Forty-second Meeting of the Regional Director with the WHO Representatives, New Delhi 15 to 25 November 1993

Aaenda Item 14 1 . INTRODUCTION The Forty-second annual meeting of the Regional Director with the WHO Representatives (WRs) was held in the Regional Office, New Delhi, from 15 to 25 November 1993. The agenda and programme for the meeting are attached (see Annex 1 and ,Annex 2). 1.1 OPENING ADDRESS BY THE REGIONAL DIRECTOR Inaugurating the meeting, the Regional Director said that the presence of representatives from UN Agencies demonstrated their close relationship with WHO, which would become more crucial in the coming years. He reaffmed WHO’s close cooperation with partners in the UN system while fulfilling its constitutional mandate of directing and coordinating international health work and providing technical support to Member States to’attain the social goal of Health for All by the year 2000. Referring to the nomination by the Forty-sixth session of the WHO Regional Committee for South-East Asia of Dr Uton Muchtar Rafei as the:next Regional Director, effective 1 March 1994, Dr U Ko Ko took the’opportunity to congratulate Dr Uton on his nomination. Referring to the implementation of the recommendations of the Executive Board Working Group on WHO Response to Global Change, Dr U Ko Ko said that these recommendations had been discussed by the 24th CCPDM and RC46 in September 1993, and in pursuance of the directive of RC46, he had convened a meeting of the Sub-committee of the Regional Committee in the Regional Office on 5-6 November 1993 to further study the implications of implementing the recommendations at the country and regional levels and for WHO as a whole. The views and comments of the Sub-committee would be sentto the Director-General for consideration at the 93rd session of the Executive Board in January 1994. He said that the reform process in WHO was already underway at Headquarters. The Director-General had established a Global Policy Council which includes all the Regional Directors, to strengthen overall development, coordination, implementation and updating of WHO policies. *A Management Development Committee had also been established to ensure linkages of programme and budget management between headquarters and the Regional Offices, ,wherein the Directors of Programme Management from the six regions will represent the RegionalOffices. With regard to the preparation of the programme budget for 1996-1997, the Regional Director stated that the Director-General’s procedural guidance m&been transmitted to the WHO Representatives to enable them to prepare preliminary proposals- for 19961997. While drawing the attention of the WRs to the section of the procedural guidance ,that elaborated on the classified list of programmes for the-1996-1997 Programme Budget, ‘he pointed out that the programme budget proposals for 1996-1997 would be formulated on the basis of an “overall zero- growth”, using the 1994-1995 approved budget less three per cent as the planning figure. Dr U Ko Ko then referred to some of ‘the important subjects included in the agenda of the meeting, and hoped that the WRs would have an opportunity of having an in depth and analytical discussion on them. He particularly referred to the agenda ‘item on “Recent Developments in the UN System - Implications on WHO’s Role at Country Level” which would 2have an important bearing on the work of the WHO Representatives in technical cooperation in the countries in the light of ongoing restructuring of the UN system, with a view to providing more coherent, coordinated and sound technical assistance to the Member countries. In conclusion, he stated that this would be the last occasion he addressed the WHO Representatives as Regional Director. He took the opportunity to thank the WRs, both present and past, for their immense and unstinted support which enabled him and his colleagues in SEAR0 to successfully carry out the Organization’s programmes in the midst of severe financial constraints and difficulties, and for making his task easy and smooth. He was confident that the WRs would continue to provide the same kind of support to his successor, Dr Uton M. Rafei. 1.2 STATEMENT BY THE UNDP REPRESENTATIVE Mr Bayani S. Aguire, Senior Deputy Resident Representative, UNDP, Delhi, expressed satisfaction that the UNDP country field offices in the Region had extremely close and fruitful interaction with their WHO colleagues. There had been many successful combined initiatives aimed at prevention and control of diseases like malaria, leishmaniasis and leprosy. The UNDP- WHO Global Alliance against HIV/AIDS had been successfully implemented in the Asia-Pacific Region. Disaster Management and Mitigation was another crucial area of cooperation. He said that if the common concern of the UN funding and specialized agencies was basically sustainable human development, then the primacy of good health as an essential component of human development was undeniable. UNDP would welcome any concrete ideas for closer interaction between WHO and UNDP towards the socio-economic upliftment of the region. 1.3 STATEMENT BY THE UNICEF REPRESENTATIVE MS Ann-Lis Svensson, Deputy Director, UNICEF, Delhi, referred to the strong linkages existing between the two organizations in all countries of the region, She said that UNICEF’s current focus was on strong commitment towards achievement of the world summit goals for children in health and health related sectors, which had been ratified by different countries in the region. UNICEF strongly focus&l on problem areas and a particular segment of population, viz. women and children, who were the most vulnerable to preventable diseases and malnutrition. The number of areas where WHO and UNICEF had worked together were considerable: i.e. CDD, ARI, Safe Motherhood, micronutrient deficiencies, prevention and control of AIDS in women and children, immunization, and contribution of vaccine production, which, had offered tremendous scope for developing common approaches and collaboration. 1.4 STATEMENT BY THE UNESCO REPRESENTATIVE Dr John V. Kingston, Director, UNESCO, Delhi, expressed the hope that in future years it would be possible to find more areas where UNESCO might be able to help mobilize and promote support for health development. UNESCO was attempting to mobilize support for the 33 programme on AIDS education in the Sot&-East Asia Region, in cooperation with WHO. UNESCO would be happy to extend this c*ration to<other areas of population education as well. Another area of cooperation could be provision. of’safe water, The other field of cooperation could be medicinal plants in the context of ~traditionalmedicines, as there was a great deal of emphasis on traditional medicine techniques, and at the sametitie there was a great deal of ignorance about this. UNESCO had proposed to WHO Geneva that greater efforts should be placed on the area of medicinal plants in terms of the botanical aspects andalso in the area of intellectual property rights. :_ ; 1.5 STATEMENT BY THE IL0 REPRESENTATIV-E I Mrs Josephine Karavasil, Director, ILO, Delhi, stated that the particular area of interest to IL0 was labour. IL0 was the only United NationsAgency to have a tripartite structure, with governments, employers’ organization and workers’ organization, which gave IL0 the opportunity of working closely with groups of employers and workers. IL0 had”expertise, in the generation of employment and in the. areas. of social security; the fmancing of social security, and health care schemes. IL0 had also collaborated with -WHO on ADS. In this respect; ILO’s particular contribution was that of ensuring equality of opportunity and absence of discrimination in recruitment, and later on the question of insurance protection of those affected with HIV/AIDS. 2. WHO PROGRAMME REVIEW (Agenda item 2) : ‘. : - The Director, Programme Management, said that&e averall *programme implementation during the biennium 1992-1993. had showri:,rn~k~~~~~~Yem~~t, both- by country and by component, as compared with the previous biennium; This. should encourage the responsible officials at the country and regional levels to furtherimprove -amme delivery during 1994- 1995. Unfortunately, due to the non-payment of assessed contributions by some Member States, the financial constraints of WHO were likely to continue during 199&I995 also, affecting its programme implementation. _ -, ‘. *I In this context, Dr Bisht, reiteratedthatextrabudgetaryresources played a significant role. Though the share of extrabudgetary resources to the South-East Asia Region had registered a marked increase during the current biermium, 1992-1993; res@%w from.UNDP and UNFPA under WHO execution had declined. The Member countries should make concerted efforts to fully utilize the resources provided by these agencies, with a view to