Western Pacific Advisory Committee on Medical Research, Manila, Philippines, 14-16 April 1980 : report of the fifth session

ICP/RPD/OOI

WPlt/ACMR/80.20 August 1980

LIMITED DISTRIBUTION ENGLISH ONLY

. ,......,

WESTERN PACIFIC ADVISORY COMMITTEE ON MEDICAL RESEARCH Report of the fifth session Manila, Philippines 14-16 April 1980

Printed and distributed by the Regional Office for the Western Pacific of the World Health Organization Manila, Philippines August 1980

NOTE

The views expressed in this report do not necessarily reflect the policy of the World Health Organization.

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CONTENTS SUloDoIA.RY ........................................................................................................................ 1

OPENING CEREMONY •••••••••••••••••.••••.•••••••••••••••••••.•••••••• CHA.IRMA.N·S ADDRESS ..................................................................................................

1 1

ADOPTION OF THE AGENDA ••••••••••••••••.••.••••.•••••••••••••••••••• ELECTION OF OFFICERS ••••••.••••.••••••••••••••.•••••••••••••••••••• IMPLEMENTATION OF REGIONAL COMMITTEE RESOLUTIONS ••••••••••••••••••• SUMMARY AND RECOMMENDATIONS OF THE WORKING GROUP ON MEDICAL RESEARCH COUNCILS .••••••••••••••••••••••.••••.•.•••••••• TRAINING AND CAREER STRUCTURES OF HEALTH RESEARCHERS ••••.•••••••••• IMPLEMENTATION OF ACMR 21 ••••••..••......••••••.••••••••••••••••••• IMPLEMENTATION OF WPACMR IV ••••••••.••••••...••••••••.••••••••••••• REPORT OF THE WPACMR SECRETARY •.•••••••••••••••••••••.•..•.•••••••• REPORT OF THE SECRETARIES OF SUBCOMMITTEES ••••••••••••••••••••••••• REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON PARASITIC DISEASES.. REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON COMMUNICABLE DIS'EASES ..............................................................................................................

2 2 3 3 4 5

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6 6 7 7 7

REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON DIARRHOEAL DISEASES .............................................................................................................. 8

REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON FAMILY HEALTH •••••• REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON HEALTH SERVICES AND OCCUPATIONAL HEALTH •..••••••.•.•••••••••••••••••••.•••••••• REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON CARDIOVASCULAR AND METABOLIC DISEASES •••••••.••••••••••••••••••••••.•••••••••• ADMINISTRATIVE MATTERS CONCERNING OPERATION OF WPACMR AND ITS SUBCOMMITTEES .••••.•••••••••••••••••••.••••••.••••.•••••••• ACTIVITIES OF THE SPECIAL PROGRAMME FOR RESEARCH AND TRAINING IN TROPICAL DISEASES IN THE WESTERN PACIFIC REGION ••••.•••••••• STRATEGIC PLAN FOR APPLIED RESEARCH IN MALARIA ••••••••••.•.•••••••• SPECIAL PROGRANME OF RESEARCH, DEVELOPMENT AND RESEARCH TRAINING IN HUMAN REPRODUCTION ••••••••••••••••.•••••...•••••••• MENTAL HEALTH RESEARCH ..........................................................................................

8 8

9 9 9 9 10 10

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CONTENTS

COMMUNITY HEALTH INFORMATION SYSTEM: AN IMPORTANT TOOL FOR THE DEVELOPMENT OF PRIMARY HEALTH CARE ••••••••.•••.•••••.. ACTION-ORIENTED RESEARCH IN NUTRITION .•.•..••.••••••••••..•••••• VETERINARY PUBLIC HEALTH

11 11 11

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REVIEW OF PROCEDURES FOR PROCESSING RESEARCH PROPOSALS ••••.•••.....•..•...•.••••.•...•••••...•.•.. TECHNICAL PRESENTATION •..........•.•.••••..••••.•.••.••.••.•••.. TUBERCULOSIS RESEARCH ACTIVITIES IN THE WESTERN PACIFIC REGION •......•....•..•••....•••.••••••.... EFFICACY OF TRADITIONAL MEDICINE IN CARDIOVASCULAR DISEASE IN THE PEOPLE'S REPUBLIC OF CHINA ••..••••••••..••••••. OTHER BUSINESS DESIGNATION OF CHAIRMAN FOR WPACMR VI AND OF INCOMING MEMBERS •••••••.•.•..•...•••••••••••••••••••••• CLOS ING REMARKS •••••••.•••....•.....•....•.••••••.••.••..•.••••• ANNEX 1 ANNEX 2 ANNEX 3 ANNEX 4 ANNEX 5 AGENDA.... • • • • • • . . . . . . • . . . • • . • • . • • • • • • • • • . • • • • • • • • • • . LIST OF MEMBERS, TEMPORARY ADVISERS AND SECRETARIAT ...................................... ADMINISTRATIVE MATTERS CONCERNING OPERATION OF WPACMR AND ITS SUBCOMMITTEES ..•.•.••..•.•••••••••• FORM FOR REVIEW OF RESEARCH PROPOSALS AND SUCCESSIVE REVIEW OF THE PROGRESS OF THE PROJECT PROGRAMME AND BUDGET, RESEARCH PROMOTION AND DEVELOPMENT •.•••••••••.•••••••••..••••.••.••••••• Table 1 - Programme budget, RPD, 1979-1981 ••••••••••• Table 2 - Programme budget, RPD, Principal Components, 1978-1981 •••.••.••.•.••.••••••• Table 3 - Programme budget, RPD, Regular Budget and Voluntary Funds, 1977, 1978 and 1979 (Actual) and 1980-1981 (projected) Table 4 - Research projects supported by WPRO and TDR/HQ from 1975 to December 1979 ••••.••••• ANNEX 6 LIST OF WORKING DOCUMENTS •.... ••..••••••••.••••••...

12 13 13 13 13 14 14 15 17 23

29 35 35 40

41

42 43

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SUMMARY The Western Pacific Advisory Committee on Medical Research (WPACMR) held its fifth session in Manila on 14-16 April 1980. Members reviewed the progress made in implementing the recommendations of WPACMR at its fourth session, which had been endorsed by the Regional Committee at its thirtieth session, and were funded from the regular budget and the Voluntary Fund for Health Promotion. l The total amount spent in 1979 in support of research activities was US$751 071, of which US$l84 266 were contributed by the Japan Shipbuilding Industry Foundation (JSIF). All the JSIF funds were disbursed for research grants (US$114 331), research training (US$57 195) and for a research study carried out by a consultant in Papua New Guinea on community support in the control of leprosy and tuberculosis (US$12 740). Concurrently with the slight increase in funds for research from . ~

regional sources, increased support was provided to countries or areas of

the Region from the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the Special Programme of Research, Development and Research Training in Human Reproduction (HRP). In 1979, TDR provided US$1.54 million and HRP US$1.67 million. The main recommendations and programme expectations of WPACMR expressed at its fifth session are given below. 1. STRENGfHENING OF NATIONAL RESEARCH CAPABILITY

With a view to encouraging coordination of health research activities, the WHO Regional Office for the Western Pacific is requested to pursue vigorously with national authorities the establishment of national focal points or national health research councils. Following the Working Group on Medical Research Councils, held in Manila in February 1980, a similar meeting is being proposed for 1982. The information base for the formulation of policies to improve the career structures of research workers in developing countries is weak. WPACMR agreed that a career structure for research workers could not be considered in isolation but only as part of an overall national commitment to research development. More information is being collected on the current situation with regard to career structures and, with collaboration from the Office of Research Promotion and Development, WHO, Geneva, a report on the subject will be prepared for presentation to the sixth session.

lSee resolution WPR/RC30.R18, Handbook of Resolutions and Decisions, Vol. II, 2nd ed., 1980, page 18. Note: Sentences/paragraphs underlined relate to the main recommendations and programme expectations of WPACMR.

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Progress has been made, in the areaS of biostatistics, epidemiology and entomology, in strengthening the capability of the WHO Regional Centre for Research and Training in Tropical Disease$, Institute for Medical Research, Kuala Lumpur. A large-scale population-based study on endemic diseases is planned for the State of Sabah, Malaysia. Preparations are being made to improve data processing through the computer facilities provided by TDR in Kuala Lumpur. Attention will also be focused on strengthening the Institute of Medical Research, Goroka, Papua New Guinea, and on the development of collaboration between it and the Regional Centre in Kuala Lumpur. At the same Institute in Goroka, WHO-supported research activities in acute respiratory infections are also contributing to institution strengthening. Following the feasibility study carried out by a WHO consultant in 1978, plans are being developed to strengthen the Wellcome Virus

Laboratory, Fiji, as a subregional virus laboratory. 2. RESEARCH WITHIN WHO PROGRAMMES OF TECHNICAL COOPERATION

A number of important research and tra1n1ng activities are being generated in relation to clonorchiasis and paragonimiasis. In the Republic of Korea, research is continuing on the treatment of cases of paragonimiasis with new drugs. Current research in China centres on the taxonomy and life cycle of flukes, the development of diagnostic tests and drug trials. Strategies for the development of a regional programme on diarrhoeal diseases research and control have been developed by the WPACKR Sub-Committee on Diarrhoeal Diseases. Further efforts will be made to promote the preparation of sound research proposals capable of attracting extrabudgetary funding. Research on acute respiratory infections (ARI) is progressing in Papua New Guinea, with cooperation at a substantial level from WHO. The programme will be further expanded to include research activities in Malaysia and the Philippines. The final aim of the programme ;s to bring about a better management of acute respiratory infections at the primary health level so as to reduce mortality. Efforts to promote and develop schistosomiasis research have started to yield dividends and a greater number of activities are expected in the years to come. Research being carried out on cardiovascular and metabolic diseases was reviewed and priorities in relation to specific areas identified. Research training will be conducted in the epidemiology of the two diseases. Promotion of research and control will focus on diabetes among the Polynesian and Micronesian island populationa. ~.

