC4S/Conf. Paper No.8) Dr BART (United States of America), noting that during the debate concerns had been
expressed about the lack of timely reporting by countries, suggested that both the problem and the proposed solution should be set out in the resolution. He proposed, in operative paragraph 2, adding an exhortation to Member States to report in a timely way. In paragraph 2(1), he suggested deleting the word "monitor" and replacing it by a statement on supporting timely reporting by Member States. Dr TAPA (Tonga) suggested deleting the words "and promote" in operative paragraph 2(2).
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REGIONAL COMMlTIEE: FORTY-FIFTH SESSION
The REGIONAL DIRECTOR suggested that the addition urging Member States to report in a timely way should be inserted in operative paragraph 1 (2) which dealt with monitoring and evaluation.
It was so agreed. Decision: WPRJRC45.R8). The draft resolution, as amended, was adopted (see resolution
1.9
Collaboration with nongovernmental organizations: Report of the Sub-Committee of the Regional Committee on Programmes and Technical Cooperation. Part III (Document WPRJRC45IConf. Paper No.9) Dr TAPA (Tonga), referring to operative paragraph I, pointed out that the document
under discussion had clearly stated "with selected nongovernmental organizations", and suggested that the word .. selected" should be inserted after "relations with". Referring to the guiding principles for establishment of working relations with nongovernmental organizations adopted by the Regional Committee at its fortieth session, he recalled that collaboration with such organizations should be reviewed periodically. No mention was made of such review in the operative paragraphs of the draft resolution and he asked whether one should be included. Dr BART (United States of America) considered that, in the fourth preambular paragraph, the phrase reading "and that such relations may not need to be formalized if flexible working arrangements are adequate and effective", was superfluous, as selection of an organization which required formal relations was a prerogative of management. The REGIONAL DIRECTOR explained that three types of nongovernmental organizations were covered by the document: those affiliated to international nongovernmental organizations in official relations with WHO; those with no international-level structure; and those which were not in official relations with WHO. The resolution referred to those organizations which were not affiliated to an international nongovernmental organization and which were in official relations with WHO. Responding to the representatives of Tonga and the United States of America, he said that the phrase in question referred more to the regional or national nongovernmental organizations which were not in official relations with WHO. There was no need to formalize that relationship; it was sufficient to collaborate with them, hence the reference to "flexible arrangements".
SUMMARY RECORD OF THE SIXTH MEETING
201
Dr TAPA (Tonga) asked whether it was necessary to include in the resolution a reference to a review in three to five years time. Would it be sufficient to have the reference in the guiding principles? The REGIONAL DIRECTOR pointed out that such review was covered by point 4.7 of the guiding principles. However. the Regional Committee might wish to include a reference in the resolution. Mr WAENA (Solomon Islands). in the light of his country's experience. suggested that. in operative paragraph I. the word "harmonious" be inserted after "to foster". should be based on a harmonious relationship. Dr TAPA (Tonga), noting the reference in the guiding principles. considered that. as collaboration with nongovernmental organizations was likely to increase. he would prefer a new operative paragraph to be inserted to the effect that there should be a review of working relations with such organizations, and a report submitted to the Regional Committee. within five years. It was so agreed.
It should be
emphasized that the contribution of nongovernmental organizations to government programmes
Decision: WPRlRC45 .R9). 2.
The
draft
resolution.
as
amended,
was
adopted
(see
resolution
WHO RESPONSE TO GLOBAL CHANGE: REPORT OF THE SUB-COMMITTEE. PART IV: Item 14 of the Agenda (Document WPRlRC45/11) Dr MILAN (Philippines), introducing the report of the Sub-Committee. said that
although there had been three other topics for the Sub-Committee to review, the item on the WHO Response to Global Change had occupied the greatest amount of the Sub-Committee's time. She drew the Committee's attention to Annex 1. which summarized the preliminary views of the Regional Committee (as expressed at its forty-fourth session). indicated the responses of the Sub-Committee to the Executive Board action points. and noted action being taken by the governing bodies and the WHO Regional Office. the WHO Response to Global Change. Included among the Sub-Committee's responses to the Executive Board action points were the following recommendations for the Regional Committee's consideration: Annex 2 described the mechanisms which had been set up within WHO to review and implement recommendations on
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REGIONAL COMMITTEE: FORTY-FIFTH SESSION
regional/subregional workshops or other forums should consensus for changes in the health-for-all strategy;
be utilized to develop
Executive Board members representing countries from the Western Pacific Region should also allend the Regional Conunillee; the current procedures for selecting the Director-General and the Regional Directors were currently appropriate, but that in view of rapidly changing health needs throughout the world, dialogue among Member States on the issue should continue; although the current method of work of the Regional Conunillee could be generally endorsed, the need for ongoing review and evaluation in the light of changing circumstances and health needs should be emphasized. Other important mailers considered by the Sub-Commillee included: personnel in administration and management positions should be included in the scope of WHO's review of the effectiveness of current procedures and criteria for the development of appropriate staffing patterns and the selection and recruitment of staff; WHO should define and promote a relevant role for itself in the changing United Nations system, and a unified approach should be taken among United Nations agencies to programme development and implementation; projects undertaken to date on integrating health and environment considerations in sustainable development planning, and on urban health development, should be widely promoted elsewhere; with respect to the use of modem communication techniques and methods, WHO needed to be more creative and strategic in its approaches, and more involved in and aware of what is going on across the full spectrum of health-related programmes and organizations; and responding to the recommendations of the Executive Board Working Group was a collective responsibility of the Member States, and the Regional Committee should take more initiative in improving the effectiveness of WHO's work.
SUMMARY RECORD OF THE SIXTH MEETING
203
Another principal recommendation of the Sub-Committee had been that, although the mechanisms that had been set up within WHO to review and implement recommendations of the Executive Board Working Group on the WHO Response to Global Change, as welI as others that had been established for some time, were sufficient in structure to support the reform process, careful attention should be paid by alI parties concerned to utilizing fulIy and increasing the effectiveness of those mechanisms. Particularly, members of the governing bodies should participate vigorously and with greater involvement and continuity in directing the work of WHO to the ends they desired. It had been emphasized that representatives to all such bodies should be technicalIy qualified; well briefed and aware of the current issues; and prepared to participate fulIy in the work of the sessions. That would require, among other things, more meaningful and in-depth interaction between the Regional Office and the representatives; and, the effective use of available forums to develop consensus and ensure coordination of efforts. The Sub-Committee felt that the Report of the Executive Board Working Group on the WHO Response to Global Change had served to initiate a process of change and evaluation that should be ongoing within WHO in general and the Committee in particular. The mechanisms for change were apparent. The onus for making them work properly was on the representatives of the Member States, working in collaboration with the Secretariat.
The meeting rose at 11.40 a.m.