enabling mobilization of more resources for national health developmentfrom ‘donor agencies;. * .. j :_. , ’ Referring to the formulation of the programme’budget for the / 1996 1997 biennium, which would be based on “zero” growth in real terms, the Director, Programme’ Management sttited that at the first meeting of the Management Development Committee,. held in Geneva in November 1993, a suggestion was made by the Dimctors+~Programme Management, that the three per cent of the budget withheld by the DG from the initialplanning allocation should:be restored to the Regional Directors. However, he thought that if prioritization” was undertaken by WHO 4Headquarters, the Regional Offices might not get back the three. per cent unless the programme budget for 1996-1997 was qualitatively good, provided sound justification and adhered to the format provided in the DG’s procedural guidance. This might enable the DG to restore the three per cent to SEAR at a later date. The following observations were made during the discussions which followed: Although programme delivery in financial terms has registered marked improvement, there is a need to look into its qualitative aspects too. Ways and means of monitoring qualitative aspects of programme implementation should be explored. Perhaps the CST mechanism can be used to support the evaluation of qualitative aspects of programme implementation at the country level. Evaluation of WHO’s programme activities per se might ,be a difficult exercise in as much as WHO played a catalytic role in providing support to total national health development efforts. There is, however, scope for improving’qualitative asp&& of WHO’s collaboration. A shift should be made from budget-oriented programming to output/result-oriented programming, with a view to ensuring optimal utilization of WHO’s resources. There are a number of activities in the pipeline, for which funds have been earmarked The technical and administrative units in SEAR0 should follow up the implementation status of such activities and provide regular feed-back to the WRs so that, in case a pipeline activity is not likely to be implemented, the WR can take timely action to reprogramme those funds for another activity. There is an increasing trend towards ud hoc short-term study tours, which has many implications, This matter is under detailed review in the Regional Office. The WR’s should also carefully scrutinize the study tours suggested in plans of action and provide necessary technical guidance to the national authorities. There is a need to promote and support ,in-country training,.in view of the ever-increasing costs of training outside the country. . . If any activity is financially supported.from extrabudgetary sources and a similar activity is proposed to be implemented with WHO Regular Budget funds, WRs should reprogramme such funds for another activity, with a view to ensuring that there is no duplication of effort. At present the CST has very little information about the resources mobilized from voluntary and donor agencies for a country programme. There’ is a need to set up a suitable mechanism in the Regional Office to ensure the latest information on EBR. 5Concluding the discussions, the Regional Director cautioned that improved financial delivery should not lead to complacency; rather the Member States and WI30 should maintain the momentum in the future. Referring to the suggestion .for feed-back on implementation of pipeline activities, he stated that he would not encourage “institutionalizing” the concept of “pipeline”. Moreover, from the practical point of view, it was neither possible nor easy to provide to WRs with regular feed-back on the status of implementation. of some components, such as fellowships or S&E, which was governed -by various factors. ,fIIe :felt monitoring of pipeline activities should be integral to the implementation management.process at the country level. ,.* “ Concerning qualitative aspects of programme implementation, Dr U Ko Ko stated that the time had come for WHO to think about how to deal with monitoring and evaluating qualitative aspects of its collaborative programmes, in view of the fact that the governing bodies of the Organization were now evincing more interest in assessing- -the quality of programmes implemented by WHO. The Regional Director stated that if the original country programme proposals were prepared systematically, after a thorough study of the.>.country health situation, availability of resources, etc., it should not be difficult to translate the broad approaches, included in the programme budget document approved by the RegionalCommittee, intodetailed activities in the annual detailed plans of action. If proper planning had gone into programming, he felt there would be a minimum need for programme changes~~~~jfhis~context, he advised the WRs to be cautious and careful about programme changes, in view ofpossible objections raised by external auditors. He had already asked the programme directors to ensure compliance with the manual provisions while concluding contracts for implementing various WHO collaborative programmes. Referring to the formulation of the 1996-1997 programme budget, he said that unless SEAR presented a well formulated and qualitatively~goodprogramme~budget, it mightbe difficult to retrieve the three per cent withheld by the DG- from :ttie~~~ti~,plar~ation to country activities. He would also like the RPC to consider how this three per cent, if and when received, along with the cost increase, could be used to provide a higherzllocation to the four countries of the Region which had relatively small programme budgets. I% also requested those WRs whose offices did not have a second Medical Officer, to think about including the second post in their respective offices, which was one .way of strengtben~ing.the WR’s offices, sas. envisaged in the report of the Executive Board Working Group on’ WHO Response to Global Change. “,’ With regard to implementation of activities under- the :LCS component, the Regional Director felt that good planning should go’into implementation ofc%CS”‘activities in order to ensure good outcome of such activities. Also, there should be a systematic monitoring and follow-up system to ensure timely implementation of LCS activities. He also advised the WRs to ensure that accounts for LCS activities, already. implememed were cleared as quickly as possible since this was one of the items ~pointed out by? the extemaI auditors as requiring greater attention. -s: , ./,\ WHO, being a technical orggnization, provided technical staff to advise countries on health matters. However, most member countries of the Region now have qualified and competent people and they would not be satisfied with the support extended by WHO through its technical staff if their quality was poor. The time was ripe, therefore, to consider alternate ways of implementing WHO’s collaborative activities, such as utilization of national experts, commissioning national institutions for specific activities, technical support with staff from SEAR0 and HQ and recruitment of highly qualified short-term consultants. In future, the Regional Office should have a roster of qualified experts in various specialties, who would be available for short assignments with WHO. ACTION POINTS (1) WRs should review the position of activities planned for the remainder of 1993 with a view to ensuring their timely implementation. (2) WRs, in collaboration with SEAR0 staff, should undertake a review of the implementation of programmes financed by extrabudgetary resources in order to improve their delivery. (3) WRs should plan LCS activities systematically and thoroughly, and use their offices to clear as quickly as possible the outstanding accounts for activities already implemented under the LCS component. 3. IMPLEMENTATION OF EXECUTIVE BOARD WORKING GROUP STUDY ON THE WHO RESPONSE TO GLOBAL CHANGE (Agenda item 3) In his introductory remarks, the Regional Director said that, though this was the first time that the report of Executive Board Working Group on the WHO Response to Global Change had been brought for discussion at the RD’s meeting with WRs, the WRs had always been kept informed on this subject. In September l992, eleven talking points on this subject were sent to all WRs to elicit their views as a contribution to the work of the Executive Board Working Group. Since the recommendations of the Working Group were now being implemented or were due for implementation, it was time for the WRs to review the whole subject and be alert to the possible implications and impact of these recommendations on the work of WHO at country and regional levels. In his presentation, PLN reviewed the chronological development of the Executive Board Working Group on the WHO Response to Global Change, since the Executive Board decided to convene such a working group at its 89th session in January 1992. The review covered related activities both at regional and HQ levels. In this connection, there were three important resolutions passed by various Governing Bodies, viz., WHA46.16, EB92.R2 and SEA/RC46/R6. 