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A one-week seminar on tropical immunology, jointly funded by the Australian Development Assistanc~ Bureau, the Australian Society fo; Immunology and WHO, was conducted in Sydne~' in December 1979. The interest of Australian immunologists in undertaking collaborative activities relating to the application of modern immunological techniques was clearly demonstrated during the seminar and WHO will draw on their expertise in the future.

Scientists in the Region will be encouraged to develop research proposals on vector biology and control, especially biological control, for submission for support to the appropriate scientific working group of TDR. The regional health services research programme, an essential strategy for achieving the goal of health by the year 2000, has expanded substantially, and is now entering the implementation phase. The Sub-Committee on Health Services Research of the global Advisory Committee on Medical Research met in Manila in April 1980. Further impetus was thus provided to programme development. The need for well-prepared research proposals to attract extrabudgeta~y funding was strongly emphasized. 3. TRAINING IN RESEARCH METHODOLOGY

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Preparation are under way to organize a national workshop on biomedical research methodology for senior research workers in China in late 1980, with a view to training them at their own institutes as trainers in this important field. It is proposed to hold a similar intercountry course at the WHO Regional Centre for Research and Training in Tropical Diseases, Kuala Lumpur, in 1981. In view of the importance of the rapid diagnosis of dengue fever, a regional workshop on detecting dengue viruses by the mosquito inocuLation technique was held at the WHO Regional Centre for Research and Training in Tropical Diseases, Kuala Lumpur, in late 1979. Attended by 13 participants from 9 countries or areas of the Region, it contributed to promotion of the practical use of the technique for the rapid diagnosis of dengue fever. Training courses on the serology of parasitic diseases, using the ELISA technique, were held in Malaysia and the Republic of Korea in Harch 1980. A further group activity will be organized in 1981 to promote the use of this technique for immunodiagnosis. Problems related to the career development of epidemiologists stem from lack of understanding of the epidemiological approach in public health practice, particularly in the planning and evaluation of health services. The topic attracted attention at the Working Group on Medical Research Councils, which recommended that career structures should be developed for epidemiologists. An intercountry seminar is planned for senior health administrators on the use of epidemiology in health services. A Course on the epidemiology and community-based control of cardiovascular diseases will be held in collaboration with the Government of Singapore in September 1980.

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IV

4.

RESF.ARCH TRAINING

Despite the small disbursement for research training (US$123 215), 22 research training grants were awarded during 1979, mostly to research workers from developing countries in the Region. 5. RESEARCH GRANTS

Research grants amounted to a total of US$222 930 in 1978. In 1979, a further 20 proposals were supported at a total cost of US$182 031. Grants awarded in the Region were for studies on health problems of regional importance such as acute respiratory infections, dengue haemorrhagic fever,

schistosomiasis and those caused by liver and lung flukes. In all, research studies in 16 countries or areas of the Region were supported from both regional and global resources. 6. MANAGEMENT OF REGIONAL RESOURCES FOR RESEARCH

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As from 1979, approximately one half of the resources available for research promotion and development are being allocated to individual technical cooperation programmes, heralding a significant attempt to increase the responsibility of programme managers in programming research components as an integral part of their development activities, thus relating research to the solution of health problems of regional and national importance. A mechanism is being developed to involve programme managers in assessing, managing and monitoring research proposals. The Medical Officer, Research Promoti"n and Development, is now mainly res~onsib1e for the operation and control of the research management mechanisms being developed.

The research promotion and development programme budget for 1980-1981 reflects the following significant trends: a reduction in provisions for meetings; an increase in provisions for research grants; an increase in prOV1810ns for the strengthening of research

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capability in selected institutions. Whereas meetings and the services of consultants were necessary to establish the foundation of the research promotion and development programme, the percentage of resources utilized for such activities has been rightly diminishing since 1978, with a consequent increase in the amounts available for research grants to individuals and institutes.

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Through dissemination of information on the WHO regional research programme, further efforts will be made to increase the number of countries within which research grants are awarded and to select better research proposals, so as to obtain greater dividends from the limited investment WHO is able to make·in research in the Region. Research grants would also contribute to the strengthening of research institutions in developing countries. It is proposed therefore that a policy should be adopted of supporting research studies in institutes rather than giving grants to individuals. 7. EXCHANGE OF RESEARCH INFORMATION

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In 1980 a consultant on biomedical information exchange will develop mechanisms for the regular exchange of information on research as well as the measures needed to improve library services to research institutes in the Region. 8. INTERREGIONAL COOPERATION

Close cooperation in the field of research promotion and development has been maintained with the WHO Regional Office for South-East Asia. 9. MEMBERSHIP OF THE WESTERN PACIFIC ADVISORY COMMITTEE ON MEDICAL RESEARCH

Professor Sir Gustav Nossal, the first Chairman, and three WPACMR members, retired after the fifth session in April 1980. Sir Gustav contributed immensely to the development of the regional research programme during its critical formative phase. He has been replaced as Chairman by Professor Hiroshi Tanaka of Japan. There will now be 13 members of the Advisory Committee.

WPR/ACMR/80.20 Report page 1

OPENING CEREMONY (Item 1 of the Agenda) In welcoming participants to the fifth session of the Western Pacific Advisory Committee on Medical Research (WPACHR), the Regional Director, Dr H. Nakajima, expressed his appreciation of the indefatigable leadership of the Chairmsn, Sir Gustav Nossal, and also of the valued policy guidance and recommendations offered by the Committee for the promotion of research in the Region. The Regional Director reviewed the research coordination activities initiated and undertaken by the Regional Office since 1976, and drew attention to the vital importance of strengthening national research capabilities for the solution of health problema in developing countries, which had been one of the major preoccupations of WPACHR. Many new tools to control tropical diseases could be developed out of basic research efforts in affluent countries. At the same time field control action through the application of newly developed tools and associated applied research must be conducted and maintained in affected developing countries. The Regional Director emphasized that biomedical and health services research and the application of research results would be among the decisive factors in the attainment of the goal of health for all by the year 2000. The Regional Director stressed the importance of national medical research councils or analogous bodies, which could playa pivotal role in the creation of national research capabilities, in the concurrent development of career structures to maintain trained research workers, and in the mobilization of national resources to support research in Member countries. Such councils could also serve as focal points for cooperation between countries in the areas of research development and the transfer of appropriate health technology resulting from basic and applied research. The Regional Director stressed that research should be conducted as a coordinated enterprise as in the industrial sectors. In this way, research could be mission-oriented to meet national health needs on time. CHAIRMAN'S ADDRESS (Item 2 of the Agenda) The Chairman thanked Dr Nakajima for his warm welcome and said that he looked forward with great confidence to receiving all necessary support from him in the Committee's very important task. Three things were essential if the research component of WHO programmes was to meet the new challenge of regionalization and of closer technical cooperation for and in developing countries: (1) There should be greater involvement of professional researchers and academics in developing countries in the work of the Organization. (2) Research should be identified as an integral component of all WHO technical cooperation programmes, no matter how small.

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WPR/ACMR/80.20 Report page 2

(3) It was imperative to mainta~n the unity of the WHO Secretariat, which would serve the needs of the research c.omponent. He stated that a very important development noted in the present meeting was that for the first time WHO Programme Coordinators (WPCs) in the Region had been invited to the WPACMR session. This was both symbolically and at a practical level extremely important because the work of the Committee could not have an optimum effect until it was represented at a high level in the Member countries themselves. The Chairman said he realized that the Committee could not do all that was needed to be done with only one meeting per year. A decision had therefore been taken that most of the work of the Committee would be done by subcommittees. He noted that, of the si~ subcommittees formed, four had been assigned the task of deliberating the heavy work of the Committee. Two of the subcommittees - Family Health and Parasitic Diseases - had been less clearly and identifiably active, owing to their interface with the special global programmes on tropical diseases and human reproduction. The Chairman referred to two highlights of the year: the Working Group on Medical Research Councils, which was held successfully in Manila in February 1980, and the progress achieved with regard to the Regional Centre for Research and Training in Tropical Diseases in the Institute for Medical Research, Kuala Lumpur. Regarding the diarrhoeal diseases programme, he believed that what was needed was the development of good ideas for interesting but practical research in this field. He was disappointed that the initiative taken the previous year and agreed upon by the Committee regarding research coordination plans for China had evolved somewhat slower than which might have been hoped. He drew attention to the excellent progress achieved by the Sub-Committee on Health Services Research, paralleled by an equally active subcommittee at WHO Headquarters. The Chairman welcomed a new member to the Committee, Professor Gu Shin-yuan from China, whose additional expertise was available as a result of the recommendation of the previous session of WPACMR to strengthen the Committee by someone knowledgeable in health statistics. ADOPTION OF THE AGENDA (Item 3 of the Agenda) The provisional agenda (WPR/ACMR/80.l Rev. 2) was adopted without change (Annex 1). ELECTION OF OFFICERS (Item 4 of the Agenda) Sir Gustav Nossal continued as Chairman and the following officers were e lec ted: Vice -Chai rman: Rapporteur Professor H. Tanaka Professor D. Rowley ~.