7The last resolution passed by the RC46 had led to the convening of the RC Sub-Committee on 5 and 6 November 1993 to study, in depth the implications of implementing EBWG’s recommendations on the country and regional activities. ‘. Since this was the first time that the subject was to be” discussed in the meeting of RD with WRs, the presentation focussed on the recommendations- of the EBWG as reflected in its final report (document EB92/4). The attention of the meeting was called to section 4 of the report, which contained 46 recommendations classified into 9 groups according to management levels and types of activities of the Organization. There was. one recommendation reflected in section 5 - Conclusions. The meeting was informed*that the Director-General ~prioritized these 47 recommendations into three groups i.e, first priority -23,..saond priority - 18, and third priority 6. The Programme Committee of the Executive Board at its .lBth meeting divided these recommendations into three categories, i.e. those already being implemented - 5, those to be reported to EB93 in January 1994 - 20, and those to be implemented during 1994-1995 - 22. Then, a short version of some selected recommendations was presented ,according to the original classification in the EBWG’s report (i.e. Mission of WHO; Governing Bodies; Headquarters; Regional Offices; Country Offices; Coordination with United Nations and Other Agencies; Budgetary and Financial Considerations; Technical Expertise and Research; Communications; and the single recommendation in the “conclusions” section). In addition, the meeting was also informed of the observations made by CCPDM at its 24th meeting as endorsed by RC46, as well as some concerns of RC46 about the consequences of the implementation of the EBWG’s recommendations on the WHO Response to Global Change. The views/comments of RC Sub-committee on this subject were also presented for information of the meeting. .“ The following observations were made during the discussions that followed: As regards the recommendations relating to WRs and the&:offices, for these to be really valid and relevant, there should be an ad hoc’ group to make an ‘in-depth analysis of the situation. The country offices and the Regional Office should be involved in this process at all stages. ,: / Hope was expressed that reflection and drive for change in WHG would not necessarily be confined to the recommendations - stimulating but finite in number - contained in the EB report. There was a perception that the implementation of many’ofthese redommendations would diminish the role of the Regional Office, especially in its technical cooperation function at the country level. It should be recognized, however, that some of the recommendations were valid and relevant to the improvement of the functioning of the Organization, especially those relating to personnel management, the management information system and programme budgeting. 8In view of limited resources, recommendations relating to resource mobilization should be considered very relevant to the work of WHO in both short- and medium-term efforts. In principle, the rotation of WRs is acceptable, and its actual application should be carefully planned, keeping in mind above all the specificity of the conditions of Regions and specific countries. It was recognized that it would be very difficult for the WRs to exercise their leadership role effectively when they did not really have control over WHO country resources, especially the Regular Budget, and when the number of their field staff was dwindling, coupled with the difficulty of establishing new posts. In order to make WHO’s programme at country level really relevant and effective, a group of 4-5 WRs may be established to look into these recommendations in an objective manner; or the Regional Office may send senior staff members to WR’s offices to support the WRs in this effort. Attempts should be made to adequately involve the WRs in the work of development teams set up at HQ for facilitating the implementation of the EBWG’s recommendations in various areas, especially those relating to WRs’ matters. Winding up the discussions, the Regional Director appreciated the concern expressed by the WRs regarding the implications and impact of the implementation of the EBWG’s recommendations on the WHO Response to Global Change. He urged the WRs to keep themselves abreast with developments on this subject and to be prepared to be constructive and positive towards efforts directed to improving the functioning of the Organization, especially at country level. At the same time, the Organization’s decentralized management system should be maintained, especially its regional structure, through demonstrating the efficiency and effectiveness of this arrangement of collaboration with the Member States in national health development. He urged the WRs to act very diligently and help the Organization to get through this difficult period. The Regional Director advised the WRs to analyze the matter in depth from all angles. It was important to develop and strengthen the country national coordinating team, which handled international health matters. Though it was not possible to influence the nomination of government delegates to meetings of governing bodies, a sound system of monitoring, reporting and briefing at the country level would enable the country delegates to prepare themselves for attending such meetings. Many times delegates from the countries of SEAR had no chance of expressing their views, because they were not adequately briefed or fully conversant with the issues under debate. Dr U Ko Ko stated that the political and economic situation was not good at the moment. The donor countries also faced economic problems. At the same time, the process of restructuring the entire UN system was under way. In such an uncertain situation, it was imperative that WHO 9worked very closely with the countries and briefed appropriately the focal ministry, i.e. the Ministry of Health on the ongoing reforms in the UN System in general and in WHO in particular. ACTION POINTS (1) The Regional Office will continue to keep the WRs informed of further developments in the implementation of ~the EBWG’s recommendations on the WHO Response to Global Change, The WRs should also, in turn, keep the concerned national authorities informed of the developments in this regard. This topic will again be included in the agenda of the next meeting of RD with WRs. (2) (3) (4) The WRs will remain vigilant to developments relating to this subject which may come directly from, sources other than. the Regional Office, informing the ,Regional j Office of such developments and in particular, keeping senior, national officials , and board .members fully informed. \ ., r The Regional Office will try to keep all WRs apprised of all ,qsults to promote their involvement, particularly that relating to WHO country office operations. ‘i J. b : jib . .I Since many of the proposed reforms entail application of’ W&G country level operations involving the::countries and the WRs’ offices, the Regional Office should undertake a comprehensive and. objective analysis on how to resolve critical issues and improve WHO country level operations. (5) This subject should be included in the agenda of the 25th meeting of the CCPDM, to be held at the Regional Office in April 1994, with a view to apprising the Member countries and t.he=W& on the deliberations of the Ninety-third session of the Executive Board in J a n u a r y 1 9 9 4 . . ,* 4 . RECENT DEVELOPMENTS IN THE VN $YSTEM y ~~P&ICATIQ~S ON WHO’s ROLE AT COUNTRY LEVEti (Agenda item.14) . .“ In his presentation of ‘the agenda Item, PCI highlighted- significant reforms which had recently taken place in the United Nation.