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WPR/ACMR/80.20 Report page 3

The list of members and other participants is given as Annex 2. IMPLEMENTATION OF REGIONAL COMMITTEE RESOLUTIONS SUMMARY AND RECOMMENDATIONS OF THE WORKING GROUP ON MEDICAL RESEARCH COUNCILS (Item 5.1 of the Agenda) The Secretary introduced the subject by drawing attention to the fact that the Medical Research Councils of Australia and New Zesland were accepted as patterns which could guide other developing countries in the establishment of national focal points for the centralized coordination of health research activities and also for necessary support. This meeting in February 1980 had realized that the training and career prospects for medical research workers in Member countries in the Region varied widely and were in general poorly organized. In the discussion that followed, it was stressed that the Working Group had agreed that one of the most important aspects of research was quality and that, although some countries might feel that despite their limited resources they could ill afford to divert any of their resources to research, nevertheless the Committee should encourage all Member States to make a start in this direction. An important function of this Working Group had been to encourage senior health administrators to think seriously about the involvement of their country in research. It was also felt that a valuable function of this kind of meeting was to bridge the gap which appeared to exist between the health administrators and those who were already involved in research. It was stated that the Australian Development Assistance Bureau (ADAB) was interested in having contacts with research agencies in developing countries. It was also emphasized that ADAB was interested in promoting research and that WHO's backing was regarded as very important by influencing national health authorities to request aid for medical and health research projects as part of the bilateral aid programme. The suggestion was made that a national workshop should be held in a country which was judged to be useful in giving a stimulus for the formation of a central health research council. The workshop could be attended by a few advisers and might catalyze health administrators towards acceptance of the idea of a national council for medical research. It was also suggested that the name ''health research council" would be more acceptable to governments and to the lay people.

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Finally, the Chairman summarized the debate as follows: The fifth session of WPACHR had received a summary of the recommendations of the Working Group on Medical Research Councils and awaited receipt of the full report and annexes, which were at present in draft form.

WPR/ ACMR/80. 20 Report page 4

The Committee endorsed the broad thrust of the recommendations of the Working Group, bearing in mind the need to mairtain a good degree of pluralism necessitated by the heterogeneity of the countries and areas in the Region and the disparities in size and wealth. The same model would not be suitable for every country. Despite this constraint, the Committee reaffirmed its belief that health research should be an integral part of all health intervention programmes in developing countries so that the fruits of what was being done could be properly assessed for future health planning and applied to improving the health of the population. The Committee was keen to preserve the momentum of this initiative for greater consultation with and collaboration between the various focal points for health research in the Member States. The Committee therefore proposed the following interim action between now and the sixth session of the WPACMR. 1. It urged the Secretariat to be vigorous 1.n circulating material, 1n particular the report and recommendations, and in gathering information. ~,

2. It urged that the following report should strongly endorse the principle of a single national focal point within each country for coordination of health research and that countries should be asked to identify such a focal point. 3. It asked whether national or subregional workshops on this general matter should be held within the Member States, the decision, of course, lying with Member States, which would be free to request some limited financial and logistic support from the Regional Office. 4. It particularly requested the WPCs to vigorously pursue this matter with the authorities in the countries whiCh they served to see whether they would be interested in such a national workshop in the next 12-18 months. 5. It did not believe that a further meeting of heads of medical research councils between now and the sixth session of WPACMR would be appropriate; quite possibly a two-year interval would be sufficient for another productive meeting to be held. 6. It requested the Regional Director to consider the possibility, after more mature consideration by the Research Promotion and Development office, that a consultant spend two or more weeks in various parts of the Region to keep up the initiative, to assist with the information gathering exercise, and to help in the preparation of the report, to give an impetus to a possible meeting in two years time. Such a consultant's report could serve as a working paper to be considered at the sixth session of WPACMR. TRAINING AND CAREER STRUCTURES OF HEALTH RESEARCHERS (Item 5.2 of the Agenda) The Committee considered two documents under this agenda item, dealing with training and career structures and related matters in research.

.. WPR/ACMR/80.20 Report page 5

From the report by the WHO Epidemiologist, Institute for Medical Research, Kuala Lumpur, it was clear that there was a weak data base on which to try to formulate policies for the improvement of career opportunities in research in developing countries; and that an information gathering exercise, followed by an educational exercise involving the various interacting parties, including administrators and policy makers, would be necessary. The Committee discussed in broad terms the goals of a stronger career structure for medical research. It was realized that the goals had to be related to national goals; that in the developing countries one could not afford to pursue research simply for the glory of the research workers, but that the research had to have some defined goals - realistic chances of contributing to the solution of public health problems, not necessarily in the short term . It was agreed that a career structure for research workers could not be seen in isolation but only as part of the nation's total commitment to the development of research and, furthermore, as part of the health services of that nation. It was noted that research had to be a part of all major new programmes in public health or community health intervention. In furthering the cause of research within Member States, it might be judicious to promote the idea of research as a component of a total package. It was admitted that a too solid career base for full-time research workers, particularly in countries without a long tradition of medical research, might have some dangers. There might be countries in which too many positions of a full-time nature could create a cadre of people who might stay in positions for a long time without being productive. That again raised the question of the need to view career structures as part of the total national plan for the upgrading of research. The Committee agreed that further information gathering was necessary, and that the WHO Epidemiologist, Institute for Medical Research, Kuala Lumpur, should carryon his private research on this matter, and expand on the interesting list of recommendations placed before the Committee. It also encouraged the Medical Officer for Research Promotion and Development during his travels in the Region to get as much information about the current situation as he possibly could while pursuing his other duties.

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With respect to the two sets of further inputs thereby generated, it was urged that this matter should be raised again at the sixth session, at which time, through the global ACMR Sub-Committee on this subject, the inputs at global level could be expected. IMPLEMENTATION OF ACMR 21 (Item 6 of the Agenda) The COlllllli t t e e had before it the Report of the global ACMR meeting held in November 1979. (document ACMR 21/79.11).

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It noted the great attention being given by ACMR to advice received from the regions, including WPACMR, expressed its appreciation of the good cooperation existing. It noted that the global ACMR also was starting to establish a series of subcommittees. It further noted that the Special Programmes were fully supported and approved by ACMR, and that new special programmes were in the early stages of development. For some of these, particularly the new control of diarrhoeal diseases programme, there would have to be a full and frank discussion at Secretariat level to define the relative roles of the two ACMRs. IMPLEMENTATION OF WPACMR IV REPORT OF THE WPACMR SECRETARY (Item 7.1 of the Agenda) The Committee had before it the report on the activities of the Research Promotion and Development Unit for the year (document WPR/ACMR/80.10). The Committee was unanimous that the WHO Programme Coordinators should be more involved in the regional research programme and that accurate, full and timely information should be given to them by both the Regional Office and Headquarters. It was agreed that WHO Programme Coordinators could perform a useful function in helping to identify promising researchers and in verifying to a certain extent the appropriateness of the fellows proposed for training. It was also agreed that a prerequisite for any further stimulation of research was the promotion of good quality proposals. Several mechanisms were suggested for this, including the mechanism of re-application. There were instances where proposals were weak when first submitted but became stronger as the Regional Office started reviewing and ACMR members or scientists concerned offered comments on proposals. Proposals might be re-submitted for a second or even third time, during which the learning process gradually improved the presentation and content of the research proposal. The Committee had an extensive discussion on the question of how vigorously advertising mechanisms, including leaflets, booklets, etc., should promote the possibility of research support from the Regional Office. The Committee did not reach unanimity on this matter. A majority view was that advertising should be more extensive; and that there should be more definite efforts to publicize within the Region the fact that regional research funding could be obtained. However, there was a strong minority view that there were dangers in over-promotion of the research ~.

efforts; and that a lot of paper work could ensue without good results. This suggested that a cautious and gradual approach to the provision of dare publicity should be taken. The Committee requested the Secretary to study this matter further and to report back to the next session.

WPR/ACMR/80.20 Report page 7

On the question of pUblicity and quality of research proposals, the Committee was unanimous that workshops, seminars and symposia sponsored by WPACMR and by the Regional Office would be an excellent focal point for the announcement and promotion of research projects. Such workshops, as part of the follow-up activity. often promoted good research proposals. The Committee also strongly agreed that WHO should continue to collaborate with various donor agencies, both bilateral aid agencies and private foundations, for the support of various projects which, for one reason or another, could not be supported by regional or headquarters funds.