‘s System&$ in.operationaI activities and its structure and institutions. The UNGA resolution 44/211, together with its follow-up resolutions 46/219 and 47/199, had introduced new concepts, .policy orientations, approaches, modalities and responsibilities for planning and implementing United Nation&Technical Cooperation Activities , ,c: 1 0 at country level. The reforms and changes which were of immediate significance to WHO included, inter aliu, those relating to the mandate for Resident Coordinator, programme approach, national execution, coordinated and integrated response of UN System, decentralization, and Country Strategy Note. UNDP and UNFPA had resorted to the programme approach and national execution of their programmes; which had left WHO with a diminishing role as an executing agency. In most of the UNDP’s Fifth Country Programmes, which were based on certain thematic orientations, the visibility of health priorities was rather low. Yet WHO had, to seize every occasion to work closely with UNDP and the Ministry of Health and make technical contributions to UNDP’s country and intercountry programme formulation with a view to promoting health components. The UNGA Resolutions 46/219 and 47/199 introduced the concept of Country Strategy Note (CSN), which would be a government document reflecting the country’s developmental priorities and the areas where the UN System resources could be best utilized in a coordinated manner. The WRs had a specific responsibility to see that health priorities were adequately reflected in the CSN when formulation of such notes was undertaken by Governments. WRs should remain in consultation with the Ministries of Health as well as the UNDP Resident Representatives on this matter. The UN Secretariat is restructured into three new departments, of which the Department for Policy Coordination and Sustainable Development is the main interlocutor for WHO. The other major reforms initiated by the Secretary General included: .measures to strengthen and broaden the Regional Commission’s coordinating role among the UN agencies at regional level; an experimental initiative towards the formation of a single United ‘Nation’s presence in six countries of the Commonwealth of independent States; and establishment of the Department of Humanitarian Affairs for carrying out an enhanced role in humanitarian assistance, emergency preparedness and relief operations, which had assumed great significance in the UN System activities. The fourth International Development Strategy recognized the importance of the social sector in overall human development. This new approach had resulted in important positive developments for health. The World Summit for Social Development would be convened in March 1995 in Copenhagen. WHO would make contributions to the Summit projecting health action for sustainable social development. The reforms within the UN system and the ‘global politico-economic changes are multidimensional. WHO no longer enjoyed singularity of its role in health. Many other agencies, such as UNICEF and UNFPA, had moved into the technical operations of health programmes such as safe motherhood, nutrition, EPI, MCH etc. Being increasingly cost conscious, funding agencies had the option of buying expertise ,elsewhere than WI%.% There was competition for resources at a time when the worldwide economic recession, donors’ fatigue and diversion of resources from social development to other efforts had reduced thk availability of resources for health. These trends posed a serious challenge to WHO’s leadership role in>health, warranting a new equation in its inter-agency relationship. J11 WHO’s immediate stand in the emerging scenario could be: commitment to the coordinated approach; participation in inter-agency mechanisms at all levels; assertion of its leadership role; providing support in strengthening Ministries of Health coordinationcapabilities; catalytic support in an outside health sector to focus on national h&l& development; support to governments and other agencies in mobilizing resources for health; and maintaining WHO’s special relations and direct communication. The observations made during the discussions are summed up: below: The UNDP Resident Representatives have initiated, efforts to persuade the Ministries of Planning/Departments of External Resources to formulate country strategy notes. However, the Governments do not seem prepared .or keen to undertake the exercise yet. Only in Thailand has a draft note been prepared so far. The WRs need not initiate or promote the CSN. If the governments initiate formulation of the country strategy note, the WRs should be alert and participate in the’exercise and, ensure that. health priorities are properly reflected in the CSN. The detailed instructions in this regard have already been sent to WRs from SEARO. The UNGA Resolution 44/211 and its possible implications for WHO:were discussed at the Regional Committee, the Executive Board and the World Health Assembly, which had given clear guidance with regard to WHO’s policy stand. on the resident coordinator system and the other issues raised in the UNGA Resolution. WHO accepts the principle of coordination and the leadership role of the Resident .Coordinator so long it does not interfere with the organization’s technical role. “ ” Despite UNDP and UNPPA resorting to national execution, there are still opportunities for WRs to make strong technical contributions to the formulation of UNDP country programmes and to mobilize UNDP resources for health through pro-active action, working closely with the Ministry of Health and the ,RR/UNDP. Efforts should .be made to ensure that appropriate health components are incorporated,within the broad framework of the theme-based UNDP progsammes such as poverty alleviation, human resource development, technology transfer etc. All these programmes offer scope for merging health components, although not in a distinct and highly visible .marmer as under a separate health sector programme. WHO/HQ has set up a task force to clearly identify WHO3 ‘relationship with the UN Department of Humanitarian Affairs IDHA), WHG’s role, in the UN sponsored humanitarian operations and emergency preparedness. is assuming greater importance and this will lead to increased involvement .of WRs in rebef. -operations and emergency preparedness-activities at the country level.- There will, be;a need fortraini-ng the WRs in the management of humanitarian assistance. 1 2 Health is no longer confined to the health sector or for that matter to the Health Ministry alone. Health issues are proliferating into many other development issues. This necessitates a new orientation of WHO’s role at the country level so that a new collaborative relationship can be developed at the country level between WHO and the other development ministries, promoting health as a part of the overall national development. - In a changing environment, WHO should conserve its strength and concentrate its efforts where it is strong. WHO welcomes the contributions of other partners in countries’ health development efforts through parallel programmes and technical ‘operations in health. Countries have improved their own technical base and funding agencies can buy expertise outside WHO. There is no doubt, that in the face of the challenge from these trends, WHO will have to reassert its technical leadership role in health. WHO’s task will be difficult if it dilutes its efforts by becoming too involved in areas marginal to its mandate, and in marginal roles not congruent with its basic structure and functions. The crux of the problem for the organization is to maintain a very high level of technical standard at the country level and thereby retain its credibility by showing high efficiency and effectiveness to inspire the confidence of governments, UN agencies, donors etc. The main concern should be to find ways and means to do this. Summing up, the Regional Director felt that the discussions on this important subject should be continued both at the country and regional levels. As things were moving quite fast, and some of the WRs were also changing, it was necessary to,continue the dialogue at various common fora at the country level. He said that the country strategy note was a new mechanism being envisaged for providing coordinated support to a country’s needs, and that SEAR0 had sent several briefing notes to the WRs in this regard. The WRs should effectively participate in such an exercise to ensure that health secures a pivotal place in the UN support. He also referred to the recent emphasis on national execution of projects financed by certain UN agencies. WHO should also realize that many agencies, especially UNDP and UNPPA, had moved away from traditional methods of execution. WHO should, therefore, explore alternate ways of implementing its collaborative activities and continue to give technical support to countries. ACTION POINTS (1) The decisions and recommendations of the RC, the EB and the WHA in respect of WHO’s policy stands vis-a-vis the reforms and, changes introduced by the UNGA Resolutions 44/211i 46/219 and 47/199, have been made available to WRs. WRs should refer to them for guidance in their day-to-day dealings with the Resident Coordinators as well as on issues of ‘coordination with other agencies. 