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REPORT OF THE SECRETARIES OF SUBCOMMITTEES (Items 7.2, 7.3, 7.4, 7.5, 7. j and 7.7 of the Agenda) The Committee had before it the reports of the various subcommittees. The Committee commended and endorsed the activities of the subcommittees and accepted their recommendations for submission to the Regional Director. REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON PARASITIC DISEASES (Item 7.2 of the Agenda) The Committee noted that the efforts to promote and develop schistosomiasis research had started to yield dividends. The field trials on tuba seeds against Oncomelania quadrasi had been concluded. The eight projects on schistosomiasis, all funded by the WHO Regional Office for the Western Pacific, were in progress. More attention was being given to the malacological aspects of the disease. ~.

A meeting of the Regional Steering Committee for the Working Group on japonicum had been held from 31 March to 2 April 1980 to review ongoing research and consider new research proposals to be recommended for funding. The WHO/Samoa filariasis research project activities were in progress without any major problems. The joint WPRO/SEARO Working Group on Brugian filariasis, held in Kuala Lumpur on 18-21 June 1979, had reviewed the Brugian filariasis situation in the two regions. The specific studies recommended were contained in the report. REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON COMMUNICABLE DISEASES (Item 7.3 of the Agenda) The Committee noted that the most important events since the fourth session of the Committee had been the following:

(1) First meeting of the Regional Advisory Panel on Acute Respiratory Infections (ARI) , Manila, 27-28 September 1919. The Panel recommended modified terms of reference, established a list of research priorities and reviewed programme activities in Papua New Guinea.

WPR/ACMR/80.20 R~port page 8

(2) Meeting of the WPACMR Sub-Committee on Communicable Diseases, 17-18 December 1979, Manila. An attempt had been made to allocate priorities between the diseases or disease groups. A list showing sequence of activities under the headin&s of ARI, tuberculosis, leprosy, viral hepatitis, sexually transmitted diseases, haemorrhagic fevers, Japanese encephalitis, etc. has be~n prepared.

Much remained to be done to strengthen the teaching of epidemiology but a good foundation had already been laid. REPORT OF THE SECRETARY Oi THE SUB-COMMITTEE ON DIARRHOEAL DISEASES (Item 7.4 of the Agenda) The need was emphasized to clearly define the role and functions of th~ WPACMR Sub-Committee on Diarrhoeal Diseases (CDD) , and the interrelationship between the Sub-Committee on Communicable Diseases, the WPACMR and the global ACMR, in order to avoid any overlapping of activities, and wastage of resources. There was a pressing need to develop good research proposals that would attract funds, and it was stated that Diarrhoeal Diseases Control (CDD) programme would not achieve its objectives if it was not developed as one component of primary health care. REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON FAMILY HEALTH (Item 7.5 of the Agenda) The Committee noted that the WHO Headquarters Special Programme of Research, Development and Research Training in Human Reproduction (HRP) had been implementing a number of activities in the field of family health and that many of the research workers in the Region were actively and heavily involved in the HRP programme. The areas for future collaboration in the field of research in maternal and child health in China had been agreed upon between the national health authority and WHO. REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON HEALTH SERVICES AND OCCUPATIONAL HEALTH (Item 7.6 of the Agenda) It was noted that the WHO regional programme on health services research had strengthened its secretariat and regional structure. The situation was thus favourable to a major expansion into the implementation phase of the programme. The Sub-Committee had prepared a budget for the regional programme. Emphasis was placed on the need for well-prepared study proposals, which could attract funding through WHO.

,-., .

~.

WPll/ACMR/80.20 "port page 9

REPORT OF THE SECRETARY OF THE SUB-COMMITTEE ON GARDIOV4SCULAR AIID METABOLIC DIBIAS!!S (It. . 7.7 of the Aceada) The co..ittee noted that the fourth session of the Sub-Comaittee was held on 5-7 December 1979. All activities in the field of research, as well a8 control of cardiovascular and metabolic diseales, in the Western Pacific Ilegion had been reviewed and so.. recommendationa . .de on the following: regional strategy for the cardiovascular and metabolic diseasea progr .... ; priority for research and training of research workers. ADMINISTRATIVE MATTI!llS

CONCERNING OPBRATION OF WPACMR

AND ITS SUBCOMMITTUS

(It.. 7.B of the Agenda) The Ca.aittee considered document WPll/ACMR/80.12 (Annex 3), which was adopted, with one minor .odification with regard to paragraph 5.3, where an additional phrase wa8 added, reading: ''WPACMR shall act as peer review group from ti.. to time, sometimes with cooption of some additional I scientists".

ACTIVITIES OF THB SPECIAL PllOGRAMMB roJ. DSBAJ.CH AND TRAINING IN T1lOPICAL DISIASBS IN THB WESTERN PACIFIC DGION (Item 8.1 of the Agenda) The Committee considered the report prepared by the Special Progr.... for Ilesearch and Training in Tropical Diseases (TOR). It endorsed the third annual report of the TDR progr .... and the 8upporting documentation and assured the Director of the Special Progr...e of its continuing desire to collaborate in this very important progr.... . STRATEGIC PLAIl FOIl. APPLIBD DSBAJ.CH IN JllALARIA (Item 8.1.1 of the Agenda) The members of Group A, under the Chairmanship of Professor Tanaka, reviewed the "Strategic plan for applied field reaearch in malaria in the Western Pacific Ilegion", which had been based on recm.endationa and suggestions made by participantl in the workshop on malaria, held in Kuala Lumpur in 1979. The priority areas lilted reflected the . . jor obstaclel hampering progress in the regional anti.. laria programme, which might be resolved through applied field relearch. Of theae, chloroquine resistance, G6PD deficiency, radical treatment of Plaa.odium vivax, studies on Anopheles balabacensis, !. farauti and !. sinensis, and comaunity participation were areaa listed as priority A; !, vivax strains with a long incubation period, A. litoralis in the Philippines, side-effects of DDT in Papua New Guinea, alternative insecticides and alternative vector control measures in the Philippines and .. intenance phase operations studies were considered to be priority B.

WPR/ ACMR/ RD. 20 Report pag<> 10

As China had been mentioned more than once as the appropriate Member State in the Region to undertake some of the field studies, Professor Mao Shou-bai expressed his readiness to collaborate with WPACMR. Some studies had in fact already been started. The Institute of Malariology, Parasitology and Entomology in Hanoi was likewise ready to monitor the chloroquine-resistance problem. The budgetary implications of the plan amounted to US$218 500 for 1980 and US$255 258 for 1981, the amount of US$65 500 and US$86 000 being covered respectively by means other than TDR. So far however, the financial problem did not seem so acute, owing to the scantiness of research proposals in areas of priority. The Secretariat was planning to inform relevant institutions in the Region of the suggested projects, so as to encourage capable field researchers to start the studies so urgently needed for the regional antimalaria programme. SPECIAL PROGRAMME OF RESEARCH, DEVELOPMENT AND RESEARCH TRAINING IN HUMAN REPRODUCTION (Item 8.2 of the Agenda) The Committee had before it the report of the Director, Special Programme of Research, Development and Research Training in Human Reproduction, WHO Headquarters. It vigorously endorsed the broad thrust of the Special Programme. It was agreed that the Committee would seek the help of the Regional Director and individual members in ensuring that pledges materialized. MENTAL HEALTH RESEARCH (Item 8.3 of the Agenda) Group B had before it document WPR/ACMR/80.l3. The Group recognized the growing importance of mental health research in the Western Pacific Region. The view was expressed that the Committee should recognize the scope of the problem and consider setting up a subcommittee in this field or alternatively recruit a representative of this discipline as a member of the Committee. The Group commended the work done already by the Secretariat in the Region and agreed that the Committee should encourage this to continue. It considered it was unlikely that high priority could be given to the establishment of a new subcommittee in the short term (for funding reasons chiefly), but noted the possibility that a new member with skills in the mental health field might be appointed. It was felt that individual members might in the meantime be sympathetic to needs, and draw the attention of the Committee to specific problems in the field as they arose.

......

WPR/ACMR/80.20 Report page 11

COMMUNITY HEALTH INFORMATION SYSTEM: AN IMPORTANT TOOL FOR THE DEVELOPMENT OF PRIMARY HEALTH CARE (Item 8.4 of the Agenda) Group B considered with interest document WPR/ACHR/80.14. It endorsed the principle that the community should identify its health needs and priorities in the context of the overall development of the community, that the community should be involved in the planning and provision of basic health care, and that the health provided should be available to the community when requested.

..-

However, the Group expressed reservations on the need for continuous household surveillance as opposed to periodic evaluation and on the ability to sustain a high degree of motivation an~ involvement in the absence of incentives. The Group was also concerned with the collection, computing and application of the information obtained through the continuous surveillance model presented in the document. The Group felt that the model could be modified to suit a particular community depending on the resources and conditions prevailing in the community. ACTION-oRIENTED RESEARCH IN NUTRITION (Item 8.5 of the Agenda) A brief explanatory paper on the programme had been widely circulated and was discussed by Group B. It was stated that a regional planning meeting would be held shortly and interest had been expressed in this field. There were no regular budget funds or extrabudgetary provision as yet, but potential donors had been identified. The programme would be action-oriente~ and based primarily at the community level. Detailed spproaches and methodology had not yet been worked out but would be discussed at the regional planning meeting. The question of provision of funds was discussed. It was felt that ACHR could perhaps help. SEARO had similar problems and had drawn up a number of detailed protocols which could be made available as "packages". The view was expressed that such "packages" should not be pushed either to research workers or institutions. The investigator should develop his own simple protocol to meet local needs, although the experience of others would be useful. The first requirement was to identify those problems which needed to be emphasized in the Region. VETERINARY PUBLIC HEALTH (Item 8.6 of the Agenda) Group A welcomed the presentation on veterinary public health (VPH) and recognized the importance of the three priority areas mentioned below wherein research should be intensified. It was agreed that there would be future discussions on the subject and that VPH would be included in the Sub-Committee on Parasitic Diseases.

WPR/ACMR/80.20 Report page 12

Priority areas for research in VPH WE're: (1)

Ichthyosarcotoxism

Marine food fish poisoning was a serious problem in countries and areas of the South Pacific because of the illness and death it caused. Its impact on the nutrition of the people was also a matter of great concern to populations in the area. (2) Parasitic zoonoses

Several TDR priority diseases had reservoir animals as important hosts. For instance, 25% of the overall transmission of Schistosoma ~ponicum was contributed by domestic and w~ld animals. Any control efforts being planned would therefore have to include provision for dealing with these animal reservoir hosts. The same was true for the subperiodic form of Brugian filariasis in the transmission of which monkeys and domestic cats played an important role. (3)

Rabies

Human rabies was considered to be a major public health problem in the Philippines, Republic of Korea, Lao People's Democratic Republic and Viet Nam. Action-oriented research was necessary for the successful control and surveillance of this disease. REVIEW OF PROCEDURES FOR PROCESSING RESEARCH PROPOSALS (Item 9 of the Agenda) The Committee considered the report presented by the Research and Training in Tropical Diseases (TDR) and Research Promotion and Development (RPD), and noted the efforts to improve the existing mechanism for peer review of proposals (Annex 4). It pointed out that there were still substantial gaps in procedures; in particular the procedures for consultation of reviewers outside the Committee itself needed further attention, and the members could assist in the construction of an expanded list of reviewers. The Committee believed that the secretariat should be more precise in its instruction to reviewers and should consider the possibility of obtaining a more objective assessment of proposals from reviewers. The question when peer group review of progress was to be made, at least for those projects that were to last for more than two years, should be decided initially. The Secretariat should also give due consideration to the desirability of competition between application ••

~.

WPR/ACMR/80.20 Report page 13

In particular, the Committee str~ngly endorsed the view that the WHO Progrsmme Coordinators should be brought into the decision-making process as soon as possible since their local knowledge in some cases would be decisive ..

It was felt that there were possibilities of technical difficulties in the payment itself and the Committee urged the Secretary, in consultation with the various offices, to ensure that funds were allocated to the research for which they were intended. TECHNICAL PRESENTATIONS TUBERCULOSIS RESEARCH ACTIVITIES IN THE WESTERN PACIFIC REGION (Item 10.1 of the Agenda)

. "'"'

Dr T. Shimao, Director, Research Institute of Tuberculosis, Japan, presented the results of his five country visits to assess tuberculosis research activities in these countries. It was clear from his talk that tuberculosis was still an important problem in the Region. Dr Shimao's request that a working group be convened following the sixth session of WPACMR, to which he would be invited, was accepted by the Committee. One aspect which would be discussed and on which WPACHR was seeking advice was the reported failure recently of BCG vaccine in India. EFFICACY OF TRADITIONAL MEDICINE IN CARDIOVASCULAR DISEASE IN THE PEOPLE'S REPUBLIC OF CHINA (Item 10.2 of the Agenda) Professor Chen Keji, Academy of Traditional Medicine, Beijing, presented some very interesting preliminary results on the treatment of myocardial diseases by traditional Chinese medicine. The Committee observed that traditional medicine obviously had access to a great reservoir of knowledge which, combined with the classical medical approach, could yield benefits over and above those currently achieved by western medicine. The Committee expressed its desire to keep in close contact with these potentially exciting developments. OTHER BUSINESS (Item 11 of the Agenda) The venue for the next meeting of the Committee was discussed at length. Although it was felt there were some advantages in moving around the Region, the extra financial burden that this would impose was considered to be too great and it was decided that the next meeting would accordingly be held in Manila. The dates proposed for the sixth session were 7 to 10 April 1981.

WPR/ACMR/80.20 Report page 14

DESIGNATION OF CHAIRMAN FOR WPACMR VI AND OF INCOMING MEMBERS (Item 14 of the Agenda) The Regional Director announced that he had designated Professor Hiroshi Tanaka as next Chairman of the Committee, to succeed Sir Gustav Nossal, who had expressed the desire to retire as Chairman after serving the Committee for four years since its inception. Dr Nakajima stated that his decision to nominate Professor Tanaka was based on the recommendation put forward to him by the retiring Chairman. He expressed his appreciation of the excellent and energetic chairmanship of Sir Gustav, under whom the Committee had contributed immensely to the development of a regional research management mechanism. The Regional Director also expressed his appreciation to Professor S.S. Ratnam, Dr N.I. Chandrasekharan and Dr R.S. Guinto, who had served the Committee for the past four years, for their excellent contributions to the development of the research programme in the Region. He welcomed Professor Tanaka as the new Chairman and wished him success in his challenging assignment. CLOSING REMARKS The Chairman thanked all members for their active deliberation during the session. The Regional Director, after thanking all participants for their assistance in programming the regional research coordination activities,

""" .

said that he looked forward to the development of a closer working relationship between the WHO Programme Coordinators and the members of the WPACMR in the future. Many important subjects such as the establishment of health research councils, research career structure, redistribution of research funds, and training in research methodology had received full attention and resulted in proposals for useful guidelines which he would make every endeavour to follow. Although resources at his disposal were not large enough to implement every research proposal received, he would endeavour to support good research packages with either regular budget or extrabudgetary funds. In conclusion, the Regional Director expressed his view that health services research was becoming an increasingly important aspect of the Organization's work, particularly in the context of health for all by the year 2000, and this area was receiving good support from WPACMR. The Regional Director then formally closed the session.

~.

WPR/ACMR/80.20 Report page 15

ANNEX 1

AGENDA 1. 2. 3. Opening of the session: Chairman's address Adoption of the Agenda Election of Vice-Chairman and Rapporteur Implementation of Regional Committee resolutions 5.1 5.2 6.

Regional Director's address

..-

4. 5.

Summary and recommendations of the Working Group on Medical Research Councils Training and career structures of health researchers

Implementation of ACMR 21 Implementation of WPACMR IV 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 Report of the WPACMR Secretary Report of the Secretary of the Sub-Committee on Parasitic Diseases Report of the Secretary of the Sub-Committee on Communicable Diseases Report of the Secretary of the Sub-Committee on Diarrhoeal Diseases

7.

Report of the Secretary of the Sub-Committee on Family Health Report of the Secretary of the Sub-Committee on Health Services and Occupational Health Report of the Secretary of the Sub-Committee on Cardiovascular and Metabolic Diseases Administrative matters concerning operation of WPACMR and its sub-committees

8.

Special research subjects 8.1 Activities of the Special Programme for Research and Training in Tropical Diseases in the Western Pacific Region 8.1.1 Strategic plan for applied research in malaria

WPR/ACMR/80.20 Report page 16 Annex 1 8.2 8.3 8.4 8.S 8.6 9. 10. Special programme of research, development and research training in human reproduction Mental health research Community health information system: an important tool for the development of primary health care programme Action-oriented research in nutrition Veterinary public health

Review of procedures for processing research proposals Technical presentations 10.1 10.2 Tuberculosis research activities in the Western Pacific Region Efficacy of traditional medicine in cardiovsscular disease in the People's Republic of China

""' .

11. 12.

Other business Presentation of report 12.1 Draft report of the meeting

13 14. IS.

Adoption of report Designation of Chairman for WPACMR VI and of incoming members Closing session ,"",.

WPR/AotR/80.20 Report page 17 ANNEX 2

LIST OF MEMBERS, TEMPORARY ADVISERS AND SECRETARIAT 1.