13 (2) (3) (4) (5) (6) WRs should extend their form& and informal contacts and establish collaborative relati9nship.s witbXministries/departments, particularly the Ministry of Planning, --Ministry of Finance, the External Resources Department and other development ministries having programmes through which health can be promoted, without minimizing the role of the Ministry of Health. The Resident Coordinators have been given a’ special role in environment related programmes. W’RS should try to promote health concerns of environmental issues. In order to continue the leadership role in health, sustained efforts to maintain the high techmc~al competence ,of the organization, including provision of high calibre consultancy, is essential, together with ‘quick response to national problems. WRs will have to find ways of utilizing national expertise as much as possible without compromising standards. Some..of t’hese ways may be by commissioning’ national institutions, hiring national consultants, etc. However, ,this should be done carefully and following WHO rules. The subject of WHO’s role in humanitarianassistance should be included as an agenda item for the next CCPDM. ..’ 5. NINTH GENERAL PROGRAMME OF WORK (Agenda item 5) < In his introductory remarks, the Regional Director informed the meeting that it was necessary to understand clearly the content -and direction of the -Ninth General Programme of Work since the policy and programme framework of the prop&d programme budget for 1996- 1997, which was the first of three biennial programme bu&&ts for operationalizing the Ninth General Programme of Work, was now under preparaition[‘He referred to the new classified list of programmes and the format for preparation of country progiamme statements, and said that it was important that these were clearly understood in order to develop good programme budget proposals. ; , ; ’ In his presentation, PLN informed the meeting that the second draft of the Ninth General Programme of Work (document EBPC19/4) was av$abie fp?:z&vi&v and discussion by the meeting. He also mentioned, that since the proposed’ 1996- 1997 programme budget had to be prepared soon, his presentation would also focuson .the DG’s, procedural guidance for such preparation, including the new classified list of programmes and the new. format for country programme statements. 1 4 Comparing the contents of the 8th and 9th GPsW, PLN pointed out that the broad description for each programme that existed in the 8th GPW would not be available in the 9th GPW, and although the same classified list of programmes had been used for the whole period of the 8th GPW, for the 9th GPW the CLP would be modified/changed/adapted from one biennium to the other. With regard to the classified list of programmes, PLN stated that in the 8th GPW, there were four main categories, under which there were five two-digit programmes and fifty-seven three-digit programmes; while in the 9th GPW there were 6 main categories of programmes with 27 sub-categories, under which there were 11 two-digit programmes and 50 three-digit programmes. He pointed out that the total number of programmes in the two GPsW were not much different. Concerning the proposed programme budget for the 1996i997 biennium, he stated that there were three documents to be used as guides, i.e. Procedural Guidance for the Preparation of the Proposed Programme Budget for the Financial Period 1996-1997 (document CDG/93.1), Draft Ninth General Programme of Work (covering the period 1996-2001) (document EBPC19/4), and the Regional Director’s memorandum conveying planning ~figures to countries along with his specific instructions on the preparation of the proposed programme budget for the 1996-1997 biennium. He also highlighted that the proposed programme budget for the biennium had to be prepared in the context of the four programme directions as reflected in the 9th GPW and taking into account the four global priority themes as prescribed in the procedural guidance (document CDG/93.1). A matrix illustrating the contribution of proposed programme activities to the four directions was shown for facilitating the programming process. As regards the format for the preparation of country statements, a comparison of the contents of such statements between the 1994-1995 and the 1996-1997 PB was made. PLN pointed out that, instead of the definition of the programme objective, the expected programme output/result might be used. However, he cautioned that defining the programme output/result was more difficult than defining the programme objective. As for the activities, broad activities, types of activities, groups of activities or major areas of activities should be used. However, expected outputs from these had to be defined. To apply the rolling plan concept in the implementation of the 9th GPW, projections of activities for the period 1998-2001 had to be made in the proposed 1996-1997 biennial programme budget. This would facilitate the formulation of the succeeding biennial programme budget. ‘_ Concerning the proposed budgetary requirements, PLN pointed out that, even though the planning figures had been provided and the proposed activities would have to be planned within the resources reasonably expected for the programme, attempts .should be made to apply the principle of budgeting by objectives/targets/expected results, as indicated in the Ninth General Programme of Work. The difference between the estimated’budgetary requirements and the CPF, if any, could be adjusted by prioritizing the proposed activities. An indication of major collaborators, both governmental and non-governmental, in the achievement of the proposed activities or expected outputs should be given. Budgeting requirements from regular budget for the 1996-1997 PB should be provided in comparison to the approved budget of the 1994-1995 PB. 15 The following main issues emerged during the ensuing discussions: The classified list of programmes determined the structure of the programme budget which was prepared on the basis .of national health .po&ies, strategies and programmes and to a certain extent the CLP determined the form and format of the PB. The frequent changes of the CLP during the period of the General Programme of Work might create more work and difficulty. Only broad types, groups or areas of activities are required at the stage of PB preparation. Specific activities which wouId be identified during the preparation of detailed plans of action need not be specified at this stage. It was clearly evident that more information was needed for the preparation of the 1996- 1997 PB, due to discontinuation of the Regional Medium-Term Programme, in order to make evaluation more effective and rational. As the CLP for the 1994-95 PB differed ‘from that proposed for the 1996-97 PB, it would be difficult to compare the ‘approved budget of ‘the 1994-1995 PB with the proposed budget for the 1996-1997 PB. But attempts have to bemade. Due to considerable differences between the *format for‘ the preparation of the 1996-1997 PB and that for the preparation of the PBs of pr&ous biennia, “dummy” country programme statements should be prepared by the RegiunaI:Office for facilitating the preparation of the 1996-1997 PB at country level. The principle of budgeting by objectives/targets/expee&doutputs could still be applied to the process of programme budgeting even though: the country planning figure was provided. In this connection, prioritization of proposed activities should help to reconcile the differences between the estimated budgetary requirements and the CPF. In his concluding remarks, the Regional Director statedthat all attempts should be made to develop the proposed 1996-1997 programme budget, satisfyingi the information requirements as indicated in the DG’s procedural guidance (document CDG/93.1). The proposals should be developed on the basis of countries’ needs and requirements for their health development and within the framework of the Ninth General Programme of Work (document EBPC19/4), which was still in draft form. However, it was not expected that dhanges in the format or content of the 9th GPW, if any, from now until its approval by the World Health Assembly in May 1994, would affect the preparation of the 1996-1997 biennial programme budget. While sharing the concern of the WRs regarding the changes-in the ,CLP and the new format for preparing country programme statements for the 1996-1997 PB, the Regional Director informed them that these, changes were the outcome of a global consensus, :which ‘need not confuse governments. But the WRs, along with the International Health Divisions of ,the’Ministries of Health, should try to satisfy the needs and requirements prevailing in countries’of ‘tbi%t Region, and WHO should include them in the 9th GPW framework. What was, however, important was the preparation of a good country programme budget, with adequate situation analysis and justification, and according to the new format. 