MEMBERS Professor Sir Gustav Nossal (Chairman) Director The Walter and Eliza Hall Institute of Medical Research Melbourne, Victoria Professor Derrick Rowley Department of Microbiology and IlIIIluno logy University of Adelaide Adelaide

AUSTRALIA

.CHINA, PEOPLE'S REPUBLIC OF

Professor Mao Shou-bai Director Institute of Parasitic Diseases Chinese Academy of Medical Sciences Shanghai Professor Gu Shin-yuan Deputy Chief Health Statistics Depsrtment Shanghai First Medical College Shanghai

JAPAN

Professor Y. Kaneko Professor of Public Health School of Medicine Toho University Tokyo Professor H. Tanaka Professor Department of Parasitology Institute of Medical Science University of Tokyo Tokyo

MALAYSIA

Dr N.I. Chandrasekharan Associate Professor Clinical Diagnostic Laboratory Medical Center University of Malaya Kuala Lumpur

WPR/AQ(R/80.20 Report page 18 Annex 2

NEW ZEALAND

Dr J.V. Hodge Director

The Medical Research Council of New Zealand Dunedin PHILIPPINES Dr R.S. Guinto American Leprosy Foundation (Leonard Wood Memorial) Cebu Skin Clinic Cebu Ci.ty Professor E. Hyock Kwon Professor Department of Preventive Medicine College of Medicine Seoul National University Seoul Professor Chin-Thack Soh Director Institute of Tropical Medicine Yonsei University Seoul SINGAPORE Professor S.S. Ratnam Head Department of Obstetrics and Gynaecology University of Singapore Singapore Dr Dang Duc Trach Vice-Director National Institute of Health and Epidemiology Hanoi 2. TEMPORARY ADVISERS Dr Tadao Shimao Director The Research Institute of Tuberculosis Japan Anti-Tuberculosis Association 3-1-24, Mat suyama , Kiyose-shi Tokyo 180-04 Japan

REPUBLIC OF KOREA

VIET NAM

WPR/ACHR/80.20 Report page 19 Annex 2

Professor Chen Keji Deputy Director Xi Yuan Hospital Academy of Traditional Medicine Beijing People's Republic of China 3. WHO HEADQUARTERS .SECRETARIAT Dr A. Kessler Director Special Programme of Research, Development and Research Training in Human Reproduction WHO Headquarters Geneva Switzerland Dr D. S. Rowe Medical Officer Special programme for Research and Training in Tropical Diseases WHO Headquarters Geneva Switzerland

.-

WHO REGIONAL OFFICE F<lI. SOUTH EAST AS IA

Dr B.A. Jayaweera Regional Adviser in Medical Research WHO Regional Office for South East Asia World Health House Indraprastha Estate Ring Road New De1hi-1 India Dr N. Georgievski Rooms 213-216 Building E1 Trung Tu Quarter Hanoi Socialist Republic of Viet Nam Mr T.F. Lye, a.i. Boroko P.O. Box 5896 Port Moresby Papua New Guinea

WHO PROGRAMME COORDINATORS

WPR/ACMlI./80.20 Report page 20 Annex 2

Dr A.M. Rankin Central P.O. Box 540 Seoul Republic of Korea Dr C.J. Ross-Smith P.O. Box 113 Suva Fiji Dr L.R.L. Verstuyft P.O. Box 2550 Kuala Lumpur Malaysia WHO REGIONAL OFFICE FOR THE WESTERN PACIFIC Dr G.M. Emery Director Disease Prevention and Research WHO Regional Office for the Western Pacific Manila Philippines Dr Y.H. Paik (Operational Officer) Medical Officer Research Promotion and Development WHO Regional Office for the Western Pacific Manila Philippines Dr B. Dazo Parasitologist Intercountry Project on Parasitic Diseases Control and Research WHO Regional Office for the Western Pacific Manila Philippines Dr D. Dennis Team Leader Intercountry Project ICF/RPD/002 Kuala Lumpur Malaysia

WPR/ACMR/80.20 Report page 21 Annex 2

Dr S. Endo Regional Adviser in Chronic Diseases WHO Regional Office for the Western Pacific Manila Philippines Dr G. Farid Medical Officer Tropical Diseases Research WHO Regional Office for the Western Pacific Manila Philippines Dr R. Herniman Regional Adviser in Health Services Development WHO Regional Office for the Western Pacific Manila Philippines Dr T.C. Hsu Regional Adviser in Maternal and Child Health (Family Planning) WHO Regional Office for the Western Pacific Manila Philippines Dr R. Lindner Regional Adviser in Communicable Diseases WHO Regional Office for the Western Pacific Manila Philippines Dr D. Tarantola Medical Officer Control of Diarrhoeal Disease WHO Regional Office for the Western Pacific Manila Philippines

.-

.-

WPR/AQOI./80.20 Report page 22 Annex 2

Dr L. Wasserman Medical Officer Intercountry Project on Development of Managerial Processes for Health WHO Regional Office for the Western Pacific Manila Philippines Mr J. Abcede Public Information Officer WHO Regional Office for the Western Pacific Manila Ph i li ppi nes

WPR/ACMR/80.20 Report page 23

ANNExa

ADMINISTRATIVE MATTERS CONCERNING OPERATION OF WPACMR AND ITS SUBCOMMITTEES! by Dr Y.H. Paik Secretary, Western Pacific Advisory Committee on Medical Research

. """

INTRODUCTION The terms of reference of the Western Pacific Advisory Committee on Medical Research (WPACMR), its membership, term of appointment and method of work were agreed upon by the members of WPACMR at its first session in 1976 and were summarized in Annex 5 of the report on the first session of the Advisory Committee. This was followed by another major decision of the Committee at its fourth session in 1979, at which the Committe considered the structure of its task forces or subcommittees and decided that the four existing task forces should be replaced by a number of subcommittees employing certain principles. However, none of these decisions on the structure and functions of the major advisory body in the Region have as yet been incorporated in the WHO/WPR Policy and Procedure Handbook. In order to ensure the smooth operation of the Committee and its subcommittees, and to facilitate reference, the writer, as Secretary of WPACMR, has endeavoured to consolidate the main decisions of the Committee in a format suitable for their incorporation in the WHO/WPR Policy and Procedure Handbook. The following are accordingly submitted to the Advisory Committee for consideration. 1. Policy basis

Regional Committee resolution WPR/RC26.10 '~O's role in the development and coordination of biomedical research: greater involvement of the Regions in research" endorsed the proposal to establish a regional advisory committee on medical research to advise the Regional Director on research activities that might be considered by the Regional Committee for development.

lRevised as adopted by the Committee at its fifth session.

WPR/ACMR/80.20 l!eport page 24 Annex 3

2.

Terms of reference

The Western Pacific Advisory Committe on Medical Research shall advise the Regional Director on the following matters: (a) definition of policies for the promotion of research in the Region, within the framework of the global WHO policy and the policies evolved by the Advisory Committee on Medical Research (ACMR) at WHO Headquarters; (b) determination of regional priorities for research and establishment of mechanisms for this purpose; (c) coordination in the area of research between WHO Headquarters and the Regional Office, betwren the Regional Office and the countries, and among the countries themselves; (d) development of research capability in the Region, identification and maximum utilization of locally available talent, and better use of untapped talent; (e) establishment of meaningful collaboration between WPACMR and ACKR, thereby enhancing the work of ACKR and linking the local resources of developing countries with those of the developed countries;

(f) establishment of close contacts with national and international bodies engaged in biomedical research, so as to coordinate selected research activities, ensure rapid application of the results of scientific advances through public health action wherever appropriate, and assist in setting up national medical research councils (or analogous bodies) in countries where they do not exist; (g) collection of dats on institutions, facilities, personnel and projects in the Region with a view to ultimately developing a regional research information system;

(h) by these and other means, stimulating of research in the Region on problems whose solution is identified as being of priority importance for the health of the peoples, improvement of coordination among countries of the Region, and promotion of a sense of awareness and communication among all scientists and institutions working on common problems; (i) evaluation of the programmes in terms of stated objectives and the mechanisms for their implementation.

• WPR/ACMR/80.20 Report page 25 Annex 3 3. Membership

Membership of the Committee shall be restricted to outstanding research scientists and research administrators from countries of the Region. The Committee shall be constituted by a judicious mixture of scientists of various disciplines, and shall consist of not less than 10 and not more than 13 members. 4. Term of appointment

.-

The Chairman and all the members shall be appointed by the Regional Director, some for two years and the others for four years for the initial round only. The process of retirement and appointment of new members thus starts in the third year of functioning of the Committee. After the initial round, all member shall be appointed for four years in principle unless the appointee wishes to be appointed for a shorter period which may not be less than two years. The Vice Chairman and Rapporteur shall be elected at each session of WPACMR and remain in office until the following session, when another election shall take place. 5. 5.1 Method of work Frequency of WPACMR plenary sessions WPACMR shall hold at least one regular session a year. 5.2 Agenda and planning of sessions

The preparation of the agenda and planning of each session shall be the responsibility of the Regional Office Planning Meeting for WPACMR, which shall be convened by the WPACMR Secretary. The Secretary shall consult the Chairman on the preparation of the agenda and timetable for the session. 5.3 Peer review group

WPACMR shall act as a peer review group from time to time sometimes with coopt ion of some additional scientists. A confidential letter with a photocopy of research proposals for funding by WHO shall be sent to the WPACMR Chairman and to the relevant subcommittee members, who, after reviewing the scientific interest of the project, the ability of the investigator, the adequacy and soundness of the planning and the techniques to be employed, and the reason~bleness of ,t he costs, shall give an opinion as to whether the proposal mer1ts WHO support. 5.4 Outside expertise and consultant services

Although WPACMR has as members scientists of various disciplines, it will not always be in a position to review all spheres of biomedical research and a situation may arise where, in order to review a particular

area of biomedical research of regional priority, the experience and competence of the Committee's own members are illsuffic ient and expert ise from outside has to be sought. In such a situation, support might be obtained as follows:

WPR/ACMR!80.20 Re port page 26 Annex 3

5.4.1

Scientific groups

Where the required review involves a collaborative multidimensional in-depth study by a number of recognized experts in different field or different aspects of the same field, a scientific group may be formed. The group convened shall be given specific terms of reference and a time-target for completion of the work. Its size shall depend on the nature, extent and complexity of the work, but in no case should the group be so large as to lose its effectiveness.

5.4.2

Consultant or temporary advisers ~

The need may arise to review a particular aspect of a problem in depth with the outside help of a scientist recognized for his or her contribution in that particular area. In such cases a temporary adviser/consultant may be appointed. The terms of reference and time-target shall as far as practicable be clearly specified. 5.5 Sub-committees

_

WPACMR as an advisory body consisting of a mixture of scientists of various disciplines cannot be expected to be involved in the formulation, i~lementation, and evaluation of research projects with very specific objectives which WHO would like to support. It may therefore be sometimes necessary to appoint a subcommittee of WPACMR, which may be able to coordinate research in particular fields in the Region as a result of an in-depth review and study. The subcommittee shall consist of designated WPACMR members/consultants/temporary advisers and secretariat members. The subcommittee shall report to WPACMR. 5.5.1 Structure of subcommittees (a) Each subcommittee shall include two WPACMR members, who shall be

chairman and vice-chairman, respectively.

(b) Each subcommittee shall include as an integral member of the subcommittee a secretary who shall be the appropriate WHO regional adviser for the particular discipline most concerned, as well as WHO regional technical advisers of related disciplines. (c) The appropriate secretariat members from WHO/Headquarters and other WHO regional offices may also be invited to become members of the subcommittee, wherever feasible and desirable. (d) Each subcommittee meeting shall have a number of individuals as standby resource personnel, who may be called upon to perform a specific task determined by the subcommittee. The task to be accomplished and the criteria for selecting members for each subcommittee meeting shall accordingly be defined by the Chairman, Vice-Chairman and secretariat within the framework of WPACMR.

WPR/AafR/80.20 Report page 27/28 Annex 3

6.

Status of WPACHR members

The Chairman and all the members shall be appointed by the Resional Director as temporary advisers each time they are requested to attend regular ACHR and WPACHR meet in,s , .. etinss of subcommittees and similar meetings in the Region, or to J01n special missions on visits to national research organizations.

The definition of temporary advisers, and the allowances and travel arrangements in respect of temporary advisers are set out in WHO Manual II .12, 550-640 . . ~

.-

WPR/ACHR/80.20 Report page 29 ANNEX 4

FORM FOR REVIEW OF RESEARCH PROPOSALS AND SUCCESSIVE REVIEW OF THE PROGRESS OF THE PROJECT 10. Title: Principal investigator: Date and receipt in Regional Office: 20. WHO File Reference No. : Acknowledgement sent on: Country: Cleareance required

. -""" 30. 40.

by Government If YES, state date Government clearance requested:

I I I Yes No

obtained: 50. Requesting Institution

Name

Address

Name and designation of Head of Institution

Institution Conducting Research

Name

Address

Principal Investigator with designation

Collaborating scientists

WPR/ACMR/80.20 Report page 30 Annex 4

Collaborating Institution

Name

!

Address

Principal Investigator with designation

Collaborating scientists

i , I

i I

"

I

55.

Summary of Proposal by RPD

Signature: 60.

Date:

Technical Assessment of Unit (RA to complete l ). The Regional Adviser will be responsible for the review of the progress of this project, if this proposal is approved. See 180 of this form.

"'"',

Signature: 70. Clearance by Director concerned

Date: This application merits further consideration

Signature DD;

Date:

lAttach extra sheet if necessary. The assistance required should be clearly spelt out to enable BFO to do the costing. 2

This has since been changed to CRP.

WPR/ACMR/80.20 Report page 31 Annex 4

80.

Recommendations of WPACMR External Review Group

90.

Recommendations of Internal Review by Technical Unit/RQ (date requested):

100. Recommendations of SCRIRS requested:

110. Possible source of funds: (to be indicated by RPD) Regular budget Other sources (specify) Project No. 130. Estimated cost (to be completed by RA) (in US$) 1st year 2nd Year Personnel Equipment Materials Others Total Grand Total

120. Final comments of RA on comments by external reviewers and available source of funds:

D

D 140. Availability of funds: Regular budget Other sources (specify) Amount: Allotment No. Remarks:

.-

c===J

D

Date 150. RPD's Note for DPM's Review Committee:

BFO

WPR/ACMR/80.20 Report page 32 Annex 4

160. Comments of DPK's Review Committee:

Signature:

Date:

170. Decision of Regional Director (attach CTS Agreement form WHO 362)

Approved

Deferred

Refused

Date

Signature

Regional Director 180. Monitoring of progress of the project Date due for submission of 1st technical progress report and financial report: (RPD) Date technical report received: (RPD)

Date financial report received: (RPD)

WPR/ACHR/80.20 Report page 33/34 Annex 4

Comments by Technical Unit/Adviser

Remarks made by RPD:

Date due for submission of 2nd technical progress report and financial report: (RPD) Date technical report received: (RPD)

Date financial report received: (RPD) Comments by Technical Unit/Adviser:

.-

Remarks made by RPD:

Date due for submission of final report: Date final technical report received: (RPD) Date final financial report received: Comments by Technical Unit/Adviser:

Remarks made by RPD:

WPII/ AaIIt/IO. 20 Report pale 35

_S

Table 1. Programme Budget Research Promotion and Development 1979-1981

A.

S~ry

Pro'r .... area

1979 ( Illpleunted)

Yea r 1910 (Pro jec ted) US'109 400

1981 (PrOJeCted)

1. 2. 2.1

Servicina WPACMa and progr...e ..na,eoent (rcp/apu/OOl) Institution Strengtheninl Regional Centre for Re.earch and Training in Tropical Diseases, Cuala Lu.pur*

(0)

us; 91 840

US. 89 100

(D)

111 660

180 600

227 SOD

(rcp/apu/002) 2.2 Collaborating aDd national centres for tropical di,ea.e r •••• rch (rCP/MPD/OIO) Chineae .tudy .ission to observe .adern organization and . .nage.ent of scientific research (CHM/RPD/OOl)

(0)

20 000

74 200

86 000

2.3

(0)

51 000

US'182 660 3. coaple.entary elements for research support (ICP/aPD/OO3) (0)

USU54 800 29 500 22 810 US, 52 310 241 000 128 190 US$369 190 US$634 700 151 000 US*785 700 109 400 (13.9%) 254 800 (32.61) 52 310 (6.61) 369 190 (46.9%) US$185 100 (1001)

U8$313 500 53 100 US, 53 100 209 200

(rcp/aPD/004)

JSIl)

23 870 57 195 US, 81 06S

4.

Researcb eo.,onent of regional technical progr ....

(D) (J8r,) (VP)

.1. 2.

225 010 127 071 13 425 U8'395 506

U8$209 200 US;664 900

CIWID TOTAL:

(0) (JII') (VP)

US$553 380 184 266 13 425 U&$751 071

U8'664 900

Servicing WPACMR on programme Mnagement Inatitution st'rengtheninl CODplementary research support Research ca.ponent of relioDal technical progr..-e

91 840 (12.21) 182 660 (24.31) 81 065 00.81) 395 506 (52.71)

3. 4.

..-----TDR/RQ in 1910.

US$151 071 (1001)

-------

*10 addition to US'l80 600 frca regional budset. a sua of US.185 300 .i11 be provided by

WPR/ACHI/80.20 Report pale 36 Annex 5 B. Details

Yea Progr8lllM! area 1. progr...e aanegement

r 1981 (Projected)

1979 (Impleunted)

1980 (Projected)

( ICP/RPO/OOl) 1.1 Secretariat Medical Officer (aPO) Adainistrative Assistant Duty travel Supplie. and equipment Temporary Advisers (WPACHI Kember.) Working Croup on Medical Research Councils

(lIB) (lIB) (lIB) (BB) (BB) (BB)

us.

33 900 4 560 11 280 430 41 670*

usa

49 300 5 100 6 000 24 000 25 000

usa

50 500 5 600 6 600 26400

(lIB) 2. 2.1 Institution Strengthening (ICP/RPD/002l Regional Centre for Research and Trainin& in Tropical Oileases (ICP/RPD/002) Epideaiologist

usi

91 840

US$109 400

uBi

89 100

Statistician Clinical nutritionist Secretary and custodial staff Consultants Research training (fellowships) Group training Duty travel Supplies and equipment Veh ic Ie

(RR) (aB) (U)

us.

55 030 9 330 1 500 18 000 12 700 4 500 10 600 US$lll 660

-

(BB) (RB) (aB)

(D) (RB) (D)

US$ 24 49 24 12 13 14 30 8 3

700 300 700 400 500 000 000 500 500

US. 50 50 50 13 4 15 30 10 3

500 500 500 000 500 000 000 000 500

Om)

US$l80 600*'"

US$227 500

,......,. *The coat for 4th WPACMR aeeting (US*22 615) is included. **In addition to US.180 600 fra. regional budlet, TDR/HQ provided US$18S 300 for 1980 for the purpose of institution strengthening.

wrR/ACIIa/80.20 teport pa•• 37 Annex 5

y hOlT IIIIDI!.

ar ..

1979

• 1980 • r (Projected)

(Iooplneated)

1981 (Projected)

2.2

Collaborating and Mational Centre.

for Tropical Di8e••• s Reaearch (ICr/MPD/OI0) Rea.arch contracta training CoIIIU! tant.

a••• arch

(RB) (RB) (RB) (RB)

US. 20 000

DS$ 45 000 15 700 13 500 US. 74 200

DS. 50 000 22 500 13 500 US. 86 000

US. 20 000 US. 51 000

2.3

Chineae Study Mi •• ion on DOdern organization and manaae.ent of .edical reaearcb (CRlI/RPD/OO!)