16 A C T I O N P O I N T S (1) (2) (3) (4) (5) (6) The WRs should ensure the preparation of a well formulated country programme budget for 1996-1997 in the new format, with good situation analysis and justification and meeting the information requirements of DG’s procedural guidance. The national health development plans and programmes should serve as the basis for selection of activities. “Dummy” country programme statements should be prepared in the Regional Office and sent to the WRs by the middle of December 1993, in order to facilitate the preparation of country programme statements for the proposed PB 1996-1997 . The country programme budget proposals for 1996-1997 should be well formulated in order to enable RD to, approach the DG for restoration of the three per cent withheld by the DG from the initial planning allocation. The WRs should thoroughly brief the responsible national officials in the use of the new CLP and format for preparation of the proposed country programme budget for the 1996-1997 biennium, and ensure that the changes proposed are understood and applied. The Regional Office might consider providing some staff support through the CST for the preparation of the 1996-1997 country programme budget in a limited number of countries. The completed draft of the proposed country programme budget for the 1996-1997 biennium should be sent to the Regional Office at the latest by 21 February 1994. 6. AIDS - AN UPDATE (Agenda item 6) At the outset of his presentation, TL-GPA thanked the WRs for their commitment and active involvement in supporting and guiding national AIDS control programmes in the region. He described the latest HIV/AIDS situation in South-East Asia and stated that the HIV epidemic continued to present a grave scenario and that HIV seroprevalence in many countries was increasing, not only among individuals with high risk behaviour but also in the general population. In hitherto low prevalence countries too, HIV infection rates had been increasing, particularly among commercial sex workers and among patients suffering from other sexually- transmitted diseases. The AIDS cases reported in 1992 increased six times compared to the previous year. 17 Briefly outlining the priorities for national AIDS programmes; TL-GPA urged the WRs to continue to carry out advocacy work towards enhancing’ political commitment forHIV/ AIDS programmes. While all counties had demonstratedgo@%nment commitment toFBV prevention, in a few countries this had not yet -been translated i&o practicalaotion. Commitment towards a coordinated multisectoral response was reflected in. the second generation of ‘medium-term programmes developed by many countries. Given the relative low HIV seroprevalence in the general population, the programme ,priorities should include interventionstaqted to-high-risk behaviour groups, introduction of AIlX/STD education in schools, condom social marketing and sttengthening of case management of ST&. - I, a .I , 4 Regarding-the update-on tiGle&al Programme on ARYS @PA), TL-GPA briefly spoke about the development related to the proposed jointan&co&pc&so& IBV/AB%~ programme and about the budget situation globally for the programme. En order to strengthen management capacity at the country level, GPA had developed a programme management course based on the modules, similar to those used by the EPI and GD3D~programmes:- This programme was now available and the first, intercountry course would’beheld&r @#arch 1994. ; \ ._ ;, ,_ i. ,‘. The following obse~tions were made&ring~the d&@&ion: WHO should ,continue to demonstrate its lead&ship rol&atHQ, regional and country levels. Indeed, in many countries, WHO is’ the ~onlyag&icy which initially supported national AIDS programmes, though now other agencies~are~~oining in. The countries should realize that the AIDS programme is their own programme and that they have overall responsibility for coordination of Pl programme-related efforts at country level. ~. ‘1 .;., ‘34 In all countries, notable progress is being made bythe prograinme, ,particularly in areas such as involvement of NGOs, women’s groups and youth organizations in AIDS prevention activities. I . . Given the changing situation globally, WRs should adjust accordingly~with respect to their role at the country level. While WRs will continue to have critical roles in supporting HIV/AIDS prevention, programmes, they will have, to. develop mechanisms for working together with other agencies. ‘, ,; ‘ , -: : Although many countries are now devel6piri-g ~multisectoral response to AIDS, coordination has often been problematic. Moreover, coordination is needed among UN and donor agencies to avoid overlap in activities. In this process WHO should serve as initiator and should also serve as the secr&@iat for’ such .ac&ities. Given the close association between STD and AIDS; the-two programmes should be integrated under one focal point. This should helpmaximize the use of limited resources. National expertise. in the area of AIDS is rapidly developing within the region, and this should be kept in mind while defining the role a% GPA country staff. ‘. .’ . : ,18 The Regional Director, during his summing up remarks, pointed out that countries now had lot of expertise in AIDS prevention activities and that WHO’s technical support should be considered in this context. Commenting on coordination problems, he stated that it would be important for countries to develop good mechanisms of coordination at the national level which would provide a framework to be used by all donors. ACTION POINTS (1) (2) (3) (4) (5) (6) WRs should assist the countries to develop. needs-based comprehensive plans with technical assistance from WHO country, regional and/or HQ staff, so that donors who are interested in supporting the programme can opt to provide support to a part of this plan. WRs should continue to provide the required support to the development of strategic national AIDS programmes, taking, into consideration the technical capacity at the country level, and should participate in resource mobilization. WRs should play a lead role in coordination among UN and donor agencies by organizing regular meetings to share information and to avoid duplication of effort. WRs should continue to play its advocacy role’ in mobilizing multisectoral responses, in enhancing political commitment, and in promoting priority interventions at country level. SEAR0 should provide updates on country experiences and develop mechanisms for sharing effective approaches and interventions between countries. SEAR0 and the WRs should evaluate the technical capacity at country level and should develop a roster of potential consultants from within as well as outside the region who could provide technical support and assistance to the countries. 7. WOMEN, HEALTH AND DEVELOPMENT (Agendaitem 7) In presenting the agenda item, the Chairperson of the WHD Core Group reviewed the progress made over the past year in implementing various activities. of the SEAR WHD Plan of Action and in following up the action points arising out of the previous discussions with the WRs on WHD. The development of a WHD database and the resource centre to strengthen technical support and facilitate exchange of information on WHD were well underway. The Global Commission on Women’s Health was now being established and would include three members from the South-East Asian Region. The Chairperson outlined the plan for a series of national and regional meetings in support of the work of the Commission as well as the WI-ID strategies for 19 SEAR. The preparatory activities taking place at country and regional level ,for the 4th World Conference on Women to be held in 1995 had afforded opportunities for intensified collaboration among WHO, governments, NGOs and UN and donor agencies and more substantive technical inputs on women’s health issues. In addition, the Chairperson highliihtedexampleL’of the increased attention being given to WHD such as in the goals and targets of the Ninth General Pi-&&mme ofWork and in the emphasis on sex-disaggregated data in the. Third” Momtoring of I%FA ‘Stiaiegies. Also, Women and AIDS was now receiving greater priority, and GPA had developed a framework for action for consideration in national and regional AIDS programmes. SEA/AC recently called for an increased emphasis on research into women’s health in priority researchable areas and on the enhancement of the role of women in promoting health’& a follow-up to this recommendation, a review paper would be commissioned to lay the foundation for future research initiatives related to women’s health. .) PCI, the Chairperson of the WHD Advisory Group also. noted the role of WHO in forthcoming regional and global conferences related to women and advised that efforts to incorporate WHD issues would be most effective if started at .country .level. during the national preparatory activities. He also requested WRs to keep the ‘Regional Office updated on WHD- related activities and