(RB)

. ""

3.

ae ••arch

contract. Research training

(RB)

US.

(D) (JSIr)

(D) (JSIr) 4. Reaearch cGafgnent of relionel technical prolr .....

6 17 57 US, 23 57

600

195

270 195 670

US. 25 000 4 500

US. 25 000 28 100

u., 53

100

4.1

Health Services Reaearch Taak Porce for BSa Reeearcb contracta

(Icr/HSD/017)

(Icr/RSR/OO!) US.

(D) (D) (JSI')

uS$

7 830 8 180 33 550

48 100

uat

-

4.2

-

Regional epid. .iololical lurveillance and epideaiololical trainiaa (ICr/ISD/002) Consultanta

(D)

IS 760

4.3

Schi8tosomiasis control, reaearch

aed tr.iaiD! (ICP!MPD/009) "aearch contracta Regional Steering Committee

(RB) (JSI') (RB)

IS 000 46 955 4490

10000

WPR/ACMR/80.20 Report page 38

Annex 5 y

e

Prolramme are.

1979 (Impl;tited)

1980 (Projected)

•

r 1981 (Projected)

4.4

FHadui. Research (ICPIMPD/011)

Reaearch contract. Warkin. Group on Brugi.a

(RII) (RII)

US.

5 000 24 530

US.

5 000

US.

-

Filariaei ..

4.5

Parasitic diseaees control and reeearcb (ICP~/012)

Task force Consultants Research contracts

(lIB) (lIB)

9 422 4438 36 840

(JSIF)

4.6

Acute reapiratory infections

(lCP/DVM/010) Epidemiologia t (lIB)

48 550 6 18 11 3 180 030 000 796

Reaearch contracta

Reaearch trainina Consultante Duty travel Working Group on Acute i2spiratory Infections, January 1979 Advisory ranel on Acute Respiratory Infections Supplies and equipment

(JSIP) (lIB) (RII) (lIB) (RB) (VP)

51 8 85 19 9 3

000 770 000 100 000 000

52 200 90 000 7 500 9000 3 300

'"" .

(VP)

9 629 8 500 ud 92 260 13 425 ush05 685 usil67 100 8 770 USh75 870 UsS162 000 nai162 000

(lIB) (lIB) (JSIF) (VP)

4.7

Research in dengue haemorrhagic

fever (ICP/DVM/012) Research contracts

Research training

(lIB) (JSIP) (lIB)

US. 27 920 33 826 24 570*

US$ 25 000 24 400

US$ 25 000

12 200

4.8

Tuberculoais research

(lCP/DVM/013) Research contracts Consultants

.-.... (JSI.) (lIB) 27 090 5 240

4.9

Cardiovascular dieeases

(lcp/ew/OOl) Task force

(lIB)

17460

*Regional workshop on determining dengue virusea by .a.quito inoculation teChnique.

WPII/AQIII/IO.20 Report pa,8 39

Annex 5

y

Prolr_ area

1979 (lap 10Miited)

• 1980 • r (Projected) US.

1981 (Projected)

4.10 Leprotl1 control ConlulUntl

(JSI')

U" 12 740

4 500

US.

-

4.11

Surveillance of ichtbJo •• rcotoxi .. (Icp/BSP/002)

Con.ult.au 4.12 Control of I.xuelly tran••itted dil•••• s (ICp'a1M/01S) lea.arcb CODtract,

(0)

7 910

(JSIr)

4 390

. ""'"

4.13

Prevention and control of aoonollu and food borDe

di •••••• (ICP/',"/016) " ••• rch contracts

(J8IP) (0)

(JIIP) (W)

UIUS5 010 127071 13 425 U •• 395 506

3 000 US1241 000 128 190 US$369 190

US1209200

U8.209 200

WPR/ACMR/80.20 Report page 40 Annex 5 Table 2. Programme Budget Research Promotion and Development Principal Components, 1978-1981

Year

Programme and budget programmed

Total 604 948 615 170

research contracts 91 000 222 930 (37.2%) 212 200 182 031 (24.2%) 328 190 (41.8%) ?

Sub-totals research training 91 760 46 043 (7.5%) 160 300 123 215 <16.4%) 130 510 <16.6%) ?

meetings and consultants 183 600 190 853 ( 31.0%) 143 250 184 445 (24.6%) 89 500 (11.4%) ?

1978 implemented

-,

programmed 1979 implemented

814 300 751 071

1980

progr ammed

785 700

1981

programmed

664 900

Footnote: 1. 2. Other sub-totals not listed include strengthening of research centres and programme management components. Includes Regular Budget and Voluntary Funds combined, refer Table 1.

WPR/ACMll/80.20 Report pale 41 Annex 5

Table 3. Programme Budget Reaearch Promotion and Development Regular budlet and voluntary funds, 1977, 1978 and 1979 (Actual) and 1980-1981 (projected)

Budlet Year 1977 1978 1979 1980 1981

. """'

Total 250 500 604 948 751 071 785 700 664 900

Reau1ar budaet 69 800 402 300 553 380 634 700*** 664 900

Voluntary funda* 180 700 202 648 197 691** 151 000 ?

*Provided by Japan Shipbui1dinl Industry Foundation (JSIF). **In addition to US$l84 266 from JSIF, US$.13 424 from Australian Govera.ent contribution for Acute Respiratory Infection8 Prolramme was included. ***In addition to US$634 700, the 8ua of US$185 300 will be provided for 8trenlthening the Regional Centre, Kuala Luapur (IMa), by TDR/HQ.

WPR/ACMR/80.20 Report page 42 Annex 5

Table 4.

Research project. supported by WPRO and TDR/HQ from 1975 to December 1979

Country Australia China Fi ii French Polynesia Hong Kong Japan Lao People's Democratic Republic Malaysia New Zealand Papua New Guinea Philippines Republic of Korea Sinllapore Solomon Islands United State. of America (American Samoa) Viet Nam Total

WHO Total (No. ) 2 1 1 1 1 2

sup~orted

Total (US$) 11 000 10 000 3 000 15 000 11 200 21 800

TDR Total (No. ) 13 6

su~,ported

Total (US$) 423 863 244 370

2

95 600

~.

16 1 15 1 6 18 2 5 2

446 636 5 600 420 426 16 850 191 192 569 620 29 250 105 900 38 255

3

14 950

2 19 2

97 000 239 421 19 000

1

-

442 371

1 2 90

21 000 143 950 2 752 512

34

Note: TDR/HQ allocation: 1975 - 1977 1978 1979 US$ 247 300 956 214 1 548 998

U5$2 752 512

=-._a_.=_==ac

WPR/ACMR/80.20 Report page 43 ANNEX 6

LIST OF WORKING DOCUMENTS Document/ Reference NIDDber WPR/ ACMR/ 80. 1 Rev. 2 WPR/ACHR/80.2 WPR/ACHR/80.3 WPR/ACHR/80.3 Add.l WPR/ACMR/80.3 Add.2 ACMR2l/79.ll Report Rev.l WPR/ACMR/80.4 WPR/ACMR/80.5 Agenda Summary and recommendations of the Working Group on Medical Research Councils Training and career structures of health researchers

DocIDDent Title

Note on Training of Laboratory Technicians for Research A Career Structure for Research Workers in Developing Countries ACMR2l Report Report of the Secretary of the Sub-Committee on Parasitic Diseases Report of the Secretary of the Sub-Committee on Communicable Diseases (including acute respiratory infections) Report of the Secretary of the Sub-Committee on Diarrhoeal Diseases Report of the Secretary of the Sub-Committee on Family Health Report of the Secretary of the Sub-Committee on Health Services and Occupational Health Report of the Secretary of the Sub-Committee on Cardiovascular and Metabolic Diseases Report of the WPACMR Secretary Activities of the Special Programme for Research and Training in Tropical Diseases in the Western Pacific Region

WPR/ACMR/80.6 WPR/ACMR/80.7 WPR/ACMR/80.8 WPR/ACMR/80.9 WPR/ACMR/80.l0 WPR/ACMR/80.1l

WPR/ ACMR/80. 20 Report page 44 Annex 6

DocUllent/ Reference Number WPR/ACMR/80.ll.l 8th Annual Report FHE/79.5 WPR/ACHR/80.12 WPR/ACHR/80.13 WPR/ACMR/80.14

Doc_ent Title Strategic plan for applied research in malarial Special programme of research, development and research training in human reproduction Family Planning Project Management: A Selected Annotated Sibliography Administrative matters concerning operation of WPACMR and its sub-committees Mental health research 2 Community health information system: an important tool for the development of primary health care programme 2 Action-oriented research in nutrition 2 Review of procedures for processing research proposals Tuberculosis research activities in the Western Pacific Region Efficacy of traditional medicine in cardiovascular diseases in the People's Republic of China Veterinary public health l

,.....

WPR/ACHR/80.15 WPR/ACMR/80.l6 WPR/ACMR/80.l7 WPR/ACMR/80.l8

WPR/ACHR/80.19

ICons ide red by Group A. 2Considered by Group S.

,

,