resources for inclusion in the: database an$‘resource. centre.,.. _^ During the discussion ‘the following observations were made: Since the working paper presented a comprehensive overview of the WHD initiative in SEAR, it should be updated and revised based onthe comm&tsprovided, and should be widely circulated. The exchange of information on WHD could be expanded by establishing linkages with existing networks, such as HELLIS and POPIN and other networks specific to women in development and women’s health, and by contributing torelevant journals and newsletters in addition to WINAP. A regional overview and plan .of action for the ‘Se&&Asia and Pacific Ministerial Conference on Women in Development, to be held En Jakartti in -1994, are currently being prepared by ESCAP. A request. has been made for copies of the documents to be sent to SEAR0 along with the concerned UN agencies for comments prior to their distribution. Examples of WHD-related country activities and developmen& were provided, such as the creation of a separate ministry for women’s affairs in Maldives; the appointment of a Joint Secretary for gender issues in the he’alth ministry of Bmgladesh; the proposed national meetings on WFID in Indonesia, Maldives and Nepal; and the village voluntary programme established by women in Bhutan. Specific acknowledgement was made of the important contribution of women’s groups, NGOs; community health volunteers, nurses and midwives in promoting women’s health in the countries of the Region. .’ 2 0 Because of the increasing activity and collaboration at country level related to women, health and development, there is a need to establish mechanisms for more effective coordination among the involved UN -and donor agencies, *NGOs and governmental sectors. With respect to the national a&regional meetings on W!I@Din support of the Global Commission on Women’s Health, efforts should be made -to involve the relevant UN agencies in a planned and coordinated manner, and particularly to facilitate follow-up action. The increasing number of women in the workforce in many couutries due to rural-urban population shifts and increasing industrialization is having serious implications for women’s health. Thus, women’s health in the work place,was identified as a priority area for research as well as for provision of appropriate health services. Other areas identified for priority research included women’s vulnerability to life-style related diseases and AIDS, and the role of women, as health workers or health volunteers, in health provision, health promotion and health ‘development.,, The need for WHO to demonstrate its commitment to promoting gender-sensitivity in the Region was acknowledged. One opportunity’ is to strengthen the recording and reporting of sex&aggregated data in the third monitoring of HPA strategies currently being carried out. Other opportunities to be explored include the provision of gender-sensitivity training and guidelines in WHO offices and countries. Because of the comprehensive nature of the WHD initiative, it was suggested that the representation of WHD interests should be strengthened in the Regional Programme Committee, especially in the special RPC meetings for the 1996/1997 programme budget. In conclusion, the Regional Director noted that women’s health issues and women’s perspectives had been advocated in various fora and through various mechanisms over the past several decades. Meetings and conferences and efforts. to promote the greater involvement of women should be viewed not as ends in themselves but as means for doing something to achieve the overall WHD objectives. He stressed the need for specific concrete actions in countries to effect improvements in women’s health status. In response to’the suggestion for strengthening the WHD initiative as an integral part of WHO collaborative programmes; he advised that PCI, as Chairperson of the WHD Advisory Group, could represent WI-lD ,interests in the Regional Programme Committee. ACTION POINTS (1) The WHD Core Group should periodically send to the WRs and LO/ESCAP a current listing of the reference materials available in the SEAR0 WI-ID resource centre to facilitate dissemination and use of information on WHD. The, WI-ID Core Group, in coordination with WRs, should promote advocacy for WHD in countries through, for example, production and wide dissemination of a periodic newsletter to raise awareness, and should stimulate concerted action at country level. (2) (3) (4) (5) (6) 2 1 WHO at all levels should promote the strengthening of WHD information systems, including inputs to the SEAR0 database, collection of. sex&aggregated data and research on women’s health in areas where more specific data is needed. WHO at all levels should advocate for wider. involvement of women in national and international meetings on WI-ID, and should coordinate with other UN and bilateral, .agencies on health components of WHD movements in the countries. WRs should provide the necessary technical advice on gender issues and support the incorporation of women, health and development components in WHO country prog&unmes, wherever appropriate. WRs should sensitize the Ministries of Health regarding the forthcoming World Conference on Women in Beijing and other such related international conferences on women, and advise on the inclusion of specific health issues in contributions by countries in regional and global documents. In the review of WHCJ collaborative programmes, the RPC should ensure that WHD issues are adequately monitored and addressed. 8. THIRD M?3NITOP~G OF HFA STRATEGIES(Agenda item 8) In his introduction to the agenda item, RA/HS mentioned that the Third Monitoring of the implementation of HFA strategies should have commenced in September 1993 and should be reported by Member countries before the end of February 1994. Itprovided Member countries with an opportunity to monitor progress in their efforts to: strengthen their mechanisms/processes. for national health development; improve intrasectoral coordination and intersectoral collaboration; improve their health information systems (collection, validation and utilization of data); strengthen health system infrastructures; use available resources more effectively and efficiently; and propose and implement priority actions for improving the health status of the entire population with emphasis on equity, vulnerable/priority groups, etc. As a result of this exercise, each Member, Country should be in a. position to: identify areas requiring action and outline the type of action needed, revise/upd$te the national plan of action for implementation of national HFA strategies; and report findings from the monitoring to WHO. He then briefly outlined the objectives of the Third Monitoring exercise, the contents of CFM3, the time-frame for undertaking this exercise and the observations/recommendations of the 24th meeting of the CCPDM, held in the Regional Office in September 1993. ’ j During the ensuing discussions, the twenty global indicators were noted. It was pointed out that, although there were now twenty global indicators an&heir serial numbers differed from those used in the earlier monitoring and evaluation frameworks, there were practically no changes in their content. Issues related to obtaining disaggregated data, the multisectoral approach, and practical steps to be taken during the CFM3 exercise were brought up and clarified during the discussion. 2 2 ACTION POINT% 3‘ b (1) (2) (3) The WRs should assist those persons and/or institutions who, are responsible for conduct of the Third Monitoring exercise in setting up a national task force, clarifying terms of reference for this task force, and developing a plan of action. WRs%ay also be of assistance in identifying national information and management systems which would be relevant to the Third Monitoring. ’ It should be stressed by WRs that the Third Monitoring exercise is a national endeavour that involves various,, governmental and non- governmental agencies, including professional associations in the health and related sectors, and ‘it should use existing national processes/mechanisms. The national reports should be submitted to SEAR0 by the end of February 1994. The WRs’should assist the -national authorities in’ identifying. areas where WHO/SEAR0 support for Third Monitoring activities may be required, as well as in defining the‘type of support needed and clarifying the scope of such support. 9. MEETINGS AND SPECIAL ADDRESSES In addition to the plenary sessions, the WRs 3also had, an informal meeting among themselves before their confidential session with the Regional Director. The WRs had separate meetings with the Support Programme on administrative matters, and withfthe representatives of the Staff Association on staff matters. There were also speci.al,add$esses by Mrs,,R. .Weidmer, Chief, PENS, WHO/Headquarters; Dr “FL-Melton, Director, JMS, WHO/Headquarters; and ‘Mr Nicholas Michael, Deputy Manager, Swiss Bank Corporation, ‘Geneva. .” 10. CONCLUSION i ” WR Bangladesh thanked the Regional Director for his, unstinted supp.ort and advice which greatly helped WRs in discharging their duties more efficiently, :.He lauded the, contributions made by Dr U, Ko Ko, the Regional Director. He w,as personally extremely ~influenced by his knowledge and technical excellence, and above all by his, human qualities, and his sympathetic attitude towards WRs and all other staff. Referringtothe retirement of Dr U Ko Ko, he said that it was not like the last movement of a symphony. He hoped that even after his retirement, his technical expertise would continue to be available to the countries of the Region. He also thanked Dr D.B. Bisht, DPM, and other Programme Directors/Chief who would also be retiring soon. Congratulating Dr Uton M. Rafei on,his election as RD, he expressed, the hope that, with his knowledge and experience, he would steer the WHO Regional Office through the formidable tasks and cha l lenges ahead . ‘! : 2 3 WR, Mongolia, on behalf of all WRs, expressed his thanks and gratitude to the Regional Director for having given them an opportunity to discuss issues of mutual concern, and said that he had nothing to add after the kind sentiments expressed by WR Bangladesh. Dr Uton M. Rafei, RD-nominate, said that Dr U Ko Ko was like Saya (Guru), who not only guided him in his approach to work, but also advised him how to deal with all the governments of the Region, etc. He felt that learning lessons from the past would greatly improve the image of WHO and the countries. He was glad for having been nominated as the Regional Director from 1 March 1994. He said that there was a great challenge lying ahead, and there was a need to appropriately respond to the future change, not because of requirements of UN system but because of requirements in many countries and the global trend. He felt that this change was not for the sake of change, but it would perhaps be better for human life. He felt that WHO should continue to maintain its high image and be responsible in the technical field especially in technical coordination in health development. He believed that this would be possible not by the efforts of one person but by moving together hand-in-hand. He was sure that the advice and guidance of Dr Ko Ko would be available even after his retirement. He wished him all the best. The Regional Director thanked the WRs and RD-nominate for their kind sentiments. He said that, apart from AIDS and WHD, most of the other agenda items discussed at the meeting related to the WHO requirements of the future. He emphasized that the year 1994 would be very important and crucial in many ways. The Regional Office would continue to give guidance and coordination to the WRs, but at the country level the whole future depended upon how the WRs would react, proact, and deal with the various agencies, and especially the donor agencies. He advised WRs to remain alert and to keep themselves abreast with the latest developments, as a lot of changes would be taking place inside and outside WHO. The extent of closeness of the WRs to the Ministries of Health and Foreign Affairs would determine the future of WHO. H e stressed the importance of the International Health Divisions in the Ministries of Health, which needed to be strengthened further, and there was a need to make them understand and follow the proceedings of WHO governing bodies very well. He re-emphasized that HQ, the Regional Office and the countries should work as a team, using their best efforts wherever necessary. This being his last meeting with the WRs as Regional Director, he thanked the present and past WRs, and the professional and General Service staff for the support given to him during his tenure as Regional Director. He urged all to give full support to Dr Uton during his tenure as Regional Director, and hoped that Dr Uton would do very well. He wished everyone all the best and a very successful future. Finally, the Regional Director wished all the WRs safe journeys back to their respective duty stations. Annex - 1 WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR SOUTH-EAST ASIA For&-second Meetina of the Reaional Director SEAMIR42Il with the WHO Representatives, New Delhi Rev. 1 15-25 November 1993 20 July 1993 jl5-17 November 1993: Individual Discussions with PO&Chief & 18-25 November 1993: Plenary Sessions and Special RPC Meetinasl PROVISIONAL AGENDA (for Plenary Sessions and Special RPC Meetings) 1. 2 . 3 . 4 . 5 . 6 . 7. 8. 9. 10. 11. 12. 13. 14. 15. Opening address by the Regional Director and Statements by Agency Representatives WHO Programme Review by Director, Programme Management Implementation of Executive Board Working Group Study on the WHO Response to Global Change Recent Developments in the UN System - Implications on WHO’s Role at Country Level Ninth General Programme of Work AIDS - An Update Women Health and Development Third Monitoring of HFA Strategies WHO Representatives’ Informal Meeting Administrative Matters Meeting with Staff Association Representatives Special RPC Meetings to review (a) preliminary programme budget proposals for the biennium 1996-1997; and (b) annual detailed plans of action for 1994 Confidential Session of the Regional Director with the WHO Representatives Summing up of Issues Closing Session - 2 WORLD HEALTH REGfONAL OFFfCE FOR ORGANIZATION SOUTH-EAST ASIA For&-second Meetina of the f%m&ml Director with the WHO Reoresentatives, I4mv Delhi 15 to 25 November E&93 SWWR42ll. 1 Rev.2 30 September 1993 _-__-_-___--__-________________________D--_ ____________-____________________-------- Date Timing Agenda Item -----------__-__--_-_l___________l____ --_-------___-_-_-I_---------------------------- Mon, 15 Nov to 0900hrstof700hrs Individual discussions with @mgmmme Diihief and Wed, 17 Nuv their groups (see Annex) Thu, 18 Nov o9oohrsto1mhrs Agenda Item 1: Opening address by the Regii Director and Statements by Agency Representatives lOOOhrsto103Ohrs Tea/Coffee Break 1030 hrs to 1130 hrs Agenda Item 7: Women Health and Development 1130 hrs to 1300 hrs 1430 hrs to 1545 hrs Agenda Item 6: AIDS - An Update Agenda Item 5: Ninth General Programme of Work Fri, 19 Nov 16OOhrstolMOhrs 0900hrsto1030hrs 1045 hrs to 1230 hrs Agenda Item 8: Third Monitoring of HFA Strategies Agenda Item 3: ImplemPntation uf Executive Board Working Group Study on the WHO Response to Global Change Agenda Item 4: Recent Developments in the UN System - Emplications on WHO’s Role at Country Level 1400 hrs to 1600 hrs Agenda Item 9: WHO Representatives’ Informal Meeting Sat, 20 Nov 0930 brs to 1XKl hrs Agenda Item 10: Administrative Matters 14OObrsto16OOhrs ’ Agenda Item 13: Confident&d Sdssion of the Regional Diiettor with tbe WHO Representatives 2----------------_-------------------------.------.-------------------------------------------------------- Date Timing Agenda Item Mon, 22 Nov Tue, 23 Nov 0845 hrs to 1030 hrs llOOhrstol23Ohrs 1330 hrs to 1700 hrs 1330 hrs to 1500 hrs 1500 hrs to 1600 hrs 1600hrsto1700hrs 09OOhrstol03Ohrs 1030 hrs to 1200 hrs 1330 hrs to 1500 hrs 1500 hrs to 1630 hrs Wed, 24 Nov 0 9 0 0 hrs to 1030 hrs 1030 hrs to 1200 hrs 1330 hrs t o 1500 hrs 1500 hrs to 1630 hrs Thu, 25 Nov 09OOhrstolltXhrs Apenda Item 11: Meeting with Staff Association Representatives Agenda Item 2: WHO Programme Review by Director, Programme Management Agenda I&m 12: Special RPC Meetings to review (a) preliminary programme budget proposals for the biennium 1996-1997; and (b) annual detailed plans of action for 1994 - Bangladesh - Bhutan DPR Korea Agenda Item 12: Special RPC Meetings to review (a) preliminary programme budget .proposals for the biennium 1996-1997; and (b) annual detailed plans of action for 1994 India Indonesia - Maldives - Mongolia Agenda Item 12: Special RPC Meetings to review (a) preliminary programme budget proposals for the biennium 1996-1997; and (b) annual detailed plans of action for 1994 - Myanmar - Nepal s Sri Lanka s Thailand Agenda Item 14: Summing up of Issues Agenda Item 15: Closing Session 1. All plenary sessions during 18-22 November, and on 25 November will be held in the Conference Hall. 2 . The Informal Meeting of WHO Representatives (Item 9), Meeting on Administrative Matters (Item lo), Meeting with Staff Association Representatives (Item 1 1), and the Confidential Session with the Regional Director (Item 13) will be held in the Committee Room. 3. The Special RPC Meetings during 22-24 November will be held in Room 220. 4 . During plenary sessions, Tea/Coffee Break will be at 1030 hrs and at 1545 hrs and Lunch Break will be during 1230-1430 hrs, unless shown otherwise. 5. DSP will be the focal point